HSHS St. Mary's Hospital Medical Center
1726 SHAWANO AVE, GREEN BAY, WI · Hshs · · NPI 1649246877
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 |
|---|---|---|---|---|
| Drng hand tendon sheath 26020 CPT 26020 | $7,792.62 | $11,807.00 | $576.77 – $7,188.86 | 14 |
| Drng of eyelid abscess 67700 CPT 67700 | $513.48 | $778.00 | $127.74 – $697.37 | 14 |
| Drng of finger abscess comp 26011 CPT 26011 | $3,873.54 | $5,869.00 | $474.26 – $3,628.70 | 14 |
| Drng of hydrocele 55000 CPT 55000 | not published | not published | not published | 0 |
| Drng of scrotum abscess 55100 CPT 55100 | $1,871.10 | $2,835.00 | $1,046.14 – $3,628.70 | 14 |
| Drng salivary gland simple 42300 CPT 42300 | $1,582.02 | $2,397.00 | $528.96 – $3,408.96 | 14 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $51.81 | $78.50 | $11.85 – $13.31 | 5 |
| Drug admin & hemodynmic meas CPT 93463 | $397.32 | $602.00 | $20.47 – $21.70 | 7 |
| Drug assay caffeine CPT 80155 | $125.40 | $190.00 | $15.44 – $86.78 | 16 |
| Drug assay posaconazole CPT 80187 | $130.02 | $197.00 | $21.69 – $61.00 | 16 |
| Drug assay vedolizumab CPT 80280 | $308.88 | $468.00 | $30.85 – $86.78 | 16 |
| Drug assay voriconazole CPT 80285 | $100.98 | $153.00 | $21.69 – $61.00 | 16 |
| Drug of abuse screen urine CPT 80305 | $120.78 | $183.00 | $12.60 – $28.35 | 16 |
| Drug screening tapentadol CPT 80372 | $36.30 | $55.00 | $4.99 – $39.00 | 10 |
| Drug screen quant tiagabine CPT 80199 | $83.82 | $127.00 | $19.70 – $61.00 | 16 |
| Drug/substance nos 4-6 CPT 80376 | $49.50 | $75.00 | $4.99 – $45.00 | 10 |
| Drug test def 15-21 classes HCPCS G0482 | $244.86 | $371.00 | $132.80 – $447.17 | 16 |
| Drug test def 1-7 classes HCPCS G0480 | $230.34 | $349.00 | $63.95 – $257.47 | 16 |
| Drug test def 22+ classes HCPCS G0483 | $699.60 | $1,060.00 | $172.18 – $555.57 | 16 |
| Drug test def 8-14 classes HCPCS G0481 | $188.76 | $286.00 | $98.39 – $352.33 | 16 |
| Drug test prsmv instrmnt CPT 80306 | $209.88 | $318.00 | $17.14 – $38.57 | 16 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $258.72 | $392.00 | $62.14 – $139.82 | 16 |
| Ductogram sgl duct CPT 77053 | $691.68 | $1,048.00 | $52.32 – $524.23 | 16 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $489.72 | $742.00 | $48.32 – $472.83 | 16 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $1,049.40 | $1,590.00 | $48.32 – $474.40 | 16 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $769.56 | $1,166.00 | $48.32 – $524.23 | 16 |
| Dx bronchoscope/brush 31623 CPT 31623 | $2,970.00 | $4,500.00 | $792.34 – $3,910.59 | 14 |
| Dx bronchoscope/lavage 31624 CPT 31624 | $2,970.00 | $4,500.00 | $792.34 – $3,910.59 | 14 |
| Dx bronchoscope/wash 31622 CPT 31622 | $2,970.00 | $4,500.00 | $792.34 – $3,910.59 | 14 |
| Dx gastr intub w/asp spec CPT 43754 | $642.18 | $973.00 | $210.85 – $474.40 | 9 |
| Ear irrigation 69209 CPT 69209 | $122.10 | $185.00 | $57.60 – $129.61 | 9 |
| Ecg 12 lead tracing only CPT 93005 | $186.78 | $283.00 | $11.36 – $144.99 | 16 |
| Ecg < 30 days transmission & analysis CPT 93271 | $675.18 | $1,023.00 | $18.44 – $545.33 | 16 |
| Ecg external < 48 hours recording CPT 93225 | $396.00 | $600.00 | $27.31 – $545.33 | 16 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $582.12 | $882.00 | $27.31 – $545.33 | 16 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | $105.60 | $160.00 | $27.31 – $160.00 | 16 |
| Ecg external >7 days up to 15 days recording CPT 93246 | $149.82 | $227.00 | $27.31 – $144.99 | 16 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $1,709.40 | $2,590.00 | $191.46 – $1,200.52 | 16 |
| Echocardiography doppler color flow mapping CPT 93325 | $423.06 | $641.00 | $24.16 – $567.70 | 10 |
| Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 | $1,906.74 | $2,889.00 | $191.46 – $1,722.34 | 16 |
| Echocardiography transthoracic 2d followup/limited CPT 93308 | $766.92 | $1,162.00 | $191.46 – $524.23 | 16 |
| Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast HCPCS C8924 | $957.00 | $1,450.00 | $191.46 – $766.50 | 16 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $418.44 | $634.00 | $95.73 – $567.70 | 10 |
| Echo exam uterus 76831- CPT 76831 | $489.72 | $742.00 | $74.44 – $524.23 | 16 |
| Echo guide for amniocentesis CPT 76946 | $153.78 | $233.00 | $29.60 – $233.00 | 11 |
| Echo guide for artery repair CPT 76936 | $880.44 | $1,334.00 | $89.39 – $521.52 | 16 |
| Echo stress CPT 93350 | $1,606.44 | $2,434.00 | $191.46 – $1,200.52 | 16 |
| Echo tee probe placement image acquisition interpretation & report CPT 93312 | $2,113.98 | $3,203.00 | $191.46 – $1,200.52 | 16 |
| Echo transthoracic CPT 93303 | $2,050.62 | $3,107.00 | $191.46 – $1,200.52 | 16 |
| Echo transthoracic CPT 93304 | $1,530.54 | $2,319.00 | $191.46 – $1,200.52 | 16 |
| Echo tte 2d comp wo ctrst wo clr/dplr CPT 93307 | $1,453.98 | $2,203.00 | $191.46 – $524.23 | 16 |
| Eeg 41-60 minutes 95812-26 CPT 95812 | $774.18 | $1,173.00 | $198.12 – $474.40 | 16 |
| Eeg/cerebral death evaluation only 95824 -26 CPT 95824 | $864.60 | $1,310.00 | $146.51 – $819.86 | 16 |
| Eeg monitor/record/awake/drowsy 95816 CPT 95816 | $787.38 | $1,193.00 | $146.51 – $474.40 | 16 |
| Eeg over 1 hour 95813 - 26 CPT 95813 | $1,404.48 | $2,128.00 | $198.12 – $474.40 | 16 |
| Eeg/record in coma or sleep only 95822 CPT 95822 | $1,081.08 | $1,638.00 | $146.51 – $474.40 | 16 |
| Eeg recording awake and asleep CPT 95819 | $1,351.02 | $2,047.00 | $146.51 – $474.40 | 16 |
| Eeg without vid 2-12 hr unmntr CPT 95705 | $2,432.76 | $3,686.00 | $146.51 – $474.40 | 16 |
| Eeg wo vid ea 12-26hr unmntr CPT 95708 | $4,505.16 | $6,826.00 | $198.12 – $819.86 | 16 |
| E equine encephalitis igg CPT 86652 | $60.06 | $91.00 | $8.17 – $29.68 | 16 |
| Egd balloon dil esoph30 mm/> CPT 43233 | not published | not published | not published | 0 |
| Egd control bleeding any CPT 43255 | not published | not published | not published | 0 |
| Egd dilate stricture CPT 43245 | not published | not published | not published | 0 |
| Egd endo mucosal resection CPT 43254 | not published | not published | not published | 0 |
| Egd endoscopic stent place CPT 43266 | not published | not published | not published | 0 |
| Egd esophagogastrc fndoplsty CPT 43210 | not published | not published | not published | 0 |
| Egd guide wire insertion CPT 43248 | not published | not published | not published | 0 |
| Egd/insert intraluminal tube/cath 43241 CPT 43241 | not published | not published | not published | 0 |
| Egd lesion ablation CPT 43270 | not published | not published | not published | 0 |
| Egd remove foreign body CPT 43247 | not published | not published | not published | 0 |
| Egd remove lesion snare CPT 43251 | not published | not published | not published | 0 |
| Egd Ultrasound exam duodenum/jejunum CPT 43259 | not published | not published | not published | 0 |
| Egd Ultrasound fine needle bx/aspir CPT 43238 | not published | not published | not published | 0 |
| Egd Ultrasound fine needle bx/aspir CPT 43242 | not published | not published | not published | 0 |
| Egd Ultrasound transmural injxn/mark CPT 43253 | not published | not published | not published | 0 |
| Egd varices ligation CPT 43244 | not published | not published | not published | 0 |
| Egd w/transmural drain cyst CPT 43240 | not published | not published | not published | 0 |
| Egfr gene com variants CPT 81235 | $1,189.32 | $1,802.00 | $264.01 – $730.31 | 16 |
| Ehrlicha chaffeensis amp prb CPT 87484 | $237.60 | $360.00 | $35.09 – $78.95 | 16 |
| Eia hiv-1/hiv-2 screen HCPCS G0432 | $79.86 | $121.00 | $3.79 – $44.03 | 16 |
| Elec stim unattend for press HCPCS G0281 | $89.10 | $135.00 | $11.23 – $135.00 | 16 |
| Electrolyte panel CPT 80051 | $48.84 | $74.00 | $7.01 – $15.77 | 16 |
| Electron microscopy diagnostic CPT 88348 | $2,982.54 | $4,519.00 | $58.17 – $1,770.15 | 16 |
| Electrophysiology evaluation CPT 93619 | $8,764.14 | $13,279.00 | $1,308.14 – $17,136.51 | 16 |
| Electrophysiology evaluation CPT 93620 | $8,764.14 | $13,279.00 | $2,816.70 – $17,136.51 | 14 |
| Electrophysiology evaluation CPT 93621 | $6,306.96 | $9,556.00 | $2,816.70 – $2,985.70 | 7 |
| Electrophysiology evaluation CPT 93622 | $4,324.98 | $6,553.00 | $2,816.70 – $2,985.70 | 7 |
| Electrophysiology evaluation CPT 93641 | $1,981.98 | $3,003.00 | $2,816.70 – $2,985.70 | 7 |
| Electrophysiology evaluation CPT 93642 | $1,981.98 | $3,003.00 | $1,188.90 – $2,985.70 | 14 |
| Electrophysiology evaluation CPT 93644 | $126.06 | $191.00 | $191.00 – $2,816.70 | 7 |
| Electrophys map 3d add-on CPT 93613 | $7,485.72 | $11,342.00 | $2,816.70 – $2,985.70 | 7 |
| Embolization s&i CPT 75894 | $3,927.00 | $5,950.00 | $89.39 – $1,995.47 | 11 |
| Embo or occlude vascular arterial s&i CPT 37242 | $20,739.84 | $31,424.00 | $4,729.17 – $40,276.14 | 14 |
| Embo or occlude vascular hemorrhage s&i CPT 37244 | $12,884.52 | $19,522.00 | $4,729.17 – $25,363.55 | 14 |
| Embo or occlude vascular tumor/organ/infarct s&i CPT 37243 | $13,098.36 | $19,846.00 | $4,729.17 – $25,363.55 | 14 |
| Embo or occlude vascular venous s&i CPT 37241 | $13,098.36 | $19,846.00 | $4,729.17 – $25,363.55 | 14 |
| Emb without cervical dilation 58100 CPT 58100 | $503.58 | $763.00 | $197.42 – $444.19 | 14 |
| Emg 2 ext w-w/o paraspinal area 95861 CPT 95861 | $533.94 | $809.00 | $58.61 – $809.00 | 16 |
| Emg 3 ext w-w/o paraspinal area 95863 CPT 95863 | $592.68 | $898.00 | $58.61 – $885.08 | 16 |
| Emg needle test 1-extremity CPT 95860 | $413.82 | $627.00 | $58.61 – $627.00 | 16 |
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.