Cryptosporidium antigen 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

$89.10

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.

$135.00

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.

$11.98 with MEDICARE MANAGED vs $135.00 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 $11.98 ↓ -87%
MEDICA MEDICA MEDICARE ADVANTAGE $11.98 ↓ -87%
UNITED HEALTHCARE UNITED HEALTH CARE MEDICARE $11.98 ↓ -87%
MOLINA HEALTHCARE MOLINA MEDICARE $11.98 ↓ -87%
HUMANA HUMANA MEDICARE ADVANTAGE $11.98 ↓ -87%
AETNA AETNA MEDICARE $11.98 ↓ -87%
ANTHEM ANTHEM MEDICARE ADVANTAGE HMO $11.98 ↓ -87%
SECURITY HEALTH PLAN MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI $12.10 ↓ -86%
ANTHEM ANTEHM MEDICAID $12.38 ↓ -86%
MERIDIAN HEALTH PLAN MERIDIAN HMO MCD $12.38 ↓ -86%
MANAGED HEALTH SERVICES MANAGED HEALTH SERVICES MEDICAID $12.38 ↓ -86%
CONTINUUS MEDICAID MANAGED CONTINUUS MEDICAID MANAGED $12.38 ↓ -86%
COMMUNITY CARE FAMILY CARE COMMUNITY CARE FAMILY CARE MEDICAID MANAGED $12.38 ↓ -86%
TRIOLOGY TRILOGY MEDICAID $13.12 ↓ -85%
MOLINA HEALTHCARE MOLINA MEDICAID $13.12 ↓ -85%
UNITED HEALTHCARE ALL COMMERCIAL UNITED HEALTHCARE $14.38 ↓ -84%
UNITED HEALTHCARE UNITED HEALTHCARE $14.38 ↓ -84%
PREVEA HEALTH NETWORK PREVEA360 $14.38 ↓ -84%
UNITED HEALTHCARE UHC ONEIDA NATION $14.38 ↓ -84%
PREVEA HEALTH NETWORK PREVEA EMPLOYEES $15.57 ↓ -83%
P360 SMALL GROUP PREVEA 360 SMALL GROUP COMMERCIAL PLAN $15.57 ↓ -83%
PREVEA HEALTH NETWORK PREVEA360 - NETWORK $15.57 ↓ -83%
HUMANA HUMANA CHOICE CARE HMO $20.37 ↓ -77%
HUMANA ALL COMMERCIAL HUMANA HPN CHOICECARE $20.37 ↓ -77%
HUMANA HUMANA NATIIONAL POS HMO $20.37 ↓ -77%
NAPHCARE ALL COMMERICAL NAPHCARE $26.96 ↓ -70%
ANTHEM ANTHEM PPO $41.93 ↓ -53%
ANTHEM ANTHEM POS/HMO $41.93 ↓ -53%
HSHS EMPLOYEES HSHS EMPLOYEES $65.61 ↓ -26%
MOLINA HEALTHCARE OF WI ALL COMMERICAL MOLINA MARKETPLACE $67.50 ↓ -24%
ARISE HEALTH PLAN ALL COMMERCIAL ARISE HEALTH PLAN $81.00 ↓ -9%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION PPP $83.70 ↓ -6%
SECURITY HEALTH PLAN ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK $86.17 ↓ -3%
INTERPLAN ALL COMMERCIAL INTERPLAN HEALTH GROUP $94.50 ↑ +6%
CIGNA ALL COMMERCIAL CIGNA $94.50 ↑ +6%
WEA PROVIDER NETWORK WEA TRUST PPP/TRUST PREFERRED $97.20 ↑ +9%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION TRUST SELECT $97.20 ↑ +9%
WEA PROVIDER NETWORK WEA INSURANCE CORPORATION $97.20 ↑ +9%
NETWORK HEALTH PLAN ALL COMMERICAL NETWORK HEALTH PLAN $101.25 ↑ +14%
HEALTH EOS ALL COMMERCIAL HEALTH EOS $101.25 ↑ +14%
HEALTHSMART ALL COMMERCIAL HEALTHSMART $101.25 ↑ +14%
TRIOLOGY ALL COMMERCIAL TRIOLOGY $106.65 ↑ +20%
WISCONSIN PHYSICIAN SERVICE WISCONSIN PHYSICIAN SERVICE $108.00 ↑ +21%
HEALTH CARE ALLIANCE THE ALLIANCE $113.40 ↑ +27%
MULTIPLAN/PHCS ALL COMMERCIAL MULTIPLAN $113.40 ↑ +27%
CHOICECARE ALL COMMERCIAL CHOICE CARE $114.75 ↑ +29%
HUMANA HUMANA CHOICE CARE PPO $114.75 ↑ +29%
NORTH CENTRAL HEALTHCARE ALLIANCE NEHA $124.20 ↑ +39%
FIRST HEALTH ALL COMMERCIAL FIRST HEALTH NETWORK $128.25 ↑ +44%
LIVE360 LIVE360 HSHS HEALTHY PLAN $135.00 ↑ +52%
AETNA ALL COMMERCIAL AETNA $135.00 ↑ +52%
CATERPILLAR, INC. UHC CATERPILLAR EMPLOYER GROUP $135.00 ↑ +52%
COFINITY COFINITY $135.00 ↑ +52%

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