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 |
|---|---|---|---|---|
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | $125.40 | $228.00 | $9.14 – $12.19 | 2 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $129.25 | $235.00 | $21.19 – $28.25 | 2 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $106.15 | $193.00 | $21.56 – $28.75 | 2 |
| Pt wheelchair management each 15 minutes CPT 97542 | not published | not published | $22.66 – $30.21 | 2 |
| Pul art balloon repr percut CPT 92997 | not published | not published | $8,409.93 – $16,310.00 | 3 |
| Pul art balloon repr percut CPT 92998 | not published | not published | $16,310.00 – $16,310.00 | 1 |
| Pulm ds ipf mrna 190 gen alg CPT 81554 | not published | not published | $4,057.20 – $40,132.70 | 5 |
| Pulm endartercomy w/bypass 33916 CPT 33916 | not published | not published | $17,411.00 – $17,411.00 | 1 |
| Pulmonary decortication partial 32225 CPT 32225 | not published | not published | $16,781.00 – $16,781.00 | 1 |
| Pulmonary vent imaging CPT 78579 | $1,080.75 | $1,965.00 | $291.23 – $1,828.08 | 3 |
| Pulse ox continuous overnight monitoring CPT 94762 | $364.65 | $663.00 | $93.74 – $124.98 | 2 |
| Pulse ox multiple CPT 94761 | $157.85 | $287.00 | not published | 0 |
| Pulse ox single CPT 94760 | $47.30 | $86.00 | not published | 0 |
| Punc of shunt for asp or inj CPT 61070 | not published | not published | $514.23 – $4,401.00 | 4 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $162.80 | $296.00 | $96.93 – $4,401.00 | 4 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $528.00 | $960.00 | $296.15 – $4,401.00 | 4 |
| Puncture/clear windpipe 31612 CPT 31612 | not published | not published | $2,415.31 – $6,687.00 | 4 |
| Puncture spinal lumbar diagnostic CPT 62270 | $840.40 | $1,528.00 | $514.23 – $4,401.00 | 4 |
| Puraply 1 sq cm HCPCS Q4195 | not published | not published | $90.66 – $205.04 | 5 |
| Puraply xt 1 sq cm HCPCS Q4197 | not published | not published | $90.66 – $134.97 | 5 |
| Pvb thoracic 2nd+ inj site CPT 64462 | not published | not published | $1,676.00 – $1,676.00 | 1 |
| Pvb thoracic cont infusion CPT 64463 | not published | not published | $514.23 – $4,401.00 | 4 |
| Pvb thoracic single inj site CPT 64461 | not published | not published | $514.23 – $4,401.00 | 4 |
| Pwr adpt pneum vad, rep veh HCPCS Q0504 | not published | not published | $633.72 – $844.96 | 2 |
| Pwr pck base combo vad, rep HCPCS Q0489 | not published | not published | $15,011.60 – $20,015.46 | 2 |
| Pyelotomy complicated CPT 50135 | not published | not published | $11,044.00 – $11,044.00 | 1 |
| Pyelotomy w/drg pyelostomy CPT 50125 | not published | not published | $11,044.00 – $11,044.00 | 1 |
| Pyelotomy w/exploration CPT 50120 | not published | not published | $11,044.00 – $11,044.00 | 1 |
| Pyelotomy w/removal calculus CPT 50130 | not published | not published | $11,044.00 – $11,044.00 | 1 |
| Pyloroplasty 43800 CPT 43800 | not published | not published | $11,257.00 – $11,257.00 | 1 |
| Pyridoxine hcl 100 mg HCPCS J3415 | not published | not published | $18.23 – $29.19 | 3 |
| Pyruvate CPT 84210 | $171.60 | $312.00 | $10.86 – $107.93 | 5 |
| Pyruvate kinase CPT 84220 | $57.20 | $104.00 | $7.08 – $93.85 | 5 |
| Quadrilateral brim HCPCS L2188 | not published | not published | $258.11 – $344.15 | 2 |
| Quan puplmtry phy/qhp uni/bi CPT 95919 | not published | not published | $96.93 – $129.23 | 2 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $2,332.55 | $4,241.00 | $395.55 – $2,980.16 | 3 |
| Quant diff pulm perf w/imaging CPT 78597 | $1,251.80 | $2,276.00 | $291.23 – $1,870.51 | 3 |
| Quest t3 uptake CPT 84479 | $9.35 | $17.00 | $4.85 – $64.28 | 5 |
| Quick disconn hook adapter o HCPCS L6628 | not published | not published | $525.64 – $700.86 | 2 |
| Rabies ig ht&sol human im/sc CPT 90377 | not published | not published | $182.40 – $463.46 | 5 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | not published | not published | $210.89 – $518.68 | 5 |
| Radial keratotomy CPT 65771 | not published | not published | $6,687.00 – $11,257.00 | 2 |
| Radiation handling CPT 77790 | not published | not published | $160.50 – $160.50 | 1 |
| Radiation physics consult CPT 77336 | $538.45 | $979.00 | $97.92 – $853.30 | 3 |
| Radiation therapy dose plan CPT 77300 | $475.20 | $864.00 | $97.92 – $372.70 | 3 |
| Radiation therapy management CPT 77431 | not published | not published | $1,123.71 – $1,123.71 | 1 |
| Radiation treatment aid(s) CPT 77332 | $546.15 | $993.00 | $97.92 – $596.48 | 3 |
| Radiation treatment aid(s) CPT 77333 | $728.20 | $1,324.00 | $97.92 – $130.56 | 3 |
| Radiation treatment aid(s) CPT 77334 | $1,072.50 | $1,950.00 | $272.77 – $959.20 | 3 |
| Radiation treatment delivery CPT 77401 | not published | not published | $264.67 – $264.67 | 1 |
| Radiation treatment delivery CPT 77402 | $452.10 | $822.00 | $74.33 – $1,561.12 | 3 |
| Radiation treatment delivery CPT 77412 | $825.55 | $1,501.00 | $402.53 – $3,015.78 | 3 |
| Radiation tx management x5 CPT 77427 | not published | not published | $2,045.40 – $2,045.40 | 1 |
| Radical abdominal hysterectomy 58210 CPT 58210 | not published | not published | $16,781.00 – $16,781.00 | 1 |
| Radical rescj tumor clavicle CPT 23200 | not published | not published | $5,286.15 – $16,310.00 | 4 |
| Radical rescj tumor prox hum CPT 23220 | not published | not published | $5,286.15 – $16,310.00 | 4 |
| Radical rescj tumor scapula CPT 23210 | not published | not published | $5,286.15 – $16,310.00 | 4 |
| Radical resection of elbow CPT 24149 | not published | not published | $5,286.15 – $20,477.00 | 4 |
| Radical resection sternum 21630 CPT 21630 | not published | not published | $5,286.15 – $16,310.00 | 4 |
| Radic resect abd tumor<5cm 22904 CPT 22904 | not published | not published | $2,116.08 – $11,257.00 | 4 |
| Radic resect shoulder tumor 5cm/> 23078 CPT 23078 | not published | not published | $2,116.08 – $11,257.00 | 4 |
| Radiofq trsmtr for implt neu HCPCS L8683 | not published | not published | $4,976.71 – $6,635.61 | 2 |
| Radiof trsmtr implt scrl neu HCPCS L8684 | not published | not published | $780.91 – $1,041.21 | 2 |
| Radiology port images(s) CPT 77417 | $259.60 | $472.00 | $118.02 – $118.02 | 1 |
| Radiotherapy dose plan imrt CPT 77301 | $5,626.50 | $10,230.00 | $1,008.34 – $16,721.97 | 3 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | not published | not published | $395.55 – $3,180.82 | 3 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | not published | not published | $395.55 – $5,780.57 | 3 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | not published | not published | $943.15 – $6,827.53 | 3 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $1,461.90 | $2,658.00 | $395.55 – $3,242.56 | 3 |
| Radphm lcl tumor plr sgl day CPT 78800 | not published | not published | $291.23 – $1,770.18 | 3 |
| Radphm quant measure sgl area add-on CPT 78835 | $13.20 | $24.00 | $883.48 – $883.48 | 1 |
| Rad rescj tum dstl/shft hum CPT 24150 | not published | not published | $5,286.15 – $20,477.00 | 4 |
| Rad rescj tum shoulder<5 cm CPT 23077 | not published | not published | $2,116.08 – $11,257.00 | 4 |
| Rad rescj tum tiss a/e 5 cm+ CPT 24079 | not published | not published | $2,116.08 – $11,257.00 | 4 |
| Rad rescj tum tiss a/e <5cm CPT 24077 | not published | not published | $2,116.08 – $11,257.00 | 4 |
| Rad resec soft tis tum/ft/toe/<3cm 28046 CPT 28046 | not published | not published | $2,116.08 – $11,257.00 | 4 |
| Rad resect abd tumor 5 cm/> CPT 22905 | not published | not published | $2,116.08 – $11,257.00 | 4 |
| Rad resect hand tumor < 3 cm CPT 26117 | not published | not published | $2,116.08 – $11,257.00 | 4 |
| Rad resect hand tumor 3 cm/> CPT 26118 | not published | not published | $2,116.08 – $11,257.00 | 4 |
| Rad resection tum radial h/n CPT 24152 | not published | not published | $5,286.15 – $20,477.00 | 4 |
| Rad resect tumor/neck/ant thor/<5cm21557 CPT 21557 | not published | not published | $2,116.08 – $11,257.00 | 4 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | not published | not published | $57.42 – $141.46 | 5 |
| Range of motion measurements CPT 95852 | not published | not published | $3.56 – $4.74 | 2 |
| Ranibizumab injection HCPCS J2778 | not published | not published | $38.32 – $229.36 | 5 |
| Rapid desensitization CPT 95180 | not published | not published | $325.44 – $433.92 | 2 |
| Rapid Strep Test CPT 87880 | $120.45 | $219.00 | $12.40 – $119.16 | 5 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | not published | not published | $290.59 – $715.31 | 5 |
| Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 | not published | not published | $170.19 – $427.87 | 5 |
| Rbc count only automated CPT 85041 | not published | not published | $2.26 – $29.99 | 5 |
| Rbc depletion of harvest CPT 38212 | not published | not published | $321.40 – $4,401.00 | 4 |
| Rbc mechanical fragility CPT 85547 | not published | not published | $6.45 – $85.53 | 5 |
| Rbc osmotic fragility CPT 85555 | $91.30 | $166.00 | $5.60 – $66.39 | 5 |
| Rbc serum pretx incubj drugs CPT 86975 | $126.50 | $230.00 | $212.23 – $433.92 | 3 |
| Rcnst bfrnt sp orb rm&lw fhd CPT 21175 | not published | not published | $4,312.59 – $14,304.00 | 4 |
| Rcnstj forehead w/autograft CPT 21180 | not published | not published | $4,312.59 – $14,304.00 | 4 |
| Rcnstj forehead with grafts CPT 21179 | not published | not published | $4,312.59 – $14,304.00 | 4 |
| Rcnstj mdfc lefort i 1 w/grf CPT 21145 | not published | not published | $4,312.59 – $14,304.00 | 4 |
| Rcnstj mdfc lefort i 2 w/grf CPT 21146 | not published | not published | $4,312.59 – $14,304.00 | 4 |
| Rcnstj mdfc lefort iii w/i CPT 21155 | not published | not published | $4,312.59 – $14,304.00 | 4 |
| Rcnstj mdfc lefort iii without i CPT 21154 | not published | not published | $4,312.59 – $14,304.00 | 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.