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 |
|---|---|---|---|---|
| Replacement pulmonary valve 33475 CPT 33475 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Replacement tricuspid valve 33465 CPT 33465 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Replacemnt lithium ionbatter HCPCS L7367 | not published | not published | $359.56 – $925.28 | 4 |
| Replace molded calf lacer HCPCS L4050 | not published | not published | $379.03 – $975.36 | 4 |
| Replace molded thigh lacer HCPCS L4040 | not published | not published | $382.72 – $984.86 | 4 |
| Replace non-molded calf lace HCPCS L4055 | not published | not published | $230.40 – $592.90 | 4 |
| Replace non-molded thigh lac HCPCS L4045 | not published | not published | $282.70 – $727.49 | 4 |
| Replace picvad cath CPT 36585 | not published | not published | $2,342.32 – $8,770.00 | 6 |
| Replace pretibial shell HCPCS L4130 | not published | not published | $441.79 – $1,136.87 | 4 |
| Replace prox & dist upright HCPCS L4070 | not published | not published | $242.54 – $624.14 | 4 |
| Replace quadlat socket brim HCPCS L4020 | not published | not published | $889.30 – $2,288.48 | 4 |
| Replace/revise brain shunt CPT 62230 | not published | not published | $4,428.00 – $16,752.93 | 6 |
| Replace skull plate/flap CPT 62143 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Replace socket above knee HCPCS L5701 | not published | not published | $3,514.28 – $9,043.40 | 4 |
| Replace socket below knee HCPCS L5700 | not published | not published | $2,832.74 – $7,289.59 | 4 |
| Replace socket brim cust fit HCPCS L4030 | not published | not published | $565.12 – $1,454.26 | 4 |
| Replace socket hip HCPCS L5702 | not published | not published | $4,429.21 – $11,397.83 | 4 |
| Replace tissue expander w/perm prost 11970 CPT 11970 | not published | not published | $5,382.89 – $16,106.00 | 6 |
| Replace trilateral socket br HCPCS L4010 | not published | not published | $740.30 – $1,905.05 | 4 |
| Replace tunneled cv cath CPT 36578 | $2,929.30 | $5,326.00 | $2,342.32 – $8,770.00 | 6 |
| Replace ureter by bowel CPT 50840 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Replace vad intra w/bp CPT 33983 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Replace vad intra without bp CPT 33982 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Replace vad pump ext CPT 33981 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Replacment pt electronic sys HCPCS G0555 | not published | not published | $637.04 – $1,639.32 | 4 |
| Repl alkaline battery HCPCS L8622 | not published | not published | $0.30 – $0.77 | 4 |
| Replantation arm complete CPT 20802 | not published | not published | $6,779.00 – $33,471.73 | 6 |
| Replantation digit complete CPT 20822 | not published | not published | $1,192.86 – $7,791.00 | 6 |
| Replantation digit complete CPT 20816 | not published | not published | $1,192.86 – $18,364.00 | 6 |
| Replantation foot complete CPT 20838 | not published | not published | $6,779.00 – $33,471.73 | 6 |
| Replantation hand complete CPT 20808 | not published | not published | $6,779.00 – $33,471.73 | 6 |
| Replantation thumb complete CPT 20827 | not published | not published | $1,192.86 – $18,364.00 | 6 |
| Replantation thumb complete CPT 20824 | not published | not published | $1,192.86 – $18,364.00 | 6 |
| Replant forearm complete CPT 20805 | not published | not published | $6,779.00 – $33,471.73 | 6 |
| Replc sockt above elbow disa HCPCS L6884 | not published | not published | $2,510.08 – $6,459.27 | 4 |
| Replc sockt below e/w disa HCPCS L6883 | not published | not published | $1,834.55 – $4,720.92 | 4 |
| Replc sockt shldr dis/interc HCPCS L6885 | not published | not published | $3,899.44 – $10,034.57 | 4 |
| Repl girdle milwaukee orth HCPCS L4000 | not published | not published | $1,217.98 – $3,134.26 | 4 |
| Repl leath cuff kafo-afo cal HCPCS L4110 | not published | not published | $73.09 – $188.08 | 4 |
| Repl leath cuff kafo prox th HCPCS L4100 | not published | not published | $93.61 – $240.88 | 4 |
| Repl met band kafo-afo calf/ HCPCS L4090 | not published | not published | $77.91 – $200.49 | 4 |
| Repl met band kafo-afo prox HCPCS L4080 | not published | not published | $91.57 – $235.63 | 4 |
| Repl trach puncture dilator HCPCS L8514 | not published | not published | $87.10 – $224.13 | 4 |
| Repl zinc air battery HCPCS L8621 | not published | not published | $0.58 – $1.49 | 4 |
| Reposg phrnc nrv stim trnsvn CPT 33281 | not published | not published | $2,593.52 – $8,657.00 | 5 |
| Reposition intraocular lens CPT 66825 | not published | not published | $1,712.02 – $7,791.00 | 6 |
| Reposition pm/icd lead CPT 33215 | $2,312.75 | $4,205.00 | $2,342.32 – $8,770.00 | 6 |
| Reposition vad w/image rt/lt sep session CPT 33993 | $5,402.10 | $9,822.00 | $7,609.00 – $7,609.00 | 1 |
| Repos lv lead pm/icd CPT 33226 | $2,815.45 | $5,119.00 | $2,342.32 – $8,770.00 | 6 |
| Repos sq defib eltrd CPT 33273 | not published | not published | $2,772.20 – $8,770.00 | 6 |
| Rep perf anoper fistu CPT 46715 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Rep perf anoper/vestib fistu CPT 46716 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Repr elbow lat ligmnt w/tiss CPT 24343 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Repr elbw med ligmnt w/tissu CPT 24345 | not published | not published | $5,382.89 – $13,851.98 | 6 |
| Repriza, 1cm HCPCS Q4143 | not published | not published | $37.31 – $237.56 | 5 |
| Repr of anal fistula w/glue CPT 46706 | not published | not published | $2,059.07 – $7,791.00 | 6 |
| Reprogram cochlear implt <7 CPT 92602 | not published | not published | $95.45 – $245.63 | 4 |
| Reprogram cochlear implt 7/> CPT 92604 | not published | not published | $95.45 – $245.63 | 4 |
| Repr per/vag pouch dbl proc CPT 46712 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Repr per/vag pouch sngl proc CPT 46710 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Repr pul art unifocal w/cpb CPT 33926 | not published | not published | $6,019.00 – $6,019.00 | 1 |
| Reptilase test CPT 85635 | $42.35 | $77.00 | $7.39 – $19.01 | 7 |
| Reremove wrist tendon lesion CPT 25112 | not published | not published | $1,192.86 – $7,791.00 | 6 |
| Rerepair fem hernia blocked CPT 49557 | not published | not published | $2,656.06 – $8,770.00 | 6 |
| Rerepair ing hernia blocked CPT 49521 | not published | not published | $3,735.00 – $12,358.40 | 6 |
| Rerepair ing hernia reduce CPT 49520 | not published | not published | $2,656.06 – $8,770.00 | 6 |
| Rerevise eye muscles add-on CPT 67332 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Rescj external cardiac tumor CPT 33130 | not published | not published | $6,019.00 – $6,019.00 | 1 |
| Resc recr ovr tbl pp utr mal CPT 58958 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Resect apical lung tum/chest with rcnstj 32504 CPT 32504 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Resect apical lung tumor without rcnstj 32503 CPT 32503 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Resect back tum < 5 cm CPT 21935 | not published | not published | $2,154.81 – $5,545.05 | 6 |
| Resect back tum 5 cm/> CPT 21936 | not published | not published | $2,154.81 – $7,791.00 | 6 |
| Resect condyle distal phalanx ea toe 28153 CPT 28153 | not published | not published | $2,427.27 – $7,791.00 | 6 |
| Resect/debrid pancreas 48105 CPT 48105 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Resect diaphragm complex CPT 39561 | not published | not published | $5,257.00 – $5,257.00 | 1 |
| Resect diaphragm simple 39560 CPT 39560 | not published | not published | $5,257.00 – $5,257.00 | 1 |
| Resect distal finger tumor CPT 26262 | not published | not published | $1,192.86 – $4,761.00 | 6 |
| Resect enlarged toe CPT 28341 | not published | not published | $2,427.27 – $7,791.00 | 6 |
| Resect enlarged toe tissue CPT 28340 | not published | not published | $2,427.27 – $7,791.00 | 6 |
| Resect/excise cranial lesion CPT 61600 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Resect/excise cranial lesion CPT 61601 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Resect/excise cranial lesion CPT 61605 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Resect/excise cranial lesion CPT 61606 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Resect/excise cranial lesion CPT 61607 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Resect/excise cranial lesion CPT 61608 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Resect/excise lesion skull CPT 61615 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Resect/excise lesion skull CPT 61616 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Resect extraplural rib(s) 32900 CPT 32900 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Resect face/scalp tum < 2 cm CPT 21015 | not published | not published | $2,154.81 – $5,545.05 | 6 |
| Resect face/scalp tum 2 cm/> CPT 21016 | not published | not published | $2,154.81 – $7,791.00 | 6 |
| Resect femur/knee tumor CPT 27365 | not published | not published | $2,427.27 – $18,364.00 | 6 |
| Resect fibula tumor CPT 27646 | not published | not published | $2,427.27 – $18,364.00 | 6 |
| Resect foot/toe tumor 3 cm/> CPT 28047 | not published | not published | $2,154.81 – $7,791.00 | 6 |
| Resect forarm/wrist tum 3cm> CPT 25078 | not published | not published | $2,154.81 – $7,791.00 | 6 |
| Resect forearm/wrist tum<3cm CPT 25077 | not published | not published | $2,154.81 – $5,545.05 | 6 |
| Resect heart sac lesion 33050 CPT 33050 | not published | not published | $6,019.00 – $6,019.00 | 1 |
| Resect hip/pelv tum < 5 cm CPT 27049 | not published | not published | $2,154.81 – $5,545.05 | 6 |
| Resect hip/pelv tum 5 cm/> CPT 27059 | not published | not published | $2,154.81 – $7,791.00 | 6 |
| Resect hip tum incl acetabul CPT 27076 | not published | not published | $3,735.00 – $18,364.00 | 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.