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 |
|---|---|---|---|---|
| Cardiac MRI seg dys strain HCPCS C9762 | not published | not published | $405.35 – $1,043.10 | 4 |
| Cardiac MRI seg dys stress HCPCS C9763 | not published | not published | $405.35 – $1,043.10 | 4 |
| Cardiac MRI w/stress img CPT 75559 | not published | not published | $405.35 – $1,043.10 | 4 |
| Cardiac perf planar mult/ef/wm CPT 78454 | not published | not published | $960.41 – $2,471.46 | 4 |
| Cardiac perf planar sgl/ef/wm CPT 78453 | not published | not published | $880.89 – $2,471.46 | 4 |
| Cardiac perf spect sgl/ef/wm rst/strs CPT 78451 | $2,038.30 | $3,706.00 | $948.60 – $2,471.46 | 4 |
| Cardiac rehabilitation op phase 2 w/continous ecg monitoring CPT 93798 | $369.60 | $672.00 | $95.63 – $246.08 | 4 |
| Cardiac rehabilitation op phase 2 without continous ecg monitoring CPT 93797 | $238.70 | $434.00 | $95.63 – $246.08 | 4 |
| Cardiac shunt imaging CPT 78428 | not published | not published | $296.56 – $763.16 | 4 |
| Cardiokymography HCPCS Q0035 | not published | not published | $27.71 – $71.30 | 4 |
| Cardiolipin antibody iga CPT 86147 | $35.75 | $65.00 | $11.77 – $49.12 | 7 |
| Cardioversion elective electrical conversion arrhythmia external CPT 92960 | $1,458.05 | $2,651.00 | $490.31 – $3,030.00 | 6 |
| Cardioversion/elective/internal 92961 CPT 92961 | not published | not published | $490.31 – $3,030.00 | 6 |
| Card MRI veloc flow mapping CPT 75565 | not published | not published | $141.39 – $141.39 | 1 |
| Caregiver training strategies&tq 1st 30 minutes CPT 97550 | $75.90 | $138.00 | $29.44 – $75.77 | 4 |
| Caregiver training strategies&tq ea addl 15 min CPT 97551 | $66.00 | $120.00 | $15.69 – $40.38 | 4 |
| Carfilzomib 10 mg intravenous solution HCPCS J9047 | not published | not published | $45.22 – $141.49 | 8 |
| Car ion chnnlpath inc 10 gns CPT 81413 | not published | not published | $438.68 – $1,128.86 | 7 |
| Car ion chnnlpath inc 2 gns CPT 81414 | not published | not published | $438.68 – $1,128.86 | 7 |
| Carmustine 100 mg intravenous powder for solution HCPCS J9050 | not published | not published | $160.16 – $695.11 | 8 |
| Carotene CPT 82380 | $17.05 | $31.00 | $6.92 – $17.79 | 7 |
| Carotid Artery Ultrasound (Duplex) CPT 93880 | $963.05 | $1,751.00 | $177.00 – $455.49 | 4 |
| Car outp meas drg cath chd CPT 93598 | not published | not published | $1,887.00 – $2,334.00 | 2 |
| Carpal Tunnel Release Surgery CPT 64721 | $6,884.35 | $12,517.00 | $1,448.59 – $7,791.00 | 7 |
| Car seat/bed test 60 minutes CPT 94780 | $277.75 | $505.00 | $27.71 – $71.30 | 4 |
| Car seat/bed test additional 30 minutes CPT 94781 | $137.50 | $250.00 | not published | 0 |
| Car-t admn autologous CPT 38228 | not published | not published | $245.03 – $630.55 | 4 |
| Ca screen;flexi sigmoidscope HCPCS G0104 | not published | not published | $689.87 – $3,030.00 | 6 |
| Caspofungin acetate HCPCS J0637 | not published | not published | $3.67 – $13.78 | 5 |
| Cataract Surgery CPT 66984 | not published | not published | $1,712.02 – $7,791.00 | 7 |
| Cataract surg w/iol 1 stage CPT 66983 | not published | not published | $1,712.02 – $7,791.00 | 6 |
| Catecholamines,fractionated, urine CPT 82382 | not published | not published | $20.48 – $52.69 | 7 |
| Cath 2lum 14.5frx43cm maxid kt mahurkar HCPCS C1752 | $245.46 | $446.30 | not published | 0 |
| Cath ablat bi-d d-d 8fr 115cm HCPCS C2630 | $5,652.30 | $10,276.91 | not published | 0 |
| Cath ablt clsfast 7fx100cmx HCPCS C1888 | $1,215.42 | $2,209.85 | not published | 0 |
| Cath ablt rx lasr 2.0mm turbo HCPCS C1885 | $3,473.59 | $6,315.62 | not published | 0 |
| Cath access del ds spyscop 2.0 HCPCS C1748 | $5,244.39 | $9,535.25 | not published | 0 |
| Cath acuity innr ic130 6f 63cm HCPCS C1887 | $431.89 | $785.26 | not published | 0 |
| Cath acunav ge 10frx90cm HCPCS C1759 | $2,516.53 | $4,575.51 | not published | 0 |
| Cath adherent clot 10mm 6f 10 HCPCS C1757 | $5,393.98 | $9,807.24 | not published | 0 |
| Cath blazer dx/20 2-10-2 space HCPCS C1731 | $421.43 | $766.23 | not published | 0 |
| Cath combo lt&rt heart w/inj/s CPT 93453 | $8,723.00 | $15,860.00 | $2,404.97 – $16,106.00 | 6 |
| Cath cv dl inj 7fx16cm HCPCS C1751 | $1,072.48 | $1,949.96 | not published | 0 |
| Cath del ampltz 12f 45d 80cm HCPCS C1893 | $1,154.24 | $2,098.61 | not published | 0 |
| Catheter declot mechanical CPT 36596 | $1,073.05 | $1,951.00 | $1,167.76 – $3,030.00 | 6 |
| Catheter insert artery CPT 36625 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Catheterization collection of specimen single patient all places of service HCPCS P9612 | not published | not published | $3.00 – $18.03 | 7 |
| Catheter stripping venous CPT 36595 | $3,239.50 | $5,890.00 | $2,342.32 – $8,770.00 | 6 |
| Cath groshong MRI 8fr plstc port HCPCS C1788 | $537.61 | $977.47 | not published | 0 |
| Cath hawkone s directional HCPCS C1714 | $3,306.29 | $6,011.43 | not published | 0 |
| Cath imag ivus pv 8.5fx90 .035 HCPCS C1753 | $2,595.30 | $4,718.73 | not published | 0 |
| Cathj rmvl dev ischmc rmdlg CPT 53866 | not published | not published | $185.35 – $476.96 | 4 |
| Cathj umbilical vein dx/ther nb CPT 36510 | $106.15 | $193.00 | $1,887.00 – $5,512.00 | 3 |
| Cath left heart/lv gram CPT 93452 | not published | not published | $2,404.97 – $16,106.00 | 6 |
| Cath left heart transseptal punc CPT 93462 | $4,416.50 | $8,030.00 | $1,887.00 – $5,512.00 | 3 |
| Cath lt/rt pulm art CPT 36014 | $1,823.80 | $3,316.00 | $1,887.00 – $5,512.00 | 3 |
| Cath malecot 28fr 4-wing ltx HCPCS C1729 | $911.50 | $1,657.28 | not published | 0 |
| Cath occl flo-rester 2.25x12mm cor internal vessel occluder HCPCS C1817 | $20,316.15 | $36,938.45 | not published | 0 |
| Cath place 1st order venous 36011 CPT 36011 | $1,492.70 | $2,714.00 | $1,887.00 – $5,512.00 | 3 |
| Cath place cardio brachytx CPT 92974 | not published | not published | $1,887.00 – $2,334.00 | 2 |
| Cath plc art ang/grft lt/rt hr CPT 93461 | $5,959.80 | $10,836.00 | $2,404.97 – $16,106.00 | 6 |
| Cath plc art/angio/rt hrt cath CPT 93456 | $8,820.90 | $16,038.00 | $2,404.97 – $16,106.00 | 6 |
| Cath plc art/grft/angio right hrt CPT 93457 | not published | not published | $2,404.97 – $16,106.00 | 6 |
| Cath right heart w/o2 sat & card CPT 93451 | $3,161.95 | $5,749.00 | $2,404.97 – $16,106.00 | 6 |
| Cath right hrt mnpul art CPT 36013 | $1,617.55 | $2,941.00 | $1,887.00 – $5,512.00 | 3 |
| Cath/saline/contrast/sis/hysteosal 58340 CPT 58340 | $237.60 | $432.00 | $1,887.00 – $5,512.00 | 3 |
| Cath segmntl pulm art CPT 36015 | $1,662.65 | $3,023.00 | $1,887.00 – $5,512.00 | 3 |
| Cath steerable flex adv 12f HCPCS C1766 | $1,911.44 | $3,475.34 | not published | 0 |
| Cath stripping venous s&i CPT 75901 | $983.40 | $1,788.00 | $510.42 – $510.42 | 1 |
| Cath uret open tp 6fx70cm HCPCS C1758 | $116.00 | $210.90 | not published | 0 |
| Cauterization chemical granulation tissue CPT 17250 | $564.85 | $1,027.00 | $148.84 – $2,334.00 | 6 |
| Cauterization of cervix 57510 CPT 57510 | not published | not published | $2,401.40 – $7,791.00 | 6 |
| #cbg+cort-cbg CPT 84449 | not published | not published | $13.50 – $34.74 | 7 |
| Ccnd1/igh translocation alys CPT 81168 | not published | not published | $155.48 – $400.11 | 7 |
| Cdna analysis for variants CPT 81403 | $493.90 | $898.00 | $138.90 – $357.44 | 7 |
| Cdp-sot 6 cond w/i&r CPT 92548 | not published | not published | $98.70 – $253.99 | 4 |
| Cdp-sot 6 cond w/i&r mct&adt CPT 92549 | not published | not published | $98.70 – $253.99 | 4 |
| Cebpa gene full sequence CPT 81218 | not published | not published | $181.42 – $466.87 | 7 |
| Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr HCPCS J0690 | not published | not published | $0.89 – $2.21 | 5 |
| Cefepime 1 gram solution for injection HCPCS J0692 | not published | not published | $1.32 – $3.38 | 5 |
| Cefotaxime sodium injection HCPCS J0698 | not published | not published | $16.45 – $16.45 | 1 |
| Cefoxitin 1 gram intravenous solution HCPCS J0694 | not published | not published | $4.82 – $12.11 | 5 |
| Ceftaroline fosamil 600 mg intravenous solution HCPCS J0712 | not published | not published | $3.29 – $10.76 | 8 |
| Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr HCPCS J0713 | not published | not published | $1.76 – $4.49 | 5 |
| Ceftazidime and avibactam HCPCS J0714 | not published | not published | $82.33 – $274.23 | 8 |
| Ceftriaxone 1 gram solution for injection HCPCS J0696 | not published | not published | $0.48 – $1.22 | 5 |
| Cefuroxime in ns IV syringe 30 mg/ml (neo/ped) - cnr HCPCS J0697 | not published | not published | $2.04 – $5.15 | 5 |
| #celiac hla-dq2 CPT 81377 | not published | not published | $71.06 – $182.85 | 7 |
| #celiac hla-dq8 CPT 81383 | $289.85 | $527.00 | $81.85 – $210.62 | 7 |
| Cell count body fluid CPT 89050 | not published | not published | $3.54 – $9.11 | 7 |
| Cell count w differential body fluid CPT 89051 | $70.95 | $129.00 | $4.20 – $10.81 | 7 |
| Cell cryopreserve/storage CPT 88240 | not published | not published | $9.80 – $25.23 | 7 |
| Cell enumeration & id CPT 86152 | not published | not published | $188.08 – $484.01 | 7 |
| Cell function assay w/stim CPT 86352 | $224.40 | $408.00 | $101.90 – $262.21 | 7 |
| Cell marker study CPT 88182 | $124.85 | $227.00 | $38.66 – $99.48 | 5 |
| Cemiplimab-rwlc 50 mg/ml intravenous solution HCPCS J9119 | not published | not published | $22.25 – $76.81 | 8 |
| Centralization wrist on ulna CPT 25335 | not published | not published | $2,427.27 – $16,106.00 | 6 |
| Centruroides immune f(ab) HCPCS J0716 | not published | not published | $13,065.56 – $13,065.56 | 1 |
| Cerclage cervix pregnancy abdominal 59325 CPT 59325 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Cerclage of uterine cervix nonob 57700 CPT 57700 | not published | not published | $2,401.40 – $7,791.00 | 6 |
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.