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 |
|---|---|---|---|---|
| Exc forearm les sc 3 cm/> CPT 25071 | not published | not published | not published | 0 |
| Exc hand les sc < 1.5 cm CPT 26115 | not published | not published | not published | 0 |
| Exc hand tum deep 1.5 cm/> CPT 26113 | not published | not published | not published | 0 |
| Exc hand tum deep < 1.5 cm 26116 CPT 26116 | not published | not published | not published | 0 |
| Exchange biliary drg cath CPT 47536 | $3,544.20 | $5,370.00 | $246.25 – $7,866.44 | 16 |
| Exchange drainage catheter CPT 49423 | $2,191.20 | $3,320.00 | $131.98 – $4,216.00 | 16 |
| Exchange nephrostomy cath CPT 50435 | $2,955.48 | $4,478.00 | $187.92 – $4,592.75 | 16 |
| Exc hip/pelv tum deep 5 cm/> CPT 27045 | not published | not published | not published | 0 |
| Exc im tumor/foot/toe < 1.5 cm 28045 CPT 28045 | not published | not published | not published | 0 |
| Exc im tumor/shoulder area 5cm/> 23073 CPT 23073 | not published | not published | not published | 0 |
| Excise intrspinl lesion lmbr CPT 63267 | not published | not published | not published | 0 |
| Excise lip or cheek fold CPT 40819 | not published | not published | not published | 0 |
| Excise max/zygoma b9 tumor CPT 21030 | not published | not published | not published | 0 |
| Excise tendon forearm/wrist CPT 25109 | not published | not published | not published | 0 |
| Excision addl breast lesion 19126 CPT 19126 | not published | not published | not published | 0 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | not published | not published | not published | 0 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | $1,683.00 | $2,550.00 | $185.89 – $1,555.83 | 14 |
| Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 | $3,509.22 | $5,317.00 | $790.35 – $3,628.70 | 14 |
| Excision breast lesion CPT 19125 | not published | not published | not published | 0 |
| Excision of anal lesion(s) CPT 46922 | not published | not published | not published | 0 |
| Excision tumor soft tissue back/flank subcutaneous >= 3 cm CPT 21931 | not published | not published | not published | 0 |
| Excis partial tal calc CPT 28120 | not published | not published | not published | 0 |
| Exc les/mucos/sub/ves mouth/no rpr 40810 CPT 40810 | not published | not published | not published | 0 |
| Exc malig feenl 1.1-2 11642 CPT 11642 | not published | not published | not published | 0 |
| Exc malig feenl 3.1-4.0 11644 CPT 11644 | not published | not published | not published | 0 |
| Exc malig snhfg 2.1-3 cm 11623 CPT 11623 | not published | not published | not published | 0 |
| Exc mal+marg tal 2.1-3 cm 11603 CPT 11603 | not published | not published | not published | 0 |
| Exc mal+marg tal 3.1-4 cm 11604 CPT 11604 | not published | not published | not published | 0 |
| Exc prtl bn phlnx toe CPT 28124 | not published | not published | not published | 0 |
| Exc snhfg mal+mrg 3.1-4 11624 CPT 11624 | not published | not published | not published | 0 |
| Exc snhfg mal+mrg >4 cm 11626 CPT 11626 | not published | not published | not published | 0 |
| Exc sq tum/neck/ant thorax 3cm/> 21552 CPT 21552 | not published | not published | not published | 0 |
| Exc sq tumor/forearm/wrist/<3cm 25075 CPT 25075 | not published | not published | not published | 0 |
| Exc sq tumor/leg/ankle 3cm/> 27632 CPT 27632 | not published | not published | not published | 0 |
| Exc sq tumor/shoulder area 3cm/> 23071 CPT 23071 | not published | not published | not published | 0 |
| Exc sq tumor/thigh/knee area 3cm/> 27337 CPT 27337 | not published | not published | not published | 0 |
| Exc subq tum/sft tis/pel/hip 3cm/> 27043 CPT 27043 | not published | not published | not published | 0 |
| Exc tendon sheath or cap lesion 26160 CPT 26160 | not published | not published | not published | 0 |
| Exc thrombosed hemorrhoid 46320 CPT 46320 | $2,175.36 | $3,296.00 | $635.82 – $2,629.12 | 14 |
| Exc tr-ext mal+marg tal >4 cm 11606 CPT 11606 | not published | not published | not published | 0 |
| Exercise tst brncspsm w/ecg CPT 94617 | $247.50 | $375.00 | $25.49 – $375.00 | 16 |
| Exercise w/hemodynamic meas CPT 93464 | $567.60 | $860.00 | $73.27 – $77.67 | 7 |
| Exome re-evaluation CPT 81417 | $1,395.90 | $2,115.00 | $59.04 – $720.00 | 16 |
| Exome sequence analysis CPT 81415 | $5,520.90 | $8,365.00 | $835.31 – $10,755.00 | 16 |
| Exome sequence analysis CPT 81416 | $1,796.52 | $2,722.00 | $835.31 – $6,124.50 | 16 |
| Exploration of knee joint CPT 27310 | not published | not published | not published | 0 |
| Explore penetrating wnd/extremity 20103 CPT 20103 | $1,871.10 | $2,835.00 | $168.77 – $3,628.70 | 14 |
| Explore/treat knee joint CPT 27331 | not published | not published | not published | 0 |
| Expose art endoprosth iliac 34820 CPT 34820 | $7,485.72 | $11,342.00 | $7,257.52 – $7,692.97 | 7 |
| Expose endoprosth brachial 34834 CPT 34834 | $5,988.18 | $9,073.00 | $1,766.63 – $1,872.63 | 7 |
| Ext ecg>48hr<7d scan a/r CPT 93243 | $157.08 | $238.00 | $27.31 – $292.32 | 16 |
| Ext ecg>7d<15d scan a/r CPT 93247 | $316.80 | $480.00 | $27.31 – $480.00 | 16 |
| External chromosome analysis 20-25 cells CPT 88264 | $737.22 | $1,117.00 | $144.61 – $325.37 | 16 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $339.24 | $514.00 | $70.04 – $323.44 | 16 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $118.14 | $179.00 | $17.93 – $40.34 | 16 |
| Facial bones <3 CPT 70140 | $315.48 | $478.00 | $24.82 – $456.60 | 16 |
| Facility svs dental rehab HCPCS G0330 | not published | not published | not published | 0 |
| Factor ix CPT 85250 | $198.00 | $300.00 | $19.04 – $42.84 | 16 |
| Factor viii CPT 85240 | $195.36 | $296.00 | $9.84 – $40.28 | 16 |
| Fallopian tube recnl CPT 58345 | $3,672.24 | $5,564.00 | $1,027.53 – $7,112.24 | 14 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $0.40 | $0.61 | $0.02 – $0.02 | 4 |
| Fancc gene CPT 81242 | $122.10 | $185.00 | $36.62 – $82.40 | 16 |
| Fat/lipids feces qualitative CPT 82705 | $28.38 | $43.00 | $5.10 – $11.48 | 16 |
| Fatty acids nonesterified CPT 82725 | $126.06 | $191.00 | $18.72 – $42.23 | 16 |
| #fecal-sodium CPT 84302 | $29.70 | $45.00 | $4.86 – $10.94 | 16 |
| Femoral endovas graft add-on 34813 CPT 34813 | $11,977.02 | $18,147.00 | $7,257.52 – $7,692.97 | 7 |
| Fem/popl revasc w/stent CPT 37226 | $16,782.48 | $25,428.00 | $4,729.17 – $5,012.92 | 7 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $32.34 | $49.00 | $1.43 – $2.13 | 5 |
| Ferritin CPT 82728 | $81.18 | $123.00 | $13.63 – $30.67 | 16 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | $11.40 | $17.27 | $0.36 – $83.22 | 16 |
| Fetal contract stress test 59020 - 26 CPT 59020 | $494.34 | $749.00 | $85.57 – $452.28 | 16 |
| Fetal fibronectin CPT 82731 | $396.00 | $600.00 | $64.41 – $144.92 | 16 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $147.84 | $224.00 | $7.73 – $17.39 | 16 |
| Fetal hemoglobin rosette CPT 85461 | $59.40 | $90.00 | $9.33 – $21.06 | 16 |
| Fetal lung maturity assess lam body dnst CPT 83664 | $131.34 | $199.00 | $6.82 – $43.47 | 16 |
| Fetal non stress test CPT 59025 | $413.82 | $627.00 | $85.57 – $452.28 | 16 |
| #_fet/norfentcnfrmur CPT 80354 | $126.06 | $191.00 | $4.99 – $114.60 | 10 |
| Fibrin degradation d dimer quantitative CPT 85379 | $68.64 | $104.00 | $10.18 – $22.91 | 16 |
| Fibrin degradation products CPT 85362 | $47.52 | $72.00 | $6.89 – $15.50 | 16 |
| Fibrinogen activity CPT 85384 | $68.64 | $104.00 | $9.72 – $21.87 | 16 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $294.36 | $446.00 | $7.27 – $34.83 | 16 |
| Fibrinolytic antiplasmin CPT 85410 | $178.86 | $271.00 | $7.71 – $17.35 | 16 |
| Fibrinolytic plasminogen CPT 85415 | $220.44 | $334.00 | $17.19 – $38.68 | 16 |
| Fibrinolytic plasminogen CPT 85421 | $126.06 | $191.00 | $10.18 – $22.91 | 16 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | $207.90 | $315.00 | $6.53 – $14.69 | 16 |
| Filleted finger/toe flap CPT 14350 | not published | not published | not published | 0 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $2,325.84 | $3,524.00 | $1,938.20 – $1,938.20 | 1 |
| Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 CPT 10007 | $1,087.02 | $1,647.00 | $301.92 – $1,555.83 | 14 |
| Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008 CPT 10008 | $543.84 | $824.00 | $301.92 – $320.04 | 7 |
| Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 | $543.84 | $824.00 | $301.92 – $320.04 | 7 |
| Fixation of knee joint CPT 27570 | not published | not published | not published | 0 |
| Fix g/colon tube w/device CPT 49460 | $1,083.06 | $1,641.00 | $94.57 – $1,992.72 | 16 |
| Flecainide (tambocor)-sendout CPT 80181 | $21.78 | $33.00 | $14.91 – $41.94 | 16 |
| Fl exam g/colon tube w contrast CPT 49465 | $499.62 | $757.00 | $52.32 – $524.23 | 16 |
| Flexible Sigmoidoscopy CPT 45330 | not published | not published | not published | 0 |
| Flow cytometry marker each additional CPT 88185 | $258.06 | $391.00 | $11.76 – $63.00 | 11 |
| Flow cytometry one marker technical component CPT 88184 | $416.46 | $631.00 | $65.34 – $787.54 | 16 |
| #flow interp 9 - 15 markers CPT 88188 | $263.34 | $399.00 | $11.76 – $239.40 | 11 |
| Flt3 gene CPT 81245 | $247.50 | $375.00 | $132.74 – $372.40 | 16 |
| Flt3 gene analysis CPT 81246 | $207.90 | $315.00 | $83.00 – $186.75 | 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.