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 |
|---|---|---|---|---|
| Zenith amniotic membrane psc HCPCS Q4253 | not published | not published | $78.65 – $325.15 | 7 |
| Ziconotide injection HCPCS J2278 | not published | not published | $8.09 – $26.63 | 8 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | not published | not published | $1.13 – $4.11 | 8 |
| Zika virus dna/rna amp probe CPT 87662 | not published | not published | $38.48 – $99.03 | 7 |
| Zika virus igm antibody CPT 86794 | not published | not published | $12.64 – $32.52 | 7 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | not published | not published | $5.70 – $19.57 | 5 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | not published | not published | $6.51 – $21.73 | 8 |
| Zolbetuximab-clzb 100 mg intravenous solution HCPCS J1326 | not published | not published | $25.44 – $65.47 | 5 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | not published | not published | $6.06 – $15.25 | 5 |
| Zoster vaccine-live inj CPT 90736 | not published | not published | $361.93 – $361.93 | 1 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $144.94 – $372.97 | 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.