Transcath closure of asd at HSHS St. Nicholas Hospital
3100 SUPERIOR AVE, SHEBOYGAN, WI · Hshs · · NPI 1730184342
$18,034.50
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.
$27,325.00
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.
$6,378.61 with MANAGED HEALTH SERVICES vs $40,336.82 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 |
|---|---|---|---|
| MANAGED HEALTH SERVICES | MANAGED HEALTH SERVICES MEDICAID | $6,378.61 | ↓ -65% |
| CONTINUUS MEDICAID MANAGED | CONTINUUS MEDICAID MANAGED | $6,378.61 | ↓ -65% |
| COMMUNITY CARE FAMILY CARE | COMMUNITY CARE FAMILY CARE MEDICAID MANAGED | $6,378.61 | ↓ -65% |
| ANTHEM | ANTEHM MEDICAID | $6,378.61 | ↓ -65% |
| MERIDIAN HEALTH PLAN | MERIDIAN HMO MCD | $6,378.61 | ↓ -65% |
| TRIOLOGY | TRILOGY MEDICAID | $6,761.33 | ↓ -63% |
| MOLINA HEALTHCARE | MOLINA MEDICAID | $6,761.33 | ↓ -63% |
| HUMANA | ALL COMMERCIAL HUMANA HPN CHOICECARE | $7,604.00 | ↓ -58% |
| HUMANA | HUMANA NATIIONAL POS HMO | $7,604.00 | ↓ -58% |
| HUMANA | HUMANA CHOICE CARE HMO | $7,604.00 | ↓ -58% |
| PREVEA HEALTH NETWORK | PREVEA360 | $12,372.00 | ↓ -31% |
| HSHS EMPLOYEES | HSHS EMPLOYEES | $13,279.95 | ↓ -26% |
| PREVEA HEALTH NETWORK | PREVEA EMPLOYEES | $13,386.50 | ↓ -26% |
| P360 SMALL GROUP | PREVEA 360 SMALL GROUP COMMERCIAL PLAN | $13,386.50 | ↓ -26% |
| PREVEA HEALTH NETWORK | PREVEA360 - NETWORK | $13,386.50 | ↓ -26% |
| MOLINA HEALTHCARE OF WI | ALL COMMERICAL MOLINA MARKETPLACE | $13,662.50 | ↓ -24% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $14,281.50 | ↓ -21% |
| UNITED HEALTHCARE | UHC ONEIDA NATION | $14,281.50 | ↓ -21% |
| UNITED HEALTHCARE | ALL COMMERCIAL UNITED HEALTHCARE | $14,281.50 | ↓ -21% |
| ARISE HEALTH PLAN | ALL COMMERCIAL ARISE HEALTH PLAN | $16,395.00 | ↓ -9% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION PPP | $16,941.50 | ↓ -6% |
| SECURITY HEALTH PLAN | ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK | $17,441.55 | ↓ -3% |
| MEDICA | MEDICA MEDICARE ADVANTAGE | $17,927.48 | ↓ -1% |
| HUMANA | HUMANA MEDICARE ADVANTAGE | $17,927.48 | ↓ -1% |
| MOLINA HEALTHCARE | MOLINA MEDICARE | $17,927.48 | ↓ -1% |
| ANTHEM | ANTHEM MEDICARE ADVANTAGE HMO | $17,927.48 | ↓ -1% |
| MEDICARE MANAGED | MANAGED MEDICARE NO SEQUESTRATION | $17,927.48 | ↓ -1% |
| UNITED HEALTHCARE | UNITED HEALTH CARE MEDICARE | $17,927.48 | ↓ -1% |
| AETNA | AETNA MEDICARE | $17,927.48 | ↓ -1% |
| SECURITY HEALTH PLAN | MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI | $18,106.75 | ↑ +0% |
| ANTHEM | ANTHEM POS/HMO | $18,410.00 | ↑ +2% |
| CIGNA | ALL COMMERCIAL CIGNA | $19,127.50 | ↑ +6% |
| INTERPLAN | ALL COMMERCIAL INTERPLAN HEALTH GROUP | $19,127.50 | ↑ +6% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION TRUST SELECT | $19,674.00 | ↑ +9% |
| WEA PROVIDER NETWORK | WEA TRUST PPP/TRUST PREFERRED | $19,674.00 | ↑ +9% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION | $19,674.00 | ↑ +9% |
| HEALTH EOS | ALL COMMERCIAL HEALTH EOS | $20,493.75 | ↑ +14% |
| NETWORK HEALTH PLAN | ALL COMMERICAL NETWORK HEALTH PLAN | $20,493.75 | ↑ +14% |
| HEALTHSMART | ALL COMMERCIAL HEALTHSMART | $20,493.75 | ↑ +14% |
| TRIOLOGY | ALL COMMERCIAL TRIOLOGY | $21,586.75 | ↑ +20% |
| WISCONSIN PHYSICIAN SERVICE | WISCONSIN PHYSICIAN SERVICE | $21,860.00 | ↑ +21% |
| ANTHEM | ANTHEM PPO | $22,500.00 | ↑ +25% |
| HEALTH CARE ALLIANCE | THE ALLIANCE | $22,953.00 | ↑ +27% |
| MULTIPLAN/PHCS | ALL COMMERCIAL MULTIPLAN | $22,953.00 | ↑ +27% |
| HUMANA | HUMANA CHOICE CARE PPO | $23,226.25 | ↑ +29% |
| CHOICECARE | ALL COMMERCIAL CHOICE CARE | $23,226.25 | ↑ +29% |
| NORTH CENTRAL HEALTHCARE ALLIANCE | NEHA | $25,139.00 | ↑ +39% |
| FIRST HEALTH | ALL COMMERCIAL FIRST HEALTH NETWORK | $25,958.75 | ↑ +44% |
| CATERPILLAR, INC. | UHC CATERPILLAR EMPLOYER GROUP | $27,325.00 | ↑ +52% |
| LIVE360 | LIVE360 HSHS HEALTHY PLAN | $27,325.00 | ↑ +52% |
| AETNA | ALL COMMERCIAL AETNA | $27,325.00 | ↑ +52% |
| COFINITY | COFINITY | $27,325.00 | ↑ +52% |
| NAPHCARE | ALL COMMERICAL NAPHCARE | $40,336.82 | ↑ +124% |
Visitor-reported prices
Comments
Transcath closure of asd 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 | $19,715.47 | $1,463.14 – $18,652.00 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | $19,715.47 | $1,463.14 – $18,652.00 |
| UnityPoint Health - Meriter Hospital | Madison | $38,148.03 | $827.98 – $14,877.73 |
| SSM Health St. Mary's Hospital - Madison | Madison | $10,687.60 | $13,354.59 – $40,147.00 |
| SSM Health Ripon Community Hospital | Ripon | $20,724.55 | $41,120.00 – $43,643.00 |
| SSM Health St. Agnes Hospital - Fond du Lac | Fond Du Lac | $20,724.55 | $13,599.00 – $43,643.00 |
| SSM Health Waupun Memorial Hospital | Waupun | $20,724.55 | $41,120.00 – $43,643.00 |
| Midwest Orthopedic Specialty Hospital | Franklin | $14,313.71 | $3,213.99 – $3,213.99 |