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 |
|---|---|---|---|---|
| Arthro shoulder surgical distal claviculectomy incl/distal art surf left (rest method ii cah) CPT 29824 | not published | not published | $2,427.27 – $18,364.00 | 7 |
| Arthro/shoul surg; w/spacer HCPCS C9781 | not published | not published | $6,779.00 – $24,508.80 | 6 |
| Arthrotomy carpometacarpal joint 26070 CPT 26070 | not published | not published | $1,192.86 – $4,761.00 | 6 |
| Arthrotomy/elbow/exp/drain/rmv fb 24000 CPT 24000 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Arthrotomy glenhumrl jt w/bx CPT 23100 | not published | not published | $2,427.27 – $7,791.00 | 6 |
| Arthrotomy glenohumeral jt CPT 23105 | not published | not published | $5,382.89 – $13,851.98 | 6 |
| Arthrotomy strnclav joint CPT 23106 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Arthrp ntrcrp/crp/mtcr ntrps CPT 25447 | not published | not published | $2,427.27 – $16,106.00 | 6 |
| Arthrp ntrcrpl/crp/mtcrp ssp CPT 25448 | not published | not published | $2,427.27 – $6,246.19 | 4 |
| Arthrp prostc dstl scph crpl CPT 25443 | not published | not published | $5,382.89 – $16,106.00 | 6 |
| Arthrp w/prostc dstl rds CPT 25441 | not published | not published | $7,609.00 – $27,583.00 | 6 |
| Arthrp w/prostc dstl ulna CPT 25442 | not published | not published | $8,923.00 – $33,471.73 | 6 |
| Arthrp w/prostc dst rds&crps CPT 25446 | not published | not published | $8,923.00 – $33,471.73 | 6 |
| Arthrp w/prostc lunate CPT 25444 | not published | not published | $7,609.00 – $24,508.80 | 6 |
| Arthrp w/prostc trapezium CPT 25445 | not published | not published | $5,382.89 – $16,106.00 | 6 |
| Arthrs kne srg drlg ost diss CPT 29885 | not published | not published | $5,382.89 – $18,364.00 | 6 |
| Arthrt acrmclv/strnclav jt CPT 23101 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Arthrt ac sc jt exp/rmvl fb CPT 23044 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Arthrt elbow w/synovectomy CPT 24102 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Arthrt elbw capsl exc rls CPT 24006 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Arthrt elbw jt expl bx rmvl CPT 24101 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Arthrt elbw synovial bx only CPT 24100 | not published | not published | $2,427.27 – $7,791.00 | 6 |
| Arthrt gh jt expl/drg/rmv fb CPT 23040 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Arthrt glenhumrl jt w/expl CPT 23107 | not published | not published | $5,382.89 – $13,851.98 | 6 |
| Arthrt hip expl/rmv loose/fb CPT 27033 | not published | not published | $3,735.00 – $16,106.00 | 6 |
| Arthrt rdcrpl/midcarpl jt CPT 25040 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Arth shld srg decompr subacrml sp w/prt acrmplsty w/crccrml sep proc lt(rest method ii cah) CPT 29826 | not published | not published | $1,887.00 – $8,265.00 | 4 |
| Artificial insemination CPT 58321 | not published | not published | $226.06 – $2,334.00 | 6 |
| Artific inseminationintrauterine 58322 CPT 58322 | not published | not published | $149.98 – $2,334.00 | 6 |
| Artiss fibrin sealant HCPCS C9250 | not published | not published | $109.26 – $366.18 | 5 |
| Art pressure waveform analys CPT 93050 | not published | not published | $21.46 – $55.21 | 4 |
| Art trnsposj subclav carotid 35694 CPT 35694 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Asc aort gft/cp/root rem/cor recon 33864 CPT 33864 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Ascend aorta graft oth dissect 33859 CPT 33859 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Ascend aorta graft w/aortic dissection 33858 CPT 33858 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Asd repair/cp bypass w without patch 33641 CPT 33641 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Aspa gene CPT 81200 | not published | not published | $35.44 – $91.19 | 7 |
| Asp core fat pad CPT 17999 | $97.90 | $178.00 | $148.84 – $2,334.00 | 6 |
| Asp & inj bone cyst CPT 20615 | not published | not published | $525.32 – $3,030.00 | 6 |
| Asp & inj w/heparin pleurx cath CPT 32999 | $525.25 | $955.00 | $465.35 – $3,030.00 | 6 |
| Aspirate bladder/sprapubic cath 51102 CPT 51102 | $3,413.85 | $6,207.00 | $1,550.71 – $7,791.00 | 6 |
| Aspirate/inj ganglion cyst 20612 CPT 20612 | $601.15 | $1,093.00 | $227.71 – $2,334.00 | 6 |
| Aspirate pleura without imaging 32554 CPT 32554 | $1,225.95 | $2,229.00 | $465.35 – $3,030.00 | 6 |
| Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion CPT 10005 | $1,159.95 | $2,109.00 | $525.32 – $3,030.00 | 6 |
| Aspiration orbital contents CPT 67415 | not published | not published | $1,763.69 – $7,791.00 | 6 |
| Aspiration peritonsillar abscess CPT 42999 | not published | not published | $175.70 – $2,334.00 | 6 |
| Aspir/inj thyroid cyst 60300 CPT 60300 | $737.00 | $1,340.00 | $525.32 – $3,030.00 | 6 |
| Asp pq spinal cord cyst/syrinx CPT 62268 | not published | not published | $656.13 – $3,030.00 | 6 |
| Assay acid phosphatase CPT 84060 | not published | not published | $5.73 – $14.75 | 7 |
| Assay alkaline phosphatase CPT 84078 | not published | not published | $6.20 – $15.94 | 7 |
| Assay blood catecholamines CPT 82383 | not published | not published | $21.81 – $56.12 | 7 |
| Assay chondroitin sulfate CPT 82485 | not published | not published | $15.49 – $39.85 | 7 |
| Assay dir meas fr estradiol CPT 82681 | not published | not published | $20.96 – $53.92 | 7 |
| Assay duodenal fluid trypsin CPT 84485 | not published | not published | $5.40 – $13.90 | 7 |
| Assay free hydroxyproline CPT 83500 | not published | not published | $16.99 – $43.71 | 7 |
| Assay malate dehydrogenase CPT 83775 | not published | not published | $5.53 – $14.22 | 7 |
| Assay myeloperoxidase CPT 83876 | not published | not published | $38.14 – $98.16 | 7 |
| Assay neurflmnt light chain CPT 83884 | not published | not published | $87.17 – $224.32 | 4 |
| Assay of adp & amp CPT 82030 | not published | not published | $19.35 – $49.79 | 7 |
| Assay of androsterone CPT 82160 | not published | not published | $19.16 – $49.31 | 7 |
| Assay of blood lipoprotein CPT 83719 | not published | not published | $9.56 – $24.61 | 7 |
| Assay of bradykinin CPT 82286 | not published | not published | $3.87 – $9.96 | 7 |
| Assay of breath ethanol CPT 82075 | not published | not published | $22.50 – $57.90 | 7 |
| Assay of cathepsin-d CPT 82387 | not published | not published | $13.54 – $34.86 | 7 |
| Assay of chloramphenicol CPT 82415 | not published | not published | $9.50 – $24.45 | 7 |
| Assay of corticosterone CPT 82528 | not published | not published | $16.89 – $43.46 | 7 |
| Assay of digoxin free CPT 80163 | $20.90 | $38.00 | $9.96 – $25.63 | 7 |
| Assay of endocrine hormone CPT 84235 | not published | not published | $53.42 – $137.47 | 7 |
| Assay of estrogen CPT 84233 | not published | not published | $65.91 – $169.61 | 7 |
| Assay of etiocholanolone CPT 82696 | not published | not published | $19.68 – $50.64 | 7 |
| Assay of feces for trypsin CPT 84490 | not published | not published | $7.45 – $19.16 | 7 |
| Assay of feces porphyrins CPT 84126 | not published | not published | $29.33 – $75.48 | 7 |
| Assay of feces/urobilinogen CPT 84577 | not published | not published | $12.60 – $32.42 | 7 |
| Assay of fluoride CPT 82735 | not published | not published | $13.90 – $35.78 | 7 |
| Assay of galactose CPT 82760 | not published | not published | $8.40 – $21.62 | 7 |
| Assay of gdh enzyme CPT 82965 | not published | not published | $9.86 – $25.38 | 7 |
| Assay of glucosidase CPT 82963 | not published | not published | $16.11 – $41.46 | 7 |
| Assay of glutathione CPT 82978 | not published | not published | $11.59 – $29.82 | 7 |
| Assay of haptoglobins CPT 83012 | not published | not published | $20.17 – $51.90 | 7 |
| Assay of idh enzyme CPT 83570 | not published | not published | $6.64 – $17.08 | 7 |
| Assay of interleukin-6 (il-6) CPT 83529 | $124.30 | $226.00 | $12.95 – $33.33 | 7 |
| Assay of intrinsic factor CPT 83528 | not published | not published | $14.86 – $38.25 | 7 |
| Assay of lap enzyme CPT 83670 | not published | not published | $7.36 – $18.93 | 7 |
| Assay of leflunomide CPT 80193 | not published | not published | $28.93 – $74.44 | 7 |
| Assay of lrh hormone CPT 83727 | not published | not published | $12.89 – $33.18 | 7 |
| Assay of methemalbumin CPT 83857 | not published | not published | $8.06 – $20.73 | 7 |
| Assay of neonatal thyroxine CPT 84437 | not published | not published | $4.85 – $12.49 | 7 |
| Assay of osteocalcin CPT 83937 | not published | not published | $22.39 – $57.61 | 7 |
| Assay of phenylketones CPT 84035 | not published | not published | $2.98 – $7.68 | 7 |
| Assay of pregnanediol CPT 84135 | not published | not published | $15.95 – $41.05 | 7 |
| Assay of pregnanetriol CPT 84138 | not published | not published | $15.79 – $40.63 | 7 |
| Assay of procainamide w/metab CPT 80192 | not published | not published | $12.56 – $32.33 | 7 |
| Assay of progesterone CPT 84234 | not published | not published | $48.66 – $125.22 | 7 |
| Assay of prostaglandin CPT 84150 | not published | not published | $31.33 – $80.62 | 7 |
| Assay of PSA complexed CPT 84152 | not published | not published | $13.79 – $35.49 | 7 |
| Assay of quinine CPT 84228 | not published | not published | $8.72 – $22.45 | 7 |
| Assay of rbc pg6d enzyme CPT 84085 | not published | not published | $7.08 – $18.22 | 7 |
| Assay of salicylate CPT 80179 | $30.80 | $56.00 | $13.98 – $35.98 | 7 |
| Assay of semen fructose CPT 82757 | not published | not published | $12.60 – $33.47 | 7 |
| Assay of sialic acid CPT 84275 | not published | not published | $10.08 – $25.94 | 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.