Assay phosphohexose enzymes 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

$346.50

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.

Full explanation →

What you pay up front if you don't use insurance.

$525.00

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.

Full explanation →

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

$10.73 with UNITY HEALTH PLAN vs $525.00 with LIVE360 — 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 →

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
UNITY HEALTH PLAN UNITY HOSPICE $10.73 ↓ -97%
MANAGED HEALTH SERVICES MANAGED HEALTH SERVICES MEDICAID $11.09 ↓ -97%
ANTHEM ANTEHM MEDICAID $11.09 ↓ -97%
COMMUNITY CARE FAMILY CARE COMMUNITY CARE FAMILY CARE MEDICAID MANAGED $11.09 ↓ -97%
MERIDIAN HEALTH PLAN MERIDIAN HMO MCD $11.09 ↓ -97%
CONTINUUS MEDICAID MANAGED CONTINUUS MEDICAID MANAGED $11.09 ↓ -97%
MOLINA HEALTHCARE MOLINA MEDICAID $11.76 ↓ -97%
TRIOLOGY TRILOGY MEDICAID $11.76 ↓ -97%
UNITED HEALTHCARE ALL COMMERCIAL UNITED HEALTHCARE $12.88 ↓ -96%
UNITED HEALTHCARE UNITED HEALTHCARE $12.88 ↓ -96%
UNITED HEALTHCARE UHC ONEIDA NATION $12.88 ↓ -96%
P360 SMALL GROUP PREVEA 360 SMALL GROUP COMMERCIAL PLAN $13.95 ↓ -96%
PREVEA HEALTH NETWORK PREVEA360 - NETWORK $13.95 ↓ -96%
PREVEA HEALTH NETWORK PREVEA EMPLOYEES $13.95 ↓ -96%
PREVEA HEALTH NETWORK PREVEA360 $13.95 ↓ -96%
ANTHEM ANTHEM PPO $37.56 ↓ -89%
ANTHEM ANTHEM POS/HMO $37.56 ↓ -89%
HUMANA HUMANA MEDICARE ADVANTAGE $126.00 ↓ -64%
UNITED HEALTHCARE UNITED HEALTH CARE MEDICARE $126.00 ↓ -64%
AETNA AETNA MEDICARE $126.00 ↓ -64%
MOLINA HEALTHCARE MOLINA MEDICARE $126.00 ↓ -64%
ANTHEM ANTHEM MEDICARE ADVANTAGE HMO $126.00 ↓ -64%
SECURITY HEALTH PLAN MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI $127.26 ↓ -63%
HSHS EMPLOYEES HSHS EMPLOYEES $255.15 ↓ -26%
MOLINA HEALTHCARE OF WI ALL COMMERICAL MOLINA MARKETPLACE $262.50 ↓ -24%
NAPHCARE ALL COMMERICAL NAPHCARE $283.50 ↓ -18%
CIGNA ALL COMMERCIAL CIGNA $328.13 ↓ -5%
SECURITY HEALTH PLAN ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK $335.11 ↓ -3%
TRIOLOGY ALL COMMERCIAL TRIOLOGY $414.75 ↑ +20%
ARISE HEALTH PLAN ALL COMMERCIAL ARISE HEALTH PLAN $420.00 ↑ +21%
WISCONSIN PHYSICIAN SERVICE WISCONSIN PHYSICIAN SERVICE $420.00 ↑ +21%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION PPP $430.50 ↑ +24%
WEA PROVIDER NETWORK WEA TRUST PPP/TRUST PREFERRED $430.50 ↑ +24%
HEALTH CARE ALLIANCE THE ALLIANCE $441.00 ↑ +27%
HUMANA HUMANA CHOICE CARE PPO $446.25 ↑ +29%
CHOICECARE ALL COMMERCIAL CHOICE CARE $446.25 ↑ +29%
HUMANA ALL COMMERCIAL HUMANA HPN CHOICECARE $446.25 ↑ +29%
HUMANA HUMANA NATIIONAL POS HMO $446.25 ↑ +29%
HEALTH EOS ALL COMMERCIAL HEALTH EOS $467.25 ↑ +35%
MULTIPLAN/PHCS ALL COMMERCIAL MULTIPLAN $467.25 ↑ +35%
INTERPLAN ALL COMMERCIAL INTERPLAN HEALTH GROUP $472.50 ↑ +36%
NETWORK HEALTH PLAN ALL COMMERICAL NETWORK HEALTH PLAN $472.50 ↑ +36%
COFINITY COFINITY $472.50 ↑ +36%
NORTH CENTRAL HEALTHCARE ALLIANCE NEHA $483.00 ↑ +39%
FIRST HEALTH ALL COMMERCIAL FIRST HEALTH NETWORK $498.75 ↑ +44%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION $498.75 ↑ +44%
AETNA ALL COMMERCIAL AETNA $525.00 ↑ +52%
CATERPILLAR, INC. UHC CATERPILLAR EMPLOYER GROUP $525.00 ↑ +52%
HEALTHSMART ALL COMMERCIAL HEALTHSMART $525.00 ↑ +52%
LIVE360 LIVE360 HSHS HEALTHY PLAN $525.00 ↑ +52%

Visitor-reported prices

visitor-reported
Report what you paid sign in to post

Comments

Add a comment sign in to post

Assay phosphohexose enzymes at other Wisconsin hospitals

Hospital City Cash price Negotiated range
UnityPoint Health - Meriter Hospital Madison $73.60 $6.44 – $34.04
HSHS St. Mary's Hospital Medical Center GREEN BAY $346.50 $10.73 – $24.14
HSHS St. Nicholas Hospital SHEBOYGAN $346.50 $10.73 – $24.14
HSHS St. Vincent Hospital Green Bay $346.50 $10.73 – $24.14
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) Milwaukee not published $10.73 – $44.69
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) Mequon not published $10.73 – $44.69
Orthopaedic Hospital of Wisconsin, LLC Glendale not published $10.41 – $18.50
SSM Health St. Clare Hospital - Baraboo Baraboo not published $8.05 – $102.67

All Wisconsin hospitals for this procedure →