Hospital Sisters Health System · Sheboygan, WI
30
In-network payers
193
Disclosed rate categories
185
Beds
3
Care quality
St. Nicholas Hospital is a 185-bed voluntary non-profit - private hospital in Sheboygan, WI, affiliated with Hospital Sisters Health System. Below you'll find publicly disclosed negotiated rates and facility details, including 30 in-network payers and 193 disclosed rate categories.
CCN (Medicare provider number)
520044
NPI
1730184342
Type
Short Term Acute Care Hospital
Ownership
Voluntary Non-Profit - Private
Beds
185
Care Quality
3
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. Nicholas 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
$7,448 - $9,691
from 2 insurers · median $8,569
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 obstetrics / child birth services to CMS
Childbirth · Inpatient
MS-DRG 788
$12,949 - $13,635
from 2 insurers · median $13,292
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 obstetrics / child birth services to CMS
CT imaging
CPT 74177
$1,239 - $4,571
from 4 insurers · median $2,224
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 66984
$5,002 - $5,812
from 2 insurers · median $5,407
190 Medicare claims in Level 1 Intraocular Procedures (CMS 2024)
Childbirth · Inpatient
MS-DRG 807
$7,448 - $9,691
from 2 insurers · median $8,569
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 obstetrics / child birth services to CMS
Medicine & Surgery · Inpatient
MS-DRG 460
$55,096 - $75,512
from 2 insurers · median $65,304
Hospital reports neurosurgical services to CMS
CT imaging
CPT 70450
$1,239 - $1,908
from 4 insurers · median $1,292
Common here, based on CMS Medicare volume
Medicine & Surgery · Inpatient
MS-DRG 473
$40,841 - $52,423
from 2 insurers · median $46,632
Hospital reports neurosurgical services to CMS
Medicine & Surgery
CPT 47562
$10,149 - $13,334
from 2 insurers · median $11,742
17 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Medicine & Surgery
CPT 49505
$7,641 - $8,339
from 2 insurers · median $7,990
19 Medicare claims in Level 1 Abdominal/Peritoneal/Biliary and Related Procedures (CMS 2024)
Gynecology
CPT 58571
$10,149 - $15,954
from 2 insurers · median $13,051
11 Medicare claims in Level 2 Laparoscopy and Related Services (CMS 2024)
Cardiology and vascular testing
CPT 93306
$568 - $2,590
from 4 insurers · median $1,787
Common here, based on CMS Medicare volume
CT imaging
CPT 74176
$1,239 - $3,856
from 4 insurers · median $1,973
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45385
$4,506 - $4,613
from 2 insurers · median $4,560
Common here, based on CMS Medicare volume
MRI imaging
CPT 70553
$1,430 - $4,227
from 4 insurers · median $2,236
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45380
$4,613 - $5,002
from 2 insurers · median $4,808
Common here, based on CMS Medicare volume
Mammography
CPT 77067
$180 - $397
from 4 insurers · median $306
Common here, based on CMS Medicare volume
Digestive procedures
CPT 49650
$10,149 - $14,294
from 2 insurers · median $12,222
17 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
CT imaging
CPT 71275
$1,239 - $2,818
from 4 insurers · median $1,610
Common here, based on CMS Medicare volume
Digestive procedures
CPT 43239
$2,903 - $4,613
from 2 insurers · median $3,758
Common here, based on CMS Medicare volume
X-ray and bone density
CPT 71046
$98 - $418
from 4 insurers · median $355
Common here, based on CMS Medicare volume
Nuclear imaging
CPT 78815
$4,264 - $7,760
from 4 insurers · median $5,016
Common here, based on CMS Medicare volume
Urology
CPT 50590
$10,149 - $13,176
from 2 insurers · median $11,663
26 Medicare claims in Level 4 Urology and Related Services (CMS 2024)
Nuclear imaging
CPT 78452
$1,311 - $5,099
from 4 insurers · median $2,585
Common here, based on CMS Medicare volume
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* | 10 | 859% | 10 | 0 |
| Insurer B* | 10 | 601% | 8 | 2 |
| Insurer C* | 24 | 316% | 17 | 0 |
| Insurer D* | 24 | 292% | 7 | 12 |
How we chose these services: 6 appear in this hospital's own Medicare claims, 13 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. Nicholas Hospital.
3100 Superior Avenue, Sheboygan, WI 53081
(920) 459-8300
The nearest hospitals of similar type and size. Their rates are compared with St. Nicholas Hospital for the same insurers and services above.
Aurora Sheboygan Memorial Medical Center
▲ Rates typically 13% higher than St. Nicholas Hospital (21 services)
Holy Family Memorial Medical Center
▼ Rates typically 13% lower than St. Nicholas Hospital (21 services)
Aurora Medical Center Grafton
▲ Rates typically 18% higher than St. Nicholas Hospital (20 services)
St. Agnes Hospital
▼ Rates typically 10% lower than St. Nicholas Hospital (21 services)
St Marys Ozaukee
▼ Rates typically 64% lower than St. Nicholas Hospital (20 services)
Froedtert Menomonee Falls Hospital
▲ Rates typically 10% higher than St. Nicholas Hospital (21 services)
St. Vincent Hospital
St. Josephs Hospital Chippewa Falls
St. Marys Hospital Medical Center
About St. Nicholas Hospital's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at St. Nicholas Hospital range from $1,430 to $4,227 across 4 insurers. Cigna's rate is $2,959. The median at nearby comparable hospitals is $2,047. 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. Nicholas Hospital range from $1,239 to $4,571 across 4 insurers. Aetna's rate is $4,571. The median at nearby comparable hospitals is $1,786. 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. Nicholas Hospital range from $4,506 to $4,613 across 2 insurers. UnitedHealthcare's rate is $4,613. The median at nearby comparable hospitals is $3,282. 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. Nicholas Hospital range from $7,448 to $9,691 across 2 insurers. Blue Cross Blue Shield's rate is $7,448. 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. Nicholas Hospital range from $180 to $397 across 4 insurers. Aetna's rate is $360. The median at nearby comparable hospitals is $244. What a patient pays depends on their plan's deductible, coinsurance and network status.
St. Nicholas Hospital has 185 beds. Facility type: Short Term Acute Care Hospital.
St. Nicholas Hospital is located at 3100 Superior Avenue, Sheboygan, WI 53081. Its main phone number is (920) 459-8300.
St. Nicholas Hospital's CMS Certification Number (CCN), also called its Medicare provider number, is 520044.
The National Provider Identifier (NPI) on file for St. Nicholas Hospital is 1730184342.
St. Nicholas Hospital is affiliated with Hospital Sisters Health System.
St. Nicholas Hospital lists 30 in-network payers, including Ameri Health, Avera Health Plans, BCBS, Centene, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
193 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