Rmvl pm gen w/rplc pm gen mlt lead sys at SSM Health St. Agnes Hospital - Fond du Lac
430 E Division St, Fond Du Lac, WI · SSM Health · · NPI 1346228541
$6,551.60
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.
$11,912.00
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.
$8,923.00 with BCBS vs $36,770.21 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 |
|---|---|---|---|
| BCBS | Blue Preferred / Blue Preferred Plus HMO/POS | $8,923.00 | ↑ +36% |
| BCBS | Blue Traditional Traditional | $10,765.00 | ↑ +64% |
| BCBS | Blue Access PPO | $10,765.00 | ↑ +64% |
| MOLINA | Medicare Managed Care Plan | $14,288.94 | ↑ +118% |
| BCBS | Anthem Medicare Managed Care Plan | $19,051.92 | ↑ +191% |
| Wellcare | Medicare Managed Care Plan | $19,432.96 | ↑ +197% |
| Centivo | Value(WI3) Other Commercial Plan | $26,827.00 | ↑ +309% |
| Centivo | Broad(WI1) Other Commercial Plan | $26,827.00 | ↑ +309% |
| Centivo | Median(WI2) Other Commercial Plan | $26,827.00 | ↑ +309% |
| Network Health Plan | HMO/POS | $27,583.00 | ↑ +321% |
| DOC | Government | $36,770.21 | ↑ +461% |
Visitor-reported prices
Comments
Rmvl pm gen w/rplc pm gen mlt lead sys at other Wisconsin hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Milwaukee | $17,046.39 | $576.16 – $30,617.00 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | $17,046.39 | $576.16 – $30,617.00 |
| UnityPoint Health - Meriter Hospital | Madison | $24,578.93 | $323.17 – $9,585.78 |
| SSM Health St. Mary's Hospital - Madison | Madison | $13,059.75 | $14,021.00 – $27,690.00 |
| SSM Health Monroe Hospital | Monroe | $14,434.20 | $13,352.00 – $25,004.00 |
| SSM Health Ripon Community Hospital | Ripon | $6,551.60 | $8,923.00 – $27,583.00 |
| SSM Health Waupun Memorial Hospital | Waupun | $6,551.60 | $8,923.00 – $27,583.00 |
| Midwest Orthopedic Specialty Hospital | Franklin | $16,526.46 | $1,387.56 – $22,160.00 |