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 |
|---|---|---|---|---|
| Revise finger joint each CPT 26135 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Revise finger joint each CPT 26140 | not published | not published | $1,192.86 – $4,761.00 | 6 |
| Revise gastric port open 43886 CPT 43886 | not published | not published | $2,628.85 – $8,770.00 | 6 |
| Revise/graft eyelid lining CPT 68320 | not published | not published | $1,763.69 – $7,791.00 | 6 |
| Revise/graft eyelid lining CPT 68325 | not published | not published | $2,916.44 – $8,770.00 | 6 |
| Revise/graft eyelid lining CPT 68326 | not published | not published | $2,916.44 – $8,770.00 | 6 |
| Revise/graft eyelid lining CPT 68328 | not published | not published | $1,763.69 – $7,791.00 | 6 |
| Revise/graft eyelid lining CPT 68335 | not published | not published | $2,916.44 – $8,770.00 | 6 |
| Revise graft w/vein CPT 35879 | not published | not published | $4,127.91 – $18,364.00 | 6 |
| Revise graft w/vein 35881 CPT 35881 | not published | not published | $4,127.91 – $18,364.00 | 6 |
| Revise hand/finger tendon CPT 26390 | not published | not published | $5,382.89 – $13,851.98 | 6 |
| Revise head/neck of femur CPT 27179 | not published | not published | $5,382.89 – $18,364.00 | 6 |
| Revise hernia & sperm veins CPT 55540 | not published | not published | $2,656.06 – $8,770.00 | 6 |
| Revise hip joint replacement CPT 27134 | not published | not published | $6,779.00 – $27,583.00 | 6 |
| Revise hip joint replacement CPT 27138 | not published | not published | $6,779.00 – $27,583.00 | 6 |
| Revise hip joint replacement CPT 27137 | not published | not published | $6,779.00 – $27,583.00 | 6 |
| Revise/implant finger joint CPT 26536 | not published | not published | $5,382.89 – $16,106.00 | 6 |
| Revise kneecap CPT 27437 | not published | not published | $5,382.89 – $16,106.00 | 6 |
| Revise kneecap with implant CPT 27438 | not published | not published | $7,609.00 – $24,508.80 | 6 |
| Revise knuckle joint CPT 26530 | not published | not published | $3,735.00 – $16,106.00 | 6 |
| Revise knuckle with implant CPT 26531 | not published | not published | $5,382.89 – $16,106.00 | 6 |
| Revise low back nerve(s) CPT 64714 | not published | not published | $1,448.59 – $7,791.00 | 6 |
| Revise lower leg tendon CPT 27690 | not published | not published | $5,382.89 – $16,106.00 | 6 |
| Revise lower leg tendon CPT 27691 | not published | not published | $5,382.89 – $16,106.00 | 6 |
| Revise lower leg tendons CPT 27686 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Revise middle ear bone CPT 69660 | not published | not published | $4,391.52 – $16,106.00 | 6 |
| Revise middle ear bone CPT 69661 | not published | not published | $4,391.52 – $16,106.00 | 6 |
| Revise middle ear bone CPT 69662 | not published | not published | $4,391.52 – $16,106.00 | 6 |
| Revise middle ear & mastoid CPT 69641 | not published | not published | $4,391.52 – $16,106.00 | 6 |
| Revise middle ear & mastoid CPT 69642 | not published | not published | $4,391.52 – $16,106.00 | 6 |
| Revise middle ear & mastoid CPT 69643 | not published | not published | $4,391.52 – $16,106.00 | 6 |
| Revise middle ear & mastoid CPT 69644 | not published | not published | $4,391.52 – $16,106.00 | 6 |
| Revise middle ear & mastoid CPT 69646 | not published | not published | $4,391.52 – $16,106.00 | 6 |
| Revise middle ear & mastoid 69645 CPT 69645 | not published | not published | $4,391.52 – $16,106.00 | 6 |
| Revise ocular implant CPT 65125 | not published | not published | $1,763.69 – $7,791.00 | 6 |
| Revise ocular implant CPT 65150 | not published | not published | $2,916.44 – $8,770.00 | 6 |
| Revise ovarian tube(s) CPT 58752 | not published | not published | $4,428.00 – $8,770.00 | 3 |
| Revise palsy hand tendon(s) CPT 25315 | not published | not published | $5,382.89 – $13,851.98 | 6 |
| Revise palsy hand tendon(s) CPT 25316 | not published | not published | $5,382.89 – $18,364.00 | 6 |
| Revise penis/urethra CPT 54328 | not published | not published | $2,614.94 – $16,106.00 | 6 |
| Revise penis/urethra CPT 54332 | not published | not published | $2,614.94 – $8,770.00 | 6 |
| Revise penis/urethra CPT 54336 | not published | not published | $2,614.94 – $8,770.00 | 6 |
| Revise prosth vag graft lap CPT 57426 | not published | not published | $5,501.01 – $14,155.93 | 6 |
| Revise radius or ulna CPT 25370 | not published | not published | $2,427.27 – $16,106.00 | 6 |
| Revise radius & ulna CPT 25365 | not published | not published | $7,609.00 – $24,508.80 | 6 |
| Revise radius & ulna CPT 25375 | not published | not published | $2,427.27 – $16,106.00 | 6 |
| Revise reconst elbow joint CPT 24370 | not published | not published | $7,609.00 – $27,583.00 | 6 |
| Revise reconst elbow joint CPT 24371 | not published | not published | $8,923.00 – $33,471.73 | 6 |
| Revise/remove neuroelectrode CPT 61880 | not published | not published | $2,593.52 – $8,770.00 | 6 |
| Revise/remove neuroreceiver CPT 61888 | not published | not published | $7,609.00 – $21,271.19 | 6 |
| Revise/remove sling repair CPT 57287 | not published | not published | $2,401.40 – $8,770.00 | 6 |
| Revise & repair chest wall CPT 32906 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Revise/repair chest wall 32905 CPT 32905 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Revise/replace knee joint CPT 27486 | not published | not published | $6,779.00 – $27,583.00 | 6 |
| Revise/replace knee joint CPT 27487 | not published | not published | $6,779.00 – $33,471.73 | 6 |
| Revise/repl vagus n eltrd CPT 64569 | not published | not published | $7,609.00 – $21,271.19 | 6 |
| Revise spermatic cord veins CPT 55530 | not published | not published | $2,614.94 – $7,791.00 | 6 |
| Revise spermatic cord veins CPT 55535 | not published | not published | $3,735.00 – $12,358.40 | 6 |
| Revise spinal cord vsls crvl CPT 63250 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Revise spinal cord vsls thrc CPT 63251 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Revise spine cord vsl thrlmb CPT 63252 | not published | not published | $6,779.00 – $27,583.00 | 3 |
| Revise spine eltrd perq aray CPT 63663 | not published | not published | $4,727.69 – $18,364.00 | 6 |
| Revise spine eltrd plate CPT 63664 | not published | not published | $8,266.01 – $21,271.19 | 6 |
| Revise stomach bowel fusion 43860 CPT 43860 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Revise thigh muscles/tendons CPT 27400 | not published | not published | $5,382.89 – $16,106.00 | 6 |
| Revise thumb tendon CPT 26490 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Revise thumb tendon CPT 26496 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Revise two eye muscles CPT 67312 | not published | not published | $2,916.44 – $8,770.00 | 6 |
| Revise two eye muscles CPT 67316 | not published | not published | $1,763.69 – $7,791.00 | 6 |
| Revise ulnar nerve at wrist CPT 64719 | not published | not published | $1,448.59 – $7,791.00 | 6 |
| Revise ureter CPT 50727 | not published | not published | $2,614.94 – $7,791.00 | 6 |
| Revise ureter CPT 50728 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Revise urethra stage 1 CPT 53400 | not published | not published | $3,977.55 – $10,235.57 | 6 |
| Revise urethra stage 2 CPT 53405 | not published | not published | $3,977.55 – $10,235.57 | 6 |
| Revise urine flow CPT 50830 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Revise vag graft open abd CPT 57296 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Revise vag graft via vagina CPT 57295 | not published | not published | $2,401.40 – $7,791.00 | 6 |
| Revise windpipe scar CPT 31830 | not published | not published | $2,459.51 – $7,791.00 | 6 |
| Revise wrist/forearm tendon CPT 25280 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Revise wrist joint CPT 25332 | not published | not published | $2,427.27 – $16,106.00 | 6 |
| Revision gastrojejunal anastomosis w/reconstruct-43865 CPT 43865 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Revision of amputation CPT 24935 | not published | not published | $5,382.89 – $18,364.00 | 6 |
| Revision of ankle joint CPT 27700 | not published | not published | $5,382.89 – $16,106.00 | 6 |
| Revision of aqueous shunt CPT 66184 | not published | not published | $1,712.02 – $7,791.00 | 6 |
| Revision of arm nerve(s) CPT 64713 | not published | not published | $1,448.59 – $7,791.00 | 6 |
| Revision of big toe CPT 28310 | not published | not published | $3,735.00 – $13,851.98 | 6 |
| Revision of bladder & bowel CPT 51960 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Revision of bladder neck CPT 52500 | not published | not published | $2,614.94 – $7,791.00 | 6 |
| Revision of bladder/urethra CPT 51800 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Revision of calf tendon CPT 27687 | not published | not published | $2,427.27 – $8,770.00 | 6 |
| Revision of cervix CPT 57720 | not published | not published | $2,401.40 – $7,791.00 | 6 |
| Revision of cervix CPT 59320 | not published | not published | $2,401.40 – $7,791.00 | 6 |
| Revision of circulation CPT 37140 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Revision of circulation CPT 37145 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Revision of circulation CPT 37160 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Revision of circulation CPT 37180 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Revision of collar bone CPT 23480 | not published | not published | $5,382.89 – $16,106.00 | 6 |
| Revision of collar bone CPT 23485 | not published | not published | $7,609.00 – $24,508.80 | 6 |
| Revision of colostomy CPT 44340 | not published | not published | $2,628.85 – $8,770.00 | 6 |
| Revision of colostomy comp in-depth 44345 CPT 44345 | not published | not published | $2,628.85 – $8,770.00 | 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.