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 |
|---|---|---|---|---|
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $2,883.65 | $5,243.00 | $254.15 – $2,367.54 | 3 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $2,552.55 | $4,641.00 | $173.82 – $1,206.13 | 3 |
| CT thoracic spine w/contrast CPT 72129 | $1,667.05 | $3,031.00 | $127.78 – $1,811.91 | 3 |
| CT thoracic spine without contrast CPT 72128 | $1,643.40 | $2,988.00 | $76.16 – $1,399.06 | 3 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $1,117.05 | $2,031.00 | $76.16 – $1,063.09 | 3 |
| CT t-spine w /wo contrast CPT 72130 | $1,778.70 | $3,234.00 | $127.78 – $2,251.78 | 3 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $1,422.85 | $2,587.00 | $254.15 – $1,769.47 | 3 |
| CT upper extremity without contrast (both sides) CPT 73200 | $1,075.25 | $1,955.00 | $76.16 – $1,383.64 | 3 |
| CT uppr extremity w/o&w/dye CPT 73202 | $1,523.50 | $2,770.00 | $127.78 – $2,332.79 | 3 |
| Cuffs adj lock with active con HCPCS L3740 | not published | not published | $901.34 – $1,201.78 | 2 |
| Cultr oocyte/embryo <4 days CPT 89250 | not published | not published | $124.11 – $7,310.23 | 3 |
| Cultr oocyte/embryo <4 days CPT 89251 | not published | not published | $124.11 – $7,602.35 | 3 |
| Cult skin graft fnhfg 15155 CPT 15155 | not published | not published | $2,581.60 – $11,257.00 | 4 |
| Cult skin grft t/arm/leg CPT 15150 | not published | not published | $1,503.10 – $4,867.00 | 4 |
| Culture aerobic additional method definitive id each CPT 87077 | $189.20 | $344.00 | $6.06 – $80.27 | 5 |
| Culture afb any source CPT 87116 | $179.85 | $327.00 | $8.10 – $107.35 | 5 |
| Culture anaerobic additional method definitive id each CPT 87076 | $351.45 | $639.00 | $6.06 – $80.27 | 5 |
| Culture anaerobic except blood CPT 87075 | $190.30 | $346.00 | $7.10 – $94.13 | 5 |
| Culture bacteria anaerobic CPT 87073 | not published | not published | $7.24 – $93.85 | 5 |
| Culture bact stool aero addl path ea CPT 87046 | $57.20 | $104.00 | $7.08 – $93.85 | 5 |
| Culture body fluid CPT 87070 | $169.40 | $308.00 | $6.46 – $85.66 | 5 |
| Culture fungi definitive id mold CPT 87107 | $41.80 | $76.00 | $7.74 – $102.67 | 5 |
| Culture fungi definitive id yeast CPT 87106 | $114.40 | $208.00 | $7.74 – $102.67 | 5 |
| Culture fungi other (except blood) CPT 87102 | $50.05 | $91.00 | $6.31 – $83.57 | 5 |
| Culture fungi skin/hair/nail CPT 87101 | $121.00 | $220.00 | $5.78 – $76.62 | 5 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $180.95 | $329.00 | $10.96 – $108.82 | 5 |
| Culture mycoplasma any source CPT 87109 | $90.75 | $165.00 | $11.54 – $99.03 | 5 |
| Culture of specimen by kit CPT 87084 | not published | not published | $20.30 – $74.87 | 5 |
| Culture quantitative aerobic other source CPT 87071 | not published | not published | $7.42 – $93.85 | 5 |
| Culture screening strep group a CPT 87081 | $161.15 | $293.00 | $4.97 – $65.89 | 5 |
| Culture type pulse field gel CPT 87152 | not published | not published | $5.80 – $52.03 | 5 |
| Culture typing added method CPT 87158 | $105.05 | $191.00 | $5.80 – $52.03 | 5 |
| Culture typing glc/hplc CPT 87143 | $351.45 | $639.00 | $9.39 – $124.49 | 5 |
| Culture typing immunologic CPT 87147 | $101.20 | $184.00 | $3.88 – $51.45 | 5 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | $344.30 | $626.00 | $163.54 – $1,591.05 | 5 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $121.00 | $220.00 | $26.32 – $348.80 | 5 |
| Culture urine each isolate CPT 87088 | $138.05 | $251.00 | $6.07 – $80.51 | 5 |
| Culture virus isolation CPT 87250 | not published | not published | $14.67 – $194.46 | 5 |
| Curette/treat cornea CPT 65435 | not published | not published | $726.23 – $4,867.00 | 4 |
| Curette/treat cornea CPT 65436 | not published | not published | $1,732.00 – $6,687.00 | 4 |
| Cus elbo skt in for con/atyp HCPCS L6696 | not published | not published | $1,214.80 – $1,619.74 | 2 |
| Cus elbo skt in not con/atyp HCPCS L6697 | not published | not published | $1,214.80 – $1,619.74 | 2 |
| Custom glove for term device HCPCS L6895 | not published | not published | $616.75 – $822.33 | 2 |
| Custom shape cover ak HCPCS L5705 | not published | not published | $1,058.92 – $1,411.90 | 2 |
| Custom shape cover bk HCPCS L5704 | not published | not published | $577.58 – $770.11 | 2 |
| Custom shape cvr hip disart HCPCS L5707 | not published | not published | $1,387.66 – $1,850.21 | 2 |
| Custom shape cvr knee disart HCPCS L5706 | not published | not published | $1,032.84 – $1,377.12 | 2 |
| Cv line/pic reposition CPT 36597 | not published | not published | $1,146.77 – $4,867.00 | 4 |
| Cyanocobalamin unsat binding capacity CPT 82608 | not published | not published | $10.74 – $142.36 | 5 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | not published | not published | $0.97 – $2.35 | 3 |
| Cyclic citrullinated peptide antibody CPT 86200 | $44.55 | $81.00 | $9.71 – $128.65 | 5 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | not published | not published | $0.43 – $1.63 | 5 |
| Cyclophosphamide 25 mg capsule HCPCS J8530 | not published | not published | $1.55 – $3.77 | 3 |
| Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 | not published | not published | $103.53 – $138.11 | 3 |
| Cyclosporine 2 hour CPT 80158 | $32.45 | $59.00 | $13.54 – $179.44 | 5 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | not published | not published | $1.07 – $1.54 | 3 |
| Cyclosporine oral 100 mg HCPCS J7502 | not published | not published | $2.93 – $4.07 | 3 |
| Cygnus matrix, per sq cm HCPCS Q4199 | not published | not published | $90.66 – $673.01 | 5 |
| Cygnus, per sq cm HCPCS Q4170 | not published | not published | $78.95 – $644.87 | 4 |
| Cyp2c19 gene com variants CPT 81225 | not published | not published | $218.52 – $2,126.00 | 5 |
| Cyp2c9 gene com variants CPT 81227 | not published | not published | $131.11 – $1,275.58 | 5 |
| Cyp2d6 gene com variants CPT 81226 | $593.45 | $1,079.00 | $338.18 – $3,290.23 | 5 |
| Cyp3a4 gene common variants CPT 81230 | not published | not published | $131.11 – $1,226.51 | 5 |
| Cyp3a5 gene common variants CPT 81231 | not published | not published | $131.11 – $1,226.51 | 5 |
| Cystatin c CPT 82610 | $40.15 | $73.00 | $13.89 – $135.13 | 5 |
| Cystic fibrosis cftr CPT 81223 | not published | not published | $374.25 – $3,501.09 | 5 |
| Cystine urine quantitative CPT 82131 | $84.15 | $153.00 | $17.24 – $167.69 | 5 |
| Cysto cgen post urtl valves CPT 52400 | not published | not published | $2,567.95 – $11,257.00 | 4 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $589.60 | $1,072.00 | $229.94 – $338.87 | 3 |
| Cysto impl 4 or more HCPCS C9740 | not published | not published | $6,896.31 – $18,408.00 | 4 |
| Cysto insj dev ischmc rmdlg CPT 53865 | not published | not published | $6,896.31 – $11,257.00 | 3 |
| Cysto, litho, vacuum kidney HCPCS C9761 | not published | not published | $6,687.00 – $11,044.00 | 4 |
| Cystometrogram w/up 51727 CPT 51727 | not published | not published | $507.98 – $2,628.00 | 3 |
| Cystorrhaphy wound comp 51865 CPT 51865 | not published | not published | $7,789.00 – $11,257.00 | 2 |
| Cystorrhaphy wound simple 51860 CPT 51860 | not published | not published | $6,687.00 – $11,044.00 | 4 |
| Cysto rx balo cath urtl strx CPT 52284 | not published | not published | $3,906.07 – $11,044.00 | 3 |
| Cystoscopy and biopsy CPT 52007 | not published | not published | $2,567.95 – $11,257.00 | 4 |
| Cystoscopy and radiotracer CPT 52250 | not published | not published | $2,567.95 – $11,257.00 | 4 |
| Cystoscopy and treatment CPT 52214 | not published | not published | $2,567.95 – $6,687.00 | 4 |
| Cystoscopy and treatment CPT 52224 | not published | not published | $2,567.95 – $6,687.00 | 4 |
| Cystoscopy and treatment CPT 52234 | not published | not published | $2,567.95 – $11,257.00 | 4 |
| Cystoscopy and treatment CPT 52235 | not published | not published | $2,567.95 – $11,257.00 | 4 |
| Cystoscopy and treatment CPT 52240 | not published | not published | $3,906.07 – $11,044.00 | 4 |
| Cystoscopy and treatment CPT 52260 | not published | not published | $1,522.84 – $4,867.00 | 4 |
| Cystoscopy and treatment CPT 52265 | not published | not published | $1,522.84 – $4,867.00 | 4 |
| Cystoscopy and treatment CPT 52276 | not published | not published | $1,522.84 – $6,687.00 | 4 |
| Cystoscopy and treatment CPT 52277 | not published | not published | $2,567.95 – $11,257.00 | 4 |
| Cystoscopy and treatment CPT 52283 | not published | not published | $1,522.84 – $6,687.00 | 4 |
| Cystoscopy and treatment CPT 52285 | not published | not published | $507.98 – $4,401.00 | 4 |
| Cystoscopy and treatment CPT 52290 | not published | not published | $1,522.84 – $6,687.00 | 4 |
| Cystoscopy and treatment CPT 52300 | not published | not published | $2,567.95 – $11,257.00 | 4 |
| Cystoscopy and treatment CPT 52301 | not published | not published | $2,567.95 – $11,257.00 | 4 |
| Cystoscopy and treatment CPT 52305 | not published | not published | $3,906.07 – $11,044.00 | 4 |
| Cystoscopy and treatment CPT 52310 | not published | not published | $1,522.84 – $4,867.00 | 4 |
| Cystoscopy and treatment CPT 52315 | not published | not published | $1,522.84 – $6,687.00 | 4 |
| Cystoscopy and treatment CPT 52320 | not published | not published | $2,567.95 – $11,257.00 | 4 |
| Cystoscopy and treatment CPT 52330 | not published | not published | $2,567.95 – $11,257.00 | 4 |
| Cystoscopy (Bladder Scope) CPT 52000 | not published | not published | $507.98 – $4,401.00 | 4 |
| Cystoscopy chemodenervation CPT 52287 | not published | not published | $1,522.84 – $4,867.00 | 4 |
| Cystoscopy & duct catheter CPT 52010 | not published | not published | $507.98 – $4,401.00 | 4 |
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.