Consultation pathology during surgery cytological exam initial site at SSM Health St. Mary's Hospital - Janesville
3400 East Racine Street, Janesville, WI · SSM Health · · NPI 1548654676
$620.40
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.
$1,128.00
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.
$198.93 with BCBS vs $811.52 with Dean Health Plan — 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 |
|---|---|---|---|
| BCBS | Blue Preferred/Blue Preferred Plus HMO/POS | $198.93 | ↓ -68% |
| BCBS | Blue Access PPO | $214.59 | ↓ -65% |
| BCBS | Blue Traditional Traditional | $214.59 | ↓ -65% |
| Molina | Medicare Managed Care Plan | $608.64 | ↓ -2% |
| Dean Health Plan | Medicare Managed Care Plan | $811.52 | ↑ +31% |
Visitor-reported prices
Comments
Consultation pathology during surgery cytological exam initial site at other Wisconsin hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Milwaukee | $368.88 | $24.95 – $1,749.53 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | $368.88 | $24.95 – $1,749.53 |
| UnityPoint Health - Meriter Hospital | Madison | $602.40 | $25.11 – $132.42 |
| Orthopaedic Hospital of Wisconsin, LLC | Glendale | $79.50 | $21.31 – $28.51 |
| SSM Health St. Clare Hospital - Baraboo | Baraboo | $676.50 | $248.65 – $782.58 |
| SSM Health St. Mary's Hospital - Madison | Madison | $301.95 | $203.44 – $782.58 |
| SSM Health Monroe Hospital | Monroe | $228.80 | $36.61 – $782.58 |
| SSM Health Ripon Community Hospital | Ripon | $154.00 | $50.62 – $628.20 |