Alteplase 100 mg infusion from pyxis vial at HSHS St. Mary's Hospital Medical Center

1726 SHAWANO AVE, GREEN BAY, WI · Hshs · · NPI 1649246877

Source: hospital's published price file ↗ · Published Mar 24, 2026 · Ingested Sep 16, 2026

$304.31

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.

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What you pay up front if you don't use insurance.

$461.08

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.

$42.87 with COMMUNITY CARE FAMILY CARE vs $332.65 with AETNA — 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
COMMUNITY CARE FAMILY CARE COMMUNITY CARE FAMILY CARE MEDICAID MANAGED $42.87 ↓ -86%
MERIDIAN HEALTH PLAN MERIDIAN HMO MCD $42.87 ↓ -86%
MANAGED HEALTH SERVICES MANAGED HEALTH SERVICES MEDICAID $42.87 ↓ -86%
CONTINUUS MEDICAID MANAGED CONTINUUS MEDICAID MANAGED $42.87 ↓ -86%
ANTHEM ANTEHM MEDICAID $42.87 ↓ -86%
MOLINA HEALTHCARE MOLINA MEDICAID $45.44 ↓ -85%
TRIOLOGY TRILOGY MEDICAID $45.44 ↓ -85%
HUMANA HUMANA MEDICARE ADVANTAGE $93.83 ↓ -69%
UNITED HEALTHCARE UNITED HEALTH CARE MEDICARE $93.83 ↓ -69%
UNITY HEALTH PLAN UNITY HOSPICE $93.83 ↓ -69%
AETNA AETNA MEDICARE $93.83 ↓ -69%
MEDICARE MANAGED MANAGED MEDICARE NO SEQUESTRATION $93.83 ↓ -69%
ANTHEM ANTHEM MEDICARE ADVANTAGE HMO $93.83 ↓ -69%
MOLINA HEALTHCARE MOLINA MEDICARE $93.83 ↓ -69%
SECURITY HEALTH PLAN MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI $94.77 ↓ -69%
UNITED HEALTHCARE UNITED HEALTHCARE $154.82 ↓ -49%
UNITED HEALTHCARE ALL COMMERCIAL UNITED HEALTHCARE $154.82 ↓ -49%
UNITED HEALTHCARE UHC ONEIDA NATION $154.82 ↓ -49%
HUMANA HUMANA CHOICE CARE HMO $155.28 ↓ -49%
HUMANA HUMANA NATIIONAL POS HMO $155.28 ↓ -49%
ANTHEM ANTHEM POS/HMO $159.51 ↓ -48%
HSHS EMPLOYEES HSHS EMPLOYEES $161.67 ↓ -47%
MOLINA HEALTHCARE OF WI ALL COMMERICAL MOLINA MARKETPLACE $166.33 ↓ -45%
PREVEA HEALTH NETWORK PREVEA360 - NETWORK $167.96 ↓ -45%
P360 SMALL GROUP PREVEA 360 SMALL GROUP COMMERCIAL PLAN $167.96 ↓ -45%
PREVEA HEALTH NETWORK PREVEA EMPLOYEES $167.96 ↓ -45%
PREVEA HEALTH NETWORK PREVEA360 $167.96 ↓ -45%
ANTHEM ANTHEM PPO $197.04 ↓ -35%
WISCONSIN PHYSICIAN SERVICE WISCONSIN PHYSICIAN SERVICE $199.59 ↓ -34%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION PPP $206.24 ↓ -32%
NAPHCARE ALL COMMERICAL NAPHCARE $211.12 ↓ -31%
SECURITY HEALTH PLAN ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK $212.33 ↓ -30%
CIGNA ALL COMMERCIAL CIGNA $232.86 ↓ -23%
HEALTH EOS ALL COMMERCIAL HEALTH EOS $236.18 ↓ -22%
WEA PROVIDER NETWORK WEA TRUST PPP/TRUST PREFERRED $239.51 ↓ -21%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION TRUST SELECT $239.51 ↓ -21%
TRIOLOGY ALL COMMERCIAL TRIOLOGY $239.51 ↓ -21%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION $239.51 ↓ -21%
HEALTHSMART ALL COMMERCIAL HEALTHSMART $242.83 ↓ -20%
INTERPLAN ALL COMMERCIAL INTERPLAN HEALTH GROUP $242.83 ↓ -20%
NETWORK HEALTH PLAN ALL COMMERICAL NETWORK HEALTH PLAN $249.49 ↓ -18%
HEALTH CARE ALLIANCE THE ALLIANCE $279.43 ↓ -8%
MULTIPLAN/PHCS ALL COMMERCIAL MULTIPLAN $279.43 ↓ -8%
HUMANA ALL COMMERCIAL HUMANA HPN CHOICECARE $282.75 ↓ -7%
HUMANA HUMANA CHOICE CARE PPO $282.75 ↓ -7%
CHOICECARE ALL COMMERCIAL CHOICE CARE $282.75 ↓ -7%
NORTH CENTRAL HEALTHCARE ALLIANCE NEHA $306.04 ↑ +1%
FIRST HEALTH ALL COMMERCIAL FIRST HEALTH NETWORK $316.02 ↑ +4%
CENPATICO ALL MEDICAID CENPATICO $332.65 ↑ +9%
LIVE360 LIVE360 HSHS HEALTHY PLAN $332.65 ↑ +9%
CATERPILLAR, INC. UHC CATERPILLAR EMPLOYER GROUP $332.65 ↑ +9%
AETNA ALL COMMERCIAL AETNA $332.65 ↑ +9%
COFINITY COFINITY $332.65 ↑ +9%
AETNA AETNA HSHS $332.65 ↑ +9%

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Alteplase 100 mg infusion from pyxis vial at other Wisconsin hospitals

Hospital City Cash price Negotiated range
SSM Health St. Clare Hospital - Baraboo Baraboo not published $73.94 – $178.89
SSM Health St. Mary's Hospital - Janesville Janesville not published $73.94 – $178.89
SSM Health St. Mary's Hospital - Madison Madison not published $73.94 – $178.89
SSM Health Monroe Hospital Monroe not published $91.46 – $249.00
SSM Health Ripon Community Hospital Ripon not published $99.05 – $249.05
SSM Health St. Agnes Hospital - Fond du Lac Fond Du Lac not published $73.94 – $249.05
SSM Health Waupun Memorial Hospital Waupun not published $99.05 – $249.05
Aurora Psychiatric Hospital Wauwatosa not published $91.46 – $223.21

All Wisconsin hospitals for this procedure →