Ghs lac repair mouth.ant tong 2.5cm/less 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

$513.48

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.

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

$778.00

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.

$186.72 with ANTHEM vs $778.00 with LIVE360 — 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
ANTHEM ANTHEM MEDICARE ADVANTAGE HMO $186.72 ↓ -64%
UNITED HEALTHCARE UNITED HEALTH CARE MEDICARE $186.72 ↓ -64%
MOLINA HEALTHCARE MOLINA MEDICARE $186.72 ↓ -64%
AETNA AETNA MEDICARE $186.72 ↓ -64%
HUMANA HUMANA MEDICARE ADVANTAGE $186.72 ↓ -64%
SECURITY HEALTH PLAN MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI $188.59 ↓ -63%
ANTHEM ANTEHM MEDICAID $275.02 ↓ -46%
MANAGED HEALTH SERVICES MANAGED HEALTH SERVICES MEDICAID $275.02 ↓ -46%
MERIDIAN HEALTH PLAN MERIDIAN HMO MCD $275.02 ↓ -46%
CONTINUUS MEDICAID MANAGED CONTINUUS MEDICAID MANAGED $275.02 ↓ -46%
COMMUNITY CARE FAMILY CARE COMMUNITY CARE FAMILY CARE MEDICAID MANAGED $275.02 ↓ -46%
MOLINA HEALTHCARE MOLINA MEDICAID $291.52 ↓ -43%
TRIOLOGY TRILOGY MEDICAID $291.52 ↓ -43%
HSHS EMPLOYEES HSHS EMPLOYEES $378.11 ↓ -26%
MOLINA HEALTHCARE OF WI ALL COMMERICAL MOLINA MARKETPLACE $389.00 ↓ -24%
NAPHCARE ALL COMMERICAL NAPHCARE $420.12 ↓ -18%
UNITY HEALTH PLAN UNITY HOSPICE $456.40 ↓ -11%
P360 SMALL GROUP PREVEA 360 SMALL GROUP COMMERCIAL PLAN $466.80 ↓ -9%
PREVEA HEALTH NETWORK PREVEA360 $466.80 ↓ -9%
PREVEA HEALTH NETWORK PREVEA360 - NETWORK $466.80 ↓ -9%
PREVEA HEALTH NETWORK PREVEA EMPLOYEES $466.80 ↓ -9%
CIGNA ALL COMMERCIAL CIGNA $486.25 ↓ -5%
SECURITY HEALTH PLAN ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK $496.60 ↓ -3%
ANTHEM ANTHEM PPO $529.04 ↑ +3%
ANTHEM ANTHEM POS/HMO $529.04 ↑ +3%
TRIOLOGY ALL COMMERCIAL TRIOLOGY $614.62 ↑ +20%
ARISE HEALTH PLAN ALL COMMERCIAL ARISE HEALTH PLAN $622.40 ↑ +21%
WISCONSIN PHYSICIAN SERVICE WISCONSIN PHYSICIAN SERVICE $622.40 ↑ +21%
WEA PROVIDER NETWORK WEA TRUST PPP/TRUST PREFERRED $637.96 ↑ +24%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION PPP $637.96 ↑ +24%
HEALTH CARE ALLIANCE THE ALLIANCE $653.52 ↑ +27%
HUMANA ALL COMMERCIAL HUMANA HPN CHOICECARE $661.30 ↑ +29%
HUMANA HUMANA CHOICE CARE PPO $661.30 ↑ +29%
HUMANA HUMANA NATIIONAL POS HMO $661.30 ↑ +29%
CHOICECARE ALL COMMERCIAL CHOICE CARE $661.30 ↑ +29%
HEALTH EOS ALL COMMERCIAL HEALTH EOS $692.42 ↑ +35%
MULTIPLAN/PHCS ALL COMMERCIAL MULTIPLAN $692.42 ↑ +35%
INTERPLAN ALL COMMERCIAL INTERPLAN HEALTH GROUP $700.20 ↑ +36%
COFINITY COFINITY $700.20 ↑ +36%
NETWORK HEALTH PLAN ALL COMMERICAL NETWORK HEALTH PLAN $700.20 ↑ +36%
NORTH CENTRAL HEALTHCARE ALLIANCE NEHA $715.76 ↑ +39%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION $739.10 ↑ +44%
FIRST HEALTH ALL COMMERCIAL FIRST HEALTH NETWORK $739.10 ↑ +44%
UNITED HEALTHCARE ALL COMMERCIAL UNITED HEALTHCARE $753.00 ↑ +47%
UNITED HEALTHCARE UHC ONEIDA NATION $753.00 ↑ +47%
UNITED HEALTHCARE UNITED HEALTHCARE $753.00 ↑ +47%
CATERPILLAR, INC. UHC CATERPILLAR EMPLOYER GROUP $778.00 ↑ +52%
AETNA ALL COMMERCIAL AETNA $778.00 ↑ +52%
HEALTHSMART ALL COMMERCIAL HEALTHSMART $778.00 ↑ +52%
LIVE360 LIVE360 HSHS HEALTHY PLAN $778.00 ↑ +52%

Visitor-reported prices

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Ghs lac repair mouth.ant tong 2.5cm/less 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 $221.01 $244.39 – $1,102.86
UnityPoint Health - Meriter Hospital Madison $709.76 $72.22 – $466.60
SSM Health Monroe Hospital Monroe $654.50 $433.92 – $4,217.00
SSM Health Ripon Community Hospital Ripon $627.55 $1,887.00 – $2,654.00
SSM Health St. Agnes Hospital - Fond du Lac Fond Du Lac $627.55 $331.39 – $2,334.00
SSM Health Waupun Memorial Hospital Waupun $627.55 $1,887.00 – $2,654.00
Ascension Calumet Hospital, Inc. Chilton $305.52 $159.82 – $615.02
HSHS St. Mary's Hospital Medical Center GREEN BAY $513.48 $74.89 – $981.49

All Wisconsin hospitals for this procedure →