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 |
|---|---|---|---|---|
| Mayo coccidioides antibody CPT 86635 | $121.44 | $184.00 | $8.17 – $25.81 | 16 |
| Mayo cocou cortisone urine CPT 82542 | $602.58 | $913.00 | $24.09 – $54.20 | 16 |
| Mayo cortisol free CPT 82530 | $99.00 | $150.00 | $16.71 – $37.60 | 16 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $77.22 | $117.00 | $42.13 – $94.79 | 16 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $64.02 | $97.00 | $8.17 – $27.27 | 16 |
| Mayo csmpu opiod/analogs definitive assay >=5 urine CPT 80364 | $26.40 | $40.00 | $4.99 – $27.08 | 10 |
| Mayo cyanide CPT 82600 | $117.48 | $178.00 | $19.40 – $43.65 | 16 |
| Mayo cytopathology in situ hybridization urinary tract 3-5 probes each specimen manual CPT 88120 | $578.82 | $877.00 | $65.34 – $374.32 | 16 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $68.64 | $104.00 | $13.25 – $29.81 | 16 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $152.46 | $231.00 | $25.27 – $56.86 | 16 |
| Mayo dihydrotestosterone CPT 82642 | $143.88 | $218.00 | $29.28 – $65.88 | 16 |
| Mayo efpo chloride stool CPT 82438 | $61.38 | $93.00 | $5.00 – $11.25 | 16 |
| Mayo estriol CPT 82677 | $162.36 | $246.00 | $24.18 – $54.41 | 16 |
| Mayo estrone CPT 82679 | $80.52 | $122.00 | $24.95 – $56.14 | 16 |
| Mayo ethosuximide therapeutic drug level CPT 80168 | $95.70 | $145.00 | $16.34 – $36.77 | 16 |
| Mayo everolimus therapeutic drug level CPT 80169 | $132.66 | $201.00 | $13.73 – $30.89 | 16 |
| Mayo factor ii CPT 85210 | $89.10 | $135.00 | $8.17 – $29.21 | 16 |
| Mayo factor v CPT 85220 | $147.84 | $224.00 | $17.65 – $39.71 | 16 |
| Mayo factor vii CPT 85230 | $147.84 | $224.00 | $17.90 – $40.28 | 16 |
| Mayo factor viii vw factor antigen CPT 85246 | $172.92 | $262.00 | $22.94 – $51.62 | 16 |
| Mayo factor viii vw factor multimetric analysis CPT 85247 | $216.48 | $328.00 | $22.94 – $51.62 | 16 |
| Mayo factor viii vw factor ristocetin cofactor CPT 85245 | $175.56 | $266.00 | $22.94 – $51.62 | 16 |
| Mayo factor x CPT 85260 | $159.72 | $242.00 | $17.90 – $40.28 | 16 |
| Mayo factor xi CPT 85270 | $147.84 | $224.00 | $17.90 – $40.28 | 16 |
| Mayo fat/lipids feces quantitative CPT 82710 | $225.06 | $341.00 | $16.80 – $37.80 | 16 |
| Mayo fbl culture fungi blood CPT 87103 | $163.02 | $247.00 | $12.68 – $46.04 | 16 |
| Mayo ffspg allergen clam igg CPT 86001 | $18.48 | $28.00 | $4.57 – $17.60 | 16 |
| Mayo fibrinogen antigen CPT 85385 | $59.40 | $90.00 | $11.94 – $32.54 | 16 |
| Mayo gabapentin bld/srm/plasma therapeutic drug level CPT 80171 | $77.22 | $117.00 | $14.48 – $48.76 | 16 |
| Mayo gamma-globin full gene sequencing CPT 81479 | $912.12 | $1,382.00 | $16.71 – $165.60 | 9 |
| Mayo hemosiderin qualitative urine CPT 83070 | $44.88 | $68.00 | $4.75 – $10.69 | 16 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative CPT 87535 | $287.76 | $436.00 | $35.09 – $78.95 | 16 |
| Mayo hiser histoplasma antibodies immunodiffusion CPT 86698 | $147.84 | $224.00 | $13.79 – $31.03 | 16 |
| Mayo hla typing a/b/c single antigen CPT 86812 | $207.90 | $315.00 | $25.81 – $58.07 | 16 |
| Mayo hvdip HIV 1 antibody CPT 86701 | $79.86 | $121.00 | $8.89 – $20.00 | 16 |
| Mayo hvdip HIV 2 antibody CPT 86702 | $79.86 | $121.00 | $13.52 – $30.42 | 16 |
| Mayo hydroxyprogesterone 17-d CPT 83498 | $170.94 | $259.00 | $27.17 – $61.13 | 16 |
| Mayo immunoassay c1 esterase inhibitor antibody quantitative CPT 83520 | $669.90 | $1,015.00 | $17.27 – $38.86 | 16 |
| Mayo immunoassay infectious agent antibody quantitative diptheria igg CPT 86317 | $99.00 | $150.00 | $14.99 – $33.73 | 16 |
| Mayo immunoassay tumor antigen quantitative ca 27.29 CPT 86300 | $138.60 | $210.00 | $20.81 – $46.82 | 16 |
| Mayo immunoassay tumor antigen quantitative chromogranin a CPT 86316 | $147.84 | $224.00 | $20.81 – $46.82 | 16 |
| Mayo infectious agent antigen immunoassay direct optical observation cryptococcus CPT 87899 | $68.64 | $104.00 | $16.07 – $36.16 | 16 |
| Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal CPT 87305 | $118.14 | $179.00 | $11.98 – $26.96 | 16 |
| Mayo infectious agent nucleic acid amplified probe enterovirus CPT 87498 | $237.60 | $360.00 | $35.09 – $78.95 | 16 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma genitalium urine CPT 87563 | $237.60 | $360.00 | $28.07 – $78.95 | 16 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae CPT 87581 | $198.66 | $301.00 | $35.09 – $78.95 | 16 |
| Mayo infectious agent nucleic acid amplified probe pneumocystis jirovecii CPT 87594 | $165.00 | $250.00 | $35.09 – $78.95 | 11 |
| Mayo infectious agent nucleic acid quantification cytomegalovirus CPT 87497 | $227.70 | $345.00 | $42.84 – $96.39 | 16 |
| Mayo infectious disease hepatitis c chronic six biochemical assays CPT 81596 | $211.86 | $321.00 | $72.19 – $162.43 | 16 |
| Mayo infliximab therapeutic drug level CPT 80230 | $264.66 | $401.00 | $30.85 – $86.78 | 16 |
| Mayo inhab inhibin a CPT 86336 | $155.10 | $235.00 | $15.59 – $35.08 | 16 |
| Mayo insft insulin free CPT 83527 | $15.18 | $23.00 | $12.95 – $29.14 | 16 |
| Mayo insulin antibodies CPT 86337 | $207.90 | $315.00 | $21.41 – $48.17 | 16 |
| Mayo iodine CPT 83789 | $278.52 | $422.00 | $24.11 – $54.25 | 16 |
| Mayo itraconazole therapeutic drug level CPT 80189 | $48.18 | $73.00 | $27.11 – $61.00 | 16 |
| Mayo lacosamide therapeutic drug level CPT 80235 | $89.10 | $135.00 | $21.69 – $61.00 | 16 |
| Mayo lamotrigine therapeutic drug level CPT 80175 | $63.36 | $96.00 | $13.25 – $29.81 | 16 |
| Mayo ld_i lactate dehydrogenase isoenzymes CPT 83625 | $62.70 | $95.00 | $12.79 – $28.78 | 16 |
| Mayo legionella antibody CPT 86713 | $89.10 | $135.00 | $15.30 – $34.43 | 16 |
| Mayo leptospira antibody igm CPT 86720 | $87.78 | $133.00 | $8.17 – $36.45 | 16 |
| Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory CPT 86617 | $108.90 | $165.00 | $15.49 – $34.85 | 16 |
| Mayo manganese CPT 83785 | $126.06 | $191.00 | $26.65 – $59.96 | 16 |
| Mayo metanephrines plasma CPT 83835 | $107.58 | $163.00 | $16.94 – $38.12 | 16 |
| Mayo methadone definitive assay confirmation urine CPT 80358 | $146.52 | $222.00 | $4.99 – $94.80 | 10 |
| Mayo mgle voltage-gated calcium channel antibody each CPT 86596 | $217.80 | $330.00 | $12.05 – $27.11 | 16 |
| Mayo mgrm acetylcholine receptor binding antibody CPT 86041 | $89.10 | $135.00 | $14.72 – $41.40 | 16 |
| Mayo microsomal antibody liver-kidney CPT 86376 | $99.00 | $150.00 | $14.55 – $32.74 | 16 |
| Mayo mitotane (lysodren) therapeutic drug level CPT 80299 | $130.02 | $197.00 | $18.64 – $41.94 | 16 |
| Mayo molecular pathology procedure level 2 apoe genotype CPT 81401 | $1,139.82 | $1,727.00 | $109.60 – $308.25 | 16 |
| Mayo mpl sequence analysis exon 10 CPT 81339 | $644.16 | $976.00 | $148.16 – $416.70 | 16 |
| Mayo muramidase CPT 85549 | $77.88 | $118.00 | $18.75 – $42.19 | 16 |
| Mayo muscle-specific kinase (musk) antibody CPT 86366 | $495.00 | $750.00 | $14.72 – $41.40 | 16 |
| Mayo mycophenolic acid therapeutic drug level CPT 80180 | $79.20 | $120.00 | $18.05 – $40.61 | 16 |
| Mayo myoglobin CPT 83874 | $89.76 | $136.00 | $12.92 – $29.07 | 16 |
| Mayo opatu opiates definitive assay >=1 CPT 80361 | $120.12 | $182.00 | $4.99 – $27.00 | 10 |
| Mayo opatu opioid/analogs definitive assay 1 or 2 CPT 80362 | $36.30 | $55.00 | $4.99 – $39.00 | 10 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $99.00 | $150.00 | $21.21 – $47.72 | 16 |
| Mayo oxalate 24 hour urine CPT 83945 | $79.86 | $121.00 | $14.45 – $32.51 | 16 |
| Mayo pancreatic elastase fecal qualitative or semi quantitative CPT 82656 | $170.94 | $259.00 | $11.53 – $25.94 | 16 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | $79.86 | $121.00 | $15.03 – $33.82 | 16 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | $796.62 | $1,207.00 | $12.05 – $27.11 | 16 |
| Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme) CPT 87476 | $312.84 | $474.00 | $35.09 – $78.95 | 16 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $61.38 | $93.00 | $13.76 – $30.96 | 16 |
| Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 | $50.16 | $76.00 | $8.44 – $18.99 | 16 |
| Mayo pregnenolone CPT 84140 | $85.14 | $129.00 | $20.67 – $46.51 | 16 |
| Mayo prmb primidone therapeutic drug level CPT 80188 | $77.88 | $118.00 | $16.59 – $37.33 | 16 |
| Mayo proinsulin CPT 84206 | $233.64 | $354.00 | $25.05 – $60.05 | 16 |
| Mayo psaft prostate specific antigen free CPT 84154 | $117.48 | $178.00 | $18.39 – $41.38 | 16 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | $450.12 | $682.00 | $18.40 – $41.40 | 16 |
| Mayo rbcme osmotic fragility rbc incubated CPT 85557 | $228.36 | $346.00 | $13.36 – $30.06 | 16 |
| Mayo receptor assay transferrin soluble CPT 84238 | $233.64 | $354.00 | $36.57 – $82.28 | 16 |
| Mayo renin CPT 84244 | $134.64 | $204.00 | $21.99 – $49.48 | 16 |
| Mayo repu protein electrophoresis urine CPT 84166 | $116.82 | $177.00 | $17.83 – $40.12 | 16 |
| Mayo selenium CPT 84255 | $152.46 | $231.00 | $25.53 – $57.44 | 16 |
| Mayo semb semen analysis volume/count/motility/differential strict morphologic criteria CPT 89322 | $310.86 | $471.00 | $15.50 – $34.88 | 16 |
| Mayo serotonin CPT 84260 | $152.46 | $231.00 | $30.98 – $69.71 | 16 |
| Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 | $99.00 | $150.00 | $19.35 – $43.54 | 16 |
| Mayo sirolimus therapeutic drug level CPT 80195 | $71.28 | $108.00 | $13.73 – $30.89 | 16 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | $32.34 | $49.00 | $4.27 – $9.61 | 16 |
| Mayo tcgr analysis gene rearrangement trb@ abnormal clonal population(s) amplification CPT 81340 | $455.40 | $690.00 | $208.92 – $470.07 | 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.