Appl modality 1/> areas vasopneumatic devices 97016 at HSHS St. Clare Memorial Hospital

855 S MAIN STREET, OCONTO FALLS, WI · Hshs · · NPI 1851477913

Source: hospital's published price file ↗ · Published Mar 24, 2026 · Ingested Sep 16, 2026

$62.70

Cash price

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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.

$95.00

Gross charge

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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.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$11.55 with UNITY HEALTH PLAN vs $95.00 with PREVEA HEALTH NETWORK — 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 →

Payer
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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
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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
UNITY HEALTH PLAN UNITY HOSPICE $11.55 ↓ -82%
MOLINA HEALTHCARE MOLINA MEDICARE $22.80 ↓ -64%
HUMANA HUMANA MEDICARE ADVANTAGE $22.80 ↓ -64%
ANTHEM ANTHEM MEDICARE ADVANTAGE HMO $22.80 ↓ -64%
UNITED HEALTHCARE UNITED HEALTH CARE MEDICARE $22.80 ↓ -64%
AETNA AETNA MEDICARE $22.80 ↓ -64%
SECURITY HEALTH PLAN MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI $23.03 ↓ -63%
MERIDIAN HEALTH PLAN MERIDIAN HMO MCD $26.45 ↓ -58%
MANAGED HEALTH SERVICES MANAGED HEALTH SERVICES MEDICAID $26.45 ↓ -58%
ANTHEM ANTEHM MEDICAID $26.45 ↓ -58%
CONTINUUS MEDICAID MANAGED CONTINUUS MEDICAID MANAGED $26.45 ↓ -58%
COMMUNITY CARE FAMILY CARE COMMUNITY CARE FAMILY CARE MEDICAID MANAGED $26.45 ↓ -58%
MOLINA HEALTHCARE MOLINA MEDICAID $28.04 ↓ -55%
TRIOLOGY TRILOGY MEDICAID $28.04 ↓ -55%
HSHS EMPLOYEES HSHS EMPLOYEES $46.17 ↓ -26%
MOLINA HEALTHCARE OF WI ALL COMMERICAL MOLINA MARKETPLACE $47.50 ↓ -24%
NAPHCARE ALL COMMERICAL NAPHCARE $51.30 ↓ -18%
CIGNA ALL COMMERCIAL CIGNA $59.38 ↓ -5%
SECURITY HEALTH PLAN ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK $60.64 ↓ -3%
TRIOLOGY ALL COMMERCIAL TRIOLOGY $75.05 ↑ +20%
ARISE HEALTH PLAN ALL COMMERCIAL ARISE HEALTH PLAN $76.00 ↑ +21%
WISCONSIN PHYSICIAN SERVICE WISCONSIN PHYSICIAN SERVICE $76.00 ↑ +21%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION PPP $77.90 ↑ +24%
WEA PROVIDER NETWORK WEA TRUST PPP/TRUST PREFERRED $77.90 ↑ +24%
HEALTH CARE ALLIANCE THE ALLIANCE $79.80 ↑ +27%
CHOICECARE ALL COMMERCIAL CHOICE CARE $80.75 ↑ +29%
HUMANA HUMANA NATIIONAL POS HMO $80.75 ↑ +29%
HUMANA ALL COMMERCIAL HUMANA HPN CHOICECARE $80.75 ↑ +29%
HUMANA HUMANA CHOICE CARE PPO $80.75 ↑ +29%
MULTIPLAN/PHCS ALL COMMERCIAL MULTIPLAN $84.55 ↑ +35%
HEALTH EOS ALL COMMERCIAL HEALTH EOS $84.55 ↑ +35%
INTERPLAN ALL COMMERCIAL INTERPLAN HEALTH GROUP $85.50 ↑ +36%
COFINITY COFINITY $85.50 ↑ +36%
NETWORK HEALTH PLAN ALL COMMERICAL NETWORK HEALTH PLAN $85.50 ↑ +36%
NORTH CENTRAL HEALTHCARE ALLIANCE NEHA $87.40 ↑ +39%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION $90.25 ↑ +44%
FIRST HEALTH ALL COMMERCIAL FIRST HEALTH NETWORK $90.25 ↑ +44%
PREVEA HEALTH NETWORK PREVEA360 $95.00 ↑ +52%
PREVEA HEALTH NETWORK PREVEA360 - NETWORK $95.00 ↑ +52%
UNITED HEALTHCARE UNITED HEALTHCARE $95.00 ↑ +52%
CATERPILLAR, INC. UHC CATERPILLAR EMPLOYER GROUP $95.00 ↑ +52%
ANTHEM ANTHEM PPO $95.00 ↑ +52%
ANTHEM ANTHEM POS/HMO $95.00 ↑ +52%
HEALTHSMART ALL COMMERCIAL HEALTHSMART $95.00 ↑ +52%
AETNA ALL COMMERCIAL AETNA $95.00 ↑ +52%
UNITED HEALTHCARE UHC ONEIDA NATION $95.00 ↑ +52%
LIVE360 LIVE360 HSHS HEALTHY PLAN $95.00 ↑ +52%
UNITED HEALTHCARE ALL COMMERCIAL UNITED HEALTHCARE $95.00 ↑ +52%
P360 SMALL GROUP PREVEA 360 SMALL GROUP COMMERCIAL PLAN $95.00 ↑ +52%
PREVEA HEALTH NETWORK PREVEA EMPLOYEES $95.00 ↑ +52%

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Appl modality 1/> areas vasopneumatic devices 97016 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 $106.53 $11.19 – $61.48
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) Mequon $106.53 $11.19 – $61.48
UnityPoint Health - Meriter Hospital Madison $95.09 $11.19 – $42.79
SSM Health St. Clare Hospital - Baraboo Baraboo $102.85 $8.66 – $11.55
SSM Health Monroe Hospital Monroe $85.25 $11.55 – $11.55
SSM Health Ripon Community Hospital Ripon $46.75 not published
SSM Health St. Agnes Hospital - Fond du Lac Fond Du Lac $46.75 $8.66 – $22.29
SSM Health Waupun Memorial Hospital Waupun $46.75 not published

All Wisconsin hospitals for this procedure →