Emg 2 ext w-w/o paraspinal area 95861 at HSHS St. Nicholas Hospital
3100 SUPERIOR AVE, SHEBOYGAN, WI · Hshs · · NPI 1730184342
$533.94
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.
$809.00
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.
$58.61 with MERIDIAN HEALTH PLAN vs $450.00 with UNITED HEALTHCARE — 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 |
|---|---|---|---|
| MERIDIAN HEALTH PLAN | MERIDIAN HMO MCD | $58.61 | ↓ -89% |
| COMMUNITY CARE FAMILY CARE | COMMUNITY CARE FAMILY CARE MEDICAID MANAGED | $58.61 | ↓ -89% |
| ANTHEM | ANTEHM MEDICAID | $58.61 | ↓ -89% |
| MANAGED HEALTH SERVICES | MANAGED HEALTH SERVICES MEDICAID | $58.61 | ↓ -89% |
| CONTINUUS MEDICAID MANAGED | CONTINUUS MEDICAID MANAGED | $58.61 | ↓ -89% |
| TRIOLOGY | TRILOGY MEDICAID | $62.12 | ↓ -88% |
| MOLINA HEALTHCARE | MOLINA MEDICAID | $62.13 | ↓ -88% |
| MEDICA | MEDICA MEDICARE ADVANTAGE | $130.11 | ↓ -76% |
| UNITED HEALTHCARE | UNITED HEALTH CARE MEDICARE | $130.11 | ↓ -76% |
| AETNA | AETNA MEDICARE | $130.11 | ↓ -76% |
| MEDICARE MANAGED | MANAGED MEDICARE NO SEQUESTRATION | $130.11 | ↓ -76% |
| ANTHEM | ANTHEM MEDICARE ADVANTAGE HMO | $130.11 | ↓ -76% |
| HUMANA | HUMANA MEDICARE ADVANTAGE | $130.11 | ↓ -76% |
| MOLINA HEALTHCARE | MOLINA MEDICARE | $130.11 | ↓ -76% |
| SECURITY HEALTH PLAN | MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI | $131.41 | ↓ -75% |
| HSHS EMPLOYEES | HSHS EMPLOYEES | $218.70 | ↓ -59% |
| MOLINA HEALTHCARE OF WI | ALL COMMERICAL MOLINA MARKETPLACE | $225.00 | ↓ -58% |
| ARISE HEALTH PLAN | ALL COMMERCIAL ARISE HEALTH PLAN | $270.00 | ↓ -49% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION PPP | $279.00 | ↓ -48% |
| HUMANA | HUMANA CHOICE CARE HMO | $285.75 | ↓ -46% |
| HUMANA | ALL COMMERCIAL HUMANA HPN CHOICECARE | $285.75 | ↓ -46% |
| HUMANA | HUMANA NATIIONAL POS HMO | $285.75 | ↓ -46% |
| SECURITY HEALTH PLAN | ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK | $287.24 | ↓ -46% |
| NAPHCARE | ALL COMMERICAL NAPHCARE | $292.76 | ↓ -45% |
| ANTHEM | ANTHEM PPO | $306.00 | ↓ -43% |
| ANTHEM | ANTHEM POS/HMO | $306.00 | ↓ -43% |
| INTERPLAN | ALL COMMERCIAL INTERPLAN HEALTH GROUP | $315.00 | ↓ -41% |
| CIGNA | ALL COMMERCIAL CIGNA | $315.00 | ↓ -41% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION TRUST SELECT | $324.00 | ↓ -39% |
| WEA PROVIDER NETWORK | WEA TRUST PPP/TRUST PREFERRED | $324.00 | ↓ -39% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION | $324.00 | ↓ -39% |
| HEALTH EOS | ALL COMMERCIAL HEALTH EOS | $337.50 | ↓ -37% |
| HEALTHSMART | ALL COMMERCIAL HEALTHSMART | $337.50 | ↓ -37% |
| NETWORK HEALTH PLAN | ALL COMMERICAL NETWORK HEALTH PLAN | $337.50 | ↓ -37% |
| TRIOLOGY | ALL COMMERCIAL TRIOLOGY | $355.50 | ↓ -33% |
| WISCONSIN PHYSICIAN SERVICE | WISCONSIN PHYSICIAN SERVICE | $360.00 | ↓ -33% |
| MULTIPLAN/PHCS | ALL COMMERCIAL MULTIPLAN | $378.00 | ↓ -29% |
| HEALTH CARE ALLIANCE | THE ALLIANCE | $378.00 | ↓ -29% |
| HUMANA | HUMANA CHOICE CARE PPO | $382.50 | ↓ -28% |
| CHOICECARE | ALL COMMERCIAL CHOICE CARE | $382.50 | ↓ -28% |
| NORTH CENTRAL HEALTHCARE ALLIANCE | NEHA | $414.00 | ↓ -22% |
| FIRST HEALTH | ALL COMMERCIAL FIRST HEALTH NETWORK | $427.50 | ↓ -20% |
| PREVEA HEALTH NETWORK | PREVEA360 - NETWORK | $450.00 | ↓ -16% |
| PREVEA HEALTH NETWORK | PREVEA360 | $450.00 | ↓ -16% |
| UNITED HEALTHCARE | UHC ONEIDA NATION | $450.00 | ↓ -16% |
| PREVEA HEALTH NETWORK | PREVEA EMPLOYEES | $450.00 | ↓ -16% |
| UNITED HEALTHCARE | ALL COMMERCIAL UNITED HEALTHCARE | $450.00 | ↓ -16% |
| P360 SMALL GROUP | PREVEA 360 SMALL GROUP COMMERCIAL PLAN | $450.00 | ↓ -16% |
| AETNA | ALL COMMERCIAL AETNA | $450.00 | ↓ -16% |
| LIVE360 | LIVE360 HSHS HEALTHY PLAN | $450.00 | ↓ -16% |
| CATERPILLAR, INC. | UHC CATERPILLAR EMPLOYER GROUP | $450.00 | ↓ -16% |
| COFINITY | COFINITY | $450.00 | ↓ -16% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $450.00 | ↓ -16% |
Visitor-reported prices
Comments
Emg 2 ext w-w/o paraspinal area 95861 at other Wisconsin hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | $85.33 | $125.48 – $302.85 |
| UnityPoint Health - Meriter Hospital | Madison | $1,396.04 | $69.45 – $331.59 |
| SSM Health St. Mary's Hospital - Madison | Madison | $452.10 | $96.93 – $129.23 |
| SSM Health Ripon Community Hospital | Ripon | $225.50 | not published |
| SSM Health St. Agnes Hospital - Fond du Lac | Fond Du Lac | $225.50 | $98.70 – $253.99 |
| SSM Health Waupun Memorial Hospital | Waupun | $225.50 | not published |
| Aurora Sinai Medical Center of Aurora Health Care Metro | Milwaukee | $372.50 | not published |
| Aurora Medical Center Summit | Summit | $372.50 | not published |