#flow interp 9 - 15 markers at HSHS St. Clare Memorial Hospital
855 S MAIN STREET, OCONTO FALLS, WI · Hshs · · NPI 1851477913
$263.34
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.
?
What you pay up front if you don't use insurance.
$399.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$43.20 with MERIDIAN HEALTH PLAN vs $399.00 with CATERPILLAR, INC. — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| MERIDIAN HEALTH PLAN | MERIDIAN HMO MCD | $43.20 | ↓ -84% |
| MANAGED HEALTH SERVICES | MANAGED HEALTH SERVICES MEDICAID | $43.20 | ↓ -84% |
| ANTHEM | ANTEHM MEDICAID | $43.20 | ↓ -84% |
| CONTINUUS MEDICAID MANAGED | CONTINUUS MEDICAID MANAGED | $43.20 | ↓ -84% |
| COMMUNITY CARE FAMILY CARE | COMMUNITY CARE FAMILY CARE MEDICAID MANAGED | $43.20 | ↓ -84% |
| MOLINA HEALTHCARE | MOLINA MEDICAID | $45.79 | ↓ -83% |
| TRIOLOGY | TRILOGY MEDICAID | $45.79 | ↓ -83% |
| UNITED HEALTHCARE | ALL COMMERCIAL UNITED HEALTHCARE | $74.00 | ↓ -72% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $74.00 | ↓ -72% |
| UNITED HEALTHCARE | UHC ONEIDA NATION | $74.00 | ↓ -72% |
| ANTHEM | ANTHEM MEDICARE ADVANTAGE HMO | $95.76 | ↓ -64% |
| AETNA | AETNA MEDICARE | $95.76 | ↓ -64% |
| HUMANA | HUMANA MEDICARE ADVANTAGE | $95.76 | ↓ -64% |
| UNITED HEALTHCARE | UNITED HEALTH CARE MEDICARE | $95.76 | ↓ -64% |
| MOLINA HEALTHCARE | MOLINA MEDICARE | $95.76 | ↓ -64% |
| SECURITY HEALTH PLAN | MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI | $96.72 | ↓ -63% |
| HSHS EMPLOYEES | HSHS EMPLOYEES | $193.91 | ↓ -26% |
| MOLINA HEALTHCARE OF WI | ALL COMMERICAL MOLINA MARKETPLACE | $199.50 | ↓ -24% |
| ANTHEM | ANTHEM PPO | $209.83 | ↓ -20% |
| ANTHEM | ANTHEM POS/HMO | $209.83 | ↓ -20% |
| NAPHCARE | ALL COMMERICAL NAPHCARE | $215.46 | ↓ -18% |
| PREVEA HEALTH NETWORK | PREVEA360 - NETWORK | $239.40 | ↓ -9% |
| P360 SMALL GROUP | PREVEA 360 SMALL GROUP COMMERCIAL PLAN | $239.40 | ↓ -9% |
| PREVEA HEALTH NETWORK | PREVEA EMPLOYEES | $239.40 | ↓ -9% |
| PREVEA HEALTH NETWORK | PREVEA360 | $239.40 | ↓ -9% |
| CIGNA | ALL COMMERCIAL CIGNA | $249.38 | ↓ -5% |
| SECURITY HEALTH PLAN | ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK | $254.68 | ↓ -3% |
| TRIOLOGY | ALL COMMERCIAL TRIOLOGY | $315.21 | ↑ +20% |
| ARISE HEALTH PLAN | ALL COMMERCIAL ARISE HEALTH PLAN | $319.20 | ↑ +21% |
| WISCONSIN PHYSICIAN SERVICE | WISCONSIN PHYSICIAN SERVICE | $319.20 | ↑ +21% |
| WEA PROVIDER NETWORK | WEA TRUST PPP/TRUST PREFERRED | $327.18 | ↑ +24% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION PPP | $327.18 | ↑ +24% |
| HEALTH CARE ALLIANCE | THE ALLIANCE | $335.16 | ↑ +27% |
| CHOICECARE | ALL COMMERCIAL CHOICE CARE | $339.15 | ↑ +29% |
| HUMANA | HUMANA NATIIONAL POS HMO | $339.15 | ↑ +29% |
| HUMANA | ALL COMMERCIAL HUMANA HPN CHOICECARE | $339.15 | ↑ +29% |
| HUMANA | HUMANA CHOICE CARE PPO | $339.15 | ↑ +29% |
| HEALTH EOS | ALL COMMERCIAL HEALTH EOS | $355.11 | ↑ +35% |
| MULTIPLAN/PHCS | ALL COMMERCIAL MULTIPLAN | $355.11 | ↑ +35% |
| NETWORK HEALTH PLAN | ALL COMMERICAL NETWORK HEALTH PLAN | $359.10 | ↑ +36% |
| COFINITY | COFINITY | $359.10 | ↑ +36% |
| INTERPLAN | ALL COMMERCIAL INTERPLAN HEALTH GROUP | $359.10 | ↑ +36% |
| NORTH CENTRAL HEALTHCARE ALLIANCE | NEHA | $367.08 | ↑ +39% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION | $379.05 | ↑ +44% |
| FIRST HEALTH | ALL COMMERCIAL FIRST HEALTH NETWORK | $379.05 | ↑ +44% |
| AETNA | ALL COMMERCIAL AETNA | $399.00 | ↑ +52% |
| HEALTHSMART | ALL COMMERCIAL HEALTHSMART | $399.00 | ↑ +52% |
| LIVE360 | LIVE360 HSHS HEALTHY PLAN | $399.00 | ↑ +52% |
| CATERPILLAR, INC. | UHC CATERPILLAR EMPLOYER GROUP | $399.00 | ↑ +52% |
Visitor-reported prices
Comments
#flow interp 9 - 15 markers at other Wisconsin hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Orthopaedic Hospital of Wisconsin, LLC | Glendale | $70.49 | $45.55 – $75.25 |
| Midwest Orthopedic Specialty Hospital | Franklin | $63.07 | $53.33 – $310.81 |
| Ascension St. Francis Hospital, Inc. | Milwaukee | $63.07 | $53.33 – $310.81 |
| Ascension SE Wisconsin Hospital - St. Joseph Campus | Milwaukee | $63.07 | $53.33 – $310.81 |
| HSHS St. Mary's Hospital Medical Center | GREEN BAY | $263.34 | $11.76 – $239.40 |
| HSHS St. Nicholas Hospital | SHEBOYGAN | $263.34 | $11.76 – $239.40 |
| HSHS St. Vincent Hospital | Green Bay | $263.34 | $12.20 – $239.40 |
| Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Milwaukee | not published | $53.33 – $301.80 |