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 |
|---|---|---|---|---|
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | not published | not published | $5.48 – $5.48 | 1 |
| P-32 chromic phos ther per mci HCPCS A9564 | not published | not published | $412.14 – $412.14 | 1 |
| P-32 sod phosphate ther per mci HCPCS A9563 | not published | not published | $208.68 – $537.00 | 5 |
| Pabpn1 gene detc abnor allel CPT 81312 | not published | not published | $102.75 – $264.41 | 7 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | not published | not published | $0.12 – $0.30 | 5 |
| Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 | not published | not published | $4.94 – $36.86 | 8 |
| Palb2 gene full gene seq CPT 81307 | not published | not published | $282.88 – $1,305.64 | 7 |
| Palb2 gene known famil vrnt CPT 81308 | not published | not published | $226.01 – $581.61 | 7 |
| Palifermin injection HCPCS J2425 | not published | not published | $29.02 – $92.53 | 8 |
| Palingen or palingen xplus HCPCS Q4173 | not published | not published | $92.32 – $3,102.40 | 6 |
| Palingen or promatrx HCPCS Q4174 | not published | not published | $3,924.49 – $3,924.49 | 1 |
| Paliperidone 117 mg/0.75 ml inj HCPCS J2426 | not published | not published | $11.57 – $40.10 | 8 |
| Palivizumab 50 mg/0.5 ml inj CPT 90378 | not published | not published | $327.56 – $1,959.85 | 5 |
| Palonosetron hcl HCPCS J2469 | not published | not published | $0.55 – $1.60 | 5 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | not published | not published | $13.62 – $34.25 | 5 |
| Pancreas removal/transplant CPT 48160 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Pancreatectomy CPT 48146 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Pancreatectomy CPT 48152 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Pancreatectomy CPT 48154 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Pancreatectomy 48153 CPT 48153 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Pancreatectomy dist subtot w/wo splenecto 48140 CPT 48140 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Pancreatorrhaphy CPT 48545 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 | not published | not published | $136.64 – $451.14 | 8 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | not published | not published | $26.63 – $26.63 | 1 |
| Papaverin hcl injection HCPCS J2440 | not published | not published | $125.07 – $125.07 | 1 |
| Parathormone (pth) intact CPT 83970 | $828.85 | $1,507.00 | $30.96 – $79.67 | 7 |
| Parathyrdec/expl parathyr medstnl sternal/tthrc 60505 CPT 60505 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Parathyrd planar w/spect&ct CPT 78072 | $1,936.00 | $3,520.00 | $402.79 – $1,036.52 | 4 |
| Parathyroid autotransplantation 60512 CPT 60512 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Parathyroid planar imaging CPT 78070 | $911.35 | $1,657.00 | $296.56 – $763.16 | 4 |
| Parathyroid planar img w/tomo spect CPT 78071 | $1,936.00 | $3,520.00 | $296.56 – $763.16 | 4 |
| Paravaginal defect repair 57284 CPT 57284 | not published | not published | $3,710.98 – $16,106.00 | 6 |
| Parial mast w/lymph removal 19302 CPT 19302 | not published | not published | $4,925.89 – $16,106.00 | 6 |
| Paricalcitol HCPCS J2501 | not published | not published | $0.89 – $2.46 | 5 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $266.20 | $484.00 | $148.84 – $2,334.00 | 6 |
| Parotid duct diversion CPT 42507 | not published | not published | $4,391.52 – $16,106.00 | 6 |
| Parotid duct diversion CPT 42509 | not published | not published | $4,391.52 – $16,106.00 | 6 |
| Parotid duct diversion CPT 42510 | not published | not published | $2,459.51 – $16,106.00 | 6 |
| Part exc/post vert comp/sng/thorac 22101 CPT 22101 | not published | not published | $3,735.00 – $18,364.00 | 6 |
| Part hymenectomy/revi hymenal ring 56700 CPT 56700 | not published | not published | $2,401.40 – $7,791.00 | 6 |
| Partial complicated cystectomy 51555 CPT 51555 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Partial exc bone humerus CPT 24140 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah) CPT 28122 | not published | not published | $2,427.27 – $7,791.00 | 6 |
| Partial excision of lip CPT 40500 | not published | not published | $2,459.51 – $6,329.15 | 6 |
| Partial hip replacement CPT 27125 | not published | not published | $3,735.00 – $24,508.80 | 6 |
| Partial hysterectomy CPT 58180 | not published | not published | $5,257.00 – $8,770.00 | 3 |
| Partial proctectomy CPT 45113 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Partial proctectomy; perineal 45123 CPT 45123 | not published | not published | $3,735.00 – $18,364.00 | 3 |
| Partial removal donor liver CPT 47140 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Partial removal donor liver CPT 47141 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Partial removal donor liver CPT 47142 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Partial removal finger bone CPT 26235 | not published | not published | $1,192.86 – $4,761.00 | 6 |
| Partial removal finger bone CPT 26236 | $3,401.20 | $6,184.00 | $1,192.86 – $4,761.00 | 6 |
| Partial removal foot fascia CPT 28060 | $3,148.75 | $5,725.00 | $2,427.27 – $7,791.00 | 6 |
| Partial removal leg bone(s) CPT 27360 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Partial removal of bladder CPT 51550 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Partial removal of esophagus CPT 43116 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Partial removal of esophagus CPT 43118 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Partial removal of esophagus CPT 43121 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Partial removal of esophagus CPT 43123 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Partial removal of esophagus 43117 CPT 43117 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Partial removal of esophagus 43122 CPT 43122 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Partial removal of eye fluid CPT 67005 | not published | not published | $1,712.02 – $7,791.00 | 6 |
| Partial removal of eye fluid CPT 67010 | not published | not published | $1,712.02 – $7,791.00 | 6 |
| Partial removal of fibula CPT 27641 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Partial removal of foot bone CPT 28288 | not published | not published | $2,427.27 – $7,791.00 | 6 |
| Partial removal of hand bone CPT 26230 | not published | not published | $2,427.27 – $6,246.19 | 6 |
| Partial removal of heart sac 33030 CPT 33030 | not published | not published | $6,019.00 – $6,019.00 | 1 |
| Partial removal of larynx CPT 31367 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Partial removal of larynx CPT 31368 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Partial removal of larynx CPT 31370 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Partial removal of larynx CPT 31375 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Partial removal of larynx CPT 31380 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Partial removal of larynx CPT 31382 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Partial removal of lip CPT 40530 | not published | not published | $2,459.51 – $7,791.00 | 6 |
| Partial removal of liver CPT 47125 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Partial removal of liver CPT 47130 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Partial removal of lung 32480 CPT 32480 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Partial removal of nose CPT 30150 | not published | not published | $4,391.52 – $16,106.00 | 6 |
| Partial removal of pancreas CPT 48145 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Partial removal of pancreas CPT 48150 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Partial removal of penis CPT 54120 | not published | not published | $2,614.94 – $8,770.00 | 6 |
| Partial removal of pharynx 42890 CPT 42890 | not published | not published | $4,391.52 – $16,106.00 | 6 |
| Partial removal of radius CPT 25151 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Partial removal of radius CPT 25230 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Partial removal of rectum CPT 45111 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Partial removal of rectum CPT 45114 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Partial removal of rectum CPT 45116 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Partial removal of rib CPT 21600 | not published | not published | $5,382.89 – $13,851.98 | 6 |
| Partial removal of sternum CPT 21620 | not published | not published | $2,427.27 – $16,106.00 | 6 |
| Partial removal of thyroid CPT 60220 | not published | not published | $4,484.77 – $18,364.00 | 6 |
| Partial removal of thyroid CPT 60225 | not published | not published | $4,484.77 – $18,364.00 | 6 |
| Partial removal of tibia CPT 27640 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Partial removal of toe CPT 28160 | not published | not published | $2,427.27 – $7,791.00 | 6 |
| Partial removal of tongue CPT 41120 | not published | not published | $4,391.52 – $16,106.00 | 6 |
| Partial removal of tongue CPT 41130 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Partial removal of ulna CPT 25119 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Partial removal of ulna CPT 25150 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Partial removal of ulna CPT 25240 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Partial removal of vaginal wall 57106 CPT 57106 | 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.