Complx repair fccmnaxghf 13131 at SSM Health St. Agnes Hospital - Fond du Lac

430 E Division St, Fond Du Lac, WI · SSM Health · · NPI 1346228541

Source: hospital's published price file ↗ · Published Apr 1, 2026 · Ingested Sep 10, 2026

$805.20

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.

$1,464.00

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.

$301.57 with MOLINA vs $3,335.00 with BCBS — 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
MOLINA Medicare Managed Care Plan $301.57 ↓ -63%
BCBS Anthem Medicare Managed Care Plan $402.09 ↓ -50%
Wellcare Medicare Managed Care Plan $410.13 ↓ -49%
DOC Government $776.03 ↓ -4%
Centivo Broad(WI1) Other Commercial Plan $1,887.00 ↑ +134%
Centivo Median(WI2) Other Commercial Plan $1,887.00 ↑ +134%
Centivo Value(WI3) Other Commercial Plan $1,887.00 ↑ +134%
Network Health Plan HMO/POS $2,334.00 ↑ +190%
BCBS Blue Preferred / Blue Preferred Plus HMO/POS $2,654.00 ↑ +230%
BCBS Blue Traditional Traditional $3,335.00 ↑ +314%
BCBS Blue Access PPO $3,335.00 ↑ +314%

Visitor-reported prices

visitor-reported
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Complx repair fccmnaxghf 13131 at other Wisconsin hospitals

Hospital City Cash price Negotiated range
UnityPoint Health - Meriter Hospital Madison $1,201.47 $74.75 – $737.57
SSM Health St. Clare Hospital - Baraboo Baraboo $614.35 $296.15 – $4,401.00
SSM Health St. Mary's Hospital - Janesville Janesville $748.00 $307.10 – $4,074.00
SSM Health St. Mary's Hospital - Madison Madison $1,065.35 $296.15 – $4,198.00
SSM Health Ripon Community Hospital Ripon $805.20 $1,887.00 – $2,654.00
SSM Health Waupun Memorial Hospital Waupun $805.20 $1,887.00 – $2,654.00
Adventhealth Durand Durand $2,771.61 not published
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) Milwaukee not published $386.48 – $1,548.32

All Wisconsin hospitals for this procedure →