X-ray exam of tear duct at Aurora Medical Center Grafton
975 Port Washington Rd, Grafton, WI · Aurorahealthcare · · NPI 1265740195
$467.50
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.
$935.00
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.
$200.00 with Aetna vs $794.75 with Anthem — 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 |
|---|---|---|---|
| Aetna | HMO | $200.00 | ↓ -57% |
| Aurora Caregiver | Commercial | $240.00 | ↓ -49% |
| Quartz One | Commercial | $245.00 | ↓ -48% |
| Common Ground | Exchange | $249.00 | ↓ -47% |
| Common Ground | Envision | $249.00 | ↓ -47% |
| Common Ground | Employee Trust Fund | $249.00 | ↓ -47% |
| Everpointe Elite | Commercial | $259.00 | ↓ -45% |
| HealthPartners | Employee Trust Fund | $266.00 | ↓ -43% |
| Anthem | Blue Priority | $275.00 | ↓ -41% |
| Quartz Group | Commercial | $290.00 | ↓ -38% |
| HS Technology | Commercial | $293.00 | ↓ -37% |
| Wisconsin Physician Service | Aurora Featured | $299.00 | ↓ -36% |
| Molina Exchange | Commercial | $308.00 | ↓ -34% |
| Wisconsin Physician Service | Statewide | $315.00 | ↓ -33% |
| Wisconsin Physician Service | Arise | $315.00 | ↓ -33% |
| Centivo | Commercial | $328.00 | ↓ -30% |
| HealthPartners | Robin | $330.00 | ↓ -29% |
| United Healthcare | Exchange | $336.00 | ↓ -28% |
| United Healthcare | Charter | $339.00 | ↓ -27% |
| United Healthcare | Nexus | $339.00 | ↓ -27% |
| Anthem | Blue Preferred | $357.00 | ↓ -24% |
| United Healthcare | HMO | $369.00 | ↓ -21% |
| Health Payment Systems | Commercial | $400.00 | ↓ -14% |
| Trilogy | Commercial | $410.00 | ↓ -12% |
| Cigna | PPO-GPPO | $460.00 | ↓ -2% |
| Health EOS Plus | Commercial | $561.00 | ↑ +20% |
| HealthPartners | Broad | $701.25 | ↑ +50% |
| Health EOS | PPO | $748.00 | ↑ +60% |
| Aetna | PPO | $772.31 | ↑ +65% |
| United Healthcare | PPO | $787.27 | ↑ +68% |
| Cigna | PPO | $791.01 | ↑ +69% |
| Anthem | PPO | $794.75 | ↑ +70% |
Visitor-reported prices
Comments
X-ray exam of tear duct 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 | $257.58 | $23.66 – $517.79 |
| SSM Health Monroe Hospital | Monroe | $217.80 | $93.46 – $231.76 |
| Aurora Sinai Medical Center of Aurora Health Care Metro | Milwaukee | $467.50 | not published |
| Aurora Baycare Medical Center | Green Bay | $467.50 | not published |
| Aurora Medical Center Washington County | Hartford | $467.50 | not published |
| HSHS St. Vincent Hospital | Green Bay | $576.84 | $54.25 – $521.46 |
| Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Milwaukee | not published | $23.66 – $517.79 |
| UnityPoint Health - Meriter Hospital | Madison | not published | $13.32 – $44.09 |