Levothyroxine 100 mcg intravenous powder for solution 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

$34.71

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.

$52.59

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.

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The hospital's undiscounted list price — almost no one pays this.

$9.87 with UNITED HEALTHCARE vs $52.59 with CENPATICO — 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
UNITED HEALTHCARE ALL COMMERCIAL UNITED HEALTHCARE $9.87 ↓ -72%
UNITED HEALTHCARE UHC ONEIDA NATION $9.87 ↓ -72%
UNITED HEALTHCARE UNITED HEALTHCARE $9.87 ↓ -72%
ANTHEM ANTHEM POS/HMO $10.17 ↓ -71%
PREVEA HEALTH NETWORK PREVEA360 - NETWORK $10.70 ↓ -69%
PREVEA HEALTH NETWORK PREVEA360 $10.70 ↓ -69%
PREVEA HEALTH NETWORK PREVEA EMPLOYEES $10.70 ↓ -69%
P360 SMALL GROUP PREVEA 360 SMALL GROUP COMMERCIAL PLAN $10.70 ↓ -69%
ANTHEM ANTHEM PPO $12.56 ↓ -64%
HSHS EMPLOYEES HSHS EMPLOYEES $25.56 ↓ -26%
MOLINA HEALTHCARE OF WI ALL COMMERICAL MOLINA MARKETPLACE $26.30 ↓ -24%
WISCONSIN PHYSICIAN SERVICE WISCONSIN PHYSICIAN SERVICE $31.55 ↓ -9%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION PPP $32.61 ↓ -6%
HUMANA HUMANA NATIIONAL POS HMO $33.39 ↓ -4%
HUMANA HUMANA CHOICE CARE HMO $33.39 ↓ -4%
SECURITY HEALTH PLAN ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK $33.57 ↓ -3%
CIGNA ALL COMMERCIAL CIGNA $36.81 ↑ +6%
HEALTH EOS ALL COMMERCIAL HEALTH EOS $37.34 ↑ +8%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION TRUST SELECT $37.86 ↑ +9%
TRIOLOGY ALL COMMERCIAL TRIOLOGY $37.86 ↑ +9%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION $37.86 ↑ +9%
WEA PROVIDER NETWORK WEA TRUST PPP/TRUST PREFERRED $37.86 ↑ +9%
INTERPLAN ALL COMMERCIAL INTERPLAN HEALTH GROUP $38.39 ↑ +11%
HEALTHSMART ALL COMMERCIAL HEALTHSMART $38.39 ↑ +11%
NETWORK HEALTH PLAN ALL COMMERICAL NETWORK HEALTH PLAN $39.44 ↑ +14%
HEALTH CARE ALLIANCE THE ALLIANCE $44.18 ↑ +27%
MULTIPLAN/PHCS ALL COMMERCIAL MULTIPLAN $44.18 ↑ +27%
HUMANA ALL COMMERCIAL HUMANA HPN CHOICECARE $44.70 ↑ +29%
CHOICECARE ALL COMMERCIAL CHOICE CARE $44.70 ↑ +29%
HUMANA HUMANA CHOICE CARE PPO $44.70 ↑ +29%
NORTH CENTRAL HEALTHCARE ALLIANCE NEHA $48.38 ↑ +39%
FIRST HEALTH ALL COMMERCIAL FIRST HEALTH NETWORK $49.96 ↑ +44%
LIVE360 LIVE360 HSHS HEALTHY PLAN $52.59 ↑ +52%
CATERPILLAR, INC. UHC CATERPILLAR EMPLOYER GROUP $52.59 ↑ +52%
COFINITY COFINITY $52.59 ↑ +52%
AETNA ALL COMMERCIAL AETNA $52.59 ↑ +52%
AETNA AETNA HSHS $52.59 ↑ +52%
CENPATICO ALL MEDICAID CENPATICO $52.59 ↑ +52%

Visitor-reported prices

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Levothyroxine 100 mcg intravenous powder for solution at other Wisconsin hospitals

Hospital City Cash price Negotiated range
HSHS St. Vincent Hospital Green Bay $34.70 $9.87 – $10.70
Aurora Baycare Medical Center Green Bay not published $5.55 – $13.15
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) Milwaukee $187.92 $8.89 – $20.31
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) Mequon $187.92 $8.89 – $20.31
UnityPoint Health - Meriter Hospital Madison $25.93 $7.45 – $27.55
Ascension St. Francis Hospital, Inc. Milwaukee $187.92 $6.63 – $16.44
Aurora Medical Center Burlington Burlington $23.74 $5.55 – $13.15
Ascension SE Wisconsin Hospital - St. Joseph Campus Milwaukee $187.92 $6.63 – $16.44

All Wisconsin hospitals for this procedure →