Annual Physical, Established Patient (age 18-39) at UnityPoint Health - Meriter Hospital
202 South Park Street, Madison, WI · UnityPoint Health · · NPI 1114920048
$278.40
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.
$348.00
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.
$32.20 with Aspirus vs $202.03 with United 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 →
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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 |
|---|---|---|---|
| Aspirus | PPO | $32.20 | ↓ -88% |
| Anthem Blue Cross and Blue Shield | HMO/POS | $35.00 | ↓ -87% |
| Anthem Blue Cross and Blue Shield | Blue Priority/Pathway | $35.00 | ↓ -87% |
| Anthem Blue Cross and Blue Shield | PPO | $35.00 | ↓ -87% |
| Wellmark UPH Self-Funded | Commercial | $35.00 | ↓ -87% |
| Cigna | Commercial | $39.20 | ↓ -86% |
| Security Health Plan | HMO/POS/SAS | $42.00 | ↓ -85% |
| Aspirus | HMO/POS | $49.00 | ↓ -82% |
| Mercy Care | HMO/POS | $49.00 | ↓ -82% |
| Medical Associates Health Plan | HMO/POS/PPO | $51.80 | ↓ -81% |
| United Healthcare | Medicare Advantage | $56.00 | ↓ -80% |
| Aspirus | Medicare Advantage | $70.00 | ↓ -75% |
| Prevea 360 | Commercial | $119.00 | ↓ -57% |
| Health Partners Open Network | Commercial | $123.90 | ↓ -55% |
| Anthem Blue Cross and Blue Shield | Traditional | $133.00 | ↓ -52% |
| United Healthcare | Commercial | $202.03 | ↓ -27% |
| Dean Health Plan | Managed Medicaid | not published by hospital | — |
| Anthem Blue Cross and Blue Shield | Managed Medicaid | not published by hospital | — |
| MeridianCare | Medicare Advantage | not published by hospital | — |
| GHC | HMO | not published by hospital | — |
| Prevea 360 | Medicare Advantage | not published by hospital | — |
| Quartz | HMO | not published by hospital | — |
| United Healthcare | Managed Medicaid | not published by hospital | — |
| Anthem Blue Cross and Blue Shield | Medicare Advantage | not published by hospital | — |
| My Choice | Managed Medicaid | not published by hospital | — |
| GHC - Eau Claire | Managed Medicaid | not published by hospital | — |
| GHC - South Central WI | Managed Medicaid | not published by hospital | — |
| Humana | Medicare Advantage | not published by hospital | — |
| IlliniCare | Medicare Advantage | not published by hospital | — |
Visitor-reported prices
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Annual Physical, Established Patient (age 18-39) 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 | $168.01 | $140.01 – $306.88 |
| Aurora Sinai Medical Center of Aurora Health Care Metro | Milwaukee | $307.50 | not published |
| Aurora Medical Center Sheboygan County | Sheboygan | $107.50 | not published |
| Ascension Calumet Hospital, Inc. | Chilton | $189.81 | $90.86 – $158.84 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | not published | $140.01 – $306.88 |
| Midwest Orthopedic Specialty Hospital | Franklin | not published | $86.74 – $316.11 |
| Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.) | Oshkosh | not published | $90.86 – $262.25 |
| Ascension St. Francis Hospital, Inc. | Milwaukee | not published | $86.74 – $316.11 |