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 |
|---|---|---|---|---|
| Exc benign tal 0.5 < cm 11400 CPT 11400 | $179.30 | $326.00 | $525.32 – $3,030.00 | 6 |
| Exc ben+marg excep skin tag feenlm <0.5cm 11440 CPT 11440 | not published | not published | $525.32 – $3,030.00 | 6 |
| Exc ben+marg excep skin tag feenlm 1.1-2cm 11442 CPT 11442 | not published | not published | $525.32 – $3,030.00 | 6 |
| Exc ben+marg excep skin tag feenlm 2.1-3cm 11443 CPT 11443 | not published | not published | $1,225.21 – $3,152.87 | 6 |
| Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 CPT 11421 | $2,269.30 | $4,126.00 | $525.32 – $3,030.00 | 6 |
| Exc ben+marg excep skin tag snhfg 2.1-3cm 11423 CPT 11423 | not published | not published | $1,225.21 – $4,761.00 | 6 |
| Exc ben+marg excep skin tag snhfg >4cm 11426 CPT 11426 | not published | not published | $2,154.81 – $7,791.00 | 6 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | $954.25 | $1,735.00 | $301.57 – $2,334.00 | 6 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | $2,360.60 | $4,292.00 | $525.32 – $3,030.00 | 6 |
| Exc breast duct fistula 19112 CPT 19112 | not published | not published | $2,904.59 – $7,791.00 | 6 |
| Exc carotid body tumor without exc art 60600 CPT 60600 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Exc cervix repair bowel 57556 CPT 57556 | not published | not published | $3,710.98 – $16,106.00 | 6 |
| Exc cervix/repair pelvis 57545 CPT 57545 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Exc cervix/repair vagina 57555 CPT 57555 | not published | not published | $3,710.98 – $9,549.58 | 6 |
| Exc chest wall tumor w/ribs 21601 CPT 21601 | not published | not published | $2,154.81 – $7,791.00 | 6 |
| Exc ch wal tum without lymphadec CPT 21602 | not published | not published | $5,382.89 – $18,364.00 | 6 |
| Exc ch wal tum w/lymphadec CPT 21603 | not published | not published | $5,382.89 – $18,364.00 | 6 |
| Exc coa rpr l subcl art/prst CPT 33851 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Exc coa w/direct anastomosis CPT 33840 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Exc coccygl pr ulc flap clsr CPT 15922 | not published | not published | $2,628.85 – $8,770.00 | 6 |
| Exc coccygl pr ulc prim sutr CPT 15920 | not published | not published | $2,154.81 – $5,545.05 | 6 |
| Exc constrict ring finger w/mlt z-plasties 26596 CPT 26596 | not published | not published | $2,427.27 – $6,246.19 | 6 |
| Exc/crtg b1 cst/b9 tum rds CPT 24120 | not published | not published | $2,427.27 – $7,791.00 | 6 |
| Exc/crtg b1 cst/tum hum agrf CPT 24115 | not published | not published | $5,382.89 – $13,851.98 | 6 |
| Exc/crtg b1 cst/tum hum algr CPT 24116 | not published | not published | $5,382.89 – $13,851.98 | 6 |
| Exc/crtg b1 cst/tum rds agrf CPT 24125 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Exc/crtg b1 cst/tum rds algr CPT 24126 | not published | not published | $5,382.89 – $13,851.98 | 6 |
| Exc/curetg cst/tum tarsal/metar w/iliac/agrf 28106 CPT 28106 | not published | not published | $5,382.89 – $18,364.00 | 6 |
| Exc/curtg b1 cst/b9 tum hum CPT 24110 | not published | not published | $2,427.27 – $7,791.00 | 6 |
| Exc/destruct open intra-abd tumors cysts or endometriomas CPT 49204 | not published | not published | $17,314.00 – $18,364.00 | 2 |
| Exc excessive skin buttock CPT 15835 | not published | not published | $2,154.81 – $7,791.00 | 6 |
| Exc excessive skin hip CPT 15834 | not published | not published | $2,154.81 – $7,791.00 | 6 |
| Exc excessive skin leg CPT 15833 | not published | not published | $2,154.81 – $7,791.00 | 6 |
| Exc excessive skin thigh CPT 15832 | not published | not published | $2,154.81 – $7,791.00 | 6 |
| Exc excsv skin forearm/hand CPT 15837 | not published | not published | $2,154.81 – $5,545.05 | 6 |
| Exc excsv submental fat pad CPT 15838 | not published | not published | $2,154.81 – $5,545.05 | 6 |
| Exc ext ear/partial/simple repair 69110 CPT 69110 | not published | not published | $2,154.81 – $5,545.05 | 6 |
| Exc face tum deep < 2 cm CPT 21013 | not published | not published | $1,225.21 – $3,152.87 | 6 |
| Exc face tum deep 2cm/> 21014 CPT 21014 | not published | not published | $2,154.81 – $5,545.05 | 6 |
| Exc feenl mal+mrg 0.6-1 11641 CPT 11641 | not published | not published | $525.32 – $3,030.00 | 6 |
| Exc feenl mal+mrg 2.1-3 11643 CPT 11643 | not published | not published | $1,225.21 – $3,152.87 | 6 |
| Exc foot/toe tum dep 1.5cm/> CPT 28041 | not published | not published | $2,154.81 – $7,791.00 | 6 |
| Exc foot/toe tum subq < 1.5 cm 28043 CPT 28043 | not published | not published | $1,225.21 – $4,761.00 | 6 |
| Exc forearm les sc 3 cm/> CPT 25071 | not published | not published | $1,225.21 – $7,791.00 | 6 |
| Exc forearm tum deep < 3 cm CPT 25076 | not published | not published | $1,225.21 – $4,761.00 | 6 |
| Exc forearm tum deep 3 cm/> CPT 25073 | not published | not published | $2,154.81 – $7,791.00 | 6 |
| Exc hand les sc < 1.5 cm CPT 26115 | not published | not published | $1,225.21 – $4,761.00 | 6 |
| Exc hand tum deep 1.5 cm/> CPT 26113 | not published | not published | $1,225.21 – $7,791.00 | 6 |
| Exc hand tum deep < 1.5 cm 26116 CPT 26116 | not published | not published | $1,225.21 – $4,761.00 | 6 |
| Exchange biliary drg cath CPT 47536 | $535.70 | $974.00 | $2,656.06 – $8,770.00 | 6 |
| Exchange blood transfusion newborn 36450 CPT 36450 | not published | not published | $327.28 – $2,334.00 | 6 |
| Exchange drainage catheter CPT 49423 | $1,106.60 | $2,012.00 | $1,423.51 – $4,761.00 | 6 |
| Exchange lens prosthesis CPT 66986 | not published | not published | $1,712.02 – $7,791.00 | 6 |
| Exchange nephrostomy cath CPT 50435 | $4,779.50 | $8,690.00 | $1,550.71 – $3,990.50 | 6 |
| Exc hidradenitis ing simpl 11462 CPT 11462 | not published | not published | $2,154.81 – $7,791.00 | 6 |
| Exc hidradenitis peri/umb comp 11471 CPT 11471 | not published | not published | $2,154.81 – $7,791.00 | 6 |
| Exc hidradenitis peri/umb int 11470 CPT 11470 | not published | not published | $2,154.81 – $7,791.00 | 6 |
| Exc hip/pelv tum deep < 5 cm CPT 27048 | not published | not published | $2,154.81 – $5,545.05 | 6 |
| Exc hip/pelv tum deep 5 cm/> CPT 27045 | not published | not published | $2,154.81 – $7,791.00 | 6 |
| Excimer lsr psriasis 250-500 CPT 96921 | not published | not published | $148.84 – $383.01 | 4 |
| Excimer lsr psriasis<250sqcm CPT 96920 | not published | not published | $148.84 – $383.01 | 4 |
| Excimer lsr psriasis>500sqcm CPT 96922 | not published | not published | $301.57 – $776.03 | 4 |
| Exc im tumor/back/flank/ < 5 cm 21932 CPT 21932 | not published | not published | $2,154.81 – $5,545.05 | 6 |
| Exc im tumor/foot/toe < 1.5 cm 28045 CPT 28045 | not published | not published | $2,154.81 – $5,545.05 | 6 |
| Exc im tumor/shoulder area 5cm/> 23073 CPT 23073 | not published | not published | $2,154.81 – $7,791.00 | 6 |
| Exc intracard tumor/resect/bypass 33120 CPT 33120 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Exc ischial pr ulcer w/ostc musc/myoq flap/skin 15946 CPT 15946 | not published | not published | $1,530.61 – $7,791.00 | 6 |
| Exc ischial pr ulc prim sutr CPT 15940 | not published | not published | $2,154.81 – $7,791.00 | 6 |
| Exc isch pr ulc prm sut ostc CPT 15941 | not published | not published | $2,154.81 – $7,791.00 | 6 |
| Exc isch pr ulc skn flp clsr CPT 15944 | not published | not published | $2,628.85 – $8,770.00 | 6 |
| Exc isch pr ulc skn flp ostc CPT 15945 | not published | not published | $1,530.61 – $4,761.00 | 6 |
| Excise anal ext tag/papilla CPT 46220 | not published | not published | $887.71 – $4,761.00 | 6 |
| Excise epiphyseal bar CPT 20150 | not published | not published | $2,427.27 – $16,106.00 | 6 |
| Excise foot tendon sheath CPT 28086 | not published | not published | $2,427.27 – $7,791.00 | 6 |
| Excise foot tendon sheath CPT 28088 | not published | not published | $2,427.27 – $7,791.00 | 6 |
| Excise ileoanal reservior CPT 45136 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Excise inferior turbinate CPT 30130 | not published | not published | $2,459.51 – $7,791.00 | 6 |
| Excise intestine lesion(s) 44110 CPT 44110 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Excise intraspinl lesion crv CPT 63265 | not published | not published | $5,382.89 – $18,364.00 | 6 |
| Excise intrspinl lesion crvl CPT 63270 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Excise intrspinl lesion lmbr CPT 63267 | not published | not published | $5,382.89 – $13,851.98 | 6 |
| Excise intrspinl lesion lmbr CPT 63272 | not published | not published | $6,779.00 – $27,583.00 | 3 |
| Excise intrspinl lesion scrl CPT 63268 | not published | not published | $5,382.89 – $18,364.00 | 6 |
| Excise intrspinl lesion scrl CPT 63273 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Excise intrspinl lesion thrc CPT 63271 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Excise lesion testis CPT 54512 | not published | not published | $2,614.94 – $7,791.00 | 6 |
| Excise lip or cheek fold CPT 40819 | not published | not published | $1,151.01 – $4,761.00 | 6 |
| Excise lwr jaw cyst w/repair CPT 21047 | not published | not published | $4,391.52 – $16,106.00 | 6 |
| Excise mandible lesion CPT 21040 | not published | not published | $2,459.51 – $7,791.00 | 6 |
| Excise max/zygoma b9 tumor CPT 21030 | not published | not published | $4,391.52 – $11,300.84 | 6 |
| Excise max/zygoma mal tumor CPT 21034 | not published | not published | $4,391.52 – $16,106.00 | 6 |
| Excise oral mucosa for graft 40818 CPT 40818 | not published | not published | $400.09 – $2,334.00 | 6 |
| Excise parotid gland/lesion CPT 42410 | not published | not published | $4,391.52 – $16,106.00 | 6 |
| Excise parotid gland/lesion CPT 42415 | not published | not published | $4,391.52 – $16,106.00 | 6 |
| Excise parotid gland/lesion CPT 42420 | not published | not published | $4,391.52 – $16,106.00 | 6 |
| Excise parotid gland/lesion CPT 42425 | not published | not published | $4,391.52 – $16,106.00 | 6 |
| Excise parotid gland/lesion CPT 42426 | not published | not published | $4,428.00 – $7,791.00 | 3 |
| Excise pharynx lesion CPT 42808 | not published | not published | $2,459.51 – $7,791.00 | 6 |
| Excise/repair mouth lesion CPT 40812 | not published | not published | $1,151.01 – $4,761.00 | 6 |
| Excise sacral spine tumor CPT 49215 | not published | not published | $3,735.00 – $3,735.00 | 1 |
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.