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 tgrp testosterone free CPT 84402 | $152.46 | $231.00 | $25.47 – $57.31 | 16 |
| Mayo tgrp testosterone total CPT 84403 | $152.46 | $231.00 | $25.81 – $58.07 | 16 |
| Mayo thiopurine s-methyltransferase CPT 84433 | $278.52 | $422.00 | $22.17 – $49.88 | 16 |
| Mayo thyroglobulin CPT 84432 | $287.76 | $436.00 | $16.06 – $36.14 | 16 |
| Mayo ticks anaplasma phagocytophilum antibody igg CPT 86666 | $36.30 | $55.00 | $8.17 – $22.91 | 16 |
| Mayo ticks babesia microti antibody igg CPT 86753 | $84.48 | $128.00 | $8.17 – $27.88 | 16 |
| Mayo tramadol definitive assay w metabolite quantitative urine CPT 80373 | $130.68 | $198.00 | $4.99 – $118.80 | 10 |
| Mayo tulab francisella tularensis antibody igg CPT 86668 | $59.40 | $90.00 | $14.16 – $31.86 | 16 |
| Mayo valpg valproic acid free therapeutic drug level CPT 80165 | $58.08 | $88.00 | $13.54 – $30.47 | 16 |
| Mayo vasoactive intestinal peptide CPT 84586 | $152.46 | $231.00 | $17.93 – $79.49 | 16 |
| Mayo vitamin b-2 (riboflavin) CPT 84252 | $120.12 | $182.00 | $20.24 – $45.54 | 16 |
| Mayo vitamin b3 (niacin) CPT 84591 | $110.22 | $167.00 | $16.32 – $38.39 | 16 |
| Mayo vitamin k CPT 84597 | $314.82 | $477.00 | $13.72 – $30.87 | 16 |
| Mayo zonisamide therapeutic drug level CPT 80203 | $69.96 | $106.00 | $13.25 – $29.81 | 16 |
| Measure kidney pressure CPT 50396 | $770.88 | $1,168.00 | $178.39 – $1,532.02 | 16 |
| Measurement post void urine by ultrasound CPT 51798 | $178.86 | $271.00 | $21.77 – $271.00 | 16 |
| #mec-opiates CPT 80356 | $69.30 | $105.00 | $4.99 – $63.00 | 10 |
| Mecp2 gene full seq CPT 81302 | $1,149.72 | $1,742.00 | $281.65 – $1,187.71 | 16 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | $32.34 | $49.00 | $10.23 – $14.59 | 5 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $14.61 | $22.14 | $0.54 – $0.68 | 5 |
| Metabolic Blood Panel (Basic) CPT 80048 | $85.80 | $130.00 | $8.46 – $19.04 | 16 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $118.80 | $180.00 | $10.56 – $23.76 | 16 |
| Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 | $48.71 | $73.80 | $7.49 – $13.77 | 5 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | $22.84 | $34.60 | $9.81 – $22.07 | 11 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $96.26 | $145.85 | $35.24 – $38.23 | 5 |
| Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 | $4.43 | $6.71 | $1.90 – $3.47 | 2 |
| Methylphenidate CPT 80360 | $72.60 | $110.00 | $4.99 – $66.00 | 10 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $5.28 | $8.00 | $0.23 – $0.41 | 5 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | $1.39 | $2.10 | $0.20 – $0.21 | 4 |
| Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 | $4.05 | $6.13 | $0.43 – $0.47 | 4 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $32.34 | $49.00 | $1.58 – $1.93 | 5 |
| Metoprolol tartrate 5 mg/5 ml intravenous (wrapper) HCPCS J0616 | $6.47 | $9.80 | $0.20 – $0.21 | 4 |
| Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 | $0.73 | $1.10 | $0.04 – $0.05 | 5 |
| Mgmt promoter methylation analysis CPT 81287 | $521.40 | $790.00 | $83.09 – $280.44 | 16 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $2.59 | $3.92 | $0.41 – $0.71 | 5 |
| Microdissection laser CPT 88380 | $1,026.30 | $1,555.00 | $58.17 – $933.00 | 11 |
| Microdissection manual CPT 88381 | $248.16 | $376.00 | $14.25 – $191.00 | 11 |
| Microsatellite instability CPT 81301 | $1,080.42 | $1,637.00 | $316.03 – $784.26 | 16 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $16.17 | $24.50 | $0.23 – $0.25 | 5 |
| Midazolam 1 mg/ml in sodium chloride IV infusion (wrapper) HCPCS J2251 | $1.66 | $2.52 | $0.30 – $0.36 | 5 |
| Mlh1 gene CPT 81288 | $469.26 | $711.00 | $164.96 – $432.72 | 16 |
| Mnpj anes sho jt fixj aprats CPT 23700 | not published | not published | not published | 0 |
| Mog-igg1 antb flo cytmtry ea CPT 86363 | $488.40 | $740.00 | $12.05 – $84.89 | 16 |
| Mopath procedure level 1 CPT 81400 | $370.92 | $562.00 | $51.17 – $143.91 | 16 |
| Mopath procedure level 3 CPT 81402 | $495.00 | $750.00 | $120.26 – $338.24 | 16 |
| Mopath procedure level 5 CPT 81404 | $972.84 | $1,474.00 | $219.86 – $618.37 | 16 |
| Mopath procedure level 6 CPT 81405 | $686.40 | $1,040.00 | $241.08 – $678.04 | 16 |
| Mopath procedure level 7 CPT 81406 | $1,016.40 | $1,540.00 | $226.30 – $636.48 | 16 |
| Mopath procedure level 8 CPT 81407 | $977.46 | $1,481.00 | $677.02 – $1,904.11 | 16 |
| Mopath procedure level 9 CPT 81408 | $2,310.00 | $3,500.00 | $1,600.00 – $4,500.00 | 16 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $186.32 | $282.30 | $5.02 – $5.51 | 5 |
| Morphine 4 mg/ml injection (wrapper)|discarded drug not administered HCPCS J2272 | $32.34 | $49.00 | $7.74 – $12.12 | 5 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted CPT 88361 | $424.38 | $643.00 | $58.17 – $787.54 | 16 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $411.18 | $623.00 | $58.17 – $374.32 | 16 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $551.76 | $836.00 | $58.17 – $501.60 | 16 |
| M/phmtrc alysishquant/semiq CPT 88369 | $362.34 | $549.00 | $14.25 – $329.40 | 11 |
| MRA chest w IV cont HCPCS C8909 | $2,789.16 | $4,226.00 | $217.39 – $1,444.47 | 16 |
| MRA chest wwo IV cont HCPCS C8911 | $2,929.08 | $4,438.00 | $217.39 – $1,444.47 | 16 |
| MRA w/cont, abd HCPCS C8900 | $2,789.16 | $4,226.00 | $217.39 – $1,444.47 | 16 |
| MRA w/cont, lwr ext HCPCS C8912 | $2,233.44 | $3,384.00 | $217.39 – $1,444.47 | 16 |
| Mra, w/dye, upper extremity HCPCS C8934 | $2,233.44 | $3,384.00 | $217.39 – $1,444.47 | 16 |
| MRA without cont, abd HCPCS C8901 | $2,656.50 | $4,025.00 | $217.39 – $1,444.47 | 16 |
| MRA without fol w/cont, abd HCPCS C8902 | $3,068.34 | $4,649.00 | $217.39 – $1,444.47 | 16 |
| MRA without fol w/cont, lwr ext HCPCS C8914 | $2,913.90 | $4,415.00 | $217.39 – $1,444.47 | 16 |
| Mr elastography CPT 76391 | $1,535.16 | $2,326.00 | $106.68 – $1,444.47 | 16 |
| MRI breast without cont bi CPT 77047 | $2,656.50 | $4,025.00 | $106.68 – $1,444.47 | 16 |
| MRI cardiac morph & func wo IV cont CPT 75557 | $2,913.90 | $4,415.00 | $106.68 – $1,444.47 | 16 |
| MRI cardiac morph & func wwo IV cont CPT 75561 | $2,913.90 | $4,415.00 | $179.97 – $1,444.47 | 16 |
| MRI chest without contrast CPT 71550 | $2,656.50 | $4,025.00 | $106.68 – $1,444.47 | 16 |
| MRI chest without & w/contrast CPT 71552 | $3,036.00 | $4,600.00 | $179.97 – $1,444.47 | 16 |
| MRI chest w IV cont CPT 71551 | $2,845.92 | $4,312.00 | $179.97 – $1,722.34 | 16 |
| MRI fetal ea addl gestation CPT 74713 | $2,233.44 | $3,384.00 | $106.68 – $2,383.00 | 11 |
| MRI fetal sngl/1st gestation CPT 74712 | $2,233.44 | $3,384.00 | $106.68 – $1,444.47 | 16 |
| MRI loex nonjt w IV cont CPT 73719 | $2,311.32 | $3,502.00 | $179.97 – $1,444.47 | 16 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $2,420.88 | $3,668.00 | $106.68 – $1,444.47 | 16 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $2,669.70 | $4,045.00 | $179.97 – $1,444.47 | 16 |
| MRI orbit/face/neck without contrast CPT 70540 | $2,310.00 | $3,500.00 | $106.68 – $1,444.47 | 16 |
| MRI orbit/face/neck without & w/contrast CPT 70543 | $2,934.36 | $4,446.00 | $179.97 – $1,444.47 | 16 |
| MRI orbit fac&nck w IV cont CPT 70542 | $2,425.50 | $3,675.00 | $179.97 – $1,444.47 | 16 |
| MRI tmj CPT 70336 | $3,107.94 | $4,709.00 | $106.68 – $524.23 | 16 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $2,410.98 | $3,653.00 | $106.68 – $1,444.47 | 16 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $2,669.70 | $4,045.00 | $179.97 – $1,444.47 | 16 |
| MRI upper extremity w/dye CPT 73219 | $2,542.32 | $3,852.00 | $179.97 – $1,444.47 | 16 |
| MRI without fol w/cont, breast HCPCS C8908 | $3,068.34 | $4,649.00 | $179.97 – $1,444.47 | 16 |
| Mr safety determination physician/other qhp CPT 76016 | $203.94 | $309.00 | $84.98 – $309.00 | 11 |
| Mr safety implant elec prepj CPT 76018 | $239.58 | $363.00 | $92.83 – $363.00 | 11 |
| Mr safety implant&/fb assmt clin staff ea add 30 CPT 76015 | $80.52 | $122.00 | $122.00 – $122.00 | 5 |
| Mr safety implt pos&/immoblj CPT 76019 | $143.22 | $217.00 | $57.60 – $217.00 | 11 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | $65.34 | $99.00 | $28.24 – $99.00 | 11 |
| Mr sfty med physics xm cstmz CPT 76017 | $718.08 | $1,088.00 | $232.99 – $1,088.00 | 11 |
| Mr spectroscopy CPT 76390 | $2,352.24 | $3,564.00 | $84.98 – $1,444.47 | 16 |
| Mthfr gene analy common variants CPT 81291 | $277.20 | $420.00 | $16.71 – $147.02 | 16 |
| Mucopolysaccharides CPT 83864 | $555.06 | $841.00 | $28.00 – $64.13 | 16 |
| Mumps antibody igg CPT 86735 | $108.90 | $165.00 | $13.05 – $29.36 | 16 |
| Muscle test cran nerv unilat CPT 95867 | $413.82 | $627.00 | $58.61 – $627.00 | 16 |
| Musc/tdn transfer upr a/e 1 CPT 24301 | not published | not published | not published | 0 |
| Mycobacteria dna amp probe CPT 87551 | $482.46 | $731.00 | $48.24 – $108.54 | 16 |
| Mycophenolic acid HCPCS J7518 | $10.26 | $15.55 | $0.53 – $0.63 | 5 |
| Mycoplasma antibody igm CPT 86738 | $68.64 | $104.00 | $13.24 – $29.79 | 16 |
| Myd88 gene p.leu265pro vrnt CPT 81305 | $679.80 | $1,030.00 | $140.32 – $394.65 | 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.