Ghs simple repair 12.6 - 20.0 cm - 12005 at SSM Health St. Mary's Hospital - Madison
700 South Park St, Madison, WI · SSM Health · · NPI 1902290034
$1,217.70
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.
$2,214.00
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.
$296.15 with Molina vs $5,563.00 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 | $296.15 | ↓ -76% |
| Dean Health Plan | Medicare Managed Care Plan | $394.86 | ↓ -68% |
| Centivo | Broad(WI2) Other Commercial Plan | $2,036.00 | ↑ +67% |
| BCBS | Blue Preferred/Blue Preferred Plus HMO/POS | $4,198.00 | ↑ +245% |
| BCBS | Blue Access PPO | $5,563.00 | ↑ +357% |
| BCBS | Anthem Blue Traditional Traditional | $5,563.00 | ↑ +357% |
Visitor-reported prices
Comments
Ghs simple repair 12.6 - 20.0 cm - 12005 at other Wisconsin hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UnityPoint Health - Meriter Hospital | Madison | $1,030.76 | $33.35 – $401.99 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | $134.09 | $145.91 – $855.65 |
| SSM Health St. Clare Hospital - Baraboo | Baraboo | $408.10 | $296.15 – $4,401.00 |
| SSM Health St. Mary's Hospital - Janesville | Janesville | $1,099.45 | $307.10 – $4,074.00 |
| SSM Health Monroe Hospital | Monroe | $526.35 | $394.86 – $4,217.00 |
| SSM Health Ripon Community Hospital | Ripon | $662.20 | $1,887.00 – $2,654.00 |
| SSM Health St. Agnes Hospital - Fond du Lac | Fond Du Lac | $662.20 | $301.57 – $2,334.00 |
| SSM Health Waupun Memorial Hospital | Waupun | $662.20 | $1,887.00 – $2,654.00 |