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 |
|---|---|---|---|---|
| Inj aval alfa-nqpt 4mg HCPCS J0219 | not published | not published | $62.96 – $153.43 | 5 |
| Inj., benralizumab, 1 mg HCPCS J0517 | not published | not published | $124.17 – $319.45 | 5 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | not published | not published | $29.87 – $75.67 | 5 |
| Inj bimatoprost itc imp1mcg HCPCS J7351 | not published | not published | $160.32 – $403.49 | 5 |
| Inj, biorphen, 20 micrograms HCPCS J2372 | not published | not published | $0.26 – $0.32 | 3 |
| Inj, bortezomib, hospira HCPCS J9049 | not published | not published | $2.07 – $2.94 | 3 |
| Inj, brixadi, 7 days or less HCPCS J0577 | not published | not published | $322.93 – $803.37 | 5 |
| Inj brixadi, more than 7 day HCPCS J0578 | not published | not published | $1,291.73 – $3,213.48 | 5 |
| Inj, brolucizumab-dbll, 1 mg HCPCS J0179 | not published | not published | $269.78 – $657.77 | 5 |
| Inj, bupivacaine liposome HCPCS J0666 | not published | not published | $1.09 – $2.84 | 5 |
| Inj. byooviz, 0.1 mg HCPCS Q5124 | not published | not published | $118.09 – $313.02 | 5 |
| Inj cefazolin sodium, baxter HCPCS J0689 | not published | not published | $1.81 – $2.53 | 3 |
| Inj cefazolin sodium, hikma HCPCS J0688 | not published | not published | $1.42 – $1.85 | 3 |
| Inj cefazolin (wg crit care) HCPCS J0687 | not published | not published | $1.41 – $2.05 | 3 |
| Inj. cefepime hcl (baxter) HCPCS J0701 | not published | not published | $8.41 – $11.15 | 3 |
| Inj, cefepime hcl (b braun) HCPCS J0703 | not published | not published | $7.31 – $9.64 | 3 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | not published | not published | $1.91 – $4.56 | 5 |
| Inj ceftolozane tazobactam HCPCS J0695 | not published | not published | $7.53 – $17.34 | 5 |
| Inj. cetirizine hcl 0.5mg HCPCS J1201 | not published | not published | $12.87 – $31.15 | 5 |
| Inj, cimerli, 0.1 mg HCPCS Q5128 | not published | not published | $61.90 – $312.17 | 5 |
| Inj, cipaglucosidase, 5 mg HCPCS J1203 | not published | not published | $72.23 – $170.61 | 5 |
| Inj, clindamycin (baxter) HCPCS J0737 | not published | not published | $3.26 – $4.83 | 3 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $225.50 | $410.00 | $1,676.00 – $1,676.00 | 1 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | not published | not published | $1,513.15 – $1,983.86 | 3 |
| Inj cutaquig 100 mg HCPCS J1551 | not published | not published | $10.52 – $26.99 | 5 |
| Inj cuvitru, 100 mg HCPCS J1555 | not published | not published | $13.61 – $33.42 | 5 |
| Inj, cyclophos (baxter) 5mg HCPCS J9076 | not published | not published | $3.29 – $9.55 | 3 |
| Inj cyclophos dr.reddy's 5mg HCPCS J9072 | not published | not published | $6.69 – $17.11 | 4 |
| Inj cyclophosphamd auromedic HCPCS J9071 | not published | not published | $0.37 – $1.49 | 5 |
| Inj cyclophosphamd (ingenus) HCPCS J9073 | not published | not published | $0.37 – $4.05 | 5 |
| Inj, cyclophosphamd, sandoz HCPCS J9074 | not published | not published | $2.58 – $8.05 | 5 |
| Inj, daptomycin (baxter) HCPCS J0874 | not published | not published | $0.10 – $0.13 | 3 |
| Inj, daptomycin (hospira) HCPCS J0877 | not published | not published | $0.07 – $0.11 | 3 |
| Inj daptomycin (xellia) HCPCS J0873 | not published | not published | $0.04 – $0.08 | 3 |
| Inj daxibotulinumtoxina-lanm HCPCS J0589 | not published | not published | $2.30 – $5.91 | 4 |
| Inj, decitabine (sun pharma) HCPCS J0893 | not published | not published | $1.13 – $1.48 | 2 |
| Inj disk cerv-thor ea lev CPT 62291 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Inj, donanemab-azbt, 2 mg HCPCS J0175 | not published | not published | $3.12 – $7.87 | 5 |
| Inj dupuytren cord w/enzyme CPT 20527 | not published | not published | $223.61 – $4,401.00 | 4 |
| Inj, durolane 1 mg HCPCS J7318 | not published | not published | $4.68 – $12.70 | 5 |
| Inj dx for sinogram CPT 20501 | $225.50 | $410.00 | $1,676.00 – $1,676.00 | 1 |
| Inject for sacroiliac joint HCPCS G0259 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | $913.55 | $1,661.00 | $514.23 – $4,401.00 | 4 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $152.90 | $278.00 | $1,676.00 – $1,676.00 | 1 |
| Injection, belinostat, 10mg HCPCS J9032 | not published | not published | $40.83 – $98.88 | 5 |
| Injection, burosumab-twza 1m HCPCS J0584 | not published | not published | $385.03 – $914.98 | 5 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | not published | not published | $223.61 – $4,401.00 | 4 |
| Injection, daratumumab 10 mg HCPCS J9145 | not published | not published | $55.33 – $132.69 | 5 |
| Injection, doxercalciferol HCPCS J1270 | not published | not published | $0.55 – $0.71 | 3 |
| Injection during cath supravalvular aortography CPT 93567 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Injection, edaravone, 1 mg HCPCS J1301 | not published | not published | $4.85 – $40.11 | 5 |
| Injection epidural blood patch or clot CPT 62273 | $1,986.60 | $3,612.00 | $514.23 – $4,401.00 | 4 |
| Injection eye drug CPT 67028 | not published | not published | $240.63 – $4,401.00 | 4 |
| Injection for arthrography wrist (both sides) CPT 25246 | $152.90 | $278.00 | $1,676.00 – $1,676.00 | 1 |
| Injection for bladder x-ray CPT 51600 | $152.90 | $278.00 | $1,676.00 – $1,676.00 | 1 |
| Injection for hip x-ray CPT 27095 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $152.90 | $278.00 | $1,676.00 – $1,676.00 | 1 |
| Injection for spleen x-ray CPT 38200 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Injection for tear sac x-ray CPT 68850 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Injection for ureter x-ray CPT 50684 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Injection for ureter x-ray CPT 50690 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Injection, fulvestrant HCPCS J9395 | not published | not published | $10.01 – $13.26 | 3 |
| Injection, inclisiran, 1 mg HCPCS J1306 | not published | not published | $9.68 – $23.47 | 5 |
| Injection into brain canal CPT 61026 | not published | not published | $514.23 – $4,401.00 | 4 |
| Injection into brain canal CPT 61055 | not published | not published | $223.61 – $4,401.00 | 4 |
| Injection into hemorrhoid(s) CPT 46500 | not published | not published | $677.47 – $4,401.00 | 4 |
| Injection into spinal artery CPT 62294 | not published | not published | $644.34 – $4,401.00 | 4 |
| Injection into vocal cord CPT 31513 | not published | not published | $284.93 – $4,401.00 | 4 |
| Injection intraop add-on CPT 48400 | not published | not published | $4,401.00 – $4,401.00 | 1 |
| Injection jaw joint x-ray CPT 21116 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Injection jugular CPT 36299 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Injection, khapzory, 0.5 mg HCPCS J0642 | not published | not published | $1.71 – $2.50 | 3 |
| Injection, necitumumab, 1 mg HCPCS J9295 | not published | not published | $4.30 – $10.89 | 5 |
| Injection of HIV prep drug HCPCS G0012 | not published | not published | $52.45 – $69.94 | 2 |
| Injection of sinus tract CPT 20500 | not published | not published | $1,130.33 – $4,867.00 | 4 |
| Injection,onabotulinumtoxina HCPCS J0585 | not published | not published | $4.88 – $12.35 | 5 |
| Injection px peyronie ds CPT 54200 | not published | not published | $182.01 – $4,401.00 | 4 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $794.20 | $1,444.00 | $291.23 – $4,401.00 | 4 |
| Injection, renflexis HCPCS Q5104 | not published | not published | $19.96 – $48.58 | 5 |
| Injection, ruconest HCPCS J0596 | not published | not published | $28.37 – $69.80 | 5 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | $4,035.90 | $7,338.00 | $514.23 – $4,401.00 | 4 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $916.30 | $1,666.00 | $514.23 – $4,401.00 | 4 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $805.20 | $1,464.00 | $514.23 – $4,401.00 | 4 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $4,398.90 | $7,998.00 | $644.34 – $4,401.00 | 4 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $1,741.30 | $3,166.00 | $1,676.00 – $1,676.00 | 1 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $4,572.70 | $8,314.00 | $644.34 – $4,401.00 | 4 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $1,072.50 | $1,950.00 | $1,676.00 – $1,676.00 | 1 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $1,925.00 | $3,500.00 | $644.34 – $4,401.00 | 4 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | not published | not published | $514.23 – $4,401.00 | 4 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $2,020.70 | $3,674.00 | $514.23 – $4,401.00 | 4 |
| Injection, siltuximab HCPCS J2860 | not published | not published | $130.55 – $307.71 | 5 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $289.30 | $526.00 | $223.61 – $4,401.00 | 4 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $440.00 | $800.00 | $223.61 – $4,401.00 | 4 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | not published | not published | $223.61 – $4,401.00 | 4 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $126.50 | $230.00 | $34.11 – $45.48 | 2 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $129.80 | $236.00 | not published | 0 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $173.25 | $315.00 | $154.95 – $206.61 | 2 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $130.35 | $237.00 | $52.45 – $69.94 | 2 |
| Injection treatment of eye CPT 66020 | not published | not published | $1,681.25 – $4,867.00 | 4 |
| Injection treatment of eye CPT 66030 | not published | not published | $1,681.25 – $4,867.00 | 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.