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 |
|---|---|---|---|---|
| Ghs i and d perirectal abscess 46040 CPT 46040 | $2,471.04 | $3,744.00 | $635.82 – $2,629.12 | 14 |
| Ghs i and d pilonidal cyst complex CPT 10081 | $2,373.36 | $3,596.00 | $474.26 – $1,555.83 | 14 |
| Ghs i and d pilonidal cyst simple CPT 10080 | $706.86 | $1,071.00 | $72.99 – $1,555.83 | 14 |
| Ghs incision thrombosed ext hemorrhoid CPT 46083 | $434.28 | $658.00 | $243.97 – $658.00 | 14 |
| Ghs indirect laryngoscopy/w fb removal CPT 31511 | $334.62 | $507.00 | $74.89 – $438.55 | 14 |
| Ghs inf midline insertion CPT 36140 | $1,344.42 | $2,037.00 | $302.34 – $320.48 | 7 |
| Ghs inhibitor screen CPT 85335 | $441.54 | $669.00 | $12.87 – $28.96 | 16 |
| Ghs init tx 1st degree burn CPT 16000 | $229.68 | $348.00 | $80.58 – $440.81 | 14 |
| Ghs inj tendon origin/insertion CPT 20551 | $395.34 | $599.00 | $73.45 – $674.40 | 16 |
| Ghs inj transforaminal cerv ea add bil CPT 64480 | $721.38 | $1,093.00 | $337.74 – $358.00 | 7 |
| Ghs inj transforaminal cerv single bil CPT 64479 | $1,413.72 | $2,142.00 | $337.74 – $1,943.26 | 14 |
| Ghs insertion of needle - bone CPT 36680 | $533.94 | $809.00 | $108.83 – $981.49 | 14 |
| Ghs intermed repair 12.6 - 20.0 cm-12035 CPT 12035 | $840.18 | $1,273.00 | $168.77 – $893.15 | 14 |
| Ghs intermed repair 20.1 - 30.0 cm-12036 CPT 12036 | $898.92 | $1,362.00 | $168.77 – $1,623.80 | 14 |
| Ghs intermed repair over 30 cm - 12037 CPT 12037 | $1,186.68 | $1,798.00 | $168.77 – $4,533.20 | 14 |
| Ghs intro needle/intracath vein - 36000 CPT 36000 | $97.02 | $147.00 | $17.30 – $147.00 | 11 |
| Ghs irrigate corpora cavernosa for priapism CPT 54220 | $413.82 | $627.00 | $38.07 – $548.94 | 14 |
| Ghs IV inf sq injection, on-body injector CPT 96377 | $107.58 | $163.00 | $18.29 – $102.88 | 14 |
| Ghs IV infusion bamlanivimab/etesevimab HCPCS M0245 | $606.54 | $919.00 | $450.00 – $477.00 | 7 |
| Ghs IV infusion casirivimab/imdevimab HCPCS M0243 | $651.42 | $987.00 | $450.00 – $477.00 | 7 |
| Ghs IV infusion sotrovimab HCPCS M0247 | $904.86 | $1,371.00 | $130.24 – $138.05 | 7 |
| Ghs IV thrombolytics - cerebral CPT 37195 | $528.00 | $800.00 | $130.24 – $725.71 | 14 |
| Ghs lac repair mouth.ant tong 2.5cm/less CPT 41250 | $513.48 | $778.00 | $74.89 – $981.49 | 14 |
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | $642.18 | $973.00 | $168.77 – $893.15 | 14 |
| Ghs layer closure 2.5 cm or less - 12041 CPT 12041 | $583.44 | $884.00 | $168.77 – $893.15 | 14 |
| Ghs layer closure 2.5cm or less - 12051 CPT 12051 | $715.44 | $1,084.00 | $168.77 – $893.15 | 14 |
| Ghs layer closure 2.6 - 5.0 cm - 12052 CPT 12052 | $783.42 | $1,187.00 | $168.77 – $893.15 | 14 |
| Ghs layer closure 2.6 - 7.5 cm - 12042 CPT 12042 | $642.18 | $973.00 | $168.77 – $893.15 | 14 |
| Ghs layer closure 5.1 - 7.5 cm - 12053 CPT 12053 | $792.66 | $1,201.00 | $168.77 – $893.15 | 14 |
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | $770.22 | $1,167.00 | $168.77 – $893.15 | 14 |
| Ghs layer closure 7.6 - 12.5 cm - 12044 CPT 12044 | $711.48 | $1,078.00 | $168.77 – $1,623.80 | 14 |
| Ghs layer closure 7.6 - 12.5 cm - 12054 CPT 12054 | $809.82 | $1,227.00 | $168.77 – $893.15 | 14 |
| Ghs layered repair 12.6 - 20.0 cm -12045 CPT 12045 | $840.18 | $1,273.00 | $168.77 – $1,623.80 | 14 |
| Ghs layered repair 12.6 - 20.0 cm -12055 CPT 12055 | $865.26 | $1,311.00 | $168.77 – $893.15 | 14 |
| Ghs layered repair 20.1 - 30.0 cm -12046 CPT 12046 | $898.92 | $1,362.00 | $168.77 – $1,623.80 | 14 |
| Ghs layered repair 20.1 - 30.0 cm -12056 CPT 12056 | $898.92 | $1,362.00 | $168.77 – $893.15 | 14 |
| Ghs layered repair over 30.0 cm -12047 CPT 12047 | $2,112.66 | $3,201.00 | $168.77 – $4,533.20 | 14 |
| Ghs layered repair over 3.0 cm -12057 CPT 12057 | $1,186.68 | $1,798.00 | $168.77 – $893.15 | 14 |
| Ghs leukocyte alkaline phos (mayo) CPT 85540 | $123.42 | $187.00 | $8.60 – $19.35 | 16 |
| Ghs mbp CPT 83873 | $89.76 | $136.00 | $17.20 – $38.70 | 16 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $351.12 | $532.00 | $10.05 – $292.60 | 8 |
| Ghs moderate sedation < 5 yr, 30 min, other CPT 99155 | $351.12 | $532.00 | $10.05 – $292.60 | 8 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $351.12 | $532.00 | $10.05 – $292.60 | 8 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $74.58 | $113.00 | $10.05 – $62.15 | 8 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $74.58 | $113.00 | $10.05 – $62.15 | 8 |
| Ghs musc test done w/n test comp CPT 95886 | $209.22 | $317.00 | $58.61 – $317.00 | 10 |
| Ghs musc tst done w/nerv tst lim CPT 95885 | $161.70 | $245.00 | $58.61 – $245.00 | 10 |
| Ghs musc tst done w/n tst non ext CPT 95887 | $161.70 | $245.00 | $58.61 – $245.00 | 10 |
| Ghs nailbed repair/nail removal CPT 11760 | $657.36 | $996.00 | $29.40 – $1,623.80 | 14 |
| Ghs nerve block axillary nerve CPT 64417 | $1,028.28 | $1,558.00 | $176.37 – $1,943.26 | 14 |
| Ghs nerve block brachial plexus CPT 64415 | $949.74 | $1,439.00 | $565.72 – $1,943.26 | 14 |
| Ghs nerve block celiac plexus CPT 64530 | $2,809.62 | $4,257.00 | $565.72 – $1,943.26 | 16 |
| Ghs ng placement w fluoro guidance CPT 43752 | $460.68 | $698.00 | $75.17 – $981.49 | 16 |
| Ghs o2 saturation CPT 82810 | $121.44 | $184.00 | $9.77 – $21.98 | 16 |
| Ghs opcc repair cvp without subq port CPT 36575 | $1,656.60 | $2,510.00 | $325.87 – $1,378.24 | 14 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | $66.00 | $100.00 | $13.39 – $47.44 | 14 |
| Ghs osteopathic manipulative tx, 3-4 regions CPT 98926 | $62.04 | $94.00 | $13.39 – $47.44 | 14 |
| Ghs ot group caregiver training CPT 97552 | $43.56 | $66.00 | $21.22 – $47.75 | 14 |
| Ghs ot prosthetic training/15 min CPT 97761 | $69.96 | $106.00 | $16.89 – $106.00 | 16 |
| Ghs pacing - transcutaneous CPT 92953 | $1,087.02 | $1,647.00 | $273.97 – $1,452.15 | 14 |
| Ghs peritonsillar abscess i andd CPT 42700 | $583.44 | $884.00 | $74.89 – $520.38 | 14 |
| Ghs phenylketonurid CPT 84030 | $170.94 | $259.00 | $5.50 – $12.38 | 16 |
| Ghs picc line insert < 5 CPT 36568 | $1,794.54 | $2,719.00 | $485.09 – $3,458.55 | 14 |
| Ghs plngl fx pm cl CPT 26725 | $701.58 | $1,063.00 | $203.37 – $541.95 | 14 |
| Ghs ppd (tb intradermal) CPT 86580 | $59.40 | $90.00 | $4.14 – $63.55 | 16 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $89.76 | $136.00 | $9.66 – $21.74 | 16 |
| Ghs protoporphyrins fract CPT 84202 | $72.60 | $110.00 | $14.35 – $32.29 | 16 |
| Ghs pr without cont pulse ox CPT 94625 | $137.94 | $209.00 | $15.09 – $129.61 | 14 |
| Ghs quinidine CPT 80194 | $88.44 | $134.00 | $14.60 – $32.85 | 16 |
| Ghs removal intranasal foreign body CPT 30300 | $345.84 | $524.00 | $74.89 – $292.32 | 14 |
| Ghs removal pharyngeal foreign body CPT 42809 | $460.68 | $698.00 | $74.89 – $981.49 | 14 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $1,878.36 | $2,846.00 | $576.77 – $3,532.89 | 14 |
| Ghs reticulocyte count CPT 85044 | $129.36 | $196.00 | $4.31 – $9.70 | 16 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $99.00 | $150.00 | $13.91 – $31.30 | 16 |
| Ghs sedimentation rate CPT 85651 | $40.92 | $62.00 | $4.01 – $9.61 | 16 |
| Ghs semen analysis fert CPT 89320 | $48.18 | $73.00 | $12.31 – $27.70 | 16 |
| Ghs semen analysis, post-vas CPT 89300 | $66.66 | $101.00 | $9.84 – $22.14 | 16 |
| Ghs sensitivity (per antimicro) CPT 87184 | $67.32 | $102.00 | $7.48 – $16.83 | 16 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $658.68 | $998.00 | $80.58 – $893.15 | 14 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $731.28 | $1,108.00 | $80.58 – $893.15 | 14 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $701.58 | $1,063.00 | $80.58 – $893.15 | 14 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $751.08 | $1,138.00 | $80.58 – $893.15 | 14 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $701.58 | $1,063.00 | $80.58 – $440.81 | 14 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $602.58 | $913.00 | $80.58 – $440.81 | 14 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $721.38 | $1,093.00 | $80.58 – $440.81 | 14 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $721.38 | $1,093.00 | $80.58 – $440.81 | 14 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $770.22 | $1,167.00 | $80.58 – $440.81 | 14 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $1,431.54 | $2,169.00 | $58.61 – $1,886.72 | 16 |
| Ghs sphenopalatine ganglion block CPT 64505 | $1,162.26 | $1,761.00 | $176.37 – $1,215.09 | 16 |
| Ghs strapping shoulder - 29240 CPT 29240 | $246.18 | $373.00 | $33.47 – $292.32 | 14 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $1,186.68 | $1,798.00 | $168.77 – $1,623.80 | 14 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $465.96 | $706.00 | $168.77 – $893.15 | 14 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $1,710.72 | $2,592.00 | $908.91 – $3,408.96 | 14 |
| Ghs trypsin (fecal) CPT 84488 | $74.58 | $113.00 | $7.30 – $16.43 | 16 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $701.58 | $1,063.00 | $203.37 – $541.95 | 14 |
| Ghs urine, hydroxproline total CPT 83505 | $144.54 | $219.00 | $24.30 – $54.68 | 16 |
| Ghs urine, porphyrins quant CPT 84120 | $134.64 | $204.00 | $14.71 – $33.10 | 16 |
| Ghs vaginal delivery only CPT 59409 | $7,298.28 | $11,058.00 | $952.18 – $7,112.24 | 14 |
| Ghs windowing of cast CPT 29730 | $655.38 | $993.00 | $79.49 – $357.03 | 14 |
| Gi inhouse confirmation CPT 87045 | $68.64 | $104.00 | $9.44 – $21.24 | 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.