Ustekinumab 45 mg/0.5 ml subcutaneous solution at Aurora Medical Center Sheboygan County
3400 Union Ave, Sheboygan, WI · Aurorahealthcare · · NPI 1922053107
not published by hospital
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.
not published by hospital
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.
$155.88 with United Healthcare vs $388.69 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 | Nexus | $155.88 | — |
| United Healthcare | Exchange | $155.88 | — |
| United Healthcare | HMO | $155.88 | — |
| United Healthcare | Charter | $155.88 | — |
| Aurora Caregiver | Commercial | $159.91 | — |
| Aetna | HMO | $160.56 | — |
| HealthPartners | Employee Trust Fund | $181.90 | — |
| HealthPartners | Robin | $190.26 | — |
| Common Ground | Envision | $204.36 | — |
| Centivo | Commercial | $204.36 | — |
| Health Payment Systems | Commercial | $210.44 | — |
| Quartz One | Commercial | $210.44 | — |
| Common Ground | Employee Trust Fund | $219.08 | — |
| Common Ground | Exchange | $219.08 | — |
| Cigna | PPO-GPPO | $233.82 | — |
| Quartz Group | Commercial | $241.62 | — |
| Everpointe Elite | Commercial | $294.09 | — |
| Anthem | Blue Priority | $323.91 | — |
| Molina Exchange | Commercial | $380.35 | — |
| Anthem | Blue Preferred | $388.69 | — |
Visitor-reported prices
Comments
Ustekinumab 45 mg/0.5 ml subcutaneous solution at other Wisconsin hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health St. Clare Hospital - Baraboo | Baraboo | not published | $288.38 – $288.38 |
| SSM Health St. Mary's Hospital - Janesville | Janesville | not published | $288.38 – $288.38 |
| SSM Health St. Mary's Hospital - Madison | Madison | not published | $229.33 – $288.38 |
| SSM Health Monroe Hospital | Monroe | not published | $202.65 – $1,057.16 |
| SSM Health Ripon Community Hospital | Ripon | not published | $168.78 – $424.38 |
| SSM Health St. Agnes Hospital - Fond du Lac | Fond Du Lac | not published | $168.78 – $424.38 |
| SSM Health Waupun Memorial Hospital | Waupun | not published | $168.78 – $424.38 |
| Aurora Sinai Medical Center of Aurora Health Care Metro | Milwaukee | not published | $155.88 – $380.35 |