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 |
|---|---|---|---|---|
| Xcapsl ctrc rmvl insj 1+ CPT 66991 | not published | not published | $3,876.57 – $14,304.00 | 4 |
| Xcapsl ctrc rmvl w/ecp CPT 66988 | not published | not published | $3,011.20 – $14,304.00 | 4 |
| Xcpsl ctrc rmvl cplx insj 1+ CPT 66989 | not published | not published | $3,876.57 – $14,304.00 | 4 |
| Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/< CPT 14040 | not published | not published | $1,503.10 – $4,867.00 | 4 |
| Xfer tis s/a/l 10 sq cm/< CPT 14020 | not published | not published | $1,503.10 – $4,867.00 | 4 |
| X-linked intellectual dblt CPT 81470 | not published | not published | $685.50 – $6,669.32 | 5 |
| X-linked intellectual dblt CPT 81471 | not published | not published | $685.50 – $6,669.32 | 5 |
| Xm archive tissue molec anal CPT 88363 | not published | not published | $21.07 – $164.62 | 3 |
| Xpos opn axillary/sbclvn art w/cndt crtn CPT 34716 | not published | not published | $767.66 – $1,676.00 | 2 |
| Xpos opn fmrl eprst aor uni add-on CPT 34812 | not published | not published | $4,867.00 – $4,867.00 | 1 |
| X-ray abdomen 1 view CPT 74018 | $334.95 | $609.00 | $63.40 – $194.73 | 3 |
| X-ray abdomen 2 views CPT 74019 | $346.50 | $630.00 | $76.16 – $233.40 | 3 |
| X-ray abdomen >=3 views CPT 74021 | not published | not published | $76.16 – $272.06 | 3 |
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $424.05 | $771.00 | $76.16 – $303.23 | 3 |
| X-ray acromioclavicular joints without or w/weighted distraction bilateral CPT 73050 | $355.85 | $647.00 | $63.40 – $268.51 | 3 |
| X-ray ankle 2 views (both sides) CPT 73600 | $244.75 | $445.00 | $63.40 – $229.94 | 3 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | $609.40 | $1,108.00 | $254.15 – $781.71 | 3 |
| X-ray assay calculus CPT 82370 | not published | not published | $9.39 – $124.49 | 5 |
| X-ray bone age studies CPT 77072 | $1,195.15 | $2,173.00 | $76.16 – $145.04 | 3 |
| X-ray bone length studies CPT 77073 | $1,793.00 | $3,260.00 | $76.16 – $233.80 | 3 |
| X-ray bone survey complete CPT 77075 | $641.30 | $1,166.00 | $76.16 – $650.52 | 3 |
| X-ray bone survey infant CPT 77076 | $470.25 | $855.00 | $76.16 – $654.36 | 3 |
| X-ray cervical spine 2-3 views CPT 72040 | $326.70 | $594.00 | $63.40 – $233.80 | 3 |
| X-ray cervical spine 4-5 views CPT 72050 | $360.25 | $655.00 | $76.16 – $310.97 | 3 |
| X-ray cervical spine >= 6 views CPT 72052 | $668.80 | $1,216.00 | $76.16 – $407.43 | 3 |
| X-ray clavicle complete (both sides) CPT 73000 | $209.55 | $381.00 | $63.40 – $202.95 | 3 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $561.55 | $1,021.00 | $127.78 – $1,240.88 | 3 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $874.50 | $1,590.00 | $127.78 – $1,754.03 | 3 |
| X-ray elbow 2 views (both sides) CPT 73070 | $207.35 | $377.00 | $63.40 – $206.77 | 3 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $282.15 | $513.00 | $63.40 – $237.66 | 3 |
| Xray endovasc thor ao repr CPT 75956 | not published | not published | $3,557.08 – $3,557.08 | 1 |
| Xray endovasc thor ao repr CPT 75957 | not published | not published | $3,046.00 – $3,046.00 | 1 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $369.05 | $671.00 | $127.78 – $704.53 | 3 |
| X-ray exam entire spi 4/5 vw CPT 72083 | not published | not published | $76.16 – $538.63 | 3 |
| X-ray exam entire spi 6/> vw CPT 72084 | not published | not published | $76.16 – $646.66 | 3 |
| X-ray exam of arm infant CPT 73092 | $264.00 | $480.00 | $76.16 – $202.95 | 3 |
| X-ray exam of eye sockets CPT 70200 | not published | not published | $76.16 – $299.41 | 3 |
| X-ray exam of femur 1 CPT 73551 | $149.05 | $271.00 | $63.40 – $206.77 | 3 |
| X-ray exam of jaw joint CPT 70328 | not published | not published | $63.40 – $229.94 | 3 |
| X-ray exam of jaw joint CPT 70332 | not published | not published | $173.82 – $538.63 | 3 |
| X-ray exam of mastoids CPT 70120 | not published | not published | $76.16 – $264.67 | 3 |
| X-ray exam of middle ear CPT 70134 | not published | not published | $361.13 – $530.75 | 3 |
| X-ray exam of penis CPT 74445 | not published | not published | $76.16 – $433.45 | 3 |
| X-ray exam of perineum CPT 74775 | not published | not published | $173.82 – $572.87 | 3 |
| X-ray exam of salivary gland CPT 70380 | not published | not published | $63.40 – $287.81 | 3 |
| X-ray exam of sinuses CPT 70210 | $106.70 | $194.00 | $63.40 – $222.23 | 3 |
| X-ray exam of tear duct CPT 70170 | not published | not published | $173.82 – $378.98 | 3 |
| X-ray exam of teeth CPT 70300 | not published | not published | $63.40 – $94.88 | 3 |
| X-ray exam of teeth CPT 70310 | not published | not published | $173.82 – $307.10 | 3 |
| X-ray exam si joints CPT 72200 | not published | not published | $76.16 – $210.63 | 3 |
| X-ray exam thorac spine4/>vw CPT 72074 | not published | not published | $76.16 – $303.23 | 3 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $128.70 | $234.00 | $63.40 – $206.77 | 3 |
| X-ray facial bones complete > 3 views CPT 70150 | $352.00 | $640.00 | $76.16 – $299.41 | 3 |
| X-ray fallopian tube CPT 74742 | not published | not published | $589.34 – $589.34 | 1 |
| X-ray femur >=2 views (both sides) CPT 73552 | $289.85 | $527.00 | $63.40 – $245.38 | 3 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $264.00 | $480.00 | $63.40 – $260.80 | 3 |
| X-ray foot 2 views (both sides) CPT 73620 | $257.95 | $469.00 | $63.40 – $195.22 | 3 |
| X-ray forearm 2 views (both sides) CPT 73090 | $248.60 | $452.00 | $63.40 – $183.65 | 3 |
| X-ray hand 2 views (both sides) CPT 73120 | $244.75 | $445.00 | $76.16 – $187.48 | 3 |
| X-ray head for orthodontia CPT 70350 | not published | not published | $63.40 – $102.61 | 3 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $196.90 | $358.00 | $63.40 – $202.95 | 3 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | not published | not published | $76.16 – $399.69 | 3 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $283.80 | $516.00 | $76.16 – $303.23 | 3 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $300.85 | $547.00 | $76.16 – $361.13 | 3 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $357.50 | $650.00 | $76.16 – $434.44 | 3 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $283.80 | $516.00 | $63.40 – $218.37 | 3 |
| X-ray humerus >= 2 views left CPT 73060 | $190.85 | $347.00 | $63.40 – $218.37 | 3 |
| X-ray joint survey 1 view CPT 77077 | $259.05 | $471.00 | $76.16 – $226.08 | 3 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $234.85 | $427.00 | $63.40 – $241.51 | 3 |
| X-ray knee 3 views (both sides) CPT 73562 | $242.55 | $441.00 | $63.40 – $280.10 | 3 |
| X-ray knee ap standing bilateral CPT 73565 | $262.35 | $477.00 | $63.40 – $291.68 | 3 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $128.70 | $234.00 | $63.40 – $210.63 | 3 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $335.50 | $610.00 | $76.16 – $310.97 | 3 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $609.95 | $1,109.00 | $76.16 – $353.41 | 3 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | not published | not published | $76.16 – $492.30 | 3 |
| X-ray male genital tract CPT 74440 | not published | not published | $173.82 – $677.53 | 3 |
| X-ray mandible complete > 4 views CPT 70110 | $347.05 | $631.00 | $76.16 – $268.51 | 3 |
| X-ray mandible ltd <4 views CPT 70100 | not published | not published | $63.40 – $253.09 | 3 |
| X-ray nasal bones complete > 3 views CPT 70160 | $278.30 | $506.00 | $63.40 – $253.09 | 3 |
| X-ray neck soft tissue CPT 70360 | $239.80 | $436.00 | $63.40 – $210.63 | 3 |
| X-ray nose to rectum for foreign body child CPT 76010 | $316.25 | $575.00 | $63.40 – $179.77 | 3 |
| X-ray of mammary ducts CPT 77054 | $634.15 | $1,153.00 | $173.82 – $581.07 | 3 |
| X-ray optic foramina CPT 70190 | not published | not published | $63.40 – $260.80 | 3 |
| X-ray pelvis 1-2 views CPT 72170 | $294.25 | $535.00 | $76.16 – $245.38 | 3 |
| X-ray pelvis complete > 3 views CPT 72190 | $311.85 | $567.00 | $76.16 – $291.68 | 3 |
| Xray place dist ext thor ao CPT 75959 | not published | not published | $1,772.15 – $1,772.15 | 1 |
| Xray place prox ext thor ao CPT 75958 | not published | not published | $2,021.29 – $2,021.29 | 1 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $467.50 | $850.00 | $254.15 – $3,775.89 | 3 |
| X-ray ribs 2 views left CPT 71100 | $338.25 | $615.00 | $63.40 – $229.94 | 3 |
| X-ray ribs 3 views bilateral CPT 71110 | $441.10 | $802.00 | $76.16 – $253.09 | 3 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $406.45 | $739.00 | $76.16 – $241.51 | 3 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $627.00 | $1,140.00 | $76.16 – $334.11 | 3 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $272.25 | $495.00 | $76.16 – $249.22 | 3 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $284.35 | $517.00 | $63.40 – $206.77 | 3 |
| X-ray scapula complete (both sides) CPT 73010 | $301.40 | $548.00 | $76.16 – $222.23 | 3 |
| X-ray sella turcica CPT 70240 | not published | not published | $63.40 – $214.50 | 3 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $135.30 | $246.00 | $63.40 – $160.50 | 3 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $411.95 | $749.00 | $63.40 – $264.67 | 3 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $430.65 | $783.00 | $307.10 – $530.75 | 3 |
| X-ray skull < 4 views CPT 70250 | $272.25 | $495.00 | $76.16 – $249.22 | 3 |
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.