Chromogenic substrate assay at HSHS St. Clare Memorial Hospital
855 S MAIN STREET, OCONTO FALLS, WI · Hshs · · NPI 1851477913
$444.84
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.
$674.00
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.
$11.89 with UNITY HEALTH PLAN vs $165.00 with CATERPILLAR, INC. — 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 |
|---|---|---|---|
| UNITY HEALTH PLAN | UNITY HOSPICE | $11.89 | ↓ -97% |
| COMMUNITY CARE FAMILY CARE | COMMUNITY CARE FAMILY CARE MEDICAID MANAGED | $12.29 | ↓ -97% |
| ANTHEM | ANTEHM MEDICAID | $12.29 | ↓ -97% |
| CONTINUUS MEDICAID MANAGED | CONTINUUS MEDICAID MANAGED | $12.29 | ↓ -97% |
| MERIDIAN HEALTH PLAN | MERIDIAN HMO MCD | $12.29 | ↓ -97% |
| MANAGED HEALTH SERVICES | MANAGED HEALTH SERVICES MEDICAID | $12.29 | ↓ -97% |
| MOLINA HEALTHCARE | MOLINA MEDICAID | $13.03 | ↓ -97% |
| TRIOLOGY | TRILOGY MEDICAID | $13.03 | ↓ -97% |
| UNITED HEALTHCARE | ALL COMMERCIAL UNITED HEALTHCARE | $14.27 | ↓ -97% |
| UNITED HEALTHCARE | UHC ONEIDA NATION | $14.27 | ↓ -97% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $14.27 | ↓ -97% |
| PREVEA HEALTH NETWORK | PREVEA360 - NETWORK | $15.46 | ↓ -97% |
| PREVEA HEALTH NETWORK | PREVEA360 | $15.46 | ↓ -97% |
| PREVEA HEALTH NETWORK | PREVEA EMPLOYEES | $15.46 | ↓ -97% |
| P360 SMALL GROUP | PREVEA 360 SMALL GROUP COMMERCIAL PLAN | $15.46 | ↓ -97% |
| UNITED HEALTHCARE | UNITED HEALTH CARE MEDICARE | $39.60 | ↓ -91% |
| MOLINA HEALTHCARE | MOLINA MEDICARE | $39.60 | ↓ -91% |
| AETNA | AETNA MEDICARE | $39.60 | ↓ -91% |
| ANTHEM | ANTHEM MEDICARE ADVANTAGE HMO | $39.60 | ↓ -91% |
| HUMANA | HUMANA MEDICARE ADVANTAGE | $39.60 | ↓ -91% |
| SECURITY HEALTH PLAN | MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI | $40.00 | ↓ -91% |
| ANTHEM | ANTHEM PPO | $41.62 | ↓ -91% |
| ANTHEM | ANTHEM POS/HMO | $41.62 | ↓ -91% |
| HSHS EMPLOYEES | HSHS EMPLOYEES | $80.19 | ↓ -82% |
| MOLINA HEALTHCARE OF WI | ALL COMMERICAL MOLINA MARKETPLACE | $82.50 | ↓ -81% |
| NAPHCARE | ALL COMMERICAL NAPHCARE | $89.10 | ↓ -80% |
| CIGNA | ALL COMMERCIAL CIGNA | $103.13 | ↓ -77% |
| SECURITY HEALTH PLAN | ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK | $105.32 | ↓ -76% |
| TRIOLOGY | ALL COMMERCIAL TRIOLOGY | $130.35 | ↓ -71% |
| WISCONSIN PHYSICIAN SERVICE | WISCONSIN PHYSICIAN SERVICE | $132.00 | ↓ -70% |
| ARISE HEALTH PLAN | ALL COMMERCIAL ARISE HEALTH PLAN | $132.00 | ↓ -70% |
| WEA PROVIDER NETWORK | WEA TRUST PPP/TRUST PREFERRED | $135.30 | ↓ -70% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION PPP | $135.30 | ↓ -70% |
| HEALTH CARE ALLIANCE | THE ALLIANCE | $138.60 | ↓ -69% |
| HUMANA | HUMANA NATIIONAL POS HMO | $140.25 | ↓ -68% |
| CHOICECARE | ALL COMMERCIAL CHOICE CARE | $140.25 | ↓ -68% |
| HUMANA | ALL COMMERCIAL HUMANA HPN CHOICECARE | $140.25 | ↓ -68% |
| HUMANA | HUMANA CHOICE CARE PPO | $140.25 | ↓ -68% |
| HEALTH EOS | ALL COMMERCIAL HEALTH EOS | $146.85 | ↓ -67% |
| MULTIPLAN/PHCS | ALL COMMERCIAL MULTIPLAN | $146.85 | ↓ -67% |
| NETWORK HEALTH PLAN | ALL COMMERICAL NETWORK HEALTH PLAN | $148.50 | ↓ -67% |
| COFINITY | COFINITY | $148.50 | ↓ -67% |
| INTERPLAN | ALL COMMERCIAL INTERPLAN HEALTH GROUP | $148.50 | ↓ -67% |
| NORTH CENTRAL HEALTHCARE ALLIANCE | NEHA | $151.80 | ↓ -66% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION | $156.75 | ↓ -65% |
| FIRST HEALTH | ALL COMMERCIAL FIRST HEALTH NETWORK | $156.75 | ↓ -65% |
| HEALTHSMART | ALL COMMERCIAL HEALTHSMART | $165.00 | ↓ -63% |
| AETNA | ALL COMMERCIAL AETNA | $165.00 | ↓ -63% |
| LIVE360 | LIVE360 HSHS HEALTHY PLAN | $165.00 | ↓ -63% |
| CATERPILLAR, INC. | UHC CATERPILLAR EMPLOYER GROUP | $165.00 | ↓ -63% |
Visitor-reported prices
Comments
Chromogenic substrate assay 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 | $40.81 | $11.89 – $51.59 |
| UnityPoint Health - Meriter Hospital | Madison | $119.20 | $7.13 – $48.60 |
| Aurora Sinai Medical Center of Aurora Health Care Metro | Milwaukee | $137.50 | $9.51 – $41.72 |
| Aurora Medical Center Summit | Summit | $137.50 | $9.51 – $41.72 |
| Aurora Baycare Medical Center | Green Bay | $137.50 | $9.51 – $41.72 |
| Aurora Medical Center Manitowoc | Two Rivers | $137.50 | $9.51 – $41.72 |
| Aurora West Allis Medical Center | West Allis | $137.50 | $9.51 – $41.72 |
| Aurora Medical Center Burlington | Burlington | $137.50 | $9.51 – $41.72 |