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 |
|---|---|---|---|---|
| X-ray skull > 4 views complete CPT 70260 | $474.10 | $862.00 | $76.16 – $299.41 | 3 |
| X-ray slg plne bdy sect without urogr CPT 76100 | not published | not published | $76.16 – $654.36 | 3 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $584.10 | $1,062.00 | $127.78 – $862.73 | 3 |
| X-ray small intestine follow-through study CPT 74248 | $583.55 | $1,061.00 | $510.13 – $510.13 | 1 |
| X-ray spine single view CPT 72020 | $295.90 | $538.00 | $63.40 – $152.78 | 3 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $237.60 | $432.00 | $63.40 – $264.67 | 3 |
| X-ray sternum > 2 views CPT 71120 | $268.40 | $488.00 | $63.40 – $206.77 | 3 |
| X-ray surgical specimen CPT 76098 | not published | not published | $91.03 – $530.75 | 3 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $385.55 | $701.00 | $127.78 – $1,086.52 | 3 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $546.70 | $994.00 | $63.40 – $368.86 | 3 |
| X-ray thoracic spine 2 views CPT 72070 | $288.20 | $524.00 | $76.16 – $241.51 | 3 |
| X-ray thoracic spine 3 views CPT 72072 | not published | not published | $76.16 – $253.09 | 3 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $271.70 | $494.00 | $63.40 – $210.63 | 3 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | not published | not published | $63.40 – $272.39 | 3 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $955.35 | $1,737.00 | $76.16 – $496.18 | 3 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $287.10 | $522.00 | $63.40 – $214.50 | 3 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $167.75 | $305.00 | $63.40 – $229.94 | 3 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $716.65 | $1,303.00 | $127.78 – $993.93 | 3 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $572.55 | $1,041.00 | $127.78 – $843.44 | 3 |
| X-ray wrist 2 views (both sides) CPT 73100 | $244.75 | $445.00 | $63.40 – $222.23 | 3 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | not published | not published | $127.78 – $642.79 | 3 |
| Xwrap 1 sq cm HCPCS Q4204 | not published | not published | $90.66 – $7,172.07 | 4 |
| Xylose absorption test blood &/or urine CPT 84620 | not published | not published | $9.68 – $117.78 | 5 |
| Xyntha inj HCPCS J7185 | not published | not published | $1.03 – $2.93 | 5 |
| Yersinia antibody CPT 86793 | not published | not published | $9.89 – $57.79 | 5 |
| Zenith amniotic membrane psc HCPCS Q4253 | not published | not published | $90.66 – $220.95 | 5 |
| Ziconotide injection HCPCS J2278 | not published | not published | $8.09 – $19.25 | 5 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | not published | not published | $1.13 – $2.88 | 5 |
| Zika virus dna/rna amp probe CPT 87662 | not published | not published | $38.48 – $444.49 | 5 |
| Zika virus igm antibody CPT 86794 | not published | not published | $12.64 – $145.92 | 5 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | not published | not published | $5.96 – $13.30 | 3 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | not published | not published | $6.51 – $15.16 | 5 |
| Zolbetuximab-clzb 100 mg intravenous solution HCPCS J1326 | not published | not published | $25.44 – $63.76 | 3 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | not published | not published | $9.89 – $13.80 | 3 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $144.94 – $1,410.12 | 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.