Blood Count (CBC) Test 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

$59.40

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.

$90.00

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.

$7.77 with MEDICARE MANAGED vs $90.00 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 →

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
MEDICARE MANAGED MANAGED MEDICARE NO SEQUESTRATION $7.77 ↓ -87%
MEDICA MEDICA MEDICARE ADVANTAGE $7.77 ↓ -87%
UNITED HEALTHCARE UNITED HEALTH CARE MEDICARE $7.77 ↓ -87%
MOLINA HEALTHCARE MOLINA MEDICARE $7.77 ↓ -87%
HUMANA HUMANA MEDICARE ADVANTAGE $7.77 ↓ -87%
AETNA AETNA MEDICARE $7.77 ↓ -87%
ANTHEM ANTHEM MEDICARE ADVANTAGE HMO $7.77 ↓ -87%
SECURITY HEALTH PLAN MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI $7.85 ↓ -87%
ANTHEM ANTEHM MEDICAID $8.03 ↓ -86%
MERIDIAN HEALTH PLAN MERIDIAN HMO MCD $8.03 ↓ -86%
MANAGED HEALTH SERVICES MANAGED HEALTH SERVICES MEDICAID $8.03 ↓ -86%
CONTINUUS MEDICAID MANAGED CONTINUUS MEDICAID MANAGED $8.03 ↓ -86%
COMMUNITY CARE FAMILY CARE COMMUNITY CARE FAMILY CARE MEDICAID MANAGED $8.03 ↓ -86%
TRIOLOGY TRILOGY MEDICAID $8.51 ↓ -86%
MOLINA HEALTHCARE MOLINA MEDICAID $8.51 ↓ -86%
UNITED HEALTHCARE ALL COMMERCIAL UNITED HEALTHCARE $9.32 ↓ -84%
UNITED HEALTHCARE UNITED HEALTHCARE $9.32 ↓ -84%
PREVEA HEALTH NETWORK PREVEA360 $9.32 ↓ -84%
UNITED HEALTHCARE UHC ONEIDA NATION $9.32 ↓ -84%
PREVEA HEALTH NETWORK PREVEA EMPLOYEES $10.10 ↓ -83%
P360 SMALL GROUP PREVEA 360 SMALL GROUP COMMERCIAL PLAN $10.10 ↓ -83%
PREVEA HEALTH NETWORK PREVEA360 - NETWORK $10.10 ↓ -83%
HUMANA HUMANA CHOICE CARE HMO $13.21 ↓ -78%
HUMANA ALL COMMERCIAL HUMANA HPN CHOICECARE $13.21 ↓ -78%
HUMANA HUMANA NATIIONAL POS HMO $13.21 ↓ -78%
NAPHCARE ALL COMMERICAL NAPHCARE $17.48 ↓ -71%
ANTHEM ANTHEM PPO $27.20 ↓ -54%
ANTHEM ANTHEM POS/HMO $27.20 ↓ -54%
HSHS EMPLOYEES HSHS EMPLOYEES $43.74 ↓ -26%
MOLINA HEALTHCARE OF WI ALL COMMERICAL MOLINA MARKETPLACE $45.00 ↓ -24%
ARISE HEALTH PLAN ALL COMMERCIAL ARISE HEALTH PLAN $54.00 ↓ -9%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION PPP $55.80 ↓ -6%
SECURITY HEALTH PLAN ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK $57.45 ↓ -3%
INTERPLAN ALL COMMERCIAL INTERPLAN HEALTH GROUP $63.00 ↑ +6%
CIGNA ALL COMMERCIAL CIGNA $63.00 ↑ +6%
WEA PROVIDER NETWORK WEA TRUST PPP/TRUST PREFERRED $64.80 ↑ +9%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION TRUST SELECT $64.80 ↑ +9%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION $64.80 ↑ +9%
NETWORK HEALTH PLAN ALL COMMERICAL NETWORK HEALTH PLAN $67.50 ↑ +14%
HEALTH EOS ALL COMMERCIAL HEALTH EOS $67.50 ↑ +14%
HEALTHSMART ALL COMMERCIAL HEALTHSMART $67.50 ↑ +14%
TRIOLOGY ALL COMMERCIAL TRIOLOGY $71.10 ↑ +20%
WISCONSIN PHYSICIAN SERVICE WISCONSIN PHYSICIAN SERVICE $72.00 ↑ +21%
HEALTH CARE ALLIANCE THE ALLIANCE $75.60 ↑ +27%
MULTIPLAN/PHCS ALL COMMERCIAL MULTIPLAN $75.60 ↑ +27%
CHOICECARE ALL COMMERCIAL CHOICE CARE $76.50 ↑ +29%
HUMANA HUMANA CHOICE CARE PPO $76.50 ↑ +29%
NORTH CENTRAL HEALTHCARE ALLIANCE NEHA $82.80 ↑ +39%
FIRST HEALTH ALL COMMERCIAL FIRST HEALTH NETWORK $85.50 ↑ +44%
LIVE360 LIVE360 HSHS HEALTHY PLAN $90.00 ↑ +52%
AETNA ALL COMMERCIAL AETNA $90.00 ↑ +52%
CATERPILLAR, INC. UHC CATERPILLAR EMPLOYER GROUP $90.00 ↑ +52%
COFINITY COFINITY $90.00 ↑ +52%

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