Nm imaging hepatobiliary system w/pharmacologic intervention at SSM Health St. Mary's Hospital - Janesville
3400 East Racine Street, Janesville, WI · SSM Health · · NPI 1548654676
$1,645.60
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.
$2,992.00
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.
$410.18 with Molina vs $3,542.62 with BCBS — 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 | Medicare Managed Care Plan | $410.18 | ↓ -75% |
| Dean Health Plan | Medicare Managed Care Plan | $546.91 | ↓ -67% |
| BCBS | Blue Preferred/Blue Preferred Plus HMO/POS | $3,270.11 | ↑ +99% |
| BCBS | Blue Access PPO | $3,542.62 | ↑ +115% |
| BCBS | Blue Traditional Traditional | $3,542.62 | ↑ +115% |
Visitor-reported prices
Comments
Nm imaging hepatobiliary system w/pharmacologic intervention 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 | $2,261.51 | $69.53 – $1,152.80 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | $2,261.51 | $69.53 – $1,152.80 |
| UnityPoint Health - Meriter Hospital | Madison | $2,715.59 | $39.14 – $1,126.97 |
| SSM Health St. Clare Hospital - Baraboo | Baraboo | $1,238.05 | $395.55 – $4,556.73 |
| SSM Health St. Mary's Hospital - Madison | Madison | $1,439.90 | $395.55 – $3,430.96 |
| SSM Health Monroe Hospital | Monroe | $2,093.85 | $527.40 – $1,119.44 |
| SSM Health Ripon Community Hospital | Ripon | $1,936.00 | $1,403.19 – $1,403.19 |
| SSM Health St. Agnes Hospital - Fond du Lac | Fond Du Lac | $1,936.00 | $402.79 – $1,036.52 |