Special physics consult at HSHS St. Mary's Hospital Medical Center
1726 SHAWANO AVE, GREEN BAY, WI · Hshs · · NPI 1649246877
$1,056.00
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.
$1,600.00
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.
$52.50 with MOLINA HEALTHCARE vs $1,600.00 with UNITED HEALTHCARE — 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 |
|---|---|---|---|
| MOLINA HEALTHCARE | MOLINA MEDICARE | $52.50 | ↓ -95% |
| SECURITY HEALTH PLAN | MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI | $53.03 | ↓ -95% |
| COMMUNITY CARE FAMILY CARE | COMMUNITY CARE FAMILY CARE MEDICAID MANAGED | $53.11 | ↓ -95% |
| CONTINUUS MEDICAID MANAGED | CONTINUUS MEDICAID MANAGED | $53.11 | ↓ -95% |
| ANTHEM | ANTEHM MEDICAID | $53.11 | ↓ -95% |
| MERIDIAN HEALTH PLAN | MERIDIAN HMO MCD | $53.11 | ↓ -95% |
| MANAGED HEALTH SERVICES | MANAGED HEALTH SERVICES MEDICAID | $53.11 | ↓ -95% |
| TRIOLOGY | TRILOGY MEDICAID | $56.29 | ↓ -95% |
| MOLINA HEALTHCARE | MOLINA MEDICAID | $56.30 | ↓ -95% |
| MEDICARE MANAGED | MANAGED MEDICARE NO SEQUESTRATION | $131.25 | ↓ -88% |
| ANTHEM | ANTHEM MEDICARE ADVANTAGE HMO | $131.25 | ↓ -88% |
| HUMANA | HUMANA MEDICARE ADVANTAGE | $131.25 | ↓ -88% |
| AETNA | AETNA MEDICARE | $131.25 | ↓ -88% |
| UNITED HEALTHCARE | UNITED HEALTH CARE MEDICARE | $131.25 | ↓ -88% |
| UNITY HEALTH PLAN | UNITY HOSPICE | $131.25 | ↓ -88% |
| NAPHCARE | ALL COMMERICAL NAPHCARE | $295.31 | ↓ -72% |
| ANTHEM | ANTHEM POS/HMO | $524.77 | ↓ -50% |
| ANTHEM | ANTHEM PPO | $524.77 | ↓ -50% |
| HSHS EMPLOYEES | HSHS EMPLOYEES | $777.60 | ↓ -26% |
| MOLINA HEALTHCARE OF WI | ALL COMMERICAL MOLINA MARKETPLACE | $800.00 | ↓ -24% |
| WISCONSIN PHYSICIAN SERVICE | WISCONSIN PHYSICIAN SERVICE | $960.00 | ↓ -9% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION PPP | $992.00 | ↓ -6% |
| HUMANA | HUMANA NATIIONAL POS HMO | $1,016.00 | ↓ -4% |
| HUMANA | HUMANA CHOICE CARE HMO | $1,016.00 | ↓ -4% |
| SECURITY HEALTH PLAN | ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK | $1,021.28 | ↓ -3% |
| CIGNA | ALL COMMERCIAL CIGNA | $1,120.00 | ↑ +6% |
| HEALTH EOS | ALL COMMERCIAL HEALTH EOS | $1,136.00 | ↑ +8% |
| TRIOLOGY | ALL COMMERCIAL TRIOLOGY | $1,152.00 | ↑ +9% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION TRUST SELECT | $1,152.00 | ↑ +9% |
| WEA PROVIDER NETWORK | WEA TRUST PPP/TRUST PREFERRED | $1,152.00 | ↑ +9% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION | $1,152.00 | ↑ +9% |
| INTERPLAN | ALL COMMERCIAL INTERPLAN HEALTH GROUP | $1,168.00 | ↑ +11% |
| HEALTHSMART | ALL COMMERCIAL HEALTHSMART | $1,168.00 | ↑ +11% |
| NETWORK HEALTH PLAN | ALL COMMERICAL NETWORK HEALTH PLAN | $1,200.00 | ↑ +14% |
| MULTIPLAN/PHCS | ALL COMMERCIAL MULTIPLAN | $1,344.00 | ↑ +27% |
| HEALTH CARE ALLIANCE | THE ALLIANCE | $1,344.00 | ↑ +27% |
| HUMANA | HUMANA CHOICE CARE PPO | $1,360.00 | ↑ +29% |
| CHOICECARE | ALL COMMERCIAL CHOICE CARE | $1,360.00 | ↑ +29% |
| HUMANA | ALL COMMERCIAL HUMANA HPN CHOICECARE | $1,360.00 | ↑ +29% |
| NORTH CENTRAL HEALTHCARE ALLIANCE | NEHA | $1,472.00 | ↑ +39% |
| FIRST HEALTH | ALL COMMERCIAL FIRST HEALTH NETWORK | $1,520.00 | ↑ +44% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $1,600.00 | ↑ +52% |
| COFINITY | COFINITY | $1,600.00 | ↑ +52% |
| CATERPILLAR, INC. | UHC CATERPILLAR EMPLOYER GROUP | $1,600.00 | ↑ +52% |
| LIVE360 | LIVE360 HSHS HEALTHY PLAN | $1,600.00 | ↑ +52% |
| CENPATICO | ALL MEDICAID CENPATICO | $1,600.00 | ↑ +52% |
| AETNA | ALL COMMERCIAL AETNA | $1,600.00 | ↑ +52% |
| P360 SMALL GROUP | PREVEA 360 SMALL GROUP COMMERCIAL PLAN | $1,600.00 | ↑ +52% |
| PREVEA HEALTH NETWORK | PREVEA EMPLOYEES | $1,600.00 | ↑ +52% |
| PREVEA HEALTH NETWORK | PREVEA360 | $1,600.00 | ↑ +52% |
| PREVEA HEALTH NETWORK | PREVEA360 - NETWORK | $1,600.00 | ↑ +52% |
| AETNA | AETNA HSHS | $1,600.00 | ↑ +52% |
| UNITED HEALTHCARE | UHC ONEIDA NATION | $1,600.00 | ↑ +52% |
| UNITED HEALTHCARE | ALL COMMERCIAL UNITED HEALTHCARE | $1,600.00 | ↑ +52% |
Visitor-reported prices
Comments
Special physics consult 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 | $1,056.00 | $52.22 – $1,600.00 |
| Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Milwaukee | $732.46 | $129.25 – $387.56 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | $732.46 | $129.25 – $387.56 |
| SSM Health St. Clare Hospital - Baraboo | Baraboo | $908.05 | $97.92 – $1,304.59 |
| SSM Health St. Mary's Hospital - Janesville | Janesville | $915.75 | $101.54 – $936.25 |
| SSM Health St. Mary's Hospital - Madison | Madison | $382.25 | $97.92 – $982.29 |
| SSM Health Ripon Community Hospital | Ripon | $444.95 | $401.73 – $401.73 |