Knee Arthroscopy (Meniscus Trimming) at HSHS St. Nicholas Hospital
3100 SUPERIOR AVE, SHEBOYGAN, WI · Hshs · · NPI 1730184342
not published by hospital
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.
not published by hospital
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.
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 |
|---|---|---|---|
| AETNA | AETNA MEDICARE | not published by hospital | — |
| AETNA | ALL COMMERCIAL AETNA | not published by hospital | — |
| ANTHEM | ANTEHM MEDICAID | not published by hospital | — |
| ANTHEM | ANTHEM MEDICARE ADVANTAGE HMO | not published by hospital | — |
| ANTHEM | ANTHEM POS/HMO | not published by hospital | — |
| ANTHEM | ANTHEM PPO | not published by hospital | — |
| ARISE HEALTH PLAN | ALL COMMERCIAL ARISE HEALTH PLAN | not published by hospital | — |
| CATERPILLAR, INC. | UHC CATERPILLAR EMPLOYER GROUP | not published by hospital | — |
| CHOICECARE | ALL COMMERCIAL CHOICE CARE | not published by hospital | — |
| CIGNA | ALL COMMERCIAL CIGNA | not published by hospital | — |
| COFINITY | COFINITY | not published by hospital | — |
| COMMUNITY CARE FAMILY CARE | COMMUNITY CARE FAMILY CARE MEDICAID MANAGED | not published by hospital | — |
| CONTINUUS MEDICAID MANAGED | CONTINUUS MEDICAID MANAGED | not published by hospital | — |
| FIRST HEALTH | ALL COMMERCIAL FIRST HEALTH NETWORK | not published by hospital | — |
| HEALTH CARE ALLIANCE | THE ALLIANCE | not published by hospital | — |
| HEALTH EOS | ALL COMMERCIAL HEALTH EOS | not published by hospital | — |
| HEALTHSMART | ALL COMMERCIAL HEALTHSMART | not published by hospital | — |
| HSHS EMPLOYEES | HSHS EMPLOYEES | not published by hospital | — |
| HUMANA | ALL COMMERCIAL HUMANA HPN CHOICECARE | not published by hospital | — |
| HUMANA | HUMANA CHOICE CARE HMO | not published by hospital | — |
| HUMANA | HUMANA CHOICE CARE PPO | not published by hospital | — |
| HUMANA | HUMANA MEDICARE ADVANTAGE | not published by hospital | — |
| HUMANA | HUMANA NATIIONAL POS HMO | not published by hospital | — |
| INTERPLAN | ALL COMMERCIAL INTERPLAN HEALTH GROUP | not published by hospital | — |
| LIVE360 | LIVE360 HSHS HEALTHY PLAN | not published by hospital | — |
| MANAGED HEALTH SERVICES | MANAGED HEALTH SERVICES MEDICAID | not published by hospital | — |
| MEDICA | MEDICA MEDICARE ADVANTAGE | not published by hospital | — |
| MEDICARE MANAGED | MANAGED MEDICARE NO SEQUESTRATION | not published by hospital | — |
| MERIDIAN HEALTH PLAN | MERIDIAN HMO MCD | not published by hospital | — |
| MOLINA HEALTHCARE | MOLINA MEDICAID | not published by hospital | — |
| MOLINA HEALTHCARE | MOLINA MEDICARE | not published by hospital | — |
| MOLINA HEALTHCARE OF WI | ALL COMMERICAL MOLINA MARKETPLACE | not published by hospital | — |
| MULTIPLAN/PHCS | ALL COMMERCIAL MULTIPLAN | not published by hospital | — |
| NAPHCARE | ALL COMMERICAL NAPHCARE | not published by hospital | — |
| NETWORK HEALTH PLAN | ALL COMMERICAL NETWORK HEALTH PLAN | not published by hospital | — |
| NORTH CENTRAL HEALTHCARE ALLIANCE | NEHA | not published by hospital | — |
| P360 SMALL GROUP | PREVEA 360 SMALL GROUP COMMERCIAL PLAN | not published by hospital | — |
| PREVEA HEALTH NETWORK | PREVEA360 | not published by hospital | — |
| PREVEA HEALTH NETWORK | PREVEA360 - NETWORK | not published by hospital | — |
| PREVEA HEALTH NETWORK | PREVEA EMPLOYEES | not published by hospital | — |
| SECURITY HEALTH PLAN | ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK | not published by hospital | — |
| SECURITY HEALTH PLAN | MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI | not published by hospital | — |
| TRIOLOGY | ALL COMMERCIAL TRIOLOGY | not published by hospital | — |
| TRIOLOGY | TRILOGY MEDICAID | not published by hospital | — |
| UNITED HEALTHCARE | ALL COMMERCIAL UNITED HEALTHCARE | not published by hospital | — |
| UNITED HEALTHCARE | UHC ONEIDA NATION | not published by hospital | — |
| UNITED HEALTHCARE | UNITED HEALTHCARE | not published by hospital | — |
| UNITED HEALTHCARE | UNITED HEALTH CARE MEDICARE | not published by hospital | — |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION | not published by hospital | — |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION PPP | not published by hospital | — |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION TRUST SELECT | not published by hospital | — |
| WEA PROVIDER NETWORK | WEA TRUST PPP/TRUST PREFERRED | not published by hospital | — |
| WISCONSIN PHYSICIAN SERVICE | WISCONSIN PHYSICIAN SERVICE | not published by hospital | — |
Visitor-reported prices
Comments
Knee Arthroscopy (Meniscus Trimming) at other Wisconsin hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UnityPoint Health - Meriter Hospital | Madison | $8,683.20 | $496.73 – $2,532.60 |
| Ascension Calumet Hospital, Inc. | Chilton | $1,079.58 | $567.30 – $1,177.80 |
| Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Milwaukee | not published | $864.13 – $2,117.45 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | not published | $864.13 – $2,117.45 |
| Orthopaedic Hospital of Wisconsin, LLC | Glendale | not published | $4,754.00 – $16,897.00 |
| SSM Health St. Clare Hospital - Baraboo | Baraboo | not published | $2,383.65 – $11,257.00 |
| SSM Health St. Mary's Hospital - Janesville | Janesville | not published | $2,471.80 – $10,498.00 |
| SSM Health St. Mary's Hospital - Madison | Madison | not published | $2,383.65 – $9,052.00 |