Biopsy of salivary gland 42400 at Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)
13111 N Port Washington Rd, Mequon, WI · Ascension · · NPI 1316000706
$1,748.47
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.
$3,299.00
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.
$85.24 with NETWORK HEALTH PLAN vs $1,506.85 with MOLINA HEALTH MARKETPLACE — 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 |
|---|---|---|---|
| NETWORK HEALTH PLAN | 1136_NETWORK HEALTH PLAN 20221001 | $85.24 | ↓ -95% |
| ALLIANCE | 1066_ALLIANCE 20220101 | $380.28 | ↓ -78% |
| UHC NON OPTIONS PPO | 1130_UNITED HEALTH CARE NONOPTIONS 20221001 | $411.76 | ↓ -76% |
| HUMANA PPO | 1133_HUMANA PPO 20221001 | $411.76 | ↓ -76% |
| HUMANA HMO POS | 1127_HUMANA 20221001 | $411.76 | ↓ -76% |
| HUMANA PREFERRED | 1134_HUMANA PREFERRED 20221001 | $411.76 | ↓ -76% |
| VETERANS ADMINISTRATION | 1114_VETERANS ADMINISTRATION INPATIENT 20221001 | $684.93 | ↓ -61% |
| VETERANS ADMINISTRATION | 1064_VETERANS ADMINISTRATION OUTPATIENT 20220101 | $684.93 | ↓ -61% |
| MEDICARE REPLACEMENT | 1116_MEDICARE REPLACEMENT INPATIENT 20221001 | $684.93 | ↓ -61% |
| MEDICARE REPLACEMENT | 1109_MEDICARE REPLACEMENT OUTPATIENT 20220701 | $684.93 | ↓ -61% |
| MOLINA HEALTH MARKETPLACE | 1111_MOLINA MARKETPLACE INPATIENT 20221001 | $1,506.85 | ↓ -14% |
| MOLINA HEALTH MARKETPLACE | 1060_MOLINA MARKETPLACE OUTPATIENT 20220101 | $1,506.85 | ↓ -14% |
Visitor-reported prices
Comments
Biopsy of salivary gland 42400 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 | $1,748.47 | $85.24 – $1,506.85 |
| UnityPoint Health - Meriter Hospital | Madison | $2,295.35 | $48.89 – $895.18 |
| SSM Health St. Clare Hospital - Baraboo | Baraboo | $1,528.45 | $515.87 – $4,401.00 |
| SSM Health St. Mary's Hospital - Janesville | Janesville | $1,022.45 | $534.95 – $4,074.00 |
| SSM Health St. Mary's Hospital - Madison | Madison | $957.55 | $515.87 – $4,198.00 |
| SSM Health Monroe Hospital | Monroe | $988.35 | $687.83 – $4,217.00 |
| SSM Health Ripon Community Hospital | Ripon | $1,483.35 | $2,654.00 – $3,030.00 |
| SSM Health St. Agnes Hospital - Fond du Lac | Fond Du Lac | $1,483.35 | $525.32 – $3,030.00 |