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 |
|---|---|---|---|---|
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | not published | not published | $44.02 – $120.88 | 5 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | not published | not published | $90.66 – $2,261.83 | 5 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | not published | not published | $90.66 – $139.60 | 5 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $2,383.65 – $11,257.00 | 4 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | not published | not published | $90.66 – $124.27 | 5 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | not published | not published | $90.66 – $195.53 | 5 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $11,257.00 – $11,257.00 | 1 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | not published | not published | $90.66 – $258.74 | 5 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | not published | not published | $75.10 – $120.88 | 5 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | not published | not published | $54.38 – $253.17 | 5 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $671.03 | $1,220.06 | not published | 0 |
| Granisetron hcl injection HCPCS J1626 | not published | not published | $0.38 – $0.43 | 3 |
| Granulocyte pheresis ea unit HCPCS P9050 | $3,481.50 | $6,330.00 | not published | 0 |
| Great toe-hand transfer CPT 26551 | not published | not published | $5,286.15 – $14,304.00 | 4 |
| Great toe with reduction 28495 CPT 28495 | $311.30 | $566.00 | $179.70 – $4,401.00 | 4 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $1,503.10 – $4,867.00 | 4 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $2,581.60 – $11,257.00 | 4 |
| Grfg autol fat lipo ea addl CPT 15772 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Grfg autol soft tiss dir exc CPT 15769 | not published | not published | $2,581.60 – $11,257.00 | 4 |
| Group mnt 2 or more 30 mins HCPCS G0271 | not published | not published | $8.98 – $11.97 | 2 |
| Growth hormone antibody CPT 86277 | not published | not published | $11.80 – $156.45 | 5 |
| Growth hormone panel CPT 80428 | not published | not published | $50.02 – $662.99 | 5 |
| Growth hormone panel CPT 80430 | not published | not published | $97.00 – $780.11 | 5 |
| Growth stimulation gene 2 CPT 83006 | not published | not published | $56.70 – $218.61 | 5 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | not published | not published | $11,257.00 – $11,257.00 | 1 |
| Gstr rstcv oth/thn v-band CPT 43843 | not published | not published | $11,257.00 – $14,304.00 | 2 |
| Gstr rstcv px shrt roux-en-y CPT 43846 | not published | not published | $11,257.00 – $11,257.00 | 1 |
| Gstr rstcv px sm int rcnstj CPT 43847 | not published | not published | $11,257.00 – $11,257.00 | 1 |
| Gstr rstcv px v-banded gstp CPT 43842 | not published | not published | $11,257.00 – $11,257.00 | 1 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $1,397.92 – $6,687.00 | 4 |
| G-tube reposition CPT 43761 | $541.20 | $984.00 | $182.01 – $4,401.00 | 4 |
| Gu dilat ureter/urethra s&i CPT 74485 | not published | not published | $712.25 – $2,030.46 | 3 |
| Guided cath fluid drainage 10030 CPT 10030 | $2,261.05 | $4,111.00 | $515.87 – $4,401.00 | 4 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $174.74 | $317.70 | not published | 0 |
| Guid loc target vol rad tx CPT 77387 | $580.80 | $1,056.00 | $698.71 – $698.71 | 1 |
| Gum graft CPT 41870 | not published | not published | $1,130.33 – $4,867.00 | 4 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $2,852.39 – $11,257.00 | 4 |
| Hair analysis HCPCS P2031 | not published | not published | $6.19 – $42.87 | 3 |
| Hair removal by electrolysis 17380 CPT 17380 | not published | not published | $538.41 – $4,401.00 | 4 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $296.15 – $4,401.00 | 4 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $296.15 – $4,401.00 | 4 |
| Hallus-valgus nt dyn pre ots HCPCS L3100 | not published | not published | $39.87 – $53.16 | 2 |
| Halo cervical into body jack HCPCS L0820 | not published | not published | $1,938.02 – $2,584.02 | 2 |
| Halo cervical into jckt vest HCPCS L0810 | not published | not published | $2,463.68 – $3,284.91 | 2 |
| Halo cerv into milwaukee typ HCPCS L0830 | not published | not published | $2,965.44 – $3,953.92 | 2 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | not published | not published | $6.68 – $10.27 | 3 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | not published | not published | $1.13 – $2.24 | 3 |
| Halo repl liner/interface HCPCS L0861 | not published | not published | $198.67 – $264.89 | 2 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | $7.15 | $13.00 | not published | 0 |
| Hand orthosis metacarpal fracture orthosis prefa l3918 HCPCS L3918 | not published | not published | $88.58 – $118.11 | 2 |
| Handpiece aquabeam hp2000 HCPCS C2596 | not published | not published | $11,044.00 – $11,044.00 | 1 |
| Hand restoration multiple fi HCPCS L6905 | not published | not published | $1,772.57 – $2,363.43 | 2 |
| Hand restoration no fingers HCPCS L6910 | not published | not published | $1,742.56 – $2,323.42 | 2 |
| Hand restoration replacmnt g HCPCS L6915 | not published | not published | $748.71 – $998.28 | 2 |
| Hand restorat thumb/1 finger HCPCS L6900 | not published | not published | $1,790.98 – $2,387.98 | 2 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $2,383.65 – $11,257.00 | 4 |
| Hand tendon reconstruction CPT 26500 | not published | not published | $3,179.00 – $20,477.00 | 4 |
| Hand tendon reconstruction CPT 26502 | not published | not published | $2,383.65 – $11,257.00 | 4 |
| Hand X-ray CPT 73130 | $291.50 | $530.00 | $63.40 – $233.80 | 3 |
| Haptoglobin quantitative CPT 83010 | $156.75 | $285.00 | $9.44 – $125.00 | 5 |
| Harness chest/shlder saddle HCPCS L6672 | not published | not published | $202.07 – $269.43 | 2 |
| Harness figure of 8 dual con HCPCS L6676 | not published | not published | $115.36 – $153.82 | 2 |
| Harness figure of 8 sing con HCPCS L6675 | not published | not published | $110.26 – $147.02 | 2 |
| Harvest allogeneic stem cell CPT 38205 | not published | not published | $1,676.00 – $11,044.00 | 2 |
| Harvest auto stem cells CPT 38206 | not published | not published | $1,134.58 – $4,867.00 | 4 |
| Harvest cultured skin graft 15040 CPT 15040 | not published | not published | $1,503.10 – $4,867.00 | 4 |
| Harvest eye tissue alograft CPT 68371 | not published | not published | $1,732.00 – $6,687.00 | 4 |
| Harvest femoropopliteal vein 35572 CPT 35572 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Harvest stem cell concentrte CPT 38215 | not published | not published | $321.40 – $4,401.00 | 4 |
| Harvest vein for bypass 35500 CPT 35500 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Hast w/i&r phys/qhp CPT 94452 | not published | not published | $96.93 – $129.23 | 2 |
| Hast w/oxygen titrate CPT 94453 | not published | not published | $96.93 – $129.23 | 2 |
| Hba1/hba2 full gene sequence CPT 81259 | not published | not published | $450.00 – $4,209.72 | 5 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $2,501.40 | $4,548.00 | $151.80 – $1,420.09 | 5 |
| Hba1/hba2 gene fam vrnt CPT 81258 | not published | not published | $281.44 – $2,632.84 | 5 |
| Hbb full gene sequence CPT 81364 | not published | not published | $243.44 – $2,277.32 | 5 |
| Hbb gene com variants CPT 81361 | not published | not published | $131.11 – $1,226.51 | 5 |
| Hbb gene dup/del variants CPT 81363 | not published | not published | $151.80 – $1,420.09 | 5 |
| Hbb gene known fam variant CPT 81362 | not published | not published | $281.44 – $2,632.84 | 5 |
| Hb glycosylated a1c home dev CPT 83037 | not published | not published | $7.28 – $96.46 | 5 |
| Hc ea ha check monaural CPT 92594 | $11.00 | $20.00 | not published | 0 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | not published | not published | $127.78 – $4,146.30 | 3 |
| Hcg free betachain test CPT 84704 | $31.90 | $58.00 | $11.47 – $149.66 | 5 |
| Hcg qualitative CPT 84703 | $122.10 | $222.00 | $5.64 – $74.71 | 5 |
| Hcg quantitative CPT 84702 | $142.45 | $259.00 | $11.29 – $149.66 | 5 |
| Hc hearing aid chck binaurl CPT 92593 | $22.00 | $40.00 | not published | 0 |
| Hc hearing aid chck monarl CPT 92592 | $19.25 | $35.00 | not published | 0 |
| Hc hearing aid exam both ears CPT 92591 | $113.30 | $206.00 | not published | 0 |
| Hc hearing aid exam one ear CPT 92590 | $110.00 | $200.00 | not published | 0 |
| Hc metata joint dislocation anes CPT 28635 | not published | not published | $1,171.42 – $4,867.00 | 4 |
| Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks CPT 17311 | not published | not published | $538.41 – $4,401.00 | 4 |
| Hc mohs micrographic h/n/h/f/g each addl stage CPT 17312 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Hc mohs trunk/arm/leg 1st stage 5 blocks CPT 17313 | not published | not published | $538.41 – $4,401.00 | 4 |
| Hc mohs trunk/arm/leg ea addl block any stage CPT 17315 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Hc mohs trunk/arm/leg ea stage after 1st stage CPT 17314 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | not published | not published | $395.55 – $1,424.49 | 3 |
| Hc nm fusion spect CT unlisted CPT 78999 | not published | not published | $291.23 – $388.31 | 2 |
| Hc nm kidney imaging with flow CPT 78701 | not published | not published | $291.23 – $2,102.01 | 3 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | not published | not published | $395.55 – $2,044.14 | 3 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | not published | not published | $943.15 – $3,861.83 | 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.