Allograft graftjacket 2x12cm-q4107-cost per sq cm at HSHS St. Nicholas Hospital

3100 SUPERIOR AVE, SHEBOYGAN, WI · Hshs · · NPI 1730184342

Source: hospital's published price file ↗ · Published Mar 24, 2026 · Ingested Sep 16, 2026

$269.28

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.

$408.00

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.

$118.07 with HUMANA vs $408.00 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
HUMANA HUMANA NATIIONAL POS HMO $118.07 ↓ -56%
HUMANA HUMANA CHOICE CARE HMO $118.07 ↓ -56%
HUMANA ALL COMMERCIAL HUMANA HPN CHOICECARE $118.07 ↓ -56%
UNITED HEALTHCARE UNITED HEALTH CARE MEDICARE $121.70 ↓ -55%
AETNA AETNA MEDICARE $121.70 ↓ -55%
ANTHEM ANTHEM MEDICARE ADVANTAGE HMO $121.70 ↓ -55%
MEDICA MEDICA MEDICARE ADVANTAGE $121.70 ↓ -55%
HUMANA HUMANA MEDICARE ADVANTAGE $121.70 ↓ -55%
MOLINA HEALTHCARE MOLINA MEDICARE $121.70 ↓ -55%
MEDICARE MANAGED MANAGED MEDICARE NO SEQUESTRATION $121.70 ↓ -55%
SECURITY HEALTH PLAN MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI $122.92 ↓ -54%
PREVEA HEALTH NETWORK PREVEA360 $152.78 ↓ -43%
ANTHEM ANTHEM POS/HMO $157.41 ↓ -42%
P360 SMALL GROUP PREVEA 360 SMALL GROUP COMMERCIAL PLAN $165.74 ↓ -38%
PREVEA HEALTH NETWORK PREVEA360 - NETWORK $165.74 ↓ -38%
PREVEA HEALTH NETWORK PREVEA EMPLOYEES $165.74 ↓ -38%
ANTHEM ANTHEM PPO $194.45 ↓ -28%
HSHS EMPLOYEES HSHS EMPLOYEES $198.29 ↓ -26%
MOLINA HEALTHCARE OF WI ALL COMMERICAL MOLINA MARKETPLACE $204.00 ↓ -24%
UNITED HEALTHCARE UNITED HEALTHCARE $209.78 ↓ -22%
UNITED HEALTHCARE UHC ONEIDA NATION $209.78 ↓ -22%
UNITED HEALTHCARE ALL COMMERCIAL UNITED HEALTHCARE $209.78 ↓ -22%
ARISE HEALTH PLAN ALL COMMERCIAL ARISE HEALTH PLAN $244.80 ↓ -9%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION PPP $252.96 ↓ -6%
SECURITY HEALTH PLAN ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK $260.43 ↓ -3%
NAPHCARE ALL COMMERICAL NAPHCARE $273.83 ↑ +2%
CIGNA ALL COMMERCIAL CIGNA $285.60 ↑ +6%
INTERPLAN ALL COMMERCIAL INTERPLAN HEALTH GROUP $285.60 ↑ +6%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION $293.76 ↑ +9%
WEA PROVIDER NETWORK WEA TRUST PPP/TRUST PREFERRED $293.76 ↑ +9%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION TRUST SELECT $293.76 ↑ +9%
HEALTH EOS ALL COMMERCIAL HEALTH EOS $306.00 ↑ +14%
HEALTHSMART ALL COMMERCIAL HEALTHSMART $306.00 ↑ +14%
NETWORK HEALTH PLAN ALL COMMERICAL NETWORK HEALTH PLAN $306.00 ↑ +14%
TRIOLOGY ALL COMMERCIAL TRIOLOGY $322.32 ↑ +20%
WISCONSIN PHYSICIAN SERVICE WISCONSIN PHYSICIAN SERVICE $326.40 ↑ +21%
MULTIPLAN/PHCS ALL COMMERCIAL MULTIPLAN $342.72 ↑ +27%
HEALTH CARE ALLIANCE THE ALLIANCE $342.72 ↑ +27%
HUMANA HUMANA CHOICE CARE PPO $346.80 ↑ +29%
CHOICECARE ALL COMMERCIAL CHOICE CARE $346.80 ↑ +29%
NORTH CENTRAL HEALTHCARE ALLIANCE NEHA $375.36 ↑ +39%
FIRST HEALTH ALL COMMERCIAL FIRST HEALTH NETWORK $387.60 ↑ +44%
AETNA ALL COMMERCIAL AETNA $408.00 ↑ +52%
COFINITY COFINITY $408.00 ↑ +52%
CATERPILLAR, INC. UHC CATERPILLAR EMPLOYER GROUP $408.00 ↑ +52%
LIVE360 LIVE360 HSHS HEALTHY PLAN $408.00 ↑ +52%

Visitor-reported prices

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Allograft graftjacket 2x12cm-q4107-cost per sq cm at other Wisconsin hospitals

Hospital City Cash price Negotiated range
UnityPoint Health - Meriter Hospital Madison $1,305.31 $112.95 – $1,386.89
HSHS St. Vincent Hospital Green Bay $269.28 $118.07 – $271.97
SSM Health Monroe Hospital Monroe not published $120.88 – $371.55
SSM Health Ripon Community Hospital Ripon not published $371.55 – $371.55
SSM Health St. Agnes Hospital - Fond du Lac Fond Du Lac not published $92.32 – $371.55
SSM Health Waupun Memorial Hospital Waupun not published $371.55 – $371.55
Aurora Baycare Medical Center Green Bay not published $80.90 – $137.59
Aurora Medical Center Manitowoc Two Rivers not published $80.90 – $137.59

All Wisconsin hospitals for this procedure →