2d tee w or without fol w/con,in at SSM Health St. Agnes Hospital - Fond du Lac
430 E Division St, Fond Du Lac, WI · SSM Health · · NPI 1346228541
$1,199.00
Cash price 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.
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What you pay up front if you don't use insurance.
$2,180.00
Gross charge 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.
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The hospital's undiscounted list price — almost no one pays this.
$581.54 with MOLINA vs $1,496.49 with DOC — 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 →
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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 ?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 ?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 |
|---|---|---|---|
| MOLINA | Medicare Managed Care Plan | $581.54 | ↓ -51% |
| BCBS | Anthem Medicare Managed Care Plan | $775.38 | ↓ -35% |
| Wellcare | Medicare Managed Care Plan | $790.89 | ↓ -34% |
| DOC | Government | $1,496.49 | ↑ +25% |
Visitor-reported prices
Comments
2d tee w or without fol w/con,in at other Wisconsin hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health St. Mary's Hospital - Madison | Madison | $1,010.35 | $571.09 – $761.45 |
| SSM Health Monroe Hospital | Monroe | $2,295.70 | $761.45 – $761.45 |
| SSM Health Ripon Community Hospital | Ripon | $1,199.00 | not published |
| SSM Health Waupun Memorial Hospital | Waupun | $1,199.00 | not published |
| SSM Health St. Clare Hospital - Baraboo | Baraboo | not published | $571.09 – $761.45 |
| SSM Health St. Mary's Hospital - Janesville | Janesville | not published | $592.21 – $789.61 |