_afb id by dna probe rflx ast at Aurora Medical Center Sheboygan County
3400 Union Ave, Sheboygan, WI · Aurorahealthcare · · NPI 1922053107
$80.00
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.
$160.00
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.
$16.04 with United Healthcare vs $136.00 with Anthem — 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 |
|---|---|---|---|
| United Healthcare | HMO | $16.04 | ↓ -80% |
| United Healthcare | Nexus | $16.04 | ↓ -80% |
| United Healthcare | Exchange | $16.04 | ↓ -80% |
| United Healthcare | Charter | $16.04 | ↓ -80% |
| Anthem | Blue Priority | $20.05 | ↓ -75% |
| Aurora Caregiver | Commercial | $20.05 | ↓ -75% |
| Anthem | Blue Preferred | $24.06 | ↓ -70% |
| Common Ground | Employee Trust Fund | $42.11 | ↓ -47% |
| Common Ground | Exchange | $42.11 | ↓ -47% |
| Centivo | Commercial | $43.83 | ↓ -45% |
| Common Ground | Envision | $43.83 | ↓ -45% |
| Aetna | HMO | $44.71 | ↓ -44% |
| Quartz One | Commercial | $50.13 | ↓ -37% |
| Health Payment Systems | Commercial | $50.13 | ↓ -37% |
| HealthPartners | Employee Trust Fund | $53.18 | ↓ -34% |
| Molina Exchange | Commercial | $55.34 | ↓ -31% |
| HS Technology | Commercial | $56.42 | ↓ -29% |
| Quartz Group | Commercial | $58.15 | ↓ -27% |
| Cigna | PPO-GPPO | $58.29 | ↓ -27% |
| Everpointe Elite | Commercial | $59.17 | ↓ -26% |
| Wisconsin Physician Service | Aurora Featured | $64.96 | ↓ -19% |
| HealthPartners | Robin | $68.06 | ↓ -15% |
| Wisconsin Physician Service | Statewide | $68.37 | ↓ -15% |
| Wisconsin Physician Service | Arise | $68.37 | ↓ -15% |
| Trilogy | Commercial | $70.37 | ↓ -12% |
| Health EOS Plus | Commercial | $96.00 | ↑ +20% |
| HealthPartners | Broad | $120.00 | ↑ +50% |
| Health EOS | PPO | $128.00 | ↑ +60% |
| Aetna | PPO | $132.16 | ↑ +65% |
| United Healthcare | PPO | $134.72 | ↑ +68% |
| Cigna | PPO | $135.36 | ↑ +69% |
| Anthem | PPO | $136.00 | ↑ +70% |
Visitor-reported prices
Comments
_afb id by dna probe rflx ast 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 | $130.91 | $20.05 – $87.10 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | $130.91 | $20.05 – $87.10 |
| UnityPoint Health - Meriter Hospital | Madison | $87.78 | $12.03 – $36.63 |
| SSM Health Ripon Community Hospital | Ripon | $96.80 | $20.05 – $40.58 |
| SSM Health St. Agnes Hospital - Fond du Lac | Fond Du Lac | $96.80 | $15.04 – $38.70 |
| SSM Health Waupun Memorial Hospital | Waupun | $96.80 | $20.05 – $40.58 |
| Aurora Sinai Medical Center of Aurora Health Care Metro | Milwaukee | $80.00 | $16.04 – $70.37 |
| Aurora Medical Center Summit | Summit | $80.00 | $16.04 – $70.37 |