Mastectomy form at Aurora Medical Center Fond du Lac

210 Wisconsin American Dr., Fond Du Lac, WI · Aurorahealthcare · · NPI 1275578064

Source: hospital's published price file ↗ · Published Nov 21, 2025 · Ingested Sep 16, 2026

$249.83

Cash price

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Discounted cash price

What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge.

Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.

Full explanation →

What you pay up front if you don't use insurance.

$499.66

Gross charge

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Gross charge (chargemaster price)

The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this.

Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$39.26 with Aetna vs $68.66 with Anthem — same scan, same building. Share

Negotiated rates by payer
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Negotiated rate

The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.

Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.

Full explanation →

Payer
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Payer

The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on.

Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509.

Full explanation →
Plan
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Plan

The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates.

Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible.

Full explanation →
Negotiated rate vs. cash
Aetna HMO $39.26 ↓ -84%
Everpointe Elite Commercial $40.39 ↓ -84%
HS Technology Commercial $40.39 ↓ -84%
Quartz One Commercial $44.43 ↓ -82%
United Healthcare Exchange $47.98 ↓ -81%
United Healthcare Charter $47.98 ↓ -81%
United Healthcare HMO $47.98 ↓ -81%
United Healthcare Nexus $47.98 ↓ -81%
Common Ground Employee Trust Fund $48.47 ↓ -81%
Common Ground Envision $48.47 ↓ -81%
Health EOS Plus Commercial $48.47 ↓ -81%
Anthem Blue Priority $48.47 ↓ -81%
Quartz Group Commercial $48.47 ↓ -81%
Molina Exchange Commercial $48.47 ↓ -81%
HealthPartners Employee Trust Fund $48.47 ↓ -81%
Aurora Caregiver Commercial $48.47 ↓ -81%
Common Ground Exchange $48.47 ↓ -81%
Wisconsin Physician Service Aurora Featured $50.08 ↓ -80%
Wisconsin Physician Service Statewide $52.51 ↓ -79%
Anthem Blue Preferred $52.51 ↓ -79%
Health Payment Systems Commercial $52.51 ↓ -79%
Wisconsin Physician Service Arise $52.51 ↓ -79%
Trilogy Commercial $56.55 ↓ -77%
Cigna PPO-GPPO $60.59 ↓ -76%
HealthPartners Robin $60.59 ↓ -76%
HealthPartners Broad $60.59 ↓ -76%
Centivo Commercial $60.59 ↓ -76%
Health EOS PPO $64.62 ↓ -74%
Aetna PPO $66.72 ↓ -73%
United Healthcare PPO $68.02 ↓ -73%
Cigna PPO $68.34 ↓ -73%
Anthem PPO $68.66 ↓ -73%

Visitor-reported prices

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Mastectomy form at other Wisconsin hospitals

Hospital City Cash price Negotiated range
SSM Health St. Agnes Hospital - Fond du Lac Fond Du Lac not published $208.80 – $537.31
Aurora West Allis Medical Center West Allis $165.00 not published
UnityPoint Health - Meriter Hospital Madison not published $136.17 – $295.35
SSM Health St. Clare Hospital - Baraboo Baraboo not published $208.80 – $278.40

All Wisconsin hospitals for this procedure →