SSM Health St. Agnes Hospital - Fond du Lac
430 E Division St, Fond Du Lac, WI · SSM Health · · NPI 1346228541
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 |
|---|---|---|---|---|
| Treatment of choroid lesion CPT 67220 | not published | not published | $408.01 – $3,030.00 | 6 |
| Treatment of corneal lesion CPT 65450 | not published | not published | $235.46 – $2,334.00 | 6 |
| Treatment of eyelid lesions CPT 68040 | not published | not published | $235.46 – $2,334.00 | 6 |
| Treatment of fibula fracture CPT 27784 | not published | not published | $5,382.89 – $18,364.00 | 6 |
| Treatment of fibula fracture 27780 CPT 27780 | not published | not published | $182.99 – $2,334.00 | 6 |
| Treatment of foot infection CPT 28002 | not published | not published | $1,192.86 – $7,791.00 | 6 |
| Treatment of foot infection CPT 28003 | not published | not published | $2,427.27 – $7,791.00 | 6 |
| Treatment of gum lesion CPT 41850 | not published | not published | $1,151.01 – $4,761.00 | 6 |
| Treatment of head injury 62010 CPT 62010 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Treatment of heel fracture 28400 CPT 28400 | $498.85 | $907.00 | $182.99 – $2,334.00 | 6 |
| Treatment of miscarriage CPT 59821 | not published | not published | $2,401.40 – $7,791.00 | 6 |
| Treatment of mouth lesion physical 40820 CPT 40820 | not published | not published | $2,459.51 – $6,329.15 | 6 |
| Treatment of penis lesion CPT 54110 | not published | not published | $2,614.94 – $16,106.00 | 6 |
| Treatment of penis lesion CPT 54115 | not published | not published | $2,154.81 – $7,791.00 | 6 |
| Treatment of rectal prolapse CPT 45520 | not published | not published | $689.87 – $3,030.00 | 6 |
| Treatment of retinal lesion CPT 67208 | not published | not published | $235.46 – $2,334.00 | 6 |
| Treatment of retinal lesion CPT 67210 | not published | not published | $408.01 – $3,030.00 | 6 |
| Treatment of retinal lesion CPT 67218 | not published | not published | $2,916.44 – $8,770.00 | 6 |
| Treatment of thigh fracture CPT 27501 | not published | not published | $182.99 – $2,334.00 | 6 |
| Treatment of thigh fracture CPT 27503 | not published | not published | $1,192.86 – $3,069.63 | 6 |
| Treatment of thigh fracture CPT 27506 | not published | not published | $3,735.00 – $16,106.00 | 6 |
| Treatment of thigh fracture CPT 27508 | not published | not published | $182.99 – $2,334.00 | 6 |
| Treatment of thigh fracture CPT 27509 | not published | not published | $5,382.89 – $13,851.98 | 6 |
| Treatment of thigh fracture CPT 27510 | not published | not published | $1,192.86 – $3,069.63 | 6 |
| Treatment of thigh fracture CPT 27511 | not published | not published | $3,735.00 – $24,508.80 | 6 |
| Treatment of thigh fracture CPT 27507 | not published | not published | $3,735.00 – $16,106.00 | 6 |
| Treatment of thigh fracture CPT 27513 | not published | not published | $3,735.00 – $24,508.80 | 6 |
| Treatment of thigh fracture CPT 27514 | not published | not published | $3,735.00 – $24,508.80 | 6 |
| Treatment of tibia fracture CPT 27756 | not published | not published | $5,382.89 – $13,851.98 | 6 |
| Treatment of tibia fracture CPT 27758 | not published | not published | $7,609.00 – $24,508.80 | 6 |
| Treatment of tibia fracture CPT 27759 | not published | not published | $7,609.00 – $24,508.80 | 6 |
| Treatment of toe fracture 28510 CPT 28510 | not published | not published | $182.99 – $2,334.00 | 6 |
| Treatment of urethra lesion CPT 53220 | not published | not published | $2,614.94 – $8,770.00 | 6 |
| Treatment of urethra lesion CPT 53260 | not published | not published | $2,614.94 – $7,791.00 | 6 |
| Treatment of urethra lesion CPT 53265 | not published | not published | $1,550.71 – $7,791.00 | 6 |
| Treatment radiation delivery level 2 CPT 77407 | not published | not published | $286.12 – $736.29 | 4 |
| Treatment x10sv retinopathy CPT 67228 | not published | not published | $408.01 – $3,030.00 | 6 |
| Treat metacarpal fracture CPT 26608 | not published | not published | $2,427.27 – $7,791.00 | 6 |
| Treat metacarpal fracture CPT 26615 | not published | not published | $2,427.27 – $18,364.00 | 6 |
| Treat metatarsal fracture CPT 28476 | not published | not published | $2,427.27 – $7,791.00 | 6 |
| Treat metatarsal fracture CPT 28485 | not published | not published | $5,382.89 – $18,364.00 | 6 |
| Treat midfoot fracture each CPT 28455 | $2,391.95 | $4,349.00 | $1,192.86 – $3,069.63 | 6 |
| Treat midfoot fracture each CPT 28465 | not published | not published | $5,382.89 – $18,364.00 | 6 |
| Treat neck spine fracture CPT 22326 | not published | not published | $3,735.00 – $24,508.80 | 6 |
| Treat odontoid fx w/graft CPT 22319 | not published | not published | $3,735.00 – $24,508.80 | 6 |
| Treat odontoid fx without graft CPT 22318 | not published | not published | $3,735.00 – $24,508.80 | 6 |
| Treat pelvic fracture(s) CPT 27215 | not published | not published | $2,959.00 – $3,735.00 | 3 |
| Treat pelvic ring fracture CPT 27216 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Treat pelvic ring fracture CPT 27217 | not published | not published | $3,579.00 – $4,761.00 | 3 |
| Treat pelvic ring fracture CPT 27218 | not published | not published | $3,579.00 – $4,761.00 | 3 |
| Treat penis lesion graft CPT 54111 | not published | not published | $3,977.55 – $16,106.00 | 6 |
| Treat penis lesion graft CPT 54112 | not published | not published | $7,022.52 – $18,071.30 | 6 |
| Treat radius fracture CPT 24665 | not published | not published | $5,382.89 – $18,364.00 | 6 |
| Treat radius fracture CPT 24666 | not published | not published | $7,609.00 – $24,508.80 | 6 |
| Treat sesamoid bone fracture CPT 28531 | not published | not published | $5,382.89 – $13,851.98 | 6 |
| Treat skull fracture CPT 62000 | not published | not published | $2,459.51 – $16,106.00 | 6 |
| Treat skull fracture CPT 62005 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Treat slipped epiphysis CPT 27176 | not published | not published | $2,427.27 – $18,364.00 | 6 |
| Treat slipped epiphysis CPT 27175 | not published | not published | $2,427.27 – $18,364.00 | 6 |
| Treat slipped epiphysis CPT 27177 | not published | not published | $2,427.27 – $18,364.00 | 6 |
| Treat slipped epiphysis CPT 27178 | not published | not published | $2,427.27 – $18,364.00 | 6 |
| Treat slipped epiphysis CPT 27181 | not published | not published | $3,735.00 – $18,364.00 | 6 |
| Treat spinal cord lesion CPT 62280 | not published | not published | $656.13 – $3,030.00 | 6 |
| Treat spinal cord lesion CPT 62281 | not published | not published | $656.13 – $3,030.00 | 6 |
| Treat spine fracture CPT 22325 | not published | not published | $3,735.00 – $24,508.80 | 6 |
| Treat sternum fracture CPT 21820 | not published | not published | $182.99 – $2,334.00 | 6 |
| Treat tail bone fracture CPT 27202 | not published | not published | $2,427.27 – $18,364.00 | 6 |
| Treat thigh fracture CPT 27230 | not published | not published | $182.99 – $2,334.00 | 6 |
| Treat thigh fracture CPT 27235 | not published | not published | $5,382.89 – $13,851.98 | 6 |
| Treat thigh fracture CPT 27236 | not published | not published | $3,735.00 – $18,364.00 | 6 |
| Treat thigh fracture CPT 27238 | not published | not published | $1,192.86 – $3,069.63 | 6 |
| Treat thigh fracture CPT 27245 | not published | not published | $3,735.00 – $16,106.00 | 6 |
| Treat thigh fracture CPT 27246 | not published | not published | $182.99 – $2,334.00 | 6 |
| Treat thigh fracture CPT 27248 | not published | not published | $3,735.00 – $18,364.00 | 6 |
| Treat thigh fracture CPT 27240 | $2,501.95 | $4,549.00 | $1,192.86 – $4,761.00 | 6 |
| Treat thigh fracture CPT 27244 | not published | not published | $3,735.00 – $18,364.00 | 6 |
| Treat thigh fx growth plate CPT 27516 | not published | not published | $182.99 – $2,334.00 | 6 |
| Treat thigh fx growth plate CPT 27517 | not published | not published | $1,192.86 – $3,069.63 | 6 |
| Treat thigh fx growth plate CPT 27519 | not published | not published | $3,735.00 – $16,106.00 | 6 |
| Treat thorax spine fracture CPT 22327 | not published | not published | $3,735.00 – $24,508.80 | 6 |
| Treat thumb fracture CPT 26650 | not published | not published | $2,427.27 – $7,791.00 | 6 |
| Treat thumb fracture CPT 26665 | not published | not published | $2,427.27 – $18,364.00 | 6 |
| Treat toe dislocation CPT 28636 | not published | not published | $2,427.27 – $7,791.00 | 6 |
| Treat toe dislocation CPT 28665 | $526.35 | $957.00 | $207.48 – $2,334.00 | 6 |
| Treat toe dislocation CPT 28666 | not published | not published | $2,427.27 – $7,791.00 | 6 |
| Treat toe fracture CPT 28525 | not published | not published | $2,427.27 – $7,791.00 | 6 |
| Treat trigeminal nerve CPT 61790 | not published | not published | $1,448.59 – $7,791.00 | 6 |
| Treat trigeminal tract CPT 61791 | not published | not published | $1,448.59 – $7,791.00 | 6 |
| Treat ulnar fracture CPT 24675 | $3,109.70 | $5,654.00 | $1,192.86 – $3,069.63 | 6 |
| Treat ulnar fracture CPT 24685 | not published | not published | $5,382.89 – $18,364.00 | 6 |
| Treat vaginal bleeding CPT 57180 | not published | not published | $149.98 – $2,334.00 | 6 |
| Treat wrist bone fracture CPT 25635 | not published | not published | $1,192.86 – $3,069.63 | 6 |
| Treat wrist dislocation CPT 25675 | $448.80 | $816.00 | $182.99 – $2,334.00 | 6 |
| Tremelimumab-actl 20 mg/ml intravenous solution HCPCS J9347 | not published | not published | $110.17 – $376.88 | 8 |
| Treponema pallidum ag if CPT 87285 | not published | not published | $9.14 – $23.51 | 7 |
| Treponema pallidum antibody CPT 86780 | $211.75 | $385.00 | $9.93 – $25.55 | 7 |
| Treprostinil injection HCPCS J3285 | not published | not published | $41.06 – $152.33 | 8 |
| Treprostinil, non-comp unit HCPCS J7686 | not published | not published | $823.03 – $2,069.51 | 5 |
| Trg gene rearrangement anal CPT 81342 | $537.35 | $977.00 | $151.12 – $388.90 | 7 |
| Trh stimulation panel CPT 80439 | not published | not published | $50.41 – $129.72 | 7 |
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.