Rmvl pm gen w/rplc pm gen sgl lead sys at SSM Health St. Agnes Hospital - Fond du Lac
430 E Division St, Fond Du Lac, WI · SSM Health · · NPI 1346228541
$5,071.00
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.
$9,220.00
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.
$6,138.95 with MOLINA vs $27,583.00 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 | $6,138.95 | ↑ +21% |
| BCBS | Blue Preferred / Blue Preferred Plus HMO/POS | $7,609.00 | ↑ +50% |
| BCBS | Anthem Medicare Managed Care Plan | $8,185.27 | ↑ +61% |
| Wellcare | Medicare Managed Care Plan | $8,348.97 | ↑ +65% |
| BCBS | Blue Access PPO | $9,356.00 | ↑ +85% |
| BCBS | Blue Traditional Traditional | $9,356.00 | ↑ +85% |
| DOC | Government | $15,797.56 | ↑ +212% |
| Centivo | Median(WI2) Other Commercial Plan | $26,827.00 | ↑ +429% |
| Centivo | Broad(WI1) Other Commercial Plan | $26,827.00 | ↑ +429% |
| Centivo | Value(WI3) Other Commercial Plan | $26,827.00 | ↑ +429% |
| Network Health Plan | HMO/POS | $27,583.00 | ↑ +444% |
Visitor-reported prices
Comments
Rmvl pm gen w/rplc pm gen sgl 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 | $13,410.59 | $521.73 – $1,309.99 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | $13,410.59 | $521.73 – $1,309.99 |
| UnityPoint Health - Meriter Hospital | Madison | $22,427.09 | $294.51 – $8,746.56 |
| SSM Health St. Mary's Hospital - Madison | Madison | $6,865.10 | $6,028.62 – $27,690.00 |
| SSM Health Monroe Hospital | Monroe | $7,384.85 | $8,038.15 – $25,004.00 |
| SSM Health Ripon Community Hospital | Ripon | $5,071.00 | $7,609.00 – $27,583.00 |
| SSM Health Waupun Memorial Hospital | Waupun | $5,071.00 | $7,609.00 – $27,583.00 |
| Midwest Orthopedic Specialty Hospital | Franklin | $6,991.76 | $1,263.43 – $22,160.00 |