Hospital Sisters Health System · Oconto Falls, WI
32
In-network payers
191
Disclosed rate categories
25
Beds
St Clare Memorial Hospital Inc is a 25-bed voluntary non-profit - private hospital in Oconto Falls, WI, affiliated with Hospital Sisters Health System. Below you'll find publicly disclosed negotiated rates and facility details, including 32 in-network payers and 191 disclosed rate categories.
CCN (Medicare provider number)
521310
NPI
1851477913
Type
Critical Access Hospital
Ownership
Voluntary Non-Profit - Private
Beds
25
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 Clare Memorial Hospital Inc 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.
CT imaging
CPT 74177
$1,239 - $4,068
from 4 insurers · median $2,052
Typical for a hospital with this service line
CT imaging
CPT 70450
$1,193 - $1,698
from 4 insurers · median $1,243
Typical for a hospital with this service line
CT imaging
CPT 74176
$1,239 - $2,410
from 4 insurers · median $1,663
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93306
$568 - $1,761
from 4 insurers · median $1,340
Typical for a hospital with this service line
Digestive procedures
CPT 45385
$1,796 - $4,118
from 4 insurers · median $2,794
Typical for a hospital with this service line
CT imaging
CPT 71275
$1,239 - $2,453
from 4 insurers · median $1,504
Typical for a hospital with this service line
Mammography
CPT 77067
$180 - $470
from 4 insurers · median $322
Typical for a hospital with this service line
MRI imaging
CPT 70553
$1,430 - $4,123
from 4 insurers · median $2,045
Typical for a hospital with this service line
Digestive procedures
CPT 43239
$1,087 - $3,635
from 4 insurers · median $1,461
Typical for a hospital with this service line
Digestive procedures
CPT 45380
$1,394 - $3,635
from 4 insurers · median $1,773
Typical for a hospital with this service line
MRI imaging
CPT 72148
$1,430 - $2,866
from 4 insurers · median $1,864
Typical for a hospital with this service line
MRI imaging
CPT 70551
$1,430 - $3,576
from 4 insurers · median $1,874
Typical for a hospital with this service line
X-ray and bone density
CPT 71046
$95 - $418
from 4 insurers · median $210
Typical for a hospital with this service line
Medicine & Surgery
CPT 47562
$6,381 - $10,210
from 4 insurers · median $7,421
Typical for a hospital with this service line
Nuclear imaging
CPT 78452
$1,311 - $4,538
from 4 insurers · median $2,363
Hospital reports nuclear medicine services to CMS
MRI imaging
CPT 73721
$1,430 - $2,619
from 4 insurers · median $1,903
Typical for a hospital with this service line
Ultrasound
CPT 76705
$500 - $773
from 4 insurers · median $561
Typical for a hospital with this service line
Digestive procedures
CPT 45378
$1,268 - $3,635
from 4 insurers · median $1,704
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93971
$511 - $1,188
from 4 insurers · median $746
Typical for a hospital with this service line
X-ray and bone density
CPT 77080
$113 - $798
from 4 insurers · median $528
Typical for a hospital with this service line
Ultrasound
CPT 76642
$372 - $595
from 4 insurers · median $537
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93970
$511 - $1,362
from 4 insurers · median $1,269
Typical for a hospital with this service line
Lung function and sleep
CPT 95810
$3,610 - $5,776
from 4 insurers · median $3,775
Typical for a hospital with this service line
Ultrasound
CPT 76830
$363 - $805
from 4 insurers · median $539
Typical for a hospital with this service line
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* | 24 | 697% | 13 | 10 |
| Insurer B* | 24 | 485% | 22 | 1 |
| Insurer C* | 24 | 457% | 20 | 4 |
| Insurer D* | 24 | 390% | 10 | 10 |
How we chose these services: 0 appear in this hospital's own Medicare claims, 0 are common here based on CMS Medicare volume, and 24 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 Clare Memorial Hospital Inc.
855 South Main Street, Oconto Falls, WI 54154
(920) 846-3444
The nearest hospitals of similar type and size. Their rates are compared with St Clare Memorial Hospital Inc for the same insurers and services above.
Bellin Health Oconto Hospital
▼ Rates typically 44% lower than St Clare Memorial Hospital Inc (24 services)
Thedacare Medical Center - Shawano
▼ Rates typically 35% lower than St Clare Memorial Hospital Inc (24 services)
Thedacare Medical Center-New London
▼ Rates typically 33% lower than St Clare Memorial Hospital Inc (24 services)
Aspirus Langlade Hospital
▲ Rates typically 44% higher than St Clare Memorial Hospital Inc (23 services)
Calumet Hospital
▼ Rates typically 25% lower than St Clare Memorial Hospital Inc (22 services)
Thedacare Medical Center - Waupaca
▼ Rates typically 35% lower than St Clare Memorial Hospital Inc (24 services)
Door County Medical Center
Gundersen St Josephs Hospital
Memorial Medical Center Inc.
About St Clare Memorial Hospital Inc's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at St Clare Memorial Hospital Inc range from $1,430 to $4,123 across 4 insurers. Cigna's rate is $2,577. The median at nearby comparable hospitals is $1,191. 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 Clare Memorial Hospital Inc range from $1,239 to $4,068 across 4 insurers. Aetna's rate is $4,068. The median at nearby comparable hospitals is $1,109. 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 Clare Memorial Hospital Inc range from $1,796 to $4,118 across 4 insurers. Blue Cross Blue Shield's rate is $1,954. The median at nearby comparable hospitals is $3,119. 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 Clare Memorial Hospital Inc range from $180 to $470 across 4 insurers. Cigna's rate is $294. The median at nearby comparable hospitals is $433. What a patient pays depends on their plan's deductible, coinsurance and network status.
St Clare Memorial Hospital Inc has 25 beds. Facility type: Critical Access Hospital.
St Clare Memorial Hospital Inc is located at 855 South Main Street, Oconto Falls, WI 54154. Its main phone number is (920) 846-3444.
St Clare Memorial Hospital Inc's CMS Certification Number (CCN), also called its Medicare provider number, is 521310.
The National Provider Identifier (NPI) on file for St Clare Memorial Hospital Inc is 1851477913.
St Clare Memorial Hospital Inc is affiliated with Hospital Sisters Health System.
St Clare Memorial Hospital Inc lists 32 in-network payers, including Aetna, Aspirus Health Plan, Avera Health Plans, BCBS, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
191 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