Bilateral n block inj trigeminal 64400 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

$742.50

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.

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What you pay up front if you don't use insurance.

$1,125.00

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.

$176.37 with COMMUNITY CARE FAMILY CARE vs $1,063.00 with CATERPILLAR, INC. — 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
COMMUNITY CARE FAMILY CARE COMMUNITY CARE FAMILY CARE MEDICAID MANAGED $176.37 ↓ -76%
MERIDIAN HEALTH PLAN MERIDIAN HMO MCD $176.37 ↓ -76%
ANTHEM ANTEHM MEDICAID $176.37 ↓ -76%
MANAGED HEALTH SERVICES MANAGED HEALTH SERVICES MEDICAID $176.37 ↓ -76%
CONTINUUS MEDICAID MANAGED CONTINUUS MEDICAID MANAGED $176.37 ↓ -76%
MOLINA HEALTHCARE MOLINA MEDICAID $186.95 ↓ -75%
TRIOLOGY TRILOGY MEDICAID $186.95 ↓ -75%
MEDICA MEDICA MEDICARE ADVANTAGE $300.18 ↓ -60%
UNITED HEALTHCARE UNITED HEALTH CARE MEDICARE $300.18 ↓ -60%
AETNA AETNA MEDICARE $300.18 ↓ -60%
MEDICARE MANAGED MANAGED MEDICARE NO SEQUESTRATION $300.18 ↓ -60%
ANTHEM ANTHEM MEDICARE ADVANTAGE HMO $300.18 ↓ -60%
HUMANA HUMANA MEDICARE ADVANTAGE $300.18 ↓ -60%
MOLINA HEALTHCARE MOLINA MEDICARE $300.18 ↓ -60%
SECURITY HEALTH PLAN MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI $303.18 ↓ -59%
HSHS EMPLOYEES HSHS EMPLOYEES $516.62 ↓ -30%
MOLINA HEALTHCARE OF WI ALL COMMERICAL MOLINA MARKETPLACE $531.50 ↓ -28%
ARISE HEALTH PLAN ALL COMMERCIAL ARISE HEALTH PLAN $637.80 ↓ -14%
P360 SMALL GROUP PREVEA 360 SMALL GROUP COMMERCIAL PLAN $637.80 ↓ -14%
PREVEA HEALTH NETWORK PREVEA EMPLOYEES $637.80 ↓ -14%
PREVEA HEALTH NETWORK PREVEA360 $637.80 ↓ -14%
PREVEA HEALTH NETWORK PREVEA360 - NETWORK $637.80 ↓ -14%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION PPP $659.06 ↓ -11%
HUMANA HUMANA NATIIONAL POS HMO $675.01 ↓ -9%
HUMANA HUMANA CHOICE CARE HMO $675.01 ↓ -9%
HUMANA ALL COMMERCIAL HUMANA HPN CHOICECARE $675.01 ↓ -9%
NAPHCARE ALL COMMERICAL NAPHCARE $675.41 ↓ -9%
SECURITY HEALTH PLAN ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK $678.51 ↓ -9%
ANTHEM ANTHEM POS/HMO $722.84 ↓ -3%
ANTHEM ANTHEM PPO $722.84 ↓ -3%
INTERPLAN ALL COMMERCIAL INTERPLAN HEALTH GROUP $744.10 ↑ +0%
CIGNA ALL COMMERCIAL CIGNA $744.10 ↑ +0%
UNITED HEALTHCARE ALL COMMERCIAL UNITED HEALTHCARE $753.00 ↑ +1%
UNITED HEALTHCARE UHC ONEIDA NATION $753.00 ↑ +1%
UNITED HEALTHCARE UNITED HEALTHCARE $753.00 ↑ +1%
WEA PROVIDER NETWORK WEA TRUST PPP/TRUST PREFERRED $765.36 ↑ +3%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION TRUST SELECT $765.36 ↑ +3%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION $765.36 ↑ +3%
NETWORK HEALTH PLAN ALL COMMERICAL NETWORK HEALTH PLAN $797.25 ↑ +7%
HEALTH EOS ALL COMMERCIAL HEALTH EOS $797.25 ↑ +7%
HEALTHSMART ALL COMMERCIAL HEALTHSMART $797.25 ↑ +7%
TRIOLOGY ALL COMMERCIAL TRIOLOGY $839.77 ↑ +13%
WISCONSIN PHYSICIAN SERVICE WISCONSIN PHYSICIAN SERVICE $850.40 ↑ +15%
MULTIPLAN/PHCS ALL COMMERCIAL MULTIPLAN $892.92 ↑ +20%
HEALTH CARE ALLIANCE THE ALLIANCE $892.92 ↑ +20%
CHOICECARE ALL COMMERCIAL CHOICE CARE $903.55 ↑ +22%
HUMANA HUMANA CHOICE CARE PPO $903.55 ↑ +22%
NORTH CENTRAL HEALTHCARE ALLIANCE NEHA $977.96 ↑ +32%
FIRST HEALTH ALL COMMERCIAL FIRST HEALTH NETWORK $1,009.85 ↑ +36%
COFINITY COFINITY $1,063.00 ↑ +43%
AETNA ALL COMMERCIAL AETNA $1,063.00 ↑ +43%
LIVE360 LIVE360 HSHS HEALTHY PLAN $1,063.00 ↑ +43%
CATERPILLAR, INC. UHC CATERPILLAR EMPLOYER GROUP $1,063.00 ↑ +43%

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Bilateral n block inj trigeminal 64400 at other Wisconsin hospitals

Hospital City Cash price Negotiated range
Aurora Medical Center Sheboygan County Sheboygan $515.00 not published
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) Mequon $106.53 $77.30 – $632.19
UnityPoint Health - Meriter Hospital Madison $1,154.63 $41.17 – $450.30
SSM Health St. Clare Hospital - Baraboo Baraboo $593.45 $223.61 – $4,401.00
SSM Health St. Mary's Hospital - Janesville Janesville $530.20 $231.88 – $4,074.00
SSM Health St. Mary's Hospital - Madison Madison $586.30 $223.61 – $4,198.00
SSM Health Monroe Hospital Monroe $212.85 $298.15 – $4,217.00
SSM Health Ripon Community Hospital Ripon $834.90 $1,887.00 – $2,654.00

All Wisconsin hospitals for this procedure →