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 |
|---|---|---|---|---|
| Ureter endoscopy & biopsy CPT 50974 | not published | not published | $3,179.00 – $11,044.00 | 4 |
| Ureter endoscopy & catheter CPT 50972 | not published | not published | $2,567.95 – $11,257.00 | 4 |
| Ureter endoscopy & treatment CPT 50957 | not published | not published | $3,906.07 – $11,044.00 | 4 |
| Ureter endoscopy & treatment CPT 50961 | not published | not published | $3,906.07 – $11,044.00 | 4 |
| Ureter endoscopy & treatment CPT 50976 | not published | not published | $3,179.00 – $11,044.00 | 4 |
| Ureter endoscopy & treatment CPT 50980 | not published | not published | $3,906.07 – $11,044.00 | 4 |
| Ureteroneocystostomy 50780 CPT 50780 | not published | not published | $6,687.00 – $11,257.00 | 2 |
| Ureteroureterostomy 50760 CPT 50760 | not published | not published | $11,257.00 – $11,257.00 | 1 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | not published | not published | $173.82 – $565.25 | 3 |
| Urethrlys transvag with scope CPT 53500 | not published | not published | $2,567.95 – $11,257.00 | 4 |
| Urethrocystography void s&i CPT 74455 | $887.70 | $1,614.00 | $173.82 – $700.67 | 3 |
| Uric acid blood CPT 84550 | $37.40 | $68.00 | $3.39 – $44.95 | 5 |
| Uric acid urine CPT 84560 | $40.70 | $74.00 | $3.81 – $47.22 | 5 |
| Urinalysis glass test CPT 81020 | not published | not published | $3.52 – $36.63 | 5 |
| Urinalysis microscopic only CPT 81015 | $52.25 | $95.00 | $2.29 – $30.28 | 5 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | not published | not published | $1.63 – $21.54 | 5 |
| Urinalysis (with microscopy) CPT 81001 | $58.85 | $107.00 | $2.38 – $31.51 | 5 |
| Urinalysis (without microscopy) CPT 81003 | $35.75 | $65.00 | $1.69 – $22.33 | 5 |
| Urinary bldr retent nuc study CPT 78730 | not published | not published | $770.12 – $770.12 | 1 |
| Urinary reflex study CPT 51792 | not published | not published | $42.98 – $1,676.00 | 3 |
| Urine Culture Test CPT 87086 | $146.30 | $266.00 | $6.05 – $80.27 | 5 |
| Urine flow measurement 51736 CPT 51736 | not published | not published | $96.93 – $1,676.00 | 3 |
| Urine pregnancy test CPT 81025 | $45.65 | $83.00 | $6.46 – $62.83 | 5 |
| Urine screen for bacteria CPT 81007 | not published | not published | $22.48 – $52.47 | 5 |
| Urine shunt to intestine CPT 50815 | not published | not published | $11,257.00 – $11,257.00 | 1 |
| Urine specimen collect mult HCPCS P9615 | not published | not published | $11.36 – $21.89 | 3 |
| Urography, antegrade CPT 74425 | $521.40 | $948.00 | $254.15 – $3,775.89 | 3 |
| Urography inf drip &/or bolus CPT 74410 | not published | not published | $127.78 – $901.30 | 3 |
| Use 1st target lesion CPT 76982 | not published | not published | $76.16 – $720.56 | 3 |
| User adjustable heel height HCPCS L5990 | not published | not published | $1,675.40 – $2,233.87 | 2 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | not published | not published | $8.52 – $25.25 | 5 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | not published | not published | $288.38 – $288.38 | 1 |
| U/s trtmt, not leiomyomata HCPCS C9734 | not published | not published | $6,687.00 – $18,408.00 | 4 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | not published | not published | $234.39 – $307.14 | 3 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | not published | not published | $213.24 – $279.41 | 3 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | not published | not published | $226.06 – $296.20 | 3 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | not published | not published | $127.28 – $166.78 | 3 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | not published | not published | $95.05 – $124.55 | 3 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | not published | not published | $104.63 – $138.10 | 3 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $108.97 – $142.78 | 3 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | not published | not published | $102.05 – $133.71 | 3 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | not published | not published | $257.46 – $337.35 | 3 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | not published | not published | $45.92 – $60.17 | 3 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | not published | not published | $121.06 – $158.63 | 3 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | not published | not published | $121.06 – $158.63 | 3 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | not published | not published | $31.70 – $41.53 | 3 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | not published | not published | $32.41 – $42.47 | 3 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | not published | not published | $53.43 – $70.01 | 3 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | not published | not published | $15.85 – $20.77 | 3 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | not published | not published | $193.53 – $253.60 | 3 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | not published | not published | $374.09 – $490.18 | 3 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | not published | not published | $378.67 – $496.18 | 3 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | not published | not published | $453.71 – $594.51 | 3 |
| Vaccine rabies im CPT 90675 | not published | not published | $248.98 – $606.39 | 5 |
| Vaccine tdap >=7 years im CPT 90715 | not published | not published | $56.65 – $75.45 | 3 |
| Vaccine td preservative free >= 7 years im CPT 90714 | not published | not published | $49.24 – $69.09 | 3 |
| Vaccinia vrs vac 0.3 ml perq CPT 90622 | not published | not published | $0.01 – $0.01 | 3 |
| Vad battery clip set hmii 14-v li-ion HCPCS Q0497 | not published | not published | $432.33 – $576.44 | 2 |
| Vad cable power module dc input HCPCS Q0478 | not published | not published | $169.71 – $226.28 | 2 |
| Vad univ batt charger hm 1440 HCPCS Q0495 | not published | not published | $3,857.60 – $5,143.47 | 2 |
| Vag hys/<250g/rmv tube/rpr entero 58263 CPT 58263 | not published | not published | $3,644.28 – $11,044.00 | 4 |
| Vag hyst incl t/o complex CPT 58291 | not published | not published | $3,644.28 – $14,304.00 | 4 |
| Vag hyst including t/o CPT 58262 | not published | not published | $3,644.28 – $11,044.00 | 4 |
| Vag hyst t/o & repair compl CPT 58292 | not published | not published | $5,402.14 – $18,408.00 | 4 |
| Vag hyst w/enterocele compl 58294 CPT 58294 | not published | not published | $3,644.28 – $14,304.00 | 4 |
| Vag hyst w/enterocele repair CPT 58270 | not published | not published | $3,644.28 – $11,044.00 | 4 |
| Vaginal bx CPT 58999 | not published | not published | $147.28 – $14,312.00 | 4 |
| Vaginal delivery after cesarean delivery 59612 CPT 59612 | not published | not published | $2,358.24 – $6,687.00 | 4 |
| Vaginal Delivery (full care) CPT 59400 | not published | not published | $11,257.00 – $11,257.00 | 1 |
| Vaginal hysterectomy CPT 58260 | not published | not published | $3,644.28 – $11,044.00 | 4 |
| Vaginectomy partial w/nodes CPT 57109 | not published | not published | $2,358.24 – $6,687.00 | 4 |
| Vag inser rectal control sys HCPCS A4563 | not published | not published | $1,260.44 – $1,680.58 | 2 |
| Vagnc compl rmvl paravag tis CPT 57111 | not published | not published | $7,789.00 – $11,044.00 | 2 |
| Vagnc compl rmvl vag wall CPT 57110 | not published | not published | $11,044.00 – $11,044.00 | 1 |
| Vagotomy pfrmd w/prtl dstl gstrct 43635 CPT 43635 | not published | not published | $11,257.00 – $11,257.00 | 1 |
| Vagotomy & pylorus repair CPT 43641 | not published | not published | $11,257.00 – $11,257.00 | 1 |
| Vagotomy & pylorus repair 43640 CPT 43640 | not published | not published | $11,257.00 – $11,257.00 | 1 |
| Valproic acid total therapeutic drug level CPT 80164 | $215.05 | $391.00 | $10.16 – $134.71 | 5 |
| Valrubicin injection HCPCS J9357 | not published | not published | $935.29 – $2,615.89 | 5 |
| Valvuloplasty aortic CPT 92986 | not published | not published | $4,146.30 – $17,411.00 | 4 |
| Valvuloplasty aortic valve CPT 33390 | not published | not published | $18,408.00 – $18,408.00 | 1 |
| Valvuloplasty aortic valve CPT 33391 | not published | not published | $14,312.00 – $14,312.00 | 1 |
| Valvuloplasty mitral CPT 92987 | not published | not published | $8,409.93 – $18,408.00 | 4 |
| Valvuloplasty pulmonary CPT 92990 | not published | not published | $8,409.93 – $18,408.00 | 4 |
| Valvuloplasty/tv without ring insert 33463 CPT 33463 | not published | not published | $18,408.00 – $18,408.00 | 1 |
| Valvuloplasty/tv w/ring insertion 33464 CPT 33464 | not published | not published | $18,408.00 – $18,408.00 | 1 |
| Vancomycin 1,000 mg intravenous injection HCPCS J3373 | not published | not published | $0.06 – $0.06 | 1 |
| Vancomycin 750 mg intravenous solution HCPCS J3374 | not published | not published | $0.23 – $0.23 | 1 |
| Vancomycin hcl injection HCPCS J3370 | not published | not published | $2.83 – $3.44 | 2 |
| Vancomycin peak therapeutic drug level CPT 80202 | $187.55 | $341.00 | $10.16 – $134.71 | 5 |
| Vanomycin dna amp probe CPT 87500 | not published | not published | $26.32 – $348.80 | 5 |
| Varicella zoster antibody igg CPT 86787 | $20.90 | $38.00 | $9.66 – $57.79 | 5 |
| Varus/valgus strap padded/li HCPCS L2270 | not published | not published | $56.82 – $75.76 | 2 |
| Vasc emb/occ w/prs cath HCPCS C9797 | not published | not published | $13,354.59 – $17,806.11 | 3 |
| Vasc graft into carpal bone CPT 25430 | not published | not published | $2,383.65 – $14,304.00 | 4 |
| Vasectomy CPT 55250 | not published | not published | $1,522.84 – $6,687.00 | 4 |
| Vasopressin 20 unit/ml intravenous solution HCPCS J2598 | not published | not published | $2.06 – $3.02 | 3 |
| Vbac delivery 59610 CPT 59610 | not published | not published | $11,257.00 – $11,257.00 | 1 |
| Vbac/include postpartum care 59614 CPT 59614 | not published | not published | $11,257.00 – $11,257.00 | 1 |
| Vedolizumab 300 mg intravenous solution HCPCS J3380 | not published | not published | $16.22 – $41.92 | 5 |
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.