Rmvl icd gen w/rplc icd gen mlt lead sys at HSHS St. Nicholas Hospital
3100 SUPERIOR AVE, SHEBOYGAN, WI · Hshs · · NPI 1730184342
$15,016.32
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.
$22,752.00
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.
$9,799.05 with ANTHEM vs $69,067.87 with NAPHCARE — 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 |
|---|---|---|---|
| ANTHEM | ANTEHM MEDICAID | $9,799.05 | ↓ -35% |
| MANAGED HEALTH SERVICES | MANAGED HEALTH SERVICES MEDICAID | $9,799.05 | ↓ -35% |
| CONTINUUS MEDICAID MANAGED | CONTINUUS MEDICAID MANAGED | $9,799.05 | ↓ -35% |
| COMMUNITY CARE FAMILY CARE | COMMUNITY CARE FAMILY CARE MEDICAID MANAGED | $9,799.05 | ↓ -35% |
| MERIDIAN HEALTH PLAN | MERIDIAN HMO MCD | $9,799.05 | ↓ -35% |
| TRIOLOGY | TRILOGY MEDICAID | $10,386.99 | ↓ -31% |
| MOLINA HEALTHCARE | MOLINA MEDICAID | $10,386.99 | ↓ -31% |
| HSHS EMPLOYEES | HSHS EMPLOYEES | $11,057.47 | ↓ -26% |
| MOLINA HEALTHCARE OF WI | ALL COMMERICAL MOLINA MARKETPLACE | $11,376.00 | ↓ -24% |
| ARISE HEALTH PLAN | ALL COMMERCIAL ARISE HEALTH PLAN | $13,651.20 | ↓ -9% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION PPP | $14,106.24 | ↓ -6% |
| SECURITY HEALTH PLAN | ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK | $14,522.60 | ↓ -3% |
| INTERPLAN | ALL COMMERCIAL INTERPLAN HEALTH GROUP | $15,926.40 | ↑ +6% |
| CIGNA | ALL COMMERCIAL CIGNA | $15,926.40 | ↑ +6% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION TRUST SELECT | $16,381.44 | ↑ +9% |
| WEA PROVIDER NETWORK | WEA TRUST PPP/TRUST PREFERRED | $16,381.44 | ↑ +9% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION | $16,381.44 | ↑ +9% |
| HEALTH EOS | ALL COMMERCIAL HEALTH EOS | $17,064.00 | ↑ +14% |
| HEALTHSMART | ALL COMMERCIAL HEALTHSMART | $17,064.00 | ↑ +14% |
| NETWORK HEALTH PLAN | ALL COMMERICAL NETWORK HEALTH PLAN | $17,064.00 | ↑ +14% |
| TRIOLOGY | ALL COMMERCIAL TRIOLOGY | $17,974.08 | ↑ +20% |
| WISCONSIN PHYSICIAN SERVICE | WISCONSIN PHYSICIAN SERVICE | $18,201.60 | ↑ +21% |
| ANTHEM | ANTHEM POS/HMO | $18,410.00 | ↑ +23% |
| MULTIPLAN/PHCS | ALL COMMERCIAL MULTIPLAN | $19,111.68 | ↑ +27% |
| HEALTH CARE ALLIANCE | THE ALLIANCE | $19,111.68 | ↑ +27% |
| HUMANA | HUMANA CHOICE CARE PPO | $19,339.20 | ↑ +29% |
| CHOICECARE | ALL COMMERCIAL CHOICE CARE | $19,339.20 | ↑ +29% |
| NORTH CENTRAL HEALTHCARE ALLIANCE | NEHA | $20,931.84 | ↑ +39% |
| FIRST HEALTH | ALL COMMERCIAL FIRST HEALTH NETWORK | $21,614.40 | ↑ +44% |
| ANTHEM | ANTHEM PPO | $22,500.00 | ↑ +50% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $22,752.00 | ↑ +52% |
| HUMANA | HUMANA MEDICARE ADVANTAGE | $22,752.00 | ↑ +52% |
| HUMANA | HUMANA CHOICE CARE HMO | $22,752.00 | ↑ +52% |
| HUMANA | ALL COMMERCIAL HUMANA HPN CHOICECARE | $22,752.00 | ↑ +52% |
| HUMANA | HUMANA NATIIONAL POS HMO | $22,752.00 | ↑ +52% |
| COFINITY | COFINITY | $22,752.00 | ↑ +52% |
| CATERPILLAR, INC. | UHC CATERPILLAR EMPLOYER GROUP | $22,752.00 | ↑ +52% |
| LIVE360 | LIVE360 HSHS HEALTHY PLAN | $22,752.00 | ↑ +52% |
| AETNA | ALL COMMERCIAL AETNA | $22,752.00 | ↑ +52% |
| UNITED HEALTHCARE | UHC ONEIDA NATION | $22,752.00 | ↑ +52% |
| UNITED HEALTHCARE | UNITED HEALTH CARE MEDICARE | $22,752.00 | ↑ +52% |
| P360 SMALL GROUP | PREVEA 360 SMALL GROUP COMMERCIAL PLAN | $22,752.00 | ↑ +52% |
| PREVEA HEALTH NETWORK | PREVEA EMPLOYEES | $22,752.00 | ↑ +52% |
| PREVEA HEALTH NETWORK | PREVEA360 | $22,752.00 | ↑ +52% |
| PREVEA HEALTH NETWORK | PREVEA360 - NETWORK | $22,752.00 | ↑ +52% |
| UNITED HEALTHCARE | ALL COMMERCIAL UNITED HEALTHCARE | $22,752.00 | ↑ +52% |
| AETNA | AETNA MEDICARE | $30,696.83 | ↑ +104% |
| MEDICARE MANAGED | MANAGED MEDICARE NO SEQUESTRATION | $30,696.83 | ↑ +104% |
| MOLINA HEALTHCARE | MOLINA MEDICARE | $30,696.83 | ↑ +104% |
| MEDICA | MEDICA MEDICARE ADVANTAGE | $30,696.83 | ↑ +104% |
| ANTHEM | ANTHEM MEDICARE ADVANTAGE HMO | $30,696.83 | ↑ +104% |
| SECURITY HEALTH PLAN | MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI | $31,003.80 | ↑ +106% |
| NAPHCARE | ALL COMMERICAL NAPHCARE | $69,067.87 | ↑ +360% |
Visitor-reported prices
Comments
Rmvl icd gen w/rplc icd gen mlt lead sys at other Wisconsin hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Milwaukee | $32,018.36 | $621.37 – $1,568.95 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | $32,018.36 | $621.37 – $1,568.95 |
| UnityPoint Health - Meriter Hospital | Madison | $82,202.91 | $349.08 – $32,059.13 |
| SSM Health St. Mary's Hospital - Madison | Madison | $21,668.35 | $14,021.00 – $50,591.00 |
| SSM Health Monroe Hospital | Monroe | $23,558.70 | $13,352.00 – $51,258.00 |
| SSM Health Ripon Community Hospital | Ripon | $21,447.80 | $8,923.00 – $54,996.00 |
| SSM Health St. Agnes Hospital - Fond du Lac | Fond Du Lac | $21,447.80 | $8,923.00 – $59,920.75 |
| SSM Health Waupun Memorial Hospital | Waupun | $21,447.80 | $8,923.00 – $54,996.00 |