Aco cmplx chron care without pt visit, 60 min 99487aco at UnityPoint Health - Meriter Hospital
202 South Park Street, Madison, WI · UnityPoint Health · · NPI 1114920048
not published by hospital
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.
not published by hospital
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.
$83.16 with Prevea 360 vs $217.88 with Wellmark UPH Self-Funded — 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 |
|---|---|---|---|
| Prevea 360 | Medicare Advantage | $83.16 | — |
| United Healthcare | Medicare Advantage | $83.16 | — |
| Anthem Blue Cross and Blue Shield | Medicare Advantage | $83.16 | — |
| Aspirus | Medicare Advantage | $83.16 | — |
| IlliniCare | Medicare Advantage | $83.16 | — |
| Health Partners Open Network | Commercial | $83.45 | — |
| Humana | Medicare Advantage | $87.32 | — |
| MeridianCare | Medicare Advantage | $87.32 | — |
| United Healthcare | Commercial | $118.00 | — |
| Anthem Blue Cross and Blue Shield | Blue Priority/Pathway | $154.68 | — |
| Medical Associates Health Plan | HMO/POS/PPO | $178.79 | — |
| Anthem Blue Cross and Blue Shield | HMO/POS | $192.93 | — |
| Anthem Blue Cross and Blue Shield | PPO | $217.88 | — |
| Wellmark UPH Self-Funded | Commercial | $217.88 | — |
Visitor-reported prices
Comments
Aco cmplx chron care without pt visit, 60 min 99487aco at other Wisconsin hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health St. Mary's Hospital - Madison | Madison | not published | $129.31 – $172.41 |
| SSM Health St. Clare Hospital - Baraboo | Baraboo | $165.55 | not published |
| Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Milwaukee | not published | $147.49 – $344.10 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | not published | $147.49 – $344.10 |
| SSM Health Monroe Hospital | Monroe | not published | $172.41 – $172.41 |
| SSM Health St. Agnes Hospital - Fond du Lac | Fond Du Lac | not published | $131.67 – $338.84 |
| Midwest Orthopedic Specialty Hospital | Franklin | not published | $156.01 – $246.82 |
| Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.) | Oshkosh | not published | $95.72 – $324.37 |