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 |
|---|---|---|---|---|
| Ghs peritonsillar abscess i andd CPT 42700 | $344.30 | $626.00 | $172.55 – $4,401.00 | 4 |
| Ghs phenylketonurid CPT 84030 | not published | not published | $4.12 – $54.65 | 5 |
| Ghs picc line insert < 5 CPT 36568 | $735.90 | $1,338.00 | $1,146.77 – $4,401.00 | 4 |
| Ghs plngl fx pm cl CPT 26725 | $1,068.10 | $1,942.00 | $179.70 – $4,401.00 | 4 |
| Ghs plt ct-manual CPT 85032 | not published | not published | $3.23 – $42.76 | 5 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | not published | not published | $625.59 – $834.12 | 2 |
| Ghs pos nystagmus CPT 92542 | not published | not published | $96.93 – $129.23 | 2 |
| Ghs ppd (tb intradermal) CPT 86580 | $22.00 | $40.00 | $21.07 – $53.91 | 3 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $19.80 | $36.00 | $7.24 – $96.03 | 5 |
| Ghs protein, misc fluid CPT 84160 | $22.55 | $41.00 | $4.21 – $39.83 | 5 |
| Ghs protoporphyrins fract CPT 84202 | $22.55 | $41.00 | $10.76 – $142.57 | 5 |
| Ghs pr without cont pulse ox CPT 94625 | $172.70 | $314.00 | $42.98 – $57.30 | 2 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | $16.50 | $30.00 | $9.19 – $121.71 | 5 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | $268.95 | $489.00 | not published | 0 |
| Ghs quinidine CPT 80194 | $27.50 | $50.00 | $10.95 – $145.16 | 5 |
| Ghs refill of implantable pump CPT 95990 | not published | not published | $240.63 – $1,676.00 | 3 |
| Ghs removal intranasal foreign body CPT 30300 | $297.00 | $540.00 | $96.93 – $4,401.00 | 4 |
| Ghs removal pharyngeal foreign body CPT 42809 | not published | not published | $325.44 – $4,401.00 | 4 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | not published | not published | $1,171.42 – $4,867.00 | 4 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | $3,322.00 | $6,040.00 | $2,383.65 – $11,257.00 | 4 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | $23.65 | $43.00 | $11.92 – $57.79 | 5 |
| Ghs reticulocyte count CPT 85044 | not published | not published | $3.23 – $42.76 | 5 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $93.50 | $170.00 | $10.43 – $119.16 | 5 |
| Ghs sedimentation rate CPT 85651 | not published | not published | $3.20 – $35.24 | 5 |
| Ghs semen analysis fert CPT 89320 | not published | not published | $9.23 – $119.77 | 5 |
| Ghs semen analysis, post-vas CPT 89300 | not published | not published | $7.38 – $88.73 | 5 |
| Ghs sensitivity (per antimicro) CPT 87184 | $133.65 | $243.00 | $5.61 – $68.53 | 5 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $408.10 | $742.00 | $296.15 – $4,401.00 | 4 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $586.85 | $1,067.00 | $296.15 – $4,401.00 | 4 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $512.05 | $931.00 | $296.15 – $4,401.00 | 4 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $640.20 | $1,164.00 | $296.15 – $4,401.00 | 4 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $502.15 | $913.00 | $146.16 – $4,401.00 | 4 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $380.60 | $692.00 | $146.16 – $4,401.00 | 4 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $464.20 | $844.00 | $146.16 – $4,401.00 | 4 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $554.95 | $1,009.00 | $146.16 – $4,401.00 | 4 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $694.10 | $1,262.00 | $146.16 – $4,401.00 | 4 |
| Ghs sleep study unattended CPT 95800 | $640.20 | $1,164.00 | $157.30 – $209.73 | 2 |
| Ghs somatosensory testing lower extremit CPT 95926 | not published | not published | $157.30 – $209.73 | 2 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | not published | not published | $625.59 – $834.12 | 2 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | not published | not published | $35.06 – $46.74 | 2 |
| Ghs sphenopalatine ganglion block CPT 64505 | $899.80 | $1,636.00 | $223.61 – $4,401.00 | 4 |
| Ghs spont nystagmus CPT 92541 | not published | not published | $96.93 – $129.23 | 2 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $218.35 | $397.00 | $75.09 – $100.12 | 2 |
| Ghs st - eval for alt comm CPT 92567 | $62.70 | $114.00 | $27.21 – $36.28 | 2 |
| Ghs strapping shoulder - 29240 CPT 29240 | $330.00 | $600.00 | $96.93 – $4,401.00 | 4 |
| Ghs st - re-eval for alt comm CPT 92597 | $508.75 | $925.00 | $52.09 – $69.45 | 2 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | not published | not published | $34.11 – $45.48 | 2 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | not published | not published | $154.95 – $206.61 | 2 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $563.75 | $1,025.00 | $538.41 – $4,401.00 | 4 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | not published | not published | $296.15 – $4,401.00 | 4 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | not published | not published | $1,130.33 – $4,867.00 | 4 |
| Ghs trypsin (fecal) CPT 84488 | not published | not published | $5.48 – $72.60 | 5 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $270.05 | $491.00 | $179.70 – $4,401.00 | 4 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $179.70 – $4,401.00 | 4 |
| Ghs urine, hydroxproline total CPT 83505 | not published | not published | $18.22 – $241.68 | 5 |
| Ghs urine, porphyrins quant CPT 84120 | $46.20 | $84.00 | $11.03 – $146.24 | 5 |
| Ghs vaginal delivery only CPT 59409 | $2,159.85 | $3,927.00 | $2,358.24 – $6,687.00 | 4 |
| Ghs windowing of cast CPT 29730 | not published | not published | $118.38 – $4,401.00 | 4 |
| Giardia ag if CPT 87269 | not published | not published | $10.21 – $119.16 | 5 |
| Giardia lamblia antibody CPT 86674 | $146.85 | $267.00 | $11.04 – $146.32 | 5 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $173.82 – $627.36 | 3 |
| Gi inhouse confirmation CPT 87045 | $40.15 | $73.00 | $7.08 – $93.85 | 5 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $2,415.31 – $14,304.00 | 4 |
| Gi protein loss CPT 78282 | not published | not published | $291.23 – $506.96 | 3 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | not published | not published | $660.74 – $3,179.00 | 3 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | $677.47 – $903.30 | 2 |
| Gi trc img intral esophagus CPT 91111 | not published | not published | $660.74 – $3,179.00 | 3 |
| Gi wireless capsule measure CPT 91112 | not published | not published | $660.74 – $3,179.00 | 3 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $75.84 – $709.46 | 5 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $46.14 – $431.63 | 5 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $26.25 – $245.55 | 5 |
| Glassia injection HCPCS J0257 | not published | not published | $4.19 – $10.85 | 5 |
| Glaucoma scrn hgh risk direc HCPCS G0118 | not published | not published | $27.21 – $36.28 | 2 |
| Glaucoma surgery CPT 66150 | not published | not published | $3,011.20 – $11,044.00 | 4 |
| Glaucoma surgery CPT 66155 | not published | not published | $3,011.20 – $11,044.00 | 4 |
| Glaucoma surgery CPT 66160 | not published | not published | $1,681.25 – $6,687.00 | 4 |
| Glaucoma surgery CPT 66170 | not published | not published | $1,681.25 – $6,687.00 | 4 |
| Glove finger flexion right lg xl HCPCS L3912 | not published | not published | $88.38 – $117.84 | 2 |
| Glucagon 1 mg solution for injection HCPCS J1610 | not published | not published | $88.00 – $372.00 | 5 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | not published | not published | $96.96 – $275.28 | 5 |
| Glucagon plasma - sendout CPT 82943 | $26.40 | $48.00 | $10.72 – $98.08 | 5 |
| Glucagon tolerance panel CPT 80422 | not published | not published | $34.55 – $457.95 | 5 |
| Glucagon tolerance panel CPT 80424 | not published | not published | $37.88 – $501.95 | 5 |
| Glucagon tolerance test CPT 82946 | not published | not published | $13.33 – $73.84 | 5 |
| Glucose 1 hr post dose CPT 82950 | $62.70 | $114.00 | $3.56 – $47.22 | 5 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | not published | not published | $4.54 – $60.13 | 5 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $89.10 | $162.00 | $2.46 – $23.29 | 5 |
| Glucose blood quantitative CPT 82947 | $37.40 | $68.00 | $2.95 – $39.04 | 5 |
| Glucose body fluid CPT 82945 | $79.20 | $144.00 | $2.95 – $39.04 | 5 |
| Glucose monitoring continual min 72hr pt CPT 95249 | not published | not published | $42.98 – $57.30 | 2 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $127.05 | $231.00 | $9.65 – $127.92 | 5 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $69.30 | $126.00 | $2.94 – $38.94 | 5 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | not published | not published | $0.74 – $1.07 | 3 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | not published | not published | $8.28 – $20.96 | 5 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $106.15 | $193.00 | $13.94 – $184.70 | 5 |
| Gonadotropin hormone panel CPT 80426 | not published | not published | $111.31 – $1,475.14 | 5 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $105.60 | $192.00 | $13.89 – $184.05 | 5 |
| Gonioscopy CPT 92020 | not published | not published | $96.93 – $129.23 | 2 |
| Goniotomy CPT 65820 | not published | not published | $3,011.20 – $11,044.00 | 4 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | not published | not published | $1,022.45 – $1,394.89 | 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.