Biliary endoscopy thru skin at SSM Health Monroe Hospital
515 22Nd Ave, Monroe, WI · SSM Health · · NPI 1073653523
$1,885.40
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.
?
What you pay up front if you don't use insurance.
$3,428.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$10,325.10 with Aetna vs $17,743.00 with BCBS — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | Medicare Managed Care Plan | $10,325.10 | ↑ +448% |
| BCBS | Blue Preferred / Blue Preferred Plus HMO/POS | $13,176.00 | ↑ +599% |
| Centivo | Median(WI2) Other Commercial Plan | $17,116.00 | ↑ +808% |
| BCBS | Blue Access PPO | $17,743.00 | ↑ +841% |
| BCBS | Blue Traditional Traditional | $17,743.00 | ↑ +841% |
Visitor-reported prices
Comments
Biliary endoscopy thru skin at other Wisconsin hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UnityPoint Health - Meriter Hospital | Madison | $8,033.66 | $334.44 – $3,333.97 |
| SSM Health St. Mary's Hospital - Janesville | Janesville | $2,503.60 | $8,030.21 – $16,582.00 |
| SSM Health St. Mary's Hospital - Madison | Madison | $2,862.20 | $7,743.83 – $21,366.00 |
| Midwest Orthopedic Specialty Hospital | Franklin | $5,614.82 | $1,560.00 – $1,560.00 |
| Ascension St. Francis Hospital, Inc. | Milwaukee | $5,614.82 | $1,560.00 – $1,560.00 |
| Ascension SE Wisconsin Hospital - St. Joseph Campus | Milwaukee | $5,614.82 | $1,560.00 – $1,560.00 |
| Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Milwaukee | not published | $588.90 – $1,513.99 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | not published | $588.90 – $1,513.99 |