SSM Health St. Clare Hospital - Baraboo
707 14Th St, Baraboo, WI · SSM Health · · NPI 1720472848
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm CPT 14301 | not published | not published | $2,581.60 – $11,257.00 | 4 |
| Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/< CPT 14302 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/< CPT 14060 | not published | not published | $1,503.10 – $4,867.00 | 4 |
| Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm CPT 14061 | not published | not published | $1,503.10 – $4,867.00 | 4 |
| Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm CPT 14021 | not published | not published | $1,503.10 – $4,867.00 | 4 |
| Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm CPT 14001 | not published | not published | $1,503.10 – $4,867.00 | 4 |
| Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/< CPT 14000 | not published | not published | $1,503.10 – $4,867.00 | 4 |
| Trnsplj pd lvr&bwl cd154+cll CPT 81560 | not published | not published | $480.55 – $4,673.84 | 5 |
| Trnspl rej kdn mrna qpcr 139 CPT 81558 | not published | not published | $2,430.00 – $17,820.00 | 5 |
| Trnsxj/repos abrrnt rnl vsls CPT 50100 | not published | not published | $11,044.00 – $11,044.00 | 1 |
| Troponin quantitative CPT 84484 | $171.60 | $312.00 | $9.35 – $97.78 | 5 |
| Tr retinal les preterm inf CPT 67229 | not published | not published | $400.67 – $4,401.00 | 4 |
| Trurl dstrj prst8 tiss rf wv CPT 53854 | not published | not published | $2,567.95 – $6,687.00 | 4 |
| Truss addition to std pad wa HCPCS L8320 | not published | not published | $56.92 – $75.90 | 2 |
| Truss add to std pad scrotal HCPCS L8330 | not published | not published | $45.33 – $60.44 | 2 |
| Truss double with standard pad HCPCS L8310 | not published | not published | $137.21 – $182.95 | 2 |
| Truss single with standard pad HCPCS L8300 | not published | not published | $77.46 – $103.28 | 2 |
| Tte w or without contr, cont ecg HCPCS C8930 | not published | not published | $571.09 – $761.45 | 2 |
| Tte w or without fol w/con,stres HCPCS C8928 | $869.55 | $1,581.00 | $571.09 – $761.45 | 2 |
| Tte w or without fol w/cont, com HCPCS C8921 | not published | not published | $571.09 – $761.45 | 2 |
| Tte w or without fol w/cont, f/u HCPCS C8922 | not published | not published | $571.09 – $761.45 | 2 |
| Tubal Ligation (Laparoscopic) CPT 58670 | not published | not published | $4,404.16 – $16,781.00 | 4 |
| Tumor cell deplete of harvst CPT 38211 | not published | not published | $321.40 – $4,401.00 | 4 |
| Tvh >250 gms 58290 CPT 58290 | not published | not published | $5,402.14 – $18,408.00 | 4 |
| Tvh w/mmk 58267 CPT 58267 | not published | not published | $7,789.00 – $11,044.00 | 2 |
| Twelve volt battery utah/equ HCPCS L7364 | not published | not published | $472.27 – $629.69 | 2 |
| Tx atrial fib pulm vein isol CPT 93656 | not published | not published | $14,312.00 – $38,664.00 | 4 |
| Tx closed distal humerus fx CPT 24999 | not published | not published | $179.70 – $14,312.00 | 4 |
| Tx closed hip disl traumatic without anes CPT 27250 | $425.15 | $773.00 | $179.70 – $4,401.00 | 4 |
| Tx closed tib fx proximal w/w/o manip w/skel trac CPT 27532 | not published | not published | $2,383.65 – $11,257.00 | 4 |
| Tx closed tib shaft fx without manip CPT 27750 | $1,414.60 | $2,572.00 | $179.70 – $4,401.00 | 4 |
| Tx contour defects >10.0 cc CPT 11954 | not published | not published | $538.41 – $4,401.00 | 4 |
| Tx contour defects 1.1-5.0cc 11951 CPT 11951 | not published | not published | $538.41 – $4,401.00 | 4 |
| Tx ectopic pregnancy abdl pregnancy 59130 CPT 59130 | not published | not published | $11,044.00 – $11,044.00 | 1 |
| Tx ectopic pregnancy ntrstl prtl rescj uter 59136 CPT 59136 | not published | not published | $11,044.00 – $11,044.00 | 1 |
| Tx l/r atrial fib addl CPT 93657 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Tx open art fx mcp/iphlngl jnt incl int fixtn ea CPT 26746 | not published | not published | $2,383.65 – $11,257.00 | 4 |
| Tx open dstl phlngl fx f/t internal fixation ea CPT 26765 | not published | not published | $2,383.65 – $11,257.00 | 4 |
| Tx open iphlngl jt disl internal fixation sngl CPT 26785 | not published | not published | $2,383.65 – $11,257.00 | 4 |
| Tx open nsl fx uncomp CPT 21325 | not published | not published | $2,415.31 – $6,687.00 | 4 |
| Tx open nsl sptl fx CPT 21336 | not published | not published | $2,383.65 – $11,257.00 | 4 |
| Tx phalangeal shaft fx open prox/middle ea CPT 26735 | not published | not published | $2,383.65 – $11,257.00 | 4 |
| Tx septic abortion surgical 59830 CPT 59830 | not published | not published | $4,867.00 – $4,867.00 | 1 |
| Tx tarsal bone fx without manip 28450 CPT 28450 | not published | not published | $179.70 – $4,401.00 | 4 |
| Tympanic membrane repair CPT 69610 | not published | not published | $1,130.33 – $6,687.00 | 4 |
| Tympanolysis transcanal 69450 CPT 69450 | not published | not published | $2,415.31 – $14,304.00 | 4 |
| Tympanometry & reflex thresh CPT 92550 | $88.00 | $160.00 | $157.30 – $209.73 | 2 |
| Tympanostomy/ven tube/loc/top anes 69433 CPT 69433 | not published | not published | $392.90 – $4,401.00 | 4 |
| Tympp antrt/mastoidotomy prosthesis torp 69637 CPT 69637 | not published | not published | $4,312.59 – $14,304.00 | 4 |
| Tympp antrt/mastoid without ossic chain recnst 69635 CPT 69635 | not published | not published | $4,312.59 – $14,304.00 | 4 |
| Tyms gene com variants CPT 81346 | not published | not published | $131.11 – $1,226.51 | 5 |
| U2af1 gene common variants CPT 81357 | not published | not published | $144.94 – $1,410.12 | 5 |
| Ua w/micro/comp poc CPT 81000 | not published | not published | $3.02 – $31.51 | 5 |
| Ublituximab-xiiy 25 mg/ml intravenous solution HCPCS J2329 | not published | not published | $54.18 – $136.62 | 5 |
| Ue triple control harness HCPCS L6677 | not published | not published | $273.94 – $365.26 | 2 |
| Ugt1a1 gene analy common variants CPT 81350 | $866.80 | $1,576.00 | $175.50 – $1,641.80 | 5 |
| Ultrasound abdomen aorta screening study aaa CPT 76706 | $551.65 | $1,003.00 | $76.16 – $720.28 | 3 |
| Ultrasound bone density measure CPT 76977 | not published | not published | $44.74 – $101.55 | 3 |
| Ultrasound breast complete CPT 76641 | $588.50 | $1,070.00 | $76.16 – $770.12 | 3 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $1,097.25 | $1,995.00 | $63.40 – $588.79 | 3 |
| Ultrasound chest CPT 76604 | $707.30 | $1,286.00 | $76.16 – $662.10 | 3 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | $836.00 | $1,520.00 | $76.16 – $237.66 | 3 |
| Ultrasound dx ophth b-scan CPT 76512 | not published | not published | $76.16 – $430.59 | 3 |
| Ultrasound elastography ea l target les CPT 76983 | not published | not published | $367.35 – $367.35 | 1 |
| Ultrasound elastography parenchyma CPT 76981 | not published | not published | $76.16 – $844.31 | 3 |
| Ultrasound encephalogram CPT 76506 | $454.85 | $827.00 | $76.16 – $932.19 | 3 |
| Ultrasound exam k transpl w/doppler CPT 76776 | not published | not published | $76.16 – $1,291.01 | 3 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $939.40 | $1,708.00 | $76.16 – $538.63 | 3 |
| Ultrasound guidance for vascular access CPT 76937 | $359.70 | $654.00 | $185.20 – $185.20 | 1 |
| Ultrasound guided needle placement supervision & interpretation CPT 76942 | $746.35 | $1,357.00 | $299.41 – $299.41 | 1 |
| Ultrasound guide intraoperative CPT 76998 | not published | not published | $667.28 – $667.28 | 1 |
| Ultrasound guide tissue ablation CPT 76940 | not published | not published | $680.37 – $680.37 | 1 |
| Ultrasound hips infant dynamic CPT 76885 | $1,010.90 | $1,838.00 | $63.40 – $1,179.13 | 3 |
| Ultrasound infant hips ltd without stress CPT 76886 | not published | not published | $63.40 – $820.29 | 3 |
| Ultrasound joint complete left CPT 76881 | $710.05 | $1,291.00 | $76.16 – $909.02 | 3 |
| Ultrasound joint/nonvascular extremity limited left CPT 76882 | $505.45 | $919.00 | $76.16 – $121.90 | 3 |
| Ultrasound nrv&acc strux 1xtr compre CPT 76883 | not published | not published | $76.16 – $166.24 | 3 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $871.20 | $1,584.00 | $474.58 – $474.58 | 1 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $454.30 | $826.00 | $243.07 – $243.07 | 1 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | not published | not published | $173.82 – $915.17 | 3 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $592.35 | $1,077.00 | $76.16 – $777.84 | 3 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | $657.80 | $1,196.00 | $76.16 – $561.77 | 3 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | $750.20 | $1,364.00 | $76.16 – $642.79 | 3 |
| Ultrasound prostate/transrectal CPT 76872 | not published | not published | $76.16 – $658.24 | 3 |
| Ultrasound retroperitoneal limited CPT 76775 | $746.90 | $1,358.00 | $76.16 – $314.81 | 3 |
| Ultrasound scrotum and contents CPT 76870 | $644.60 | $1,172.00 | $76.16 – $384.29 | 3 |
| Ultrasound spinal canal and contents CPT 76800 | $304.15 | $553.00 | $76.16 – $882.02 | 3 |
| Ultrasound transabd ea addl gest CPT 76812 | $727.65 | $1,323.00 | $1,248.57 – $1,248.57 | 1 |
| Ultrasound transvaginal non obstetric CPT 76830 | $753.50 | $1,370.00 | $76.16 – $947.61 | 3 |
| Ultrasound trgt dyn mbubb 1st les CPT 76978 | not published | not published | $254.15 – $2,657.76 | 3 |
| Ultrasound trgt dyn mbubb ea addl CPT 76979 | not published | not published | $1,941.06 – $1,941.06 | 1 |
| Ultraviolet therapy CPT 97028 | not published | not published | $5.92 – $7.89 | 2 |
| Umbilical artery cath newborn 36660 CPT 36660 | not published | not published | $4,867.00 – $4,867.00 | 1 |
| Umbilical cord occlud w/us CPT 59072 | not published | not published | $222.00 – $4,401.00 | 4 |
| Umbilicoplasty 15847 CPT 15847 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Unit mobile power mpu HCPCS Q0479 | not published | not published | $11,085.67 – $14,780.89 | 2 |
| Unlisted chemotherapy px CPT 96549 | not published | not published | $34.11 – $45.48 | 2 |
| Unlisted cranfcl&maxlfcl px CPT 21299 | not published | not published | $172.55 – $14,312.00 | 4 |
| Unlisted CT procedure CPT 76497 | not published | not published | $63.40 – $851.47 | 3 |
| Unlisted cv px dx nuc med CPT 78499 | not published | not published | $291.23 – $388.31 | 2 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.