CT Angiogram of the Chest (for blood clot) 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

$1,859.88

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.

$2,818.00

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.

$179.20 with UNITY HEALTH PLAN vs $2,818.00 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 →

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 $179.20 ↓ -90%
COMMUNITY CARE FAMILY CARE COMMUNITY CARE FAMILY CARE MEDICAID MANAGED $603.07 ↓ -68%
ANTHEM ANTEHM MEDICAID $603.07 ↓ -68%
MANAGED HEALTH SERVICES MANAGED HEALTH SERVICES MEDICAID $603.07 ↓ -68%
MERIDIAN HEALTH PLAN MERIDIAN HMO MCD $603.07 ↓ -68%
CONTINUUS MEDICAID MANAGED CONTINUUS MEDICAID MANAGED $603.07 ↓ -68%
MOLINA HEALTHCARE MOLINA MEDICAID $639.25 ↓ -66%
TRIOLOGY TRILOGY MEDICAID $639.25 ↓ -66%
AETNA AETNA MEDICARE $676.32 ↓ -64%
ANTHEM ANTHEM MEDICARE ADVANTAGE HMO $676.32 ↓ -64%
HUMANA HUMANA MEDICARE ADVANTAGE $676.32 ↓ -64%
MOLINA HEALTHCARE MOLINA MEDICARE $676.32 ↓ -64%
UNITED HEALTHCARE UNITED HEALTH CARE MEDICARE $676.32 ↓ -64%
SECURITY HEALTH PLAN MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI $683.08 ↓ -63%
PREVEA HEALTH NETWORK PREVEA360 $1,215.09 ↓ -35%
PREVEA HEALTH NETWORK PREVEA EMPLOYEES $1,215.09 ↓ -35%
P360 SMALL GROUP PREVEA 360 SMALL GROUP COMMERCIAL PLAN $1,215.09 ↓ -35%
PREVEA HEALTH NETWORK PREVEA360 - NETWORK $1,215.09 ↓ -35%
ANTHEM ANTHEM POS/HMO $1,239.00 ↓ -33%
ANTHEM ANTHEM PPO $1,239.00 ↓ -33%
UNITED HEALTHCARE UNITED HEALTHCARE $1,247.60 ↓ -33%
UNITED HEALTHCARE ALL COMMERCIAL UNITED HEALTHCARE $1,247.60 ↓ -33%
UNITED HEALTHCARE UHC ONEIDA NATION $1,247.60 ↓ -33%
HSHS EMPLOYEES HSHS EMPLOYEES $1,369.55 ↓ -26%
MOLINA HEALTHCARE OF WI ALL COMMERICAL MOLINA MARKETPLACE $1,409.00 ↓ -24%
NAPHCARE ALL COMMERICAL NAPHCARE $1,521.72 ↓ -18%
CIGNA ALL COMMERCIAL CIGNA $1,761.25 ↓ -5%
SECURITY HEALTH PLAN ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK $1,798.73 ↓ -3%
TRIOLOGY ALL COMMERCIAL TRIOLOGY $2,226.22 ↑ +20%
WISCONSIN PHYSICIAN SERVICE WISCONSIN PHYSICIAN SERVICE $2,254.40 ↑ +21%
ARISE HEALTH PLAN ALL COMMERCIAL ARISE HEALTH PLAN $2,254.40 ↑ +21%
WEA PROVIDER NETWORK WEA TRUST PPP/TRUST PREFERRED $2,310.76 ↑ +24%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION PPP $2,310.76 ↑ +24%
HEALTH CARE ALLIANCE THE ALLIANCE $2,367.12 ↑ +27%
HUMANA HUMANA NATIIONAL POS HMO $2,395.30 ↑ +29%
CHOICECARE ALL COMMERCIAL CHOICE CARE $2,395.30 ↑ +29%
HUMANA ALL COMMERCIAL HUMANA HPN CHOICECARE $2,395.30 ↑ +29%
HUMANA HUMANA CHOICE CARE PPO $2,395.30 ↑ +29%
HEALTH EOS ALL COMMERCIAL HEALTH EOS $2,508.02 ↑ +35%
MULTIPLAN/PHCS ALL COMMERCIAL MULTIPLAN $2,508.02 ↑ +35%
NETWORK HEALTH PLAN ALL COMMERICAL NETWORK HEALTH PLAN $2,536.20 ↑ +36%
COFINITY COFINITY $2,536.20 ↑ +36%
INTERPLAN ALL COMMERCIAL INTERPLAN HEALTH GROUP $2,536.20 ↑ +36%
NORTH CENTRAL HEALTHCARE ALLIANCE NEHA $2,592.56 ↑ +39%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION $2,677.10 ↑ +44%
FIRST HEALTH ALL COMMERCIAL FIRST HEALTH NETWORK $2,677.10 ↑ +44%
HEALTHSMART ALL COMMERCIAL HEALTHSMART $2,818.00 ↑ +52%
AETNA ALL COMMERCIAL AETNA $2,818.00 ↑ +52%
LIVE360 LIVE360 HSHS HEALTHY PLAN $2,818.00 ↑ +52%
CATERPILLAR, INC. UHC CATERPILLAR EMPLOYER GROUP $2,818.00 ↑ +52%

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CT Angiogram of the Chest (for blood clot) 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 $1,692.29 $142.22 – $401.74
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) Mequon $2,079.72 $142.22 – $401.74
UnityPoint Health - Meriter Hospital Madison $5,539.32 $80.06 – $2,298.81
SSM Health St. Clare Hospital - Baraboo Baraboo $2,698.85 $127.78 – $2,242.50
SSM Health St. Mary's Hospital - Janesville Janesville $3,125.65 $132.50 – $1,609.32
SSM Health St. Mary's Hospital - Madison Madison $3,617.90 $127.78 – $1,688.48
SSM Health Monroe Hospital Monroe $1,955.80 $170.37 – $552.10
SSM Health Ripon Community Hospital Ripon $1,693.45 $690.54 – $690.54

All Wisconsin hospitals for this procedure →