Bilateral n block inj trigeminal 64400 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

$742.50

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.

$1,125.00

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.

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

$255.12 with ANTHEM vs $1,063.00 with LIVE360 — 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
ANTHEM ANTHEM MEDICARE ADVANTAGE HMO $255.12 ↓ -66%
HUMANA HUMANA MEDICARE ADVANTAGE $255.12 ↓ -66%
MOLINA HEALTHCARE MOLINA MEDICARE $255.12 ↓ -66%
UNITED HEALTHCARE UNITED HEALTH CARE MEDICARE $255.12 ↓ -66%
AETNA AETNA MEDICARE $255.12 ↓ -66%
SECURITY HEALTH PLAN MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI $257.67 ↓ -65%
UNITY HEALTH PLAN UNITY HOSPICE $313.60 ↓ -58%
HSHS EMPLOYEES HSHS EMPLOYEES $516.62 ↓ -30%
MOLINA HEALTHCARE OF WI ALL COMMERICAL MOLINA MARKETPLACE $531.50 ↓ -28%
NAPHCARE ALL COMMERICAL NAPHCARE $574.02 ↓ -23%
P360 SMALL GROUP PREVEA 360 SMALL GROUP COMMERCIAL PLAN $637.80 ↓ -14%
PREVEA HEALTH NETWORK PREVEA EMPLOYEES $637.80 ↓ -14%
PREVEA HEALTH NETWORK PREVEA360 $637.80 ↓ -14%
PREVEA HEALTH NETWORK PREVEA360 - NETWORK $637.80 ↓ -14%
MANAGED HEALTH SERVICES MANAGED HEALTH SERVICES MEDICAID $647.69 ↓ -13%
CONTINUUS MEDICAID MANAGED CONTINUUS MEDICAID MANAGED $647.69 ↓ -13%
COMMUNITY CARE FAMILY CARE COMMUNITY CARE FAMILY CARE MEDICAID MANAGED $647.69 ↓ -13%
ANTHEM ANTEHM MEDICAID $647.69 ↓ -13%
MERIDIAN HEALTH PLAN MERIDIAN HMO MCD $647.69 ↓ -13%
CIGNA ALL COMMERCIAL CIGNA $664.38 ↓ -11%
SECURITY HEALTH PLAN ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK $678.51 ↓ -9%
MOLINA HEALTHCARE MOLINA MEDICAID $686.55 ↓ -8%
TRIOLOGY TRILOGY MEDICAID $686.55 ↓ -8%
ANTHEM ANTHEM PPO $722.84 ↓ -3%
ANTHEM ANTHEM POS/HMO $722.84 ↓ -3%
UNITED HEALTHCARE UNITED HEALTHCARE $753.00 ↑ +1%
UNITED HEALTHCARE ALL COMMERCIAL UNITED HEALTHCARE $753.00 ↑ +1%
UNITED HEALTHCARE UHC ONEIDA NATION $753.00 ↑ +1%
TRIOLOGY ALL COMMERCIAL TRIOLOGY $839.77 ↑ +13%
WISCONSIN PHYSICIAN SERVICE WISCONSIN PHYSICIAN SERVICE $850.40 ↑ +15%
ARISE HEALTH PLAN ALL COMMERCIAL ARISE HEALTH PLAN $850.40 ↑ +15%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION PPP $871.66 ↑ +17%
WEA PROVIDER NETWORK WEA TRUST PPP/TRUST PREFERRED $871.66 ↑ +17%
HEALTH CARE ALLIANCE THE ALLIANCE $892.92 ↑ +20%
HUMANA ALL COMMERCIAL HUMANA HPN CHOICECARE $903.55 ↑ +22%
CHOICECARE ALL COMMERCIAL CHOICE CARE $903.55 ↑ +22%
HUMANA HUMANA NATIIONAL POS HMO $903.55 ↑ +22%
HUMANA HUMANA CHOICE CARE PPO $903.55 ↑ +22%
MULTIPLAN/PHCS ALL COMMERCIAL MULTIPLAN $946.07 ↑ +27%
HEALTH EOS ALL COMMERCIAL HEALTH EOS $946.07 ↑ +27%
COFINITY COFINITY $956.70 ↑ +29%
INTERPLAN ALL COMMERCIAL INTERPLAN HEALTH GROUP $956.70 ↑ +29%
NETWORK HEALTH PLAN ALL COMMERICAL NETWORK HEALTH PLAN $956.70 ↑ +29%
NORTH CENTRAL HEALTHCARE ALLIANCE NEHA $977.96 ↑ +32%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION $1,009.85 ↑ +36%
FIRST HEALTH ALL COMMERCIAL FIRST HEALTH NETWORK $1,009.85 ↑ +36%
HEALTHSMART ALL COMMERCIAL HEALTHSMART $1,063.00 ↑ +43%
CATERPILLAR, INC. UHC CATERPILLAR EMPLOYER GROUP $1,063.00 ↑ +43%
AETNA ALL COMMERCIAL AETNA $1,063.00 ↑ +43%
LIVE360 LIVE360 HSHS HEALTHY PLAN $1,063.00 ↑ +43%

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Bilateral n block inj trigeminal 64400 at other Wisconsin hospitals

Hospital City Cash price Negotiated range
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) Mequon $106.53 $77.30 – $632.19
UnityPoint Health - Meriter Hospital Madison $1,154.63 $41.17 – $450.30
SSM Health St. Clare Hospital - Baraboo Baraboo $593.45 $223.61 – $4,401.00
SSM Health St. Mary's Hospital - Janesville Janesville $530.20 $231.88 – $4,074.00
SSM Health St. Mary's Hospital - Madison Madison $586.30 $223.61 – $4,198.00
SSM Health Monroe Hospital Monroe $212.85 $298.15 – $4,217.00
SSM Health Ripon Community Hospital Ripon $834.90 $1,887.00 – $2,654.00
SSM Health St. Agnes Hospital - Fond du Lac Fond Du Lac $834.90 $227.71 – $2,334.00

All Wisconsin hospitals for this procedure →