Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm at SSM Health St. Agnes Hospital - Fond du Lac
430 E Division St, Fond Du Lac, WI · SSM Health · · NPI 1346228541
$1,167.10
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.
$2,122.00
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.
$548.27 with MOLINA vs $4,761.00 with Network Health Plan — 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 | $548.27 | ↓ -53% |
| BCBS | Anthem Medicare Managed Care Plan | $731.02 | ↓ -37% |
| Wellcare | Medicare Managed Care Plan | $745.64 | ↓ -36% |
| DOC | Government | $1,410.87 | ↑ +21% |
| BCBS | Blue Preferred / Blue Preferred Plus HMO/POS | $3,388.00 | ↑ +190% |
| Centivo | Median(WI2) Other Commercial Plan | $3,579.00 | ↑ +207% |
| Centivo | Value(WI3) Other Commercial Plan | $3,579.00 | ↑ +207% |
| Centivo | Broad(WI1) Other Commercial Plan | $3,579.00 | ↑ +207% |
| BCBS | Blue Access PPO | $4,106.00 | ↑ +252% |
| BCBS | Blue Traditional Traditional | $4,106.00 | ↑ +252% |
| Network Health Plan | HMO/POS | $4,761.00 | ↑ +308% |
Visitor-reported prices
Comments
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm at other Wisconsin hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | $149.46 | $131.44 – $592.37 |
| UnityPoint Health - Meriter Hospital | Madison | $1,417.60 | $26.91 – $253.31 |
| SSM Health Ripon Community Hospital | Ripon | $1,167.10 | $3,388.00 – $4,761.00 |
| SSM Health Waupun Memorial Hospital | Waupun | $1,167.10 | $3,388.00 – $4,761.00 |
| Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Milwaukee | not published | $131.44 – $592.37 |
| Orthopaedic Hospital of Wisconsin, LLC | Glendale | not published | $1,549.00 – $16,897.00 |
| SSM Health St. Clare Hospital - Baraboo | Baraboo | not published | $538.41 – $4,867.00 |
| SSM Health St. Mary's Hospital - Janesville | Janesville | not published | $558.33 – $4,321.00 |