Buprenorphine and metabolite - sendout 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

$116.82

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.

Full explanation →

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

$177.00

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.

$18.33 with MANAGED HEALTH SERVICES vs $177.00 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 →

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
MANAGED HEALTH SERVICES MANAGED HEALTH SERVICES MEDICAID $18.33 ↓ -84%
ANTHEM ANTEHM MEDICAID $18.33 ↓ -84%
MERIDIAN HEALTH PLAN MERIDIAN HMO MCD $18.33 ↓ -84%
COMMUNITY CARE FAMILY CARE COMMUNITY CARE FAMILY CARE MEDICAID MANAGED $18.33 ↓ -84%
CONTINUUS MEDICAID MANAGED CONTINUUS MEDICAID MANAGED $18.33 ↓ -84%
MOLINA HEALTHCARE MOLINA MEDICAID $19.43 ↓ -83%
TRIOLOGY TRILOGY MEDICAID $19.43 ↓ -83%
ANTHEM ANTHEM MEDICARE ADVANTAGE HMO $42.48 ↓ -64%
AETNA AETNA MEDICARE $42.48 ↓ -64%
HUMANA HUMANA MEDICARE ADVANTAGE $42.48 ↓ -64%
MOLINA HEALTHCARE MOLINA MEDICARE $42.48 ↓ -64%
UNITED HEALTHCARE UNITED HEALTH CARE MEDICARE $42.48 ↓ -64%
SECURITY HEALTH PLAN MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI $42.90 ↓ -63%
HSHS EMPLOYEES HSHS EMPLOYEES $86.02 ↓ -26%
MOLINA HEALTHCARE OF WI ALL COMMERICAL MOLINA MARKETPLACE $88.50 ↓ -24%
NAPHCARE ALL COMMERICAL NAPHCARE $95.58 ↓ -18%
PREVEA HEALTH NETWORK PREVEA360 $106.20 ↓ -9%
P360 SMALL GROUP PREVEA 360 SMALL GROUP COMMERCIAL PLAN $106.20 ↓ -9%
PREVEA HEALTH NETWORK PREVEA EMPLOYEES $106.20 ↓ -9%
PREVEA HEALTH NETWORK PREVEA360 - NETWORK $106.20 ↓ -9%
CIGNA ALL COMMERCIAL CIGNA $110.63 ↓ -5%
SECURITY HEALTH PLAN ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK $112.98 ↓ -3%
ANTHEM ANTHEM PPO $120.36 ↑ +3%
ANTHEM ANTHEM POS/HMO $120.36 ↑ +3%
TRIOLOGY ALL COMMERCIAL TRIOLOGY $139.83 ↑ +20%
ARISE HEALTH PLAN ALL COMMERCIAL ARISE HEALTH PLAN $141.60 ↑ +21%
WISCONSIN PHYSICIAN SERVICE WISCONSIN PHYSICIAN SERVICE $141.60 ↑ +21%
WEA PROVIDER NETWORK WEA TRUST PPP/TRUST PREFERRED $145.14 ↑ +24%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION PPP $145.14 ↑ +24%
HEALTH CARE ALLIANCE THE ALLIANCE $148.68 ↑ +27%
HUMANA ALL COMMERCIAL HUMANA HPN CHOICECARE $150.45 ↑ +29%
HUMANA HUMANA NATIIONAL POS HMO $150.45 ↑ +29%
HUMANA HUMANA CHOICE CARE PPO $150.45 ↑ +29%
CHOICECARE ALL COMMERCIAL CHOICE CARE $150.45 ↑ +29%
MULTIPLAN/PHCS ALL COMMERCIAL MULTIPLAN $157.53 ↑ +35%
HEALTH EOS ALL COMMERCIAL HEALTH EOS $157.53 ↑ +35%
COFINITY COFINITY $159.30 ↑ +36%
NETWORK HEALTH PLAN ALL COMMERICAL NETWORK HEALTH PLAN $159.30 ↑ +36%
INTERPLAN ALL COMMERCIAL INTERPLAN HEALTH GROUP $159.30 ↑ +36%
NORTH CENTRAL HEALTHCARE ALLIANCE NEHA $162.84 ↑ +39%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION $168.15 ↑ +44%
FIRST HEALTH ALL COMMERCIAL FIRST HEALTH NETWORK $168.15 ↑ +44%
CATERPILLAR, INC. UHC CATERPILLAR EMPLOYER GROUP $177.00 ↑ +52%
HEALTHSMART ALL COMMERCIAL HEALTHSMART $177.00 ↑ +52%
LIVE360 LIVE360 HSHS HEALTHY PLAN $177.00 ↑ +52%
AETNA ALL COMMERCIAL AETNA $177.00 ↑ +52%

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