Established Patient Office Visit (level 5) at HSHS St. Mary's Hospital Medical Center
1726 SHAWANO AVE, GREEN BAY, WI · Hshs · · NPI 1649246877
$339.24
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.
$514.00
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.
$95.40 with UNITED HEALTHCARE vs $514.00 with LIVE360 — 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 |
|---|---|---|---|
| UNITED HEALTHCARE | ALL COMMERCIAL UNITED HEALTHCARE | $95.40 | ↓ -72% |
| UNITED HEALTHCARE | UHC ONEIDA NATION | $95.40 | ↓ -72% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $95.40 | ↓ -72% |
| HUMANA | HUMANA NATIIONAL POS HMO | $113.00 | ↓ -67% |
| HUMANA | HUMANA CHOICE CARE HMO | $113.00 | ↓ -67% |
| ANTHEM | ANTHEM PPO | $154.00 | ↓ -55% |
| ANTHEM | ANTHEM POS/HMO | $154.00 | ↓ -55% |
| HSHS EMPLOYEES | HSHS EMPLOYEES | $249.80 | ↓ -26% |
| MOLINA HEALTHCARE OF WI | ALL COMMERICAL MOLINA MARKETPLACE | $257.00 | ↓ -24% |
| WISCONSIN PHYSICIAN SERVICE | WISCONSIN PHYSICIAN SERVICE | $308.40 | ↓ -9% |
| P360 SMALL GROUP | PREVEA 360 SMALL GROUP COMMERCIAL PLAN | $308.40 | ↓ -9% |
| PREVEA HEALTH NETWORK | PREVEA EMPLOYEES | $308.40 | ↓ -9% |
| PREVEA HEALTH NETWORK | PREVEA360 | $308.40 | ↓ -9% |
| PREVEA HEALTH NETWORK | PREVEA360 - NETWORK | $308.40 | ↓ -9% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION PPP | $318.68 | ↓ -6% |
| SECURITY HEALTH PLAN | ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK | $328.09 | ↓ -3% |
| CIGNA | ALL COMMERCIAL CIGNA | $359.80 | ↑ +6% |
| HEALTH EOS | ALL COMMERCIAL HEALTH EOS | $364.94 | ↑ +8% |
| WEA PROVIDER NETWORK | WEA TRUST PPP/TRUST PREFERRED | $370.08 | ↑ +9% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION | $370.08 | ↑ +9% |
| TRIOLOGY | ALL COMMERCIAL TRIOLOGY | $370.08 | ↑ +9% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION TRUST SELECT | $370.08 | ↑ +9% |
| INTERPLAN | ALL COMMERCIAL INTERPLAN HEALTH GROUP | $375.22 | ↑ +11% |
| HEALTHSMART | ALL COMMERCIAL HEALTHSMART | $375.22 | ↑ +11% |
| NETWORK HEALTH PLAN | ALL COMMERICAL NETWORK HEALTH PLAN | $385.50 | ↑ +14% |
| MULTIPLAN/PHCS | ALL COMMERCIAL MULTIPLAN | $431.76 | ↑ +27% |
| HEALTH CARE ALLIANCE | THE ALLIANCE | $431.76 | ↑ +27% |
| CHOICECARE | ALL COMMERCIAL CHOICE CARE | $436.90 | ↑ +29% |
| HUMANA | HUMANA CHOICE CARE PPO | $436.90 | ↑ +29% |
| HUMANA | ALL COMMERCIAL HUMANA HPN CHOICECARE | $436.90 | ↑ +29% |
| NORTH CENTRAL HEALTHCARE ALLIANCE | NEHA | $472.88 | ↑ +39% |
| FIRST HEALTH | ALL COMMERCIAL FIRST HEALTH NETWORK | $488.30 | ↑ +44% |
| AETNA | ALL COMMERCIAL AETNA | $514.00 | ↑ +52% |
| CENPATICO | ALL MEDICAID CENPATICO | $514.00 | ↑ +52% |
| AETNA | AETNA HSHS | $514.00 | ↑ +52% |
| CATERPILLAR, INC. | UHC CATERPILLAR EMPLOYER GROUP | $514.00 | ↑ +52% |
| COFINITY | COFINITY | $514.00 | ↑ +52% |
| LIVE360 | LIVE360 HSHS HEALTHY PLAN | $514.00 | ↑ +52% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 5) at other Wisconsin hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Aurora Baycare Medical Center | Green Bay | $725.00 | not published |
| HSHS St. Vincent Hospital | Green Bay | $339.24 | $113.00 – $154.00 |
| Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Milwaukee | $668.33 | $232.24 – $373.92 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | $668.33 | $232.24 – $373.92 |
| UnityPoint Health - Meriter Hospital | Madison | $831.54 | $42.32 – $346.99 |
| SSM Health St. Clare Hospital - Baraboo | Baraboo | $207.90 | not published |
| SSM Health St. Mary's Hospital - Janesville | Janesville | $165.00 | not published |
| SSM Health St. Mary's Hospital - Madison | Madison | $219.45 | not published |