At Stoughton Health, we agree that transparency about the cost of health care is important. Listed below are several resources to help patients understand and compare costs.

Obtain a Cost Estimate

For the most accurate estimate of the cost of care, patients can contact Stoughton Health at (608) 873-6611 for assistance in understanding the charges and related costs for a procedure or visit. You will need to provide some basic information, which can be found on the Billing and Financial Assistance Page.

Stoughton Health Price Estimator

The Price Estimator Tool from Stoughton Health allows you to obtain an out-of-pocket cost estimate for selected services and/or items, providing additional information regarding average procedure charges and other details.

Stoughton Health Standard Charges

To improve price transparency, all U.S. hospitals and health systems are required to provide lists of standard hospital charges ― also called a chargemaster ― so patients can compare prices across hospitals. Here are a few considerations to keep in mind as you view the list of standard charges (chargemaster).

  • These charges are rarely the price that patients pay. The chargemaster lists the dollar amount set for each service prior to insurance contract/benefit plan discounts or self-pay discounts being applied, so the price patients pay tends to be less than the standard charge.
  • Hospital charges differ from patient to patient for the same service depending upon variations in treatment.
  • Patients who are eligible for financial assistance also receive additional discounts.
  • Items included in a charge vary across hospital systems. For example, what’s included in one hospital’s charge for room and board may differ from other hospital’s charge ― some hospitals bundle services together into a single charge that others may list separately.
  • Looking at various hospital charges does not provide any indication of quality of service and outcomes.

Stoughton Health Average Charges by Type of Patient Group

All hospitals and health systems also are required to provide a listing of average charges by types of patient groups, referred to as MS-DRGs (Medicare Severity Diagnosis Related Groups). Patients can view similar listings posted by different hospitals, which provide a more direct comparison of charges than the standard charges in the chargemaster. View the list of average charges by type of patient group (MS-DRGs).

Stoughton Health Shoppable Services Prices

All hospitals and health systems also are required to post a list of at least 300 Shoppable Services along with the corresponding prices for each of those services. Each of these Shoppable Services includes the following amounts: Gross Charge, Discounted Cash Price, Payer-Specific Negotiated Charges, De-Identified Minimum Negotiated Charge, and De-Identified Maximum Negotiated Charge.

As with the list of standard hospital charges discussed above, the prices on the primary care procedures list represent the standard amount for each service prior to insurance contract/benefit plan discounts or self-pay discounts being applied. What a patient actually pays will depend on their unique benefit plan terms.

View the Shoppable Services Available at Stoughton Health.

Price Estimator

We can assist you in pricing services you require, with a simple decision tree process.

Calculate Your Out‑of‑Pocket Cost

Financial Assistance

Stoughton Health offers financial assistance for eligible patients and support from our financial counselors.

Learn About Financial Services

The estimate cannot be relied on as the final set cost for services you may receive as actual expenses can and will vary from patient to patient depending upon your physician’s treatment choices and your particular health care needs.

The estimated patient cost is based on the information entered. If you have requested an estimate for a surgical procedure, this estimate may not include:

  • Pre-Procedure Office Visits
  • Post-Procedure Office Visits
  • Diagnostic Testing
  • Surgeon
  • Pathologist
  • Radiologist

If you have met all or part of your deductible or maximum out-of-pocket expenses, the actual amount you owe may be different.

Note: The estimated cost is not a guarantee of insurance coverage.

Please check with your insurance company if you need help understanding your benefits for the service chosen.

I HAVE READ AND UNDERSTAND THE ABOVE LIMITATIONS AND I FULLY UNDERSTAND.

THIS IS ONLY AN ESTIMATE. MY ACTUAL CHARGES MAY BE DIFFERENT (HIGHER OR LOWER) THAN THE ESTIMATE.

In compliance with the CMS Price Transparency rules taking effect on 01/01/2021 (CMS Price Transparency), please click the link(s) below to view a full list of Hospital charges:

Select Your Insurance
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Check Your Eligibility
Check Your Eligibility – Result
Review Your Estimate
Insurance: 
Please click on one of the following Insurance Companies to identify the necessary fields to complete your Eligibility Check:
Aetna
Blue Shield / Blue Cross
Cigna
Humana
UnitedHealthcare
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