CMS Price Transparency Data

Drug screening test

Facility: Childrens Hospital of Wisconsin Fox Valley

Billing Code: G0480 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0480
  • Insurance Median: $264
  • Cash Discount Price: $181
  • vs. Medicare Baseline: 2.31x Medicare
The contracted insurance negotiated median rate for a Drug screening test at Childrens Hospital of Wisconsin Fox Valley is $264. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $181. Compared to the federal Medicare reimbursement reference rate of $114.43, this hospital’s rate is 2.31x the Medicare baseline. Located in 130 Second St, Neenah, WI.
Cash / Self-Pay
$181

Average discount available for prompt cash payment at this facility.

Insurance Median
$264

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$114.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $114.43 (100%)
Cash / Self-Pay: $181 (158%)
Insurance Median: $264 (231%)
Cash: $181 (158% of Medicare)
Ins. Median: $264 (231% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $114.43 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 231% of the Medicare baseline (a markup of 131%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
My Choice Wisconsin $64 - $72 56%
UnitedHealthcare $64 - $251 56%
Chorus Community Health Plan $65 57%
Managed Health Services $70 61%
Molina Healthcare of Wisconsin $70 61%
Blue Cross Blue Shield $74 - $313 65%
Icare $80 70%
Froedtert Health $231 - $280 202%
Medical College of Wisconsin $231 202%
Network Health Plan $235 205%
Aspirus Health Plan $247 216%
Common Ground Healthcare Cooperative $247 - $280 216%
Trilogy Health Solutions $247 - $280 216%
Wps Health Plan $250 - $297 218%
Advocate Aurora Healthcare $254 222%
Centivo $257 225%
Health Partners $257 - $290 225%
Employer Health Care Alliance Cooperative $259 226%
Dean Health Plan $264 231%
Group Health Cooperative of Eau Claire $264 231%
Oan LLC $264 231%
Security Health Plan $273 239%
Health Payment Systems $279 244%
Praire States $280 245%
Quartz Health Insurance $280 245%
Sheboygan Employer's Health Network $280 245%
America's PPO $287 251%
Aetna $290 - $293 253%
Bellin Thedacare $297 260%
Cigna $297 260%
Group Health Cooperative of South Central Wisconsin $297 260%
Healthsmart $297 260%
Prevea Health Network $297 260%
Multiplan $300 - $313 262%
Coventry Health Care $313 274%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 130 Second St, Neenah, WI 54956
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens