Revision tips at HSHS St. Mary's Hospital Medical Center
1726 SHAWANO AVE, GREEN BAY, WI · Hshs · · NPI 1649246877
$10,876.14
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.
$16,479.00
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.
$2,731.45 with CONTINUUS MEDICAID MANAGED vs $16,479.00 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 →
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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 |
|---|---|---|---|
| CONTINUUS MEDICAID MANAGED | CONTINUUS MEDICAID MANAGED | $2,731.45 | ↓ -75% |
| MANAGED HEALTH SERVICES | MANAGED HEALTH SERVICES MEDICAID | $2,731.45 | ↓ -75% |
| ANTHEM | ANTEHM MEDICAID | $2,731.45 | ↓ -75% |
| MERIDIAN HEALTH PLAN | MERIDIAN HMO MCD | $2,731.45 | ↓ -75% |
| COMMUNITY CARE FAMILY CARE | COMMUNITY CARE FAMILY CARE MEDICAID MANAGED | $2,731.45 | ↓ -75% |
| MOLINA HEALTHCARE | MOLINA MEDICAID | $2,895.34 | ↓ -73% |
| TRIOLOGY | TRILOGY MEDICAID | $2,895.34 | ↓ -73% |
| MOLINA HEALTHCARE | MOLINA MEDICARE | $5,557.71 | ↓ -49% |
| UNITY HEALTH PLAN | UNITY HOSPICE | $5,557.71 | ↓ -49% |
| UNITED HEALTHCARE | UNITED HEALTH CARE MEDICARE | $5,557.71 | ↓ -49% |
| AETNA | AETNA MEDICARE | $5,557.71 | ↓ -49% |
| MEDICARE MANAGED | MANAGED MEDICARE NO SEQUESTRATION | $5,557.71 | ↓ -49% |
| ANTHEM | ANTHEM MEDICARE ADVANTAGE HMO | $5,557.71 | ↓ -49% |
| HUMANA | HUMANA MEDICARE ADVANTAGE | $5,557.71 | ↓ -49% |
| SECURITY HEALTH PLAN | MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI | $5,613.29 | ↓ -48% |
| HUMANA | HUMANA NATIIONAL POS HMO | $7,604.00 | ↓ -30% |
| HUMANA | HUMANA CHOICE CARE HMO | $7,604.00 | ↓ -30% |
| HSHS EMPLOYEES | HSHS EMPLOYEES | $8,008.79 | ↓ -26% |
| MOLINA HEALTHCARE OF WI | ALL COMMERICAL MOLINA MARKETPLACE | $8,239.50 | ↓ -24% |
| WISCONSIN PHYSICIAN SERVICE | WISCONSIN PHYSICIAN SERVICE | $9,887.40 | ↓ -9% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION PPP | $10,216.98 | ↓ -6% |
| SECURITY HEALTH PLAN | ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK | $10,518.55 | ↓ -3% |
| P360 SMALL GROUP | PREVEA 360 SMALL GROUP COMMERCIAL PLAN | $11,200.86 | ↑ +3% |
| PREVEA HEALTH NETWORK | PREVEA360 - NETWORK | $11,200.86 | ↑ +3% |
| PREVEA HEALTH NETWORK | PREVEA360 | $11,200.86 | ↑ +3% |
| PREVEA HEALTH NETWORK | PREVEA EMPLOYEES | $11,200.86 | ↑ +3% |
| CIGNA | ALL COMMERCIAL CIGNA | $11,535.30 | ↑ +6% |
| HEALTH EOS | ALL COMMERCIAL HEALTH EOS | $11,700.09 | ↑ +8% |
| TRIOLOGY | ALL COMMERCIAL TRIOLOGY | $11,864.88 | ↑ +9% |
| WEA PROVIDER NETWORK | WEA TRUST PPP/TRUST PREFERRED | $11,864.88 | ↑ +9% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION | $11,864.88 | ↑ +9% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION TRUST SELECT | $11,864.88 | ↑ +9% |
| INTERPLAN | ALL COMMERCIAL INTERPLAN HEALTH GROUP | $12,029.67 | ↑ +11% |
| HEALTHSMART | ALL COMMERCIAL HEALTHSMART | $12,029.67 | ↑ +11% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $12,215.30 | ↑ +12% |
| UNITED HEALTHCARE | UHC ONEIDA NATION | $12,215.30 | ↑ +12% |
| UNITED HEALTHCARE | ALL COMMERCIAL UNITED HEALTHCARE | $12,215.30 | ↑ +12% |
| NETWORK HEALTH PLAN | ALL COMMERICAL NETWORK HEALTH PLAN | $12,359.25 | ↑ +14% |
| NAPHCARE | ALL COMMERICAL NAPHCARE | $12,504.84 | ↑ +15% |
| ANTHEM | ANTHEM POS/HMO | $13,454.00 | ↑ +24% |
| HEALTH CARE ALLIANCE | THE ALLIANCE | $13,842.36 | ↑ +27% |
| MULTIPLAN/PHCS | ALL COMMERCIAL MULTIPLAN | $13,842.36 | ↑ +27% |
| HUMANA | ALL COMMERCIAL HUMANA HPN CHOICECARE | $14,007.15 | ↑ +29% |
| CHOICECARE | ALL COMMERCIAL CHOICE CARE | $14,007.15 | ↑ +29% |
| HUMANA | HUMANA CHOICE CARE PPO | $14,007.15 | ↑ +29% |
| NORTH CENTRAL HEALTHCARE ALLIANCE | NEHA | $15,160.68 | ↑ +39% |
| FIRST HEALTH | ALL COMMERCIAL FIRST HEALTH NETWORK | $15,655.05 | ↑ +44% |
| CENPATICO | ALL MEDICAID CENPATICO | $16,479.00 | ↑ +52% |
| AETNA | AETNA HSHS | $16,479.00 | ↑ +52% |
| LIVE360 | LIVE360 HSHS HEALTHY PLAN | $16,479.00 | ↑ +52% |
| CATERPILLAR, INC. | UHC CATERPILLAR EMPLOYER GROUP | $16,479.00 | ↑ +52% |
| COFINITY | COFINITY | $16,479.00 | ↑ +52% |
| ANTHEM | ANTHEM PPO | $16,479.00 | ↑ +52% |
| AETNA | ALL COMMERCIAL AETNA | $16,479.00 | ↑ +52% |
Visitor-reported prices
Comments
Revision tips at other Wisconsin hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Aurora Baycare Medical Center | Green Bay | $8,940.00 | not published |
| HSHS St. Vincent Hospital | Green Bay | $10,876.14 | $2,832.02 – $12,438.90 |
| Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Milwaukee | $21,619.23 | $590.43 – $24,724.85 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | $21,619.23 | $590.43 – $24,724.85 |
| SSM Health St. Mary's Hospital - Madison | Madison | $14,012.35 | $4,146.30 – $27,690.00 |
| Aurora Sinai Medical Center of Aurora Health Care Metro | Milwaukee | $8,940.00 | not published |
| Aurora Medical Center Summit | Summit | $8,940.00 | not published |
| Aurora West Allis Medical Center | West Allis | $8,940.00 | not published |