CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Stoughton Hospital

Billing Code: 392 (MS-DRG)

The BaseRate · fair price medium confidence

A fair price for this

$10,605

about 1.9× the $5,676 Medicare rate · typically $4,774–$17,655

modeled estimate · not a bill or quote

What this hospital charges insurers

$9,400

Below the fair price — a good deal

about $1,205 under the fair price · 1.7× Medicare

Medicare pays $5,676 Fair price $10,605 This hospital $9,400 Cash price $5,862 Hospital's list price $10,659

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

Highest price of the 9 WI hospitals we have prices for — worth calling around.

Cheapest $5,090 Priciest $9,400

Black dot = this hospital, among the 9 WI hospitals with a price for this procedure. Full list below.

A fair price for a Digestive disorders treatment (inpatient stay) is about $10,605 (about 1.9× the $5,676 Medicare rate). Stoughton Hospital charges insurers about $9,400, or about $5,862 in cash — below the fair price — a good deal. Located in Stoughton, WI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$4,016 - $8,527	71%
Blue Cross Blue Shieldmajor	$9,273	163%
Aetnamajor	$6,265 - $9,060	110%
Cignamajor	$8,527	150%
Humanamajor	$7,109 - $9,593	125%
Dean Health Plan	$7,109 - $9,400	125%
GEHA	$7,994	141%
Health Net	$6,753	119%
Quartz	$7,109 - $7,458	125%
+ 2 smaller / regional plans	$7,331 - $9,812

Government programs also on file: Medicaid, Military & VA.

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 5,862), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 392.

Insurance Before you use insurance

Call your insurance company to confirm Stoughton Hospital is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 392.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Stoughton Hospital

Compare: Digestive disorders treatment (inpatient stay) at other WI hospitals

Thedacare Medical Center - Shawano · Shawano $5,090
Orthopaedic Hospital of Wisconsin · Glendale $5,344
Sauk Prairie Hospital · Prairie Du Sac $5,510
Oakleaf Surgical Hospital · Altoona $5,521
The Monroe Clinic · Monroe $5,545
Mile Bluff Medical Center · Mauston $5,607
Beloit Health System · Beloit $6,477
Gundersen Boscobel Area Hospital and Clinics · Boscobel $6,834

Insurance negotiated median for the same procedure, sorted lowest first.