Polatuzumab vedotin-piiq 140 mg intravenous solution at HSHS St. Vincent Hospital

835 S. Van Buren St., Green Bay, WI · Hshs · · NPI 1114908001

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

$250.36

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.

Full explanation →

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

$379.34

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.

$136.77 with ANTHEM vs $401.92 with MOLINA 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 →

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
ANTHEM ANTHEM MEDICARE ADVANTAGE HMO $136.77 ↓ -45%
MOLINA HEALTHCARE MOLINA MEDICARE $136.77 ↓ -45%
UNITED HEALTHCARE UNITED HEALTH CARE MEDICARE $136.77 ↓ -45%
AETNA AETNA MEDICARE $136.77 ↓ -45%
MEDICARE MANAGED MANAGED MEDICARE NO SEQUESTRATION $136.77 ↓ -45%
UNITY HEALTH PLAN UNITY HOSPICE $136.77 ↓ -45%
HUMANA HUMANA MEDICARE ADVANTAGE $136.77 ↓ -45%
SECURITY HEALTH PLAN MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI $138.14 ↓ -45%
HSHS EMPLOYEES HSHS EMPLOYEES $184.28 ↓ -26%
MOLINA HEALTHCARE OF WI ALL COMMERICAL MOLINA MARKETPLACE $189.59 ↓ -24%
HUMANA HUMANA NATIIONAL POS HMO $220.93 ↓ -12%
HUMANA HUMANA CHOICE CARE HMO $220.93 ↓ -12%
UNITED HEALTHCARE ALL COMMERCIAL UNITED HEALTHCARE $225.67 ↓ -10%
UNITED HEALTHCARE UNITED HEALTHCARE $225.67 ↓ -10%
UNITED HEALTHCARE UHC ONEIDA NATION $225.67 ↓ -10%
WISCONSIN PHYSICIAN SERVICE WISCONSIN PHYSICIAN SERVICE $227.50 ↓ -9%
ANTHEM ANTHEM POS/HMO $232.51 ↓ -7%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION PPP $235.09 ↓ -6%
SECURITY HEALTH PLAN ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK $242.02 ↓ -3%
PREVEA HEALTH NETWORK PREVEA EMPLOYEES $244.82 ↓ -2%
P360 SMALL GROUP PREVEA 360 SMALL GROUP COMMERCIAL PLAN $244.82 ↓ -2%
PREVEA HEALTH NETWORK PREVEA360 $244.82 ↓ -2%
PREVEA HEALTH NETWORK PREVEA360 - NETWORK $244.82 ↓ -2%
AETNA AETNA HSHS $244.94 ↓ -2%
CIGNA ALL COMMERCIAL CIGNA $265.42 ↑ +6%
HEALTH EOS ALL COMMERCIAL HEALTH EOS $269.21 ↑ +8%
WEA PROVIDER NETWORK WEA TRUST PPP/TRUST PREFERRED $273.00 ↑ +9%
TRIOLOGY ALL COMMERCIAL TRIOLOGY $273.00 ↑ +9%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION $273.00 ↑ +9%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION TRUST SELECT $273.00 ↑ +9%
HEALTHSMART ALL COMMERCIAL HEALTHSMART $276.79 ↑ +11%
INTERPLAN ALL COMMERCIAL INTERPLAN HEALTH GROUP $276.79 ↑ +11%
NETWORK HEALTH PLAN ALL COMMERICAL NETWORK HEALTH PLAN $284.38 ↑ +14%
ANTHEM ANTHEM PPO $287.22 ↑ +15%
NAPHCARE ALL COMMERICAL NAPHCARE $307.74 ↑ +23%
MULTIPLAN/PHCS ALL COMMERCIAL MULTIPLAN $318.50 ↑ +27%
HEALTH CARE ALLIANCE THE ALLIANCE $318.50 ↑ +27%
CHOICECARE ALL COMMERCIAL CHOICE CARE $322.29 ↑ +29%
HUMANA HUMANA CHOICE CARE PPO $322.29 ↑ +29%
HUMANA ALL COMMERCIAL HUMANA HPN CHOICECARE $322.29 ↑ +29%
NORTH CENTRAL HEALTHCARE ALLIANCE NEHA $348.84 ↑ +39%
FIRST HEALTH ALL COMMERCIAL FIRST HEALTH NETWORK $360.21 ↑ +44%
COFINITY COFINITY $379.17 ↑ +51%
CATERPILLAR, INC. UHC CATERPILLAR EMPLOYER GROUP $379.17 ↑ +51%
LIVE360 LIVE360 HSHS HEALTHY PLAN $379.17 ↑ +51%
COMMUNITY CARE FAMILY CARE COMMUNITY CARE FAMILY CARE MEDICAID MANAGED $379.17 ↑ +51%
CONTINUUS MEDICAID MANAGED CONTINUUS MEDICAID MANAGED $379.17 ↑ +51%
MANAGED HEALTH SERVICES MANAGED HEALTH SERVICES MEDICAID $379.17 ↑ +51%
ANTHEM ANTEHM MEDICAID $379.17 ↑ +51%
CENPATICO ALL MEDICAID CENPATICO $379.17 ↑ +51%
TRIOLOGY TRILOGY MEDICAID $379.17 ↑ +51%
AETNA ALL COMMERCIAL AETNA $379.17 ↑ +51%
MERIDIAN HEALTH PLAN MERIDIAN HMO MCD $379.17 ↑ +51%
MOLINA HEALTHCARE MOLINA MEDICAID $401.92 ↑ +61%

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Polatuzumab vedotin-piiq 140 mg intravenous solution at other Wisconsin hospitals

Hospital City Cash price Negotiated range
UnityPoint Health - Meriter Hospital Madison not published $118.78 – $136.23
SSM Health St. Clare Hospital - Baraboo Baraboo not published $107.71 – $258.84
SSM Health St. Mary's Hospital - Janesville Janesville not published $107.71 – $258.84
SSM Health St. Mary's Hospital - Madison Madison not published $107.71 – $258.84
SSM Health Monroe Hospital Monroe not published $132.73 – $361.35
SSM Health Ripon Community Hospital Ripon not published $143.91 – $361.88
SSM Health St. Agnes Hospital - Fond du Lac Fond Du Lac not published $107.71 – $361.88
SSM Health Waupun Memorial Hospital Waupun not published $143.91 – $361.88

All Wisconsin hospitals for this procedure →