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 |
|---|---|---|---|---|
| Infect ag genotype na cytomegalovirus CPT 87910 | not published | not published | $193.09 – $2,558.95 | 5 |
| Infect ag genotype na dna hepatitis b CPT 87912 | $708.40 | $1,288.00 | $193.09 – $2,558.95 | 5 |
| Infect ag genotype na hiv-1 other region CPT 87906 | $277.20 | $504.00 | $96.55 – $1,279.52 | 5 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $661.65 | $1,203.00 | $193.09 – $2,558.95 | 5 |
| Infect ag ia direct hiv-1 antgn CPT 87806 | not published | not published | $24.58 – $239.35 | 5 |
| Infect ag ia optc obs chlamydia trach CPT 87810 | not published | not published | $26.47 – $119.16 | 5 |
| Infect ag ia optc obs influenza CPT 87804 | $73.70 | $134.00 | $12.41 – $119.16 | 5 |
| Infect ag if ea plyvlnt antsrm CPT 87300 | not published | not published | $8.98 – $119.16 | 5 |
| Infect ag if hep delta agent CPT 87380 | not published | not published | $13.77 – $163.17 | 5 |
| Infect ag if influenza a CPT 87276 | $20.35 | $37.00 | $12.05 – $119.16 | 5 |
| Infect ag if influenza b CPT 87275 | $19.80 | $36.00 | $9.19 – $119.16 | 5 |
| Infect ag if legionella pneumophila CPT 87278 | $44.00 | $80.00 | $11.70 – $119.16 | 5 |
| Infect ag if nos ea CPT 87299 | $20.90 | $38.00 | $12.08 – $119.16 | 5 |
| Infect ag if pneumocystis carinii CPT 87281 | $103.40 | $188.00 | $8.98 – $119.16 | 5 |
| Infect ag if varicella zoster CPT 87290 | $44.00 | $80.00 | $10.06 – $119.16 | 5 |
| Infect ag na chlamydia trachomatis qnt CPT 87492 | not published | not published | $40.10 – $347.47 | 5 |
| Infect ag na hep b amp CPT 87516 | not published | not published | $26.32 – $348.80 | 5 |
| Infect ag na herpes simplex quant CPT 87530 | not published | not published | $32.13 – $425.78 | 5 |
| Infect ag na hpv high-risk types CPT 87624 | $243.65 | $443.00 | $26.32 – $348.80 | 5 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $163.35 | $297.00 | $71.85 – $845.86 | 5 |
| Infect ag na influenza revr/amp ea type CPT 87501 | not published | not published | $38.48 – $510.06 | 5 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | $142.45 | $259.00 | $38.48 – $282.21 | 5 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $780.45 | $1,419.00 | $312.58 – $4,142.81 | 5 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | $424.05 | $771.00 | $366.50 – $4,857.08 | 5 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | $69.85 | $127.00 | $19.55 – $259.12 | 5 |
| Infectious agent antigen immunoassay direct optical observation sars-cov-2 CPT 87811 | not published | not published | $31.04 – $301.92 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $42.35 | $77.00 | $8.98 – $119.16 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | $25.85 | $47.00 | $10.06 – $119.16 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $73.15 | $133.00 | $10.36 – $119.16 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $68.20 | $124.00 | $8.98 – $119.16 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $93.50 | $170.00 | $10.78 – $142.96 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $87.45 | $159.00 | $7.75 – $102.67 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $50.05 | $91.00 | $7.75 – $102.67 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $166.10 | $302.00 | $18.06 – $239.35 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $248.60 | $452.00 | $8.98 – $119.16 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $129.80 | $236.00 | $8.98 – $119.16 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $29.15 | $53.00 | $8.98 – $119.16 | 5 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $844.25 | $1,535.00 | $26.32 – $348.80 | 5 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $131.45 | $239.00 | $26.32 – $348.80 | 5 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $156.20 | $284.00 | $27.95 – $348.80 | 5 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $556.60 | $1,012.00 | $312.58 – $4,171.77 | 5 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $231.55 | $421.00 | $26.32 – $348.80 | 5 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $47.30 | $86.00 | $26.32 – $348.80 | 5 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $504.90 | $918.00 | $31.26 – $348.80 | 5 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $131.45 | $239.00 | $26.32 – $348.80 | 5 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $139.15 | $253.00 | $38.48 – $374.38 | 5 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $244.20 | $444.00 | $106.97 – $1,040.69 | 5 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $281.05 | $511.00 | $106.97 – $1,040.69 | 5 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | not published | not published | $26.32 – $348.80 | 5 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $131.45 | $239.00 | $26.32 – $348.80 | 5 |
| Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae CPT 87494 | not published | not published | $52.64 – $70.18 | 2 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $200.20 | $364.00 | $57.58 – $422.24 | 5 |
| Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets CPT 87627 | not published | not published | $509.83 – $679.77 | 2 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $1,093.95 | $1,989.00 | $312.58 – $4,142.81 | 5 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $180.40 | $328.00 | $96.22 – $1,275.21 | 5 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $489.50 | $890.00 | $197.24 – $2,121.50 | 5 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $490.05 | $891.00 | $32.13 – $425.78 | 5 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $189.75 | $345.00 | $32.13 – $425.78 | 5 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $176.00 | $320.00 | $32.13 – $425.78 | 5 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $443.85 | $807.00 | $63.82 – $845.86 | 5 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $151.25 | $275.00 | $106.97 – $1,275.21 | 5 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | not published | not published | $23.61 – $59.24 | 5 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | not published | not published | $23.12 – $39.68 | 5 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | not published | not published | $20.78 – $37.39 | 5 |
| Influenza dna amp prob addl CPT 87503 | not published | not published | $21.92 – $206.44 | 5 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | not published | not published | $121.06 – $158.63 | 3 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $41.86 – $54.85 | 3 |
| Infratemporal approach/skull CPT 61591 | not published | not published | $20,477.00 – $20,477.00 | 1 |
| Infratemporal approach/skull CPT 61590 | not published | not published | $20,477.00 – $20,477.00 | 1 |
| Infuse radioactive materials CPT 77750 | not published | not published | $280.98 – $1,224.58 | 3 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $425.15 | $773.00 | $159.52 – $212.70 | 2 |
| Init ak ischal plstr direct HCPCS L5505 | not published | not published | $1,915.78 – $2,554.38 | 2 |
| Init bk ptb plaster direct HCPCS L5500 | not published | not published | $1,361.87 – $1,815.83 | 2 |
| Initial care training 30 m HCPCS G0539 | not published | not published | $29.44 – $39.26 | 2 |
| Initial custom socket insert HCPCS L5683 | not published | not published | $1,214.80 – $1,619.74 | 2 |
| Initial foot exam pt lops HCPCS G0245 | not published | not published | $96.99 – $129.32 | 2 |
| Initiation & management bipap/cpap initial day CPT 94660 | $282.70 | $514.00 | $159.52 – $212.70 | 2 |
| Inj, abilify asimtufii, 1 mg HCPCS J0402 | not published | not published | $4.64 – $11.46 | 5 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | not published | not published | $5.60 – $13.75 | 5 |
| Inj acetaminoph 10mg/ibu 3mg HCPCS J0138 | not published | not published | $0.07 – $0.41 | 4 |
| Inj, acetaminophen (b braun) HCPCS J0136 | not published | not published | $0.07 – $0.09 | 3 |
| Inj acetaminophen -fresenius HCPCS J0134 | not published | not published | $0.07 – $0.11 | 3 |
| Inj, acetaminophen (hikma) HCPCS J0137 | not published | not published | $0.04 – $0.10 | 3 |
| Inj. acthar gel to 40 units HCPCS J0801 | not published | not published | $3,100.09 – $7,956.11 | 5 |
| Inj, adstiladrin, per tx dos HCPCS J9029 | not published | not published | $48,248.71 – $120,519.00 | 5 |
| Inj, aducanumab-avwa, 2 mg HCPCS J0172 | not published | not published | $8.67 – $11.36 | 3 |
| Inj, adzynma, 10 iu HCPCS J7171 | not published | not published | $27.16 – $67.61 | 5 |
| Inj, aflibercept-ayyh, 1 mg HCPCS Q5147 | not published | not published | $602.44 – $1,651.26 | 4 |
| Inj, aflibercept hd, 1 mg HCPCS J0177 | not published | not published | $224.01 – $608.76 | 5 |
| Inj, afstyla, 1 i.u HCPCS J7210 | not published | not published | $1.21 – $3.00 | 5 |
| Inj allopurinol sodium 1 mg HCPCS J0206 | not published | not published | $3.06 – $8.63 | 5 |
| Inj, alyglo, 500 mg HCPCS J1552 | not published | not published | $91.16 – $271.75 | 5 |
| Inj alymsys 10 mg HCPCS Q5126 | not published | not published | $59.96 – $107.73 | 5 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | not published | not published | $13.88 – $34.40 | 5 |
| Inj. (ani), up to 40 units HCPCS J0802 | not published | not published | $2,756.01 – $6,739.91 | 5 |
| Inj., aristada initio, 1 mg HCPCS J1943 | not published | not published | $2.60 – $6.18 | 5 |
| Inj. asceniv HCPCS J1554 | not published | not published | $381.85 – $943.36 | 5 |
| Inj, aspara, rylaze, 0.1 mg HCPCS J9021 | not published | not published | $44.02 – $105.07 | 5 |
| Inj atezolizumb 5mg hya-tqjs HCPCS J9024 | not published | not published | $24.42 – $60.11 | 4 |
| Inj avacincaptad pegol 0.1mg HCPCS J2782 | not published | not published | $77.40 – $201.20 | 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.