Venous sampling s&i at SSM Health Monroe Hospital
515 22Nd Ave, Monroe, WI · SSM Health · · NPI 1073653523
$3,616.80
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.
$6,576.00
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.
$244.16 with BCBS vs $5,404.97 with Aetna — 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 |
|---|---|---|---|
| BCBS | Blue Preferred / Blue Preferred Plus HMO/POS | $244.16 | ↓ -93% |
| BCBS | Blue Access PPO | $260.73 | ↓ -93% |
| BCBS | Blue Traditional Traditional | $260.73 | ↓ -93% |
| Aetna | Medicare Managed Care Plan | $5,404.97 | ↑ +49% |
Visitor-reported prices
Comments
Venous sampling s&i 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 | $2,885.85 | $40.60 – $10,733.33 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | $2,885.85 | $40.60 – $10,733.33 |
| SSM Health St. Mary's Hospital - Janesville | Janesville | $3,760.90 | $707.75 – $5,604.85 |
| SSM Health St. Mary's Hospital - Madison | Madison | $2,858.90 | $742.57 – $5,404.97 |
| Aurora Sinai Medical Center of Aurora Health Care Metro | Milwaukee | $3,085.00 | not published |
| Aurora Medical Center Summit | Summit | $3,085.00 | not published |
| Aurora Baycare Medical Center | Green Bay | $3,085.00 | not published |
| Aurora West Allis Medical Center | West Allis | $3,085.00 | not published |