Theophylline therapeutic drug level 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

$96.36

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.

$146.00

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.

$14.14 with UNITY HEALTH PLAN vs $105.00 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 $14.14 ↓ -85%
COMMUNITY CARE FAMILY CARE COMMUNITY CARE FAMILY CARE MEDICAID MANAGED $14.61 ↓ -85%
ANTHEM ANTEHM MEDICAID $14.61 ↓ -85%
CONTINUUS MEDICAID MANAGED CONTINUUS MEDICAID MANAGED $14.61 ↓ -85%
MERIDIAN HEALTH PLAN MERIDIAN HMO MCD $14.61 ↓ -85%
MANAGED HEALTH SERVICES MANAGED HEALTH SERVICES MEDICAID $14.61 ↓ -85%
MOLINA HEALTHCARE MOLINA MEDICAID $15.49 ↓ -84%
TRIOLOGY TRILOGY MEDICAID $15.49 ↓ -84%
UNITED HEALTHCARE ALL COMMERCIAL UNITED HEALTHCARE $16.97 ↓ -82%
UNITED HEALTHCARE UHC ONEIDA NATION $16.97 ↓ -82%
UNITED HEALTHCARE UNITED HEALTHCARE $16.97 ↓ -82%
PREVEA HEALTH NETWORK PREVEA360 - NETWORK $18.38 ↓ -81%
PREVEA HEALTH NETWORK PREVEA360 $18.38 ↓ -81%
PREVEA HEALTH NETWORK PREVEA EMPLOYEES $18.38 ↓ -81%
P360 SMALL GROUP PREVEA 360 SMALL GROUP COMMERCIAL PLAN $18.38 ↓ -81%
UNITED HEALTHCARE UNITED HEALTH CARE MEDICARE $25.20 ↓ -74%
MOLINA HEALTHCARE MOLINA MEDICARE $25.20 ↓ -74%
AETNA AETNA MEDICARE $25.20 ↓ -74%
ANTHEM ANTHEM MEDICARE ADVANTAGE HMO $25.20 ↓ -74%
HUMANA HUMANA MEDICARE ADVANTAGE $25.20 ↓ -74%
SECURITY HEALTH PLAN MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI $25.45 ↓ -74%
ANTHEM ANTHEM PPO $49.49 ↓ -49%
ANTHEM ANTHEM POS/HMO $49.49 ↓ -49%
HSHS EMPLOYEES HSHS EMPLOYEES $51.03 ↓ -47%
MOLINA HEALTHCARE OF WI ALL COMMERICAL MOLINA MARKETPLACE $52.50 ↓ -46%
NAPHCARE ALL COMMERICAL NAPHCARE $56.70 ↓ -41%
CIGNA ALL COMMERCIAL CIGNA $65.63 ↓ -32%
SECURITY HEALTH PLAN ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK $67.02 ↓ -30%
TRIOLOGY ALL COMMERCIAL TRIOLOGY $82.95 ↓ -14%
WISCONSIN PHYSICIAN SERVICE WISCONSIN PHYSICIAN SERVICE $84.00 ↓ -13%
ARISE HEALTH PLAN ALL COMMERCIAL ARISE HEALTH PLAN $84.00 ↓ -13%
WEA PROVIDER NETWORK WEA TRUST PPP/TRUST PREFERRED $86.10 ↓ -11%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION PPP $86.10 ↓ -11%
HEALTH CARE ALLIANCE THE ALLIANCE $88.20 ↓ -8%
HUMANA HUMANA NATIIONAL POS HMO $89.25 ↓ -7%
CHOICECARE ALL COMMERCIAL CHOICE CARE $89.25 ↓ -7%
HUMANA ALL COMMERCIAL HUMANA HPN CHOICECARE $89.25 ↓ -7%
HUMANA HUMANA CHOICE CARE PPO $89.25 ↓ -7%
HEALTH EOS ALL COMMERCIAL HEALTH EOS $93.45 ↓ -3%
MULTIPLAN/PHCS ALL COMMERCIAL MULTIPLAN $93.45 ↓ -3%
NETWORK HEALTH PLAN ALL COMMERICAL NETWORK HEALTH PLAN $94.50 ↓ -2%
COFINITY COFINITY $94.50 ↓ -2%
INTERPLAN ALL COMMERCIAL INTERPLAN HEALTH GROUP $94.50 ↓ -2%
NORTH CENTRAL HEALTHCARE ALLIANCE NEHA $96.60 ↑ +0%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION $99.75 ↑ +4%
FIRST HEALTH ALL COMMERCIAL FIRST HEALTH NETWORK $99.75 ↑ +4%
HEALTHSMART ALL COMMERCIAL HEALTHSMART $105.00 ↑ +9%
AETNA ALL COMMERCIAL AETNA $105.00 ↑ +9%
LIVE360 LIVE360 HSHS HEALTHY PLAN $105.00 ↑ +9%
CATERPILLAR, INC. UHC CATERPILLAR EMPLOYER GROUP $105.00 ↑ +9%

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Theophylline therapeutic drug level 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 $91.69 $14.14 – $61.91
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) Mequon $91.69 $14.14 – $61.91
UnityPoint Health - Meriter Hospital Madison $120.00 $8.48 – $18.24
Orthopaedic Hospital of Wisconsin, LLC Glendale $98.58 $13.72 – $25.34
SSM Health St. Clare Hospital - Baraboo Baraboo $226.60 $10.60 – $140.62
SSM Health St. Mary's Hospital - Janesville Janesville $190.85 $10.60 – $112.50
SSM Health St. Mary's Hospital - Madison Madison $195.25 $10.60 – $115.06
SSM Health Monroe Hospital Monroe $149.60 $14.14 – $24.75

All Wisconsin hospitals for this procedure →