Destruction benign lesions < 14 lesions at HSHS St. Clare Memorial Hospital
855 S MAIN STREET, OCONTO FALLS, WI · Hshs · · NPI 1851477913
$229.68
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.
$348.00
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.
$68.16 with ANTHEM vs $297.00 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 →
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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 |
|---|---|---|---|
| ANTHEM | ANTHEM MEDICARE ADVANTAGE HMO | $68.16 | ↓ -70% |
| UNITED HEALTHCARE | UNITED HEALTH CARE MEDICARE | $68.16 | ↓ -70% |
| MOLINA HEALTHCARE | MOLINA MEDICARE | $68.16 | ↓ -70% |
| AETNA | AETNA MEDICARE | $68.16 | ↓ -70% |
| HUMANA | HUMANA MEDICARE ADVANTAGE | $68.16 | ↓ -70% |
| SECURITY HEALTH PLAN | MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI | $68.84 | ↓ -70% |
| UNITED HEALTHCARE | ALL COMMERCIAL UNITED HEALTHCARE | $95.40 | ↓ -58% |
| UNITED HEALTHCARE | UHC ONEIDA NATION | $95.40 | ↓ -58% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $95.40 | ↓ -58% |
| HSHS EMPLOYEES | HSHS EMPLOYEES | $144.34 | ↓ -37% |
| MOLINA HEALTHCARE OF WI | ALL COMMERICAL MOLINA MARKETPLACE | $148.50 | ↓ -35% |
| NAPHCARE | ALL COMMERICAL NAPHCARE | $153.36 | ↓ -33% |
| ANTHEM | ANTHEM POS/HMO | $154.00 | ↓ -33% |
| ANTHEM | ANTHEM PPO | $154.00 | ↓ -33% |
| PREVEA HEALTH NETWORK | PREVEA360 | $178.20 | ↓ -22% |
| PREVEA HEALTH NETWORK | PREVEA360 - NETWORK | $178.20 | ↓ -22% |
| PREVEA HEALTH NETWORK | PREVEA EMPLOYEES | $178.20 | ↓ -22% |
| P360 SMALL GROUP | PREVEA 360 SMALL GROUP COMMERCIAL PLAN | $178.20 | ↓ -22% |
| CIGNA | ALL COMMERCIAL CIGNA | $185.63 | ↓ -19% |
| SECURITY HEALTH PLAN | ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK | $189.58 | ↓ -17% |
| UNITY HEALTH PLAN | UNITY HOSPICE | $204.98 | ↓ -11% |
| TRIOLOGY | ALL COMMERCIAL TRIOLOGY | $234.63 | ↑ +2% |
| ARISE HEALTH PLAN | ALL COMMERCIAL ARISE HEALTH PLAN | $237.60 | ↑ +3% |
| WISCONSIN PHYSICIAN SERVICE | WISCONSIN PHYSICIAN SERVICE | $237.60 | ↑ +3% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION PPP | $243.54 | ↑ +6% |
| WEA PROVIDER NETWORK | WEA TRUST PPP/TRUST PREFERRED | $243.54 | ↑ +6% |
| HEALTH CARE ALLIANCE | THE ALLIANCE | $249.48 | ↑ +9% |
| HUMANA | HUMANA CHOICE CARE PPO | $252.45 | ↑ +10% |
| HUMANA | ALL COMMERCIAL HUMANA HPN CHOICECARE | $252.45 | ↑ +10% |
| HUMANA | HUMANA NATIIONAL POS HMO | $252.45 | ↑ +10% |
| CHOICECARE | ALL COMMERCIAL CHOICE CARE | $252.45 | ↑ +10% |
| MULTIPLAN/PHCS | ALL COMMERCIAL MULTIPLAN | $264.33 | ↑ +15% |
| HEALTH EOS | ALL COMMERCIAL HEALTH EOS | $264.33 | ↑ +15% |
| COFINITY | COFINITY | $267.30 | ↑ +16% |
| NETWORK HEALTH PLAN | ALL COMMERICAL NETWORK HEALTH PLAN | $267.30 | ↑ +16% |
| INTERPLAN | ALL COMMERCIAL INTERPLAN HEALTH GROUP | $267.30 | ↑ +16% |
| MERIDIAN HEALTH PLAN | MERIDIAN HMO MCD | $268.03 | ↑ +17% |
| COMMUNITY CARE FAMILY CARE | COMMUNITY CARE FAMILY CARE MEDICAID MANAGED | $268.03 | ↑ +17% |
| CONTINUUS MEDICAID MANAGED | CONTINUUS MEDICAID MANAGED | $268.03 | ↑ +17% |
| MANAGED HEALTH SERVICES | MANAGED HEALTH SERVICES MEDICAID | $268.03 | ↑ +17% |
| ANTHEM | ANTEHM MEDICAID | $268.03 | ↑ +17% |
| NORTH CENTRAL HEALTHCARE ALLIANCE | NEHA | $273.24 | ↑ +19% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION | $282.15 | ↑ +23% |
| FIRST HEALTH | ALL COMMERCIAL FIRST HEALTH NETWORK | $282.15 | ↑ +23% |
| MOLINA HEALTHCARE | MOLINA MEDICAID | $284.11 | ↑ +24% |
| TRIOLOGY | TRILOGY MEDICAID | $284.11 | ↑ +24% |
| HEALTHSMART | ALL COMMERCIAL HEALTHSMART | $297.00 | ↑ +29% |
| CATERPILLAR, INC. | UHC CATERPILLAR EMPLOYER GROUP | $297.00 | ↑ +29% |
| LIVE360 | LIVE360 HSHS HEALTHY PLAN | $297.00 | ↑ +29% |
| AETNA | ALL COMMERCIAL AETNA | $297.00 | ↑ +29% |
Visitor-reported prices
Comments
Destruction benign lesions < 14 lesions 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 | $90.63 | $108.90 – $443.01 |
| UnityPoint Health - Meriter Hospital | Madison | $512.91 | $19.09 – $214.01 |
| SSM Health Monroe Hospital | Monroe | $130.90 | $194.88 – $4,217.00 |
| SSM Health Ripon Community Hospital | Ripon | $406.45 | $1,887.00 – $2,654.00 |
| SSM Health St. Agnes Hospital - Fond du Lac | Fond Du Lac | $406.45 | $148.84 – $2,334.00 |
| SSM Health Waupun Memorial Hospital | Waupun | $406.45 | $1,887.00 – $2,654.00 |
| Ascension Calumet Hospital, Inc. | Chilton | $212.61 | $73.34 – $248.29 |
| HSHS St. Nicholas Hospital | SHEBOYGAN | $229.68 | $72.99 – $441.47 |