Cell marker study at HSHS St. Nicholas Hospital
3100 SUPERIOR AVE, SHEBOYGAN, WI · Hshs · · NPI 1730184342
$546.48
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.
?
What you pay up front if you don't use insurance.
$828.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$11.76 with COMMUNITY CARE FAMILY CARE vs $203.00 with ANTHEM — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| COMMUNITY CARE FAMILY CARE | COMMUNITY CARE FAMILY CARE MEDICAID MANAGED | $11.76 | ↓ -98% |
| ANTHEM | ANTEHM MEDICAID | $11.76 | ↓ -98% |
| MERIDIAN HEALTH PLAN | MERIDIAN HMO MCD | $11.76 | ↓ -98% |
| MANAGED HEALTH SERVICES | MANAGED HEALTH SERVICES MEDICAID | $11.76 | ↓ -98% |
| CONTINUUS MEDICAID MANAGED | CONTINUUS MEDICAID MANAGED | $11.76 | ↓ -98% |
| TRIOLOGY | TRILOGY MEDICAID | $12.47 | ↓ -98% |
| MOLINA HEALTHCARE | MOLINA MEDICAID | $12.47 | ↓ -98% |
| HUMANA | HUMANA MEDICARE ADVANTAGE | $50.96 | ↓ -91% |
| UNITED HEALTHCARE | UNITED HEALTH CARE MEDICARE | $50.96 | ↓ -91% |
| AETNA | AETNA MEDICARE | $50.96 | ↓ -91% |
| ANTHEM | ANTHEM MEDICARE ADVANTAGE HMO | $50.96 | ↓ -91% |
| MEDICA | MEDICA MEDICARE ADVANTAGE | $50.96 | ↓ -91% |
| MEDICARE MANAGED | MANAGED MEDICARE NO SEQUESTRATION | $50.96 | ↓ -91% |
| MOLINA HEALTHCARE | MOLINA MEDICARE | $50.96 | ↓ -91% |
| SECURITY HEALTH PLAN | MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI | $51.47 | ↓ -91% |
| UNITED HEALTHCARE | UHC ONEIDA NATION | $60.17 | ↓ -89% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $60.17 | ↓ -89% |
| UNITED HEALTHCARE | ALL COMMERCIAL UNITED HEALTHCARE | $60.17 | ↓ -89% |
| HSHS EMPLOYEES | HSHS EMPLOYEES | $98.66 | ↓ -82% |
| MOLINA HEALTHCARE OF WI | ALL COMMERICAL MOLINA MARKETPLACE | $101.50 | ↓ -81% |
| NAPHCARE | ALL COMMERICAL NAPHCARE | $114.67 | ↓ -79% |
| ARISE HEALTH PLAN | ALL COMMERCIAL ARISE HEALTH PLAN | $121.80 | ↓ -78% |
| PREVEA HEALTH NETWORK | PREVEA360 - NETWORK | $121.80 | ↓ -78% |
| PREVEA HEALTH NETWORK | PREVEA360 | $121.80 | ↓ -78% |
| PREVEA HEALTH NETWORK | PREVEA EMPLOYEES | $121.80 | ↓ -78% |
| P360 SMALL GROUP | PREVEA 360 SMALL GROUP COMMERCIAL PLAN | $121.80 | ↓ -78% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION PPP | $125.86 | ↓ -77% |
| SECURITY HEALTH PLAN | ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK | $129.57 | ↓ -76% |
| CIGNA | ALL COMMERCIAL CIGNA | $142.10 | ↓ -74% |
| INTERPLAN | ALL COMMERCIAL INTERPLAN HEALTH GROUP | $142.10 | ↓ -74% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION TRUST SELECT | $146.16 | ↓ -73% |
| WEA PROVIDER NETWORK | WEA TRUST PPP/TRUST PREFERRED | $146.16 | ↓ -73% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION | $146.16 | ↓ -73% |
| HEALTHSMART | ALL COMMERCIAL HEALTHSMART | $152.25 | ↓ -72% |
| HEALTH EOS | ALL COMMERCIAL HEALTH EOS | $152.25 | ↓ -72% |
| NETWORK HEALTH PLAN | ALL COMMERICAL NETWORK HEALTH PLAN | $152.25 | ↓ -72% |
| TRIOLOGY | ALL COMMERCIAL TRIOLOGY | $160.37 | ↓ -71% |
| WISCONSIN PHYSICIAN SERVICE | WISCONSIN PHYSICIAN SERVICE | $162.40 | ↓ -70% |
| HEALTH CARE ALLIANCE | THE ALLIANCE | $170.52 | ↓ -69% |
| MULTIPLAN/PHCS | ALL COMMERCIAL MULTIPLAN | $170.52 | ↓ -69% |
| HUMANA | HUMANA CHOICE CARE PPO | $172.55 | ↓ -68% |
| CHOICECARE | ALL COMMERCIAL CHOICE CARE | $172.55 | ↓ -68% |
| NORTH CENTRAL HEALTHCARE ALLIANCE | NEHA | $186.76 | ↓ -66% |
| FIRST HEALTH | ALL COMMERCIAL FIRST HEALTH NETWORK | $192.85 | ↓ -65% |
| ANTHEM | ANTHEM POS/HMO | $203.00 | ↓ -63% |
| HUMANA | ALL COMMERCIAL HUMANA HPN CHOICECARE | $203.00 | ↓ -63% |
| HUMANA | HUMANA NATIIONAL POS HMO | $203.00 | ↓ -63% |
| COFINITY | COFINITY | $203.00 | ↓ -63% |
| CATERPILLAR, INC. | UHC CATERPILLAR EMPLOYER GROUP | $203.00 | ↓ -63% |
| LIVE360 | LIVE360 HSHS HEALTHY PLAN | $203.00 | ↓ -63% |
| HUMANA | HUMANA CHOICE CARE HMO | $203.00 | ↓ -63% |
| AETNA | ALL COMMERCIAL AETNA | $203.00 | ↓ -63% |
| ANTHEM | ANTHEM PPO | $203.00 | ↓ -63% |
Visitor-reported prices
Comments
Cell marker study at other Wisconsin hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Aurora Medical Center Sheboygan County | Sheboygan | $285.00 | $112.31 – $369.60 |
| Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Milwaukee | $125.61 | $51.17 – $135.31 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | $125.61 | $51.17 – $135.31 |
| SSM Health St. Clare Hospital - Baraboo | Baraboo | $682.55 | $37.96 – $526.24 |
| SSM Health St. Mary's Hospital - Janesville | Janesville | $626.45 | $39.37 – $420.99 |
| SSM Health St. Mary's Hospital - Madison | Madison | $305.25 | $37.96 – $430.58 |
| SSM Health Monroe Hospital | Monroe | $148.50 | $50.62 – $123.12 |
| SSM Health Ripon Community Hospital | Ripon | $124.85 | $49.47 – $107.12 |