Vital capacity test at HSHS St. Nicholas Hospital
3100 SUPERIOR AVE, SHEBOYGAN, WI · Hshs · · NPI 1730184342
$180.84
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.
$274.00
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.
$25.49 with COMMUNITY CARE FAMILY CARE vs $283.13 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 |
|---|---|---|---|
| COMMUNITY CARE FAMILY CARE | COMMUNITY CARE FAMILY CARE MEDICAID MANAGED | $25.49 | ↓ -86% |
| MERIDIAN HEALTH PLAN | MERIDIAN HMO MCD | $25.49 | ↓ -86% |
| ANTHEM | ANTEHM MEDICAID | $25.49 | ↓ -86% |
| MANAGED HEALTH SERVICES | MANAGED HEALTH SERVICES MEDICAID | $25.49 | ↓ -86% |
| CONTINUUS MEDICAID MANAGED | CONTINUUS MEDICAID MANAGED | $25.49 | ↓ -86% |
| MOLINA HEALTHCARE | MOLINA MEDICAID | $27.02 | ↓ -85% |
| TRIOLOGY | TRILOGY MEDICAID | $27.02 | ↓ -85% |
| MEDICA | MEDICA MEDICARE ADVANTAGE | $125.84 | ↓ -30% |
| UNITED HEALTHCARE | UNITED HEALTH CARE MEDICARE | $125.84 | ↓ -30% |
| AETNA | AETNA MEDICARE | $125.84 | ↓ -30% |
| MEDICARE MANAGED | MANAGED MEDICARE NO SEQUESTRATION | $125.84 | ↓ -30% |
| ANTHEM | ANTHEM MEDICARE ADVANTAGE HMO | $125.84 | ↓ -30% |
| HUMANA | HUMANA MEDICARE ADVANTAGE | $125.84 | ↓ -30% |
| MOLINA HEALTHCARE | MOLINA MEDICARE | $125.84 | ↓ -30% |
| SECURITY HEALTH PLAN | MEDICARE ADVANTAGE SECURITY HEALTH PLAN OF WI | $127.10 | ↓ -30% |
| HSHS EMPLOYEES | HSHS EMPLOYEES | $133.16 | ↓ -26% |
| MOLINA HEALTHCARE OF WI | ALL COMMERICAL MOLINA MARKETPLACE | $137.00 | ↓ -24% |
| ARISE HEALTH PLAN | ALL COMMERCIAL ARISE HEALTH PLAN | $164.40 | ↓ -9% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION PPP | $169.88 | ↓ -6% |
| HUMANA | HUMANA CHOICE CARE HMO | $173.99 | ↓ -4% |
| HUMANA | ALL COMMERCIAL HUMANA HPN CHOICECARE | $173.99 | ↓ -4% |
| HUMANA | HUMANA NATIIONAL POS HMO | $173.99 | ↓ -4% |
| SECURITY HEALTH PLAN | ALL COMMERCIAL SECURITY HEALTH PLAN BROAD NETWORK | $174.89 | ↓ -3% |
| ANTHEM | ANTHEM PPO | $186.32 | ↑ +3% |
| ANTHEM | ANTHEM POS/HMO | $186.32 | ↑ +3% |
| CIGNA | ALL COMMERCIAL CIGNA | $191.80 | ↑ +6% |
| INTERPLAN | ALL COMMERCIAL INTERPLAN HEALTH GROUP | $191.80 | ↑ +6% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION TRUST SELECT | $197.28 | ↑ +9% |
| WEA PROVIDER NETWORK | WEA TRUST PPP/TRUST PREFERRED | $197.28 | ↑ +9% |
| WEA PROVIDER NETWORK | WEA INSURANCE CORPORATION | $197.28 | ↑ +9% |
| HEALTH EOS | ALL COMMERCIAL HEALTH EOS | $205.50 | ↑ +14% |
| HEALTHSMART | ALL COMMERCIAL HEALTHSMART | $205.50 | ↑ +14% |
| NETWORK HEALTH PLAN | ALL COMMERICAL NETWORK HEALTH PLAN | $205.50 | ↑ +14% |
| TRIOLOGY | ALL COMMERCIAL TRIOLOGY | $216.46 | ↑ +20% |
| WISCONSIN PHYSICIAN SERVICE | WISCONSIN PHYSICIAN SERVICE | $219.20 | ↑ +21% |
| MULTIPLAN/PHCS | ALL COMMERCIAL MULTIPLAN | $230.16 | ↑ +27% |
| HEALTH CARE ALLIANCE | THE ALLIANCE | $230.16 | ↑ +27% |
| CHOICECARE | ALL COMMERCIAL CHOICE CARE | $232.90 | ↑ +29% |
| HUMANA | HUMANA CHOICE CARE PPO | $232.90 | ↑ +29% |
| NORTH CENTRAL HEALTHCARE ALLIANCE | NEHA | $252.08 | ↑ +39% |
| FIRST HEALTH | ALL COMMERCIAL FIRST HEALTH NETWORK | $260.30 | ↑ +44% |
| PREVEA HEALTH NETWORK | PREVEA360 | $274.00 | ↑ +52% |
| PREVEA HEALTH NETWORK | PREVEA360 - NETWORK | $274.00 | ↑ +52% |
| PREVEA HEALTH NETWORK | PREVEA EMPLOYEES | $274.00 | ↑ +52% |
| UNITED HEALTHCARE | UHC ONEIDA NATION | $274.00 | ↑ +52% |
| P360 SMALL GROUP | PREVEA 360 SMALL GROUP COMMERCIAL PLAN | $274.00 | ↑ +52% |
| UNITED HEALTHCARE | ALL COMMERCIAL UNITED HEALTHCARE | $274.00 | ↑ +52% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $274.00 | ↑ +52% |
| AETNA | ALL COMMERCIAL AETNA | $274.00 | ↑ +52% |
| LIVE360 | LIVE360 HSHS HEALTHY PLAN | $274.00 | ↑ +52% |
| CATERPILLAR, INC. | UHC CATERPILLAR EMPLOYER GROUP | $274.00 | ↑ +52% |
| COFINITY | COFINITY | $274.00 | ↑ +52% |
| NAPHCARE | ALL COMMERICAL NAPHCARE | $283.13 | ↑ +57% |
Visitor-reported prices
Comments
Vital capacity test at other Wisconsin hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Aurora Medical Center Sheboygan County | Sheboygan | $55.00 | not published |
| Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Milwaukee | $489.72 | $5.85 – $335.08 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | $489.72 | $5.85 – $335.08 |
| UnityPoint Health - Meriter Hospital | Madison | $226.40 | $6.78 – $151.13 |
| SSM Health St. Clare Hospital - Baraboo | Baraboo | $177.10 | $93.74 – $124.98 |
| SSM Health St. Mary's Hospital - Janesville | Janesville | $162.80 | $97.20 – $129.61 |
| SSM Health St. Mary's Hospital - Madison | Madison | $163.35 | $93.74 – $124.98 |
| SSM Health Monroe Hospital | Monroe | $122.10 | $124.98 – $124.98 |