Apl(pml-rara) quant - sendout at HSHS St. Nicholas Hospital
3100 SUPERIOR AVE, SHEBOYGAN, WI · Hshs · · NPI 1730184342
$861.96
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.
$1,306.00
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.
$207.31 with MEDICARE MANAGED vs $766.00 with COFINITY — 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 |
|---|---|---|---|
| MEDICARE MANAGED | MANAGED MEDICARE NO SEQUESTRATION | $207.31 | ↓ -76% |
| MEDICA | MEDICA MEDICARE ADVANTAGE | $207.31 | ↓ -76% |
| UNITED HEALTHCARE | UNITED HEALTH CARE MEDICARE | $207.31 | ↓ -76% |
| MOLINA HEALTHCARE | MOLINA MEDICARE | $207.31 | ↓ -76% |
| HUMANA | HUMANA MEDICARE ADVANTAGE | $207.31 | ↓ -76% |
| AETNA | AETNA MEDICARE | $207.31 | ↓ -76% |
| ANTHEM | ANTHEM MEDICARE ADVANTAGE HMO | $207.31 | ↓ -76% |
| SECURITY HEALTH PLAN | MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI | $209.38 | ↓ -76% |
| ANTHEM | ANTEHM MEDICAID | $214.21 | ↓ -75% |
| MERIDIAN HEALTH PLAN | MERIDIAN HMO MCD | $214.21 | ↓ -75% |
| MANAGED HEALTH SERVICES | MANAGED HEALTH SERVICES MEDICAID | $214.21 | ↓ -75% |
| CONTINUUS MEDICAID MANAGED | CONTINUUS MEDICAID MANAGED | $214.21 | ↓ -75% |
| COMMUNITY CARE FAMILY CARE | COMMUNITY CARE FAMILY CARE MEDICAID MANAGED | $214.21 | ↓ -75% |
| TRIOLOGY | TRILOGY MEDICAID | $227.06 | ↓ -74% |
| MOLINA HEALTHCARE | MOLINA MEDICAID | $227.06 | ↓ -74% |
| UNITED HEALTHCARE | ALL COMMERCIAL UNITED HEALTHCARE | $248.77 | ↓ -71% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $248.77 | ↓ -71% |
| PREVEA HEALTH NETWORK | PREVEA360 | $248.77 | ↓ -71% |
| UNITED HEALTHCARE | UHC ONEIDA NATION | $248.77 | ↓ -71% |
| PREVEA HEALTH NETWORK | PREVEA EMPLOYEES | $269.50 | ↓ -69% |
| P360 SMALL GROUP | PREVEA 360 SMALL GROUP COMMERCIAL PLAN | $269.50 | ↓ -69% |
| PREVEA HEALTH NETWORK | PREVEA360 - NETWORK | $269.50 | ↓ -69% |
| HUMANA | HUMANA CHOICE CARE HMO | $352.43 | ↓ -59% |
| HUMANA | HUMANA NATIIONAL POS HMO | $352.43 | ↓ -59% |
| HUMANA | ALL COMMERCIAL HUMANA HPN CHOICECARE | $352.43 | ↓ -59% |
| HSHS EMPLOYEES | HSHS EMPLOYEES | $372.28 | ↓ -57% |
| MOLINA HEALTHCARE OF WI | ALL COMMERICAL MOLINA MARKETPLACE | $383.00 | ↓ -56% |
| ARISE HEALTH PLAN | ALL COMMERCIAL ARISE HEALTH PLAN | $459.60 | ↓ -47% |
| NAPHCARE | ALL COMMERICAL NAPHCARE | $466.45 | ↓ -46% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION PPP | $474.92 | ↓ -45% |
| SECURITY HEALTH PLAN | ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK | $488.94 | ↓ -43% |
| INTERPLAN | ALL COMMERCIAL INTERPLAN HEALTH GROUP | $536.20 | ↓ -38% |
| CIGNA | ALL COMMERCIAL CIGNA | $536.20 | ↓ -38% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION TRUST SELECT | $551.52 | ↓ -36% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION | $551.52 | ↓ -36% |
| WEA PROVIDER NETWORK | WEA TRUST PPP/TRUST PREFERRED | $551.52 | ↓ -36% |
| NETWORK HEALTH PLAN | ALL COMMERICAL NETWORK HEALTH PLAN | $574.50 | ↓ -33% |
| HEALTH EOS | ALL COMMERCIAL HEALTH EOS | $574.50 | ↓ -33% |
| HEALTHSMART | ALL COMMERCIAL HEALTHSMART | $574.50 | ↓ -33% |
| TRIOLOGY | ALL COMMERCIAL TRIOLOGY | $605.14 | ↓ -30% |
| WISCONSIN PHYSICIAN SERVICE | WISCONSIN PHYSICIAN SERVICE | $612.80 | ↓ -29% |
| HEALTH CARE ALLIANCE | THE ALLIANCE | $643.44 | ↓ -25% |
| MULTIPLAN/PHCS | ALL COMMERCIAL MULTIPLAN | $643.44 | ↓ -25% |
| HUMANA | HUMANA CHOICE CARE PPO | $651.10 | ↓ -24% |
| CHOICECARE | ALL COMMERCIAL CHOICE CARE | $651.10 | ↓ -24% |
| NORTH CENTRAL HEALTHCARE ALLIANCE | NEHA | $704.72 | ↓ -18% |
| ANTHEM | ANTHEM PPO | $725.59 | ↓ -16% |
| ANTHEM | ANTHEM POS/HMO | $725.59 | ↓ -16% |
| FIRST HEALTH | ALL COMMERCIAL FIRST HEALTH NETWORK | $727.70 | ↓ -16% |
| LIVE360 | LIVE360 HSHS HEALTHY PLAN | $766.00 | ↓ -11% |
| AETNA | ALL COMMERCIAL AETNA | $766.00 | ↓ -11% |
| CATERPILLAR, INC. | UHC CATERPILLAR EMPLOYER GROUP | $766.00 | ↓ -11% |
| COFINITY | COFINITY | $766.00 | ↓ -11% |
Visitor-reported prices
Comments
Apl(pml-rara) quant - sendout at other Wisconsin hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Aurora Medical Center Sheboygan County | Sheboygan | $540.00 | $165.85 – $727.57 |
| Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Milwaukee | $1,829.56 | $207.31 – $903.23 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | $1,829.56 | $207.31 – $903.23 |
| UnityPoint Health - Meriter Hospital | Madison | $621.99 | $124.39 – $283.78 |
| SSM Health St. Clare Hospital - Baraboo | Baraboo | $1,567.50 | $155.48 – $2,060.62 |
| SSM Health St. Mary's Hospital - Janesville | Janesville | $1,516.90 | $155.48 – $1,648.50 |
| SSM Health St. Mary's Hospital - Madison | Madison | $1,283.70 | $155.48 – $1,685.98 |
| Aurora Sinai Medical Center of Aurora Health Care Metro | Milwaukee | $540.00 | $165.85 – $727.57 |