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 |
|---|---|---|---|---|
| Tc-99m pertechnetate per mci HCPCS A9512 | $11.55 | $21.00 | not published | 0 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $224.40 | $408.00 | not published | 0 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $374.00 | $680.00 | not published | 0 |
| Tc-99m sulfur colloid HCPCS A9541 | $224.40 | $408.00 | not published | 0 |
| Tc-99m tilmanocept diag HCPCS A9520 | $238.15 | $433.00 | not published | 0 |
| Tca peel dermal 15789 CPT 15789 | not published | not published | $538.41 – $4,401.00 | 4 |
| Tcd emboli detect w/inj CPT 93893 | not published | not published | $76.16 – $101.55 | 2 |
| Tcd emboli detect without inj CPT 93892 | not published | not published | $76.16 – $101.55 | 2 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $321.40 – $4,401.00 | 4 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $61.60 | $112.00 | $35.24 – $467.08 | 5 |
| T cells absolute cd 4 count CPT 86361 | not published | not published | $20.08 – $266.13 | 5 |
| T cells total count CPT 86359 | $61.60 | $112.00 | $28.30 – $374.99 | 5 |
| Tcranial magn stim tx deli CPT 90868 | not published | not published | $157.30 – $209.73 | 2 |
| Tcranial magn stim tx plan CPT 90867 | not published | not published | $157.30 – $209.73 | 2 |
| Tcran magn stim redetemine CPT 90869 | not published | not published | $157.30 – $209.73 | 2 |
| Tdh sdrl/ventr pnxr CPT 61105 | not published | not published | $4,867.00 – $4,867.00 | 1 |
| Teaec w/wo patch graft iliofemoral CPT 35355 | not published | not published | $11,044.00 – $11,044.00 | 1 |
| Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution HCPCS J9274 | not published | not published | $171.00 – $412.47 | 5 |
| Tee w or without fol w/cont,cong HCPCS C8926 | not published | not published | $571.09 – $761.45 | 2 |
| Tee w or without fol w/cont, mon HCPCS C8927 | not published | not published | $571.09 – $761.45 | 2 |
| Teflon or equal cable lining HCPCS L6665 | not published | not published | $42.28 – $56.38 | 2 |
| Telavancin injection HCPCS J3095 | not published | not published | $5.61 – $14.19 | 5 |
| Telehealth original site facility fee HCPCS Q3014 | $70.40 | $128.00 | not published | 0 |
| Telethx isodose plan cplx CPT 77307 | $651.20 | $1,184.00 | $272.77 – $1,503.94 | 3 |
| Telethx isodose plan simple CPT 77306 | $355.85 | $647.00 | $272.77 – $834.15 | 3 |
| Temozolomide HCPCS J8700 | not published | not published | $0.50 – $0.69 | 3 |
| Temozolomide 100 mg intravenous solution HCPCS J9328 | not published | not published | $7.81 – $19.75 | 5 |
| Temperature gradient studies CPT 93740 | not published | not published | $93.74 – $124.98 | 2 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | not published | not published | $24.51 – $61.34 | 5 |
| Tendon lengthening CPT 26476 | not published | not published | $2,383.65 – $11,257.00 | 4 |
| Tendon lngth upr a/e ea tdn CPT 24305 | not published | not published | $2,383.65 – $11,257.00 | 4 |
| Tendon shortening CPT 26477 | not published | not published | $2,383.65 – $11,257.00 | 4 |
| Tendon transfer with graft CPT 26492 | not published | not published | $2,383.65 – $11,257.00 | 4 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | not published | not published | $163.07 – $326.68 | 5 |
| Tenodesis biceps tdn at elbw CPT 24340 | not published | not published | $5,286.15 – $20,477.00 | 4 |
| Tenolysis extensor tendon hand/finger each CPT 26445 | not published | not published | $2,383.65 – $11,257.00 | 4 |
| Tenolysis triceps CPT 24332 | not published | not published | $2,383.65 – $11,257.00 | 4 |
| Tenoplasty elbow to sho 1 CPT 24320 | not published | not published | $5,286.15 – $20,477.00 | 4 |
| Tenosynovectomy radic 26145 CPT 26145 | not published | not published | $1,171.42 – $4,867.00 | 4 |
| Tenotomy hip flexor open CPT 27005 | not published | not published | $2,383.65 – $16,310.00 | 4 |
| Tenotomy length/rls abductor hallucis musc 28240 CPT 28240 | not published | not published | $2,383.65 – $11,257.00 | 4 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | not published | not published | $1,171.42 – $6,687.00 | 4 |
| Tension based scoliosis orth HCPCS L1005 | not published | not published | $2,950.10 – $3,933.46 | 2 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | not published | not published | $2.04 – $5.21 | 3 |
| Term dev auto grasp feature HCPCS L6881 | not published | not published | $3,775.59 – $5,034.12 | 2 |
| Term device, multi art digit HCPCS L6715 | not published | not published | $2,915.70 – $3,887.60 | 2 |
| Term dev mech hand vol close HCPCS L6709 | not published | not published | $1,284.16 – $1,712.21 | 2 |
| Term dev mech hand vol open HCPCS L6708 | not published | not published | $904.82 – $1,206.42 | 2 |
| Term dev mech hook vol close HCPCS L6707 | not published | not published | $1,368.79 – $1,825.05 | 2 |
| Term dev mech hook vol open HCPCS L6706 | not published | not published | $386.93 – $515.91 | 2 |
| Term dev modifier wrist unit HCPCS L6805 | not published | not published | $354.20 – $472.26 | 2 |
| Term dev, passive hand mitt HCPCS L6703 | not published | not published | $323.02 – $430.70 | 2 |
| Term dev precision pinch dev HCPCS L6810 | not published | not published | $188.30 – $251.06 | 2 |
| Term dev, sport/rec/work att HCPCS L6704 | not published | not published | $623.51 – $831.35 | 2 |
| Tert gene targeted seq alys CPT 81345 | not published | not published | $138.90 – $1,351.39 | 5 |
| Test for chlorohydrocarbons CPT 82441 | not published | not published | $4.51 – $59.69 | 5 |
| Test for porphobilinogen CPT 84106 | not published | not published | $4.36 – $42.54 | 5 |
| Test for urine cystines CPT 82615 | not published | not published | $7.16 – $81.16 | 5 |
| Testicular imaging w/vasc flow CPT 78761 | $762.30 | $1,386.00 | $291.23 – $1,943.82 | 3 |
| Testosterone response panel CPT 80414 | not published | not published | $38.73 – $501.09 | 5 |
| Testosterone undecanoate 1mg HCPCS J3145 | not published | not published | $1.61 – $3.79 | 5 |
| Test pathogen(s) for platelets reference HCPCS P9100 | not published | not published | $42.98 – $57.30 | 2 |
| Test sock elbw disart/above HCPCS L6682 | not published | not published | $314.03 – $418.71 | 2 |
| Test socket above knee HCPCS L5624 | not published | not published | $368.71 – $491.61 | 2 |
| Test socket below knee HCPCS L5620 | not published | not published | $273.78 – $365.04 | 2 |
| Test socket hemipelvectomy HCPCS L5628 | not published | not published | $591.08 – $788.11 | 2 |
| Test socket hip disarticulat HCPCS L5626 | not published | not published | $583.70 – $778.27 | 2 |
| Test socket knee disarticula HCPCS L5622 | not published | not published | $368.84 – $491.79 | 2 |
| Test socket shldr disart/tho HCPCS L6684 | not published | not published | $426.74 – $568.98 | 2 |
| Test socket symes HCPCS L5618 | not published | not published | $308.57 – $411.43 | 2 |
| Test sock wrist disart/bel e HCPCS L6680 | not published | not published | $284.03 – $378.71 | 2 |
| Test stress cardiovascular tracing only CPT 93017 | $648.45 | $1,179.00 | $157.30 – $209.73 | 2 |
| Test urine for lactose CPT 83633 | not published | not published | $8.44 – $54.65 | 5 |
| Test urine for porphyrins CPT 84119 | not published | not published | $10.02 – $85.66 | 5 |
| Test urine urobilinogen CPT 84578 | not published | not published | $3.35 – $32.32 | 5 |
| Tetanus immune globulin inj HCPCS J1670 | not published | not published | $446.26 – $1,096.39 | 5 |
| Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe HCPCS J2356 | not published | not published | $13.44 – $34.77 | 5 |
| Tgfbi gene common variants CPT 81333 | not published | not published | $102.75 – $999.67 | 5 |
| Tgsap hl neo 5-50 rna alys CPT 81451 | not published | not published | $569.65 – $5,540.43 | 5 |
| Tgsap so/hl 51/< rna alys CPT 81456 | not published | not published | $2,189.70 – $21,297.20 | 5 |
| Tgsap so neo 5-50 rna alys CPT 81449 | not published | not published | $448.43 – $4,361.49 | 5 |
| Thaw cryoprsvrd reprod tiss CPT 89354 | not published | not published | $124.11 – $165.49 | 2 |
| Thawing cryopresrved embryo CPT 89352 | not published | not published | $124.11 – $165.49 | 2 |
| Thawing cryopresrved oocyte CPT 89356 | not published | not published | $124.11 – $165.49 | 2 |
| Thawing cryopresrved sperm CPT 89353 | not published | not published | $37.96 – $50.62 | 2 |
| Thaw preserved stem cells CPT 38208 | not published | not published | $321.40 – $4,401.00 | 4 |
| Theophylline therapeutic drug level CPT 80198 | $226.60 | $412.00 | $10.60 – $140.62 | 5 |
| Therapy activation ipnss CPT 93150 | not published | not published | $69.26 – $92.35 | 2 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $46.20 | $84.00 | $19.35 – $25.80 | 2 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $46.20 | $84.00 | $16.15 – $21.53 | 2 |
| Therapy photodnmc lght dstr lsn skn by staff rx per day CPT 96567 | not published | not published | $146.16 – $1,676.00 | 3 |
| Ther fx nasal inf turbinate CPT 30930 | not published | not published | $2,415.31 – $6,687.00 | 4 |
| Ther nma rdctj intus/obstrcj CPT 74283 | not published | not published | $127.78 – $1,101.97 | 3 |
| Ther/proph/diag inj ia CPT 96373 | not published | not published | $154.95 – $206.61 | 2 |
| Ther radiology tx plng cplx CPT 77263 | not published | not published | $1,826.70 – $1,826.70 | 1 |
| Ther radiology tx plng intrm CPT 77262 | not published | not published | $1,249.50 – $1,249.50 | 1 |
| Ther radiology tx plng smpl CPT 77261 | not published | not published | $836.85 – $836.85 | 1 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | not published | not published | $2.55 – $3.40 | 3 |
| Thigh/wght bear high roll cu HCPCS L2550 | not published | not published | $313.62 – $418.16 | 2 |
| Thigh/wght bear lacer molded HCPCS L2540 | not published | not published | $418.28 – $557.70 | 2 |
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.