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 |
|---|---|---|---|---|
| Extraction of lens CPT 66940 | not published | not published | $1,681.25 – $4,867.00 | 4 |
| Extraction of lens 66920 CPT 66920 | not published | not published | $1,681.25 – $6,687.00 | 4 |
| Extrnl counterpulse, per tx HCPCS G0166 | not published | not published | $96.93 – $129.23 | 2 |
| Eye allergy tests CPT 95060 | not published | not published | $96.93 – $129.23 | 2 |
| Eye photodynamic ther add-on CPT 67225 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Eye surgery follow-up add-on CPT 67331 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Eye suture during surgery CPT 67335 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Ezh2 gene common variants CPT 81237 | not published | not published | $131.55 – $1,279.87 | 5 |
| Ezh2 gene full gene sequence CPT 81236 | not published | not published | $212.16 – $2,064.13 | 5 |
| F-18 fdg pet diag HCPCS A9552 | $602.25 | $1,095.00 | not published | 0 |
| F9 full gene sequence CPT 81238 | not published | not published | $450.00 – $4,209.72 | 5 |
| Face bone graft CPT 21210 | not published | not published | $4,312.59 – $14,304.00 | 4 |
| Facial bones <3 CPT 70140 | $146.30 | $266.00 | $63.40 – $202.95 | 3 |
| Facial nerve function test CPT 92516 | not published | not published | $157.30 – $209.73 | 2 |
| Facility svs dental rehab HCPCS G0330 | not published | not published | $2,415.31 – $3,220.41 | 2 |
| Factor ix CPT 85250 | $99.00 | $180.00 | $14.28 – $189.28 | 5 |
| Factor ix alprolix recomb HCPCS J7201 | not published | not published | $2.78 – $6.89 | 5 |
| Factor ix complex HCPCS J7194 | not published | not published | $1.31 – $3.24 | 5 |
| Factor ix idelvion inj HCPCS J7202 | not published | not published | $4.13 – $10.15 | 5 |
| Factor ix non-recombinant HCPCS J7193 | not published | not published | $1.05 – $2.54 | 5 |
| Factor ix recomb gly rebinyn HCPCS J7203 | not published | not published | $3.51 – $8.70 | 5 |
| Factor ix recombinan rixubis HCPCS J7200 | not published | not published | $1.29 – $3.05 | 5 |
| Factor ix recombinant nos HCPCS J7195 | not published | not published | $1.40 – $3.56 | 5 |
| Factor viia recomb sevenfact HCPCS J7212 | not published | not published | $1.65 – $4.56 | 5 |
| Factor viii CPT 85240 | $96.80 | $176.00 | $13.42 – $69.54 | 5 |
| Factor viii HCPCS J7190 | not published | not published | $0.93 – $2.15 | 5 |
| Factor viii fc fusion recomb HCPCS J7205 | not published | not published | $1.93 – $4.60 | 5 |
| Factor viii nuwiq recomb 1iu HCPCS J7209 | not published | not published | $0.92 – $2.29 | 5 |
| Factor viii pegylated recomb HCPCS J7207 | not published | not published | $1.59 – $4.09 | 5 |
| Factor viii recombinant nos HCPCS J7192 | not published | not published | $1.18 – $2.92 | 5 |
| Factor viii recomb novoeight HCPCS J7182 | not published | not published | $1.08 – $2.88 | 5 |
| Factor viii recomb obizur HCPCS J7188 | not published | not published | $2.43 – $6.14 | 5 |
| Factor xiii anti-hem factor HCPCS J7180 | not published | not published | $8.43 – $20.48 | 5 |
| Factor xiii recomb a-subunit HCPCS J7181 | not published | not published | $14.34 – $34.76 | 5 |
| Fallopian tube recnl CPT 58345 | not published | not published | $2,358.24 – $6,687.00 | 4 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | not published | not published | $0.01 – $0.02 | 2 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | not published | not published | $24.66 – $57.00 | 5 |
| Fancc gene CPT 81242 | $228.80 | $416.00 | $27.46 – $256.95 | 5 |
| Fasciotomy hip/thigh any typ CPT 27025 | not published | not published | $2,383.65 – $16,310.00 | 4 |
| Fat/lipids feces qualitative CPT 82705 | $19.25 | $35.00 | $3.82 – $50.58 | 5 |
| Fatty acids nonesterified CPT 82725 | $530.75 | $965.00 | $14.08 – $132.30 | 5 |
| Fda ide #g240020 carry bag HCPCS Q0499 | not published | not published | $154.13 – $205.51 | 2 |
| Fecal bilirubin test CPT 82252 | not published | not published | $3.42 – $45.24 | 5 |
| Fecal microbiota, live-jslm 150 ml rectal suspension enema HCPCS J1440 | not published | not published | $49.20 – $121.66 | 5 |
| Fecal microbiota prep instil HCPCS G0455 | not published | not published | $677.47 – $903.30 | 2 |
| #fecal-sodium CPT 84302 | $19.25 | $35.00 | $3.64 – $48.39 | 5 |
| Feeding tube reposition CPT 74355 | not published | not published | $1,122.40 – $1,122.40 | 1 |
| Fees w/laryngeal sense test CPT 92616 | not published | not published | $58.14 – $77.52 | 2 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | $26.95 | $49.00 | $13.98 – $136.01 | 5 |
| Fem focal defic constant fri HCPCS L5230 | not published | not published | $4,403.82 – $5,871.76 | 2 |
| Femoral endovas graft add-on 34813 CPT 34813 | not published | not published | $11,257.00 – $11,257.00 | 1 |
| Femoral lgth sock fx or equa HCPCS L2850 | not published | not published | $55.76 – $74.34 | 2 |
| Fem/popl revasc w/stent CPT 37226 | not published | not published | $18,408.00 – $23,826.00 | 2 |
| Feno poc CPT 95012 | not published | not published | $27.21 – $36.28 | 2 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | not published | not published | $1.22 – $1.83 | 3 |
| Fern test HCPCS Q0114 | $62.70 | $114.00 | $7.30 – $71.16 | 5 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | not published | not published | $0.85 – $2.17 | 5 |
| Ferritin CPT 82728 | $11.55 | $21.00 | $10.22 – $135.53 | 5 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | not published | not published | $0.28 – $0.70 | 5 |
| Ferumoxytol, esrd use HCPCS Q0139 | not published | not published | $0.28 – $0.70 | 5 |
| Fetal aneuploidy trisom risk CPT 81507 | $1,479.50 | $2,690.00 | $596.25 – $5,577.89 | 5 |
| Fetal biophys profile w/nst 76818 CPT 76818 | not published | not published | $76.16 – $733.81 | 3 |
| Fetal chrmoml microdeltj CPT 81422 | not published | not published | $569.29 – $5,854.48 | 5 |
| Fetal chrom aneuploidy gsa panel CPT 81420 | $970.75 | $1,765.00 | $569.29 – $5,854.48 | 5 |
| Fetal contract stress test 59020 - 26 CPT 59020 | $893.75 | $1,625.00 | $147.28 – $1,676.00 | 3 |
| Fetal cord puncture prenatal CPT 59012 | not published | not published | $222.00 – $4,401.00 | 4 |
| Fetal fibronectin CPT 82731 | $389.95 | $709.00 | $48.31 – $640.22 | 5 |
| Fetal fluid drainage w/us CPT 59074 | not published | not published | $222.00 – $4,401.00 | 4 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $140.25 | $255.00 | $5.80 – $76.92 | 5 |
| Fetal hemoglobin rosette CPT 85461 | $52.80 | $96.00 | $7.02 – $65.97 | 5 |
| Fetal lung maturity assess lam body dnst CPT 83664 | $90.75 | $165.00 | $14.49 – $187.97 | 5 |
| Fetal monitor w/report CPT 59050 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Fetal non stress test CPT 59025 | $432.30 | $786.00 | $147.28 – $1,676.00 | 3 |
| Fetal scalp blood sampling 59030 CPT 59030 | not published | not published | $222.00 – $1,676.00 | 3 |
| Fetal shunt placement w/us CPT 59076 | not published | not published | $222.00 – $4,401.00 | 4 |
| #_fet/norfentcnfrmur CPT 80354 | $130.90 | $238.00 | $172.28 – $172.28 | 1 |
| Fiasp for insulin pump use HCPCS J1811 | not published | not published | $9.67 – $14.75 | 3 |
| Fibrin degradation d dimer quantitative CPT 85379 | $87.45 | $159.00 | $7.64 – $80.56 | 5 |
| Fibrin degradation products CPT 85362 | $118.25 | $215.00 | $5.17 – $68.42 | 5 |
| Fibrin degrade semiquant CPT 85378 | not published | not published | $7.29 – $70.92 | 5 |
| Fibrin degradj d-dimer CPT 85380 | not published | not published | $7.64 – $80.56 | 5 |
| Fibrinogen activity CPT 85384 | $127.60 | $232.00 | $7.29 – $84.44 | 5 |
| Fibrinogen test CPT 85370 | not published | not published | $9.32 – $80.56 | 5 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $80.30 | $146.00 | $11.61 – $51.37 | 5 |
| Fibrinolytic antiplasmin CPT 85410 | not published | not published | $5.78 – $76.62 | 5 |
| Fibrinolytic plasmin CPT 85400 | not published | not published | $5.78 – $87.93 | 5 |
| Fibrinolytic plasminogen CPT 85415 | $193.54 | $351.90 | $12.89 – $170.88 | 5 |
| Fibrinolytic plasminogen CPT 85421 | not published | not published | $7.64 – $101.26 | 5 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | $73.15 | $133.00 | $4.90 – $64.93 | 5 |
| Fibula bone graft microvasc CPT 20955 | not published | not published | $5,286.15 – $20,477.00 | 4 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | not published | not published | $0.24 – $0.54 | 5 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | not published | not published | $0.75 – $1.87 | 5 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | not published | not published | $0.26 – $0.70 | 5 |
| Filleted finger/toe flap CPT 14350 | not published | not published | $1,503.10 – $4,867.00 | 4 |
| Filtered speech hearing test CPT 92571 | not published | not published | $27.21 – $36.28 | 2 |
| Filters elec/combo vad, rep HCPCS Q0500 | not published | not published | $28.18 – $37.58 | 2 |
| Fimbrioplasty 58760 CPT 58760 | not published | not published | $7,789.00 – $11,044.00 | 2 |
| Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 CPT 10007 | $1,409.65 | $2,563.00 | $515.87 – $4,401.00 | 4 |
| Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008 CPT 10008 | $705.10 | $1,282.00 | $1,676.00 – $1,676.00 | 1 |
| Fine needle aspiration biopsy without img gdn; ea addtl 10004 CPT 10004 | not published | not published | $1,676.00 – $1,676.00 | 1 |
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.