Tc-99m tilmanocept diag at Aurora Medical Center Sheboygan County
3400 Union Ave, Sheboygan, WI · Aurorahealthcare · · NPI 1922053107
$800.00
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.
$1,600.00
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.
$635.11 with Aetna vs $1,357.42 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 |
|---|---|---|---|
| Aetna | HMO | $635.11 | ↓ -21% |
| Anthem | Blue Priority | $661.57 | ↓ -17% |
| Anthem | Blue Preferred | $793.88 | ↓ -1% |
| HS Technology | Commercial | $798.48 | ↓ -0% |
| Everpointe Elite | Commercial | $798.48 | ↓ -0% |
| Quartz One | Commercial | $878.33 | ↑ +10% |
| United Healthcare | HMO | $948.59 | ↑ +19% |
| United Healthcare | Nexus | $948.59 | ↑ +19% |
| United Healthcare | Exchange | $948.59 | ↑ +19% |
| United Healthcare | Charter | $948.59 | ↑ +19% |
| Common Ground | Employee Trust Fund | $958.18 | ↑ +20% |
| Aurora Caregiver | Commercial | $958.18 | ↑ +20% |
| Common Ground | Exchange | $958.18 | ↑ +20% |
| Common Ground | Envision | $958.18 | ↑ +20% |
| Health EOS Plus | Commercial | $958.18 | ↑ +20% |
| HealthPartners | Employee Trust Fund | $958.18 | ↑ +20% |
| Molina Exchange | Commercial | $958.18 | ↑ +20% |
| Quartz Group | Commercial | $958.18 | ↑ +20% |
| Wisconsin Physician Service | Aurora Featured | $990.12 | ↑ +24% |
| Cigna | PPO-GPPO | $1,012.22 | ↑ +27% |
| Health Payment Systems | Commercial | $1,038.02 | ↑ +30% |
| Wisconsin Physician Service | Statewide | $1,038.02 | ↑ +30% |
| Wisconsin Physician Service | Arise | $1,038.02 | ↑ +30% |
| Trilogy | Commercial | $1,117.87 | ↑ +40% |
| HealthPartners | Robin | $1,197.72 | ↑ +50% |
| Centivo | Commercial | $1,197.72 | ↑ +50% |
| HealthPartners | Broad | $1,197.72 | ↑ +50% |
| Health EOS | PPO | $1,277.57 | ↑ +60% |
| Aetna | PPO | $1,319.09 | ↑ +65% |
| United Healthcare | PPO | $1,344.64 | ↑ +68% |
| Cigna | PPO | $1,351.03 | ↑ +69% |
| Anthem | PPO | $1,357.42 | ↑ +70% |
Visitor-reported prices
Comments
Tc-99m tilmanocept diag 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 | $519.93 | $958.39 – $980.46 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | $519.93 | $958.39 – $980.46 |
| SSM Health St. Clare Hospital - Baraboo | Baraboo | $238.15 | not published |
| SSM Health St. Mary's Hospital - Janesville | Janesville | $545.60 | not published |
| SSM Health St. Mary's Hospital - Madison | Madison | $545.60 | not published |
| SSM Health Ripon Community Hospital | Ripon | $306.90 | not published |
| SSM Health St. Agnes Hospital - Fond du Lac | Fond Du Lac | $306.90 | not published |
| SSM Health Waupun Memorial Hospital | Waupun | $306.90 | not published |