Lower Back (Lumbar Spine) CT scan (without contrast) at SSM Health Monroe Hospital
515 22Nd Ave, Monroe, WI · SSM Health · · NPI 1073653523
$2,190.10
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.
$3,982.00
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.
$101.55 with Aetna vs $367.66 with BCBS — 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 | Medicare Managed Care Plan | $101.55 | ↓ -95% |
| BCBS | Blue Preferred / Blue Preferred Plus HMO/POS | $341.23 | ↓ -84% |
| BCBS | Blue Access PPO | $367.66 | ↓ -83% |
| BCBS | Blue Traditional Traditional | $367.66 | ↓ -83% |
Visitor-reported prices
Comments
Lower Back (Lumbar Spine) CT scan (without contrast) 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 | $1,041.45 | $78.03 – $245.18 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | $1,395.49 | $78.03 – $245.18 |
| UnityPoint Health - Meriter Hospital | Madison | $3,187.15 | $43.92 – $1,322.66 |
| SSM Health St. Clare Hospital - Baraboo | Baraboo | $1,497.10 | $76.16 – $1,391.34 |
| SSM Health St. Mary's Hospital - Janesville | Janesville | $1,956.90 | $78.98 – $998.49 |
| SSM Health St. Mary's Hospital - Madison | Madison | $2,265.45 | $76.16 – $1,047.60 |
| SSM Health Ripon Community Hospital | Ripon | $1,495.45 | $428.45 – $428.45 |
| SSM Health St. Agnes Hospital - Fond du Lac | Fond Du Lac | $1,495.45 | $77.56 – $199.58 |