SSM Health · Fond Du Lac, WI
36
In-network payers
304
Disclosed rate categories
146
Beds
4
Care quality
St. Agnes Hospital is a 146-bed voluntary non-profit - private hospital in Fond Du Lac, WI, affiliated with SSM Health. Below you'll find publicly disclosed negotiated rates and facility details, including 36 in-network payers and 304 disclosed rate categories.
CCN (Medicare provider number)
520088
NPI
1346228541
Type
Short Term Acute Care Hospital
Ownership
Voluntary Non-Profit - Private
Beds
146
Care Quality
4
Insurance acceptance may vary by specific plan, network status, and services required. Contact your insurance provider or the hospital's billing department to confirm coverage details.
The 24 services St. Agnes Hospital most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data.
Childbirth · Inpatient
MS-DRG 807
$3,536 - $8,717
from 4 insurers · median $7,414
CMS lists this service as CPT 59400, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Childbirth · Inpatient
MS-DRG 788
$4,828 - $16,510
from 4 insurers · median $12,941
CMS lists this service as CPT 59510, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 788, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
CT imaging
CPT 74177
$758 - $2,849
from 4 insurers · median $2,667
Common here, based on CMS Medicare volume
Medicine & Surgery · Inpatient
MS-DRG 216
$82,200 - $148,966
from 3 insurers · median $147,358
Hospital reports cardiac thoracic surgery services to CMS
Cardiology and vascular testing
CPT 93306
$2,111 - $2,681
from 4 insurers · median $2,381
Common here, based on CMS Medicare volume
CT imaging
CPT 74176
$396 - $2,581
from 4 insurers · median $2,528
Common here, based on CMS Medicare volume
CT imaging
CPT 71260
$590 - $2,667
from 4 insurers · median $2,197
Common here, based on CMS Medicare volume
CT imaging
CPT 71275
$737 - $2,679
from 4 insurers · median $2,239
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 66984
$3,908 - $5,896
from 3 insurers · median $4,737
277 Medicare claims in Level 1 Intraocular Procedures (CMS 2024)
MRI imaging
CPT 70553
$928 - $3,096
from 4 insurers · median $2,713
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45385
$3,780 - $5,954
from 4 insurers · median $4,371
Common here, based on CMS Medicare volume
Nuclear imaging
CPT 78452
$1,436 - $5,333
from 4 insurers · median $4,496
Common here, based on CMS Medicare volume
Gynecology
CPT 58571
$7,666 - $27,299
from 4 insurers · median $17,329
Typical for a hospital with this service line
Nuclear imaging
CPT 78815
$3,016 - $5,953
from 4 insurers · median $5,779
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45380
$3,433 - $5,954
from 4 insurers · median $4,291
Common here, based on CMS Medicare volume
Digestive procedures
CPT 43239
$2,815 - $5,184
from 4 insurers · median $3,552
Common here, based on CMS Medicare volume
X-ray and bone density
CPT 71046
$69 - $428
from 4 insurers · median $332
Common here, based on CMS Medicare volume
MRI imaging
CPT 72148
$510 - $2,975
from 4 insurers · median $2,528
Common here, based on CMS Medicare volume
Mammography
CPT 77067
$126 - $347
from 4 insurers · median $227
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 47562
$5,267 - $16,625
from 4 insurers · median $10,105
25 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
MRI imaging
CPT 73721
$580 - $3,330
from 4 insurers · median $2,528
Common here, based on CMS Medicare volume
Childbirth · Inpatient
MS-DRG 807
$3,536 - $8,717
from 4 insurers · median $7,414
CMS lists this service as CPT 59610, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Medicine & Surgery
CPT 49505
$4,368 - $15,909
from 3 insurers · median $9,808
17 Medicare claims in Level 1 Abdominal/Peritoneal/Biliary and Related Procedures (CMS 2024)
Digestive procedures
CPT 49650
$6,183 - $16,625
from 4 insurers · median $12,870
25 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 23 | 487% | 11 | 5 |
| Insurer B* | 22 | 396% | 5 | 9 |
| Insurer C* | 24 | 395% | 18 | 2 |
| Insurer D* | 24 | 208% | 4 | 16 |
How we chose these services: 4 appear in this hospital's own Medicare claims, 15 are common here based on CMS Medicare volume, and 5 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for St. Agnes Hospital.
430 East Division Street, Fond Du Lac, WI 54935
(920) 929-2300
The nearest hospitals of similar type and size. Their rates are compared with St. Agnes Hospital for the same insurers and services above.
Ascension Ne Wisconsin - Mercy Campus
▼ Rates typically 63% lower than St. Agnes Hospital (21 services)
Aurora Medical Center Oshkosh
▲ Rates typically 28% higher than St. Agnes Hospital (21 services)
Thedacare Regional Medical Center - Neenah
▼ Rates typically 26% lower than St. Agnes Hospital (21 services)
Marshfield Medical Center Beaver Dam
▲ Rates typically 36% higher than St. Agnes Hospital (21 services)
Aurora Sheboygan Memorial Medical Center
▲ Rates typically 17% higher than St. Agnes Hospital (21 services)
St. Nicholas Hospital
▲ Rates typically 13% higher than St. Agnes Hospital (21 services)
Monroe Clinic Hospital
Ssm Health St. Clare Hospital - Baraboo
Ssm Health St. Mary S Hospital - Madison
Ssm Health St. Mary S Hospital - Janesville
About St. Agnes Hospital's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at St. Agnes Hospital range from $928 to $3,096 across 4 insurers. Aetna's rate is $3,096. The median at nearby comparable hospitals is $2,425. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at St. Agnes Hospital range from $758 to $2,849 across 4 insurers. Aetna's rate is $2,757. The median at nearby comparable hospitals is $2,231. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at St. Agnes Hospital range from $3,780 to $5,954 across 4 insurers. Cigna's rate is $5,954. The median at nearby comparable hospitals is $3,491. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at St. Agnes Hospital range from $3,536 to $8,717 across 4 insurers. UnitedHealthcare's rate is $8,717. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at St. Agnes Hospital range from $126 to $347 across 4 insurers. Blue Cross Blue Shield's rate is $126. The median at nearby comparable hospitals is $362. What a patient pays depends on their plan's deductible, coinsurance and network status.
St. Agnes Hospital has 146 beds. Facility type: Short Term Acute Care Hospital.
St. Agnes Hospital is located at 430 East Division Street, Fond Du Lac, WI 54935. Its main phone number is (920) 929-2300.
St. Agnes Hospital's CMS Certification Number (CCN), also called its Medicare provider number, is 520088.
The National Provider Identifier (NPI) on file for St. Agnes Hospital is 1346228541.
St. Agnes Hospital is affiliated with SSM Health.
St. Agnes Hospital lists 36 in-network payers, including Aetna, Ameri Health, Aspirus Health Plan, Avera Health Plans, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
304 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
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{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers