Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm at SSM Health Waupun Memorial Hospital
620 W Brown St, Waupun, WI · SSM Health · · NPI 1548248644
$1,173.70
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.
$2,134.00
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.
$2,654.00 with BCBS vs $3,335.00 with BCBS — 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 |
|---|---|---|---|
| BCBS | Blue Preferred / Blue Preferred Plus HMO/POS | $2,654.00 | ↑ +126% |
| Centivo | Broad(WI1) Other Commercial Plan | $2,959.00 | ↑ +152% |
| Centivo | Value(WI3) Other Commercial Plan | $2,959.00 | ↑ +152% |
| Centivo | Median(WI2) Other Commercial Plan | $2,959.00 | ↑ +152% |
| Network Health Plan | HMO/POS | $3,030.00 | ↑ +158% |
| BCBS | Blue Access PPO | $3,335.00 | ↑ +184% |
| BCBS | Blue Traditional Traditional | $3,335.00 | ↑ +184% |
Visitor-reported prices
Comments
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm 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 | $106.53 | $186.03 – $1,506.85 |
| UnityPoint Health - Meriter Hospital | Madison | $576.80 | $36.11 – $357.48 |
| SSM Health Monroe Hospital | Monroe | $851.40 | $687.83 – $4,217.00 |
| SSM Health Ripon Community Hospital | Ripon | $1,173.70 | $2,654.00 – $3,030.00 |
| SSM Health St. Agnes Hospital - Fond du Lac | Fond Du Lac | $1,173.70 | $525.32 – $3,030.00 |
| Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.) | Appleton | $1,496.25 | $122.41 – $1,420.44 |
| Adventhealth Durand | Durand | $2,281.07 | not published |
| Ascension Calumet Hospital, Inc. | Chilton | $424.65 | $122.41 – $366.14 |