Cyclophosphamide 25 mg capsule at Aurora Medical Center Bay Area
3003 University Dr, Marinette, WI · Aurorahealthcare · · NPI 1043397177
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.
$0.86 with Aetna vs $7.26 with Everpointe Elite — 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 |
|---|---|---|---|
| Aetna | HMO | $0.86 | — |
| Aurora Caregiver | Commercial | $0.88 | — |
| HealthPartners | Employee Trust Fund | $0.98 | — |
| HealthPartners | Robin | $1.02 | — |
| Centivo | Commercial | $1.10 | — |
| Common Ground | Envision | $1.10 | — |
| Quartz One | Commercial | $1.13 | — |
| Health Payment Systems | Commercial | $1.13 | — |
| Anthem | Blue Priority | $1.14 | — |
| Common Ground | Employee Trust Fund | $1.21 | — |
| Common Ground | Exchange | $1.21 | — |
| Cigna | PPO-GPPO | $1.26 | — |
| Quartz Group | Commercial | $1.30 | — |
| Anthem | Blue Preferred | $1.37 | — |
| Anthem | PPO | $1.37 | — |
| Molina Exchange | Commercial | $2.04 | — |
| Everpointe Elite | Commercial | $7.26 | — |
Visitor-reported prices
Comments
Cyclophosphamide 25 mg capsule at other Wisconsin hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UnityPoint Health - Meriter Hospital | Madison | $6.80 | $0.96 – $7.22 |
| Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.) | Oshkosh | $1.55 | $1.41 – $2.73 |
| Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.) | Appleton | $4.23 | $1.41 – $7.42 |
| SSM Health St. Clare Hospital - Baraboo | Baraboo | not published | $1.55 – $3.77 |
| SSM Health St. Mary's Hospital - Janesville | Janesville | not published | $1.55 – $3.77 |
| SSM Health St. Mary's Hospital - Madison | Madison | not published | $1.39 – $3.77 |
| SSM Health Monroe Hospital | Monroe | not published | $1.09 – $3.42 |
| SSM Health Ripon Community Hospital | Ripon | not published | $0.90 – $3.77 |