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 |
|---|---|---|---|---|
| Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 | $55.94 | $84.75 | $5.64 – $18.13 | 5 |
| Prostate biopsy, any mthd HCPCS G0416 | $462.66 | $701.00 | $58.17 – $787.54 | 16 |
| Prostatectomy (turp) CPT 52601 | not published | not published | not published | 0 |
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | $15.08 | $22.85 | $1.51 – $2.81 | 5 |
| Protein c activity CPT 85303 | $108.90 | $165.00 | $13.84 – $31.14 | 16 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $71.94 | $109.00 | $10.74 – $24.17 | 16 |
| Protein s total CPT 85305 | $129.36 | $196.00 | $11.61 – $26.12 | 16 |
| Protein total 24 hour urine CPT 84156 | $27.06 | $41.00 | $3.67 – $8.26 | 16 |
| Protein total body fluid CPT 84157 | $42.90 | $65.00 | $4.00 – $9.00 | 16 |
| Protein total serum plasma whole blood CPT 84155 | $23.76 | $36.00 | $3.67 – $8.26 | 16 |
| Prothrombin time substitution plasma fractions each CPT 85611 | $42.90 | $65.00 | $3.94 – $8.87 | 16 |
| Prp i/hern init block >5 yr CPT 49507 | not published | not published | not published | 0 |
| Prq card angio/athrect addl CPT 92925 | $6,190.14 | $9,379.00 | $3,625.53 – $3,843.06 | 7 |
| Prq cardiac angio addl art CPT 92921 | $4,239.84 | $6,424.00 | $3,625.53 – $3,843.06 | 7 |
| Prq card revasc chronic addl CPT 92944 | $8,982.60 | $13,610.00 | $3,625.53 – $3,843.06 | 7 |
| Prq card revasc mi 1 vsl CPT 92941 | $10,479.48 | $15,878.00 | $3,625.53 – $3,843.06 | 7 |
| Prq card revasc mi 1 vsl drug-eluting HCPCS C9606 | $10,479.48 | $15,878.00 | $3,625.53 – $3,843.06 | 7 |
| Prq card stent/ath/angio CPT 92934 | $10,730.28 | $16,258.00 | $3,625.53 – $3,843.06 | 7 |
| Prq card stent w/angio addl CPT 92929 | $8,234.16 | $12,476.00 | $3,625.53 – $3,843.06 | 7 |
| Prq revasc byp graft 1 art and/or branches CPT 92937 | $13,098.36 | $19,846.00 | $3,625.53 – $25,363.55 | 14 |
| Prq revasc byp graft addl CPT 92938 | $5,539.38 | $8,393.00 | $3,625.53 – $3,843.06 | 7 |
| Prq tcat plmt ntrac st 1 les CPT 92928 | $13,098.36 | $19,846.00 | $3,625.53 – $25,363.55 | 14 |
| Prq trlml c athrc st angiop1 CPT 92933 | $20,739.84 | $31,424.00 | $3,625.53 – $40,276.14 | 14 |
| Prq trluml c angiop 1art&/br CPT 92920 | $6,270.66 | $9,501.00 | $3,625.53 – $12,504.84 | 14 |
| Prq trluml c athrc 1 art&/br CPT 92924 | $10,479.48 | $15,878.00 | $3,625.53 – $25,363.55 | 14 |
| Prq trluml revsc ch occ ant CPT 92943 | $13,098.36 | $19,846.00 | $3,625.53 – $25,363.55 | 14 |
| Pr removal drug delivery implant CPT 11982 | $744.48 | $1,128.00 | $72.99 – $981.49 | 14 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $197.34 | $299.00 | $129.92 – $292.32 | 9 |
| Pr removal intrauterine device CPT 58301 | $351.12 | $532.00 | $93.40 – $669.52 | 14 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $711.48 | $1,078.00 | $168.77 – $893.15 | 14 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $622.38 | $943.00 | $80.58 – $440.81 | 14 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $681.12 | $1,032.00 | $80.58 – $440.81 | 14 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $503.58 | $763.00 | $80.58 – $440.81 | 14 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $553.08 | $838.00 | $80.58 – $440.81 | 14 |
| Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child CPT 15100 | not published | not published | not published | 0 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $1,700.82 | $2,577.00 | $286.04 – $3,458.55 | 16 |
| PSA (Prostate) Test CPT 84153 | $117.48 | $178.00 | $18.39 – $41.38 | 16 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $62.70 | $95.00 | $14.19 – $95.00 | 16 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $77.22 | $117.00 | $14.19 – $117.00 | 16 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $62.70 | $95.00 | $13.84 – $95.00 | 16 |
| Pt application of modality traction mechanical CPT 97012 | $69.96 | $106.00 | $13.88 – $106.00 | 16 |
| Pten gene full sequence CPT 81321 | $1,306.80 | $1,980.00 | $480.56 – $1,350.00 | 16 |
| Pt evaluation high complexity patient/family CPT 97163 | $155.10 | $235.00 | $88.79 – $215.33 | 12 |
| Pt evaluation low complexity patient/family CPT 97161 | $155.10 | $235.00 | $88.79 – $215.33 | 12 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $155.10 | $235.00 | $62.66 – $215.33 | 16 |
| Pt re-evaluation patient/family CPT 97164 | $89.10 | $135.00 | $65.77 – $147.98 | 12 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $130.02 | $197.00 | $16.89 – $197.00 | 12 |
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | $108.90 | $165.00 | $12.19 – $165.00 | 16 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $80.52 | $122.00 | $14.19 – $122.00 | 16 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $69.96 | $106.00 | $14.19 – $106.00 | 16 |
| Pt wheelchair management each 15 minutes CPT 97542 | $56.10 | $85.00 | $16.89 – $85.00 | 16 |
| Pump on-q 100mlx2ml/hr 2 day delivery HCPCS C9804 | $623.70 | $945.00 | $349.65 – $786.71 | 9 |
| Punc of shunt for asp or inj CPT 61070 | $801.24 | $1,214.00 | $105.49 – $1,550.88 | 16 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $129.36 | $196.00 | $23.90 – $292.32 | 16 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $487.74 | $739.00 | $72.99 – $893.15 | 14 |
| Puncture spinal lumbar diagnostic CPT 62270 | $1,019.04 | $1,544.00 | $337.74 – $1,550.88 | 14 |
| Pvb thoracic 2nd+ inj site CPT 64462 | $197.34 | $299.00 | $299.00 – $337.74 | 7 |
| Pvb thoracic cont infusion CPT 64463 | $1,430.22 | $2,167.00 | $337.74 – $1,550.88 | 14 |
| Pvb thoracic single inj site CPT 64461 | $1,321.98 | $2,003.00 | $337.74 – $1,550.88 | 14 |
| Pyruvate CPT 84210 | $89.76 | $136.00 | $14.48 – $32.58 | 16 |
| Pyruvate kinase CPT 84220 | $182.16 | $276.00 | $9.44 – $21.24 | 16 |
| Quest t3 uptake CPT 84479 | $54.12 | $82.00 | $6.47 – $14.56 | 16 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $660.23 | $1,000.35 | $279.95 – $629.89 | 16 |
| Radiation physics consult CPT 77336 | $646.80 | $980.00 | $52.50 – $980.00 | 16 |
| Radiation therapy dose plan CPT 77300 | $599.94 | $909.00 | $52.50 – $909.00 | 16 |
| Radiation treatment aid(s) CPT 77332 | $581.46 | $881.00 | $52.50 – $881.00 | 16 |
| Radiation treatment aid(s) CPT 77333 | $754.38 | $1,143.00 | $52.50 – $1,143.00 | 16 |
| Radiation treatment aid(s) CPT 77334 | $1,512.72 | $2,292.00 | $82.46 – $2,025.50 | 16 |
| Radiation treatment delivery CPT 77402 | $693.66 | $1,051.00 | $79.49 – $1,051.00 | 16 |
| Radiation treatment delivery CPT 77412 | $1,097.58 | $1,663.00 | $79.49 – $1,663.00 | 16 |
| Radiology port images(s) CPT 77417 | $399.96 | $606.00 | $24.82 – $606.00 | 10 |
| Radiotherapy dose plan imrt CPT 77301 | $4,513.08 | $6,838.00 | $470.57 – $3,041.05 | 16 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $1,508.10 | $2,285.00 | $389.13 – $1,246.46 | 16 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $1,584.00 | $2,400.00 | $389.13 – $1,246.46 | 16 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | $1,791.90 | $2,715.00 | $389.13 – $2,844.45 | 16 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $1,682.34 | $2,549.00 | $389.13 – $1,246.46 | 16 |
| Rad resect tumor/neck/ant thor/<5cm21557 CPT 21557 | not published | not published | not published | 0 |
| Rapid Strep Test CPT 87880 | $79.86 | $121.00 | $16.53 – $37.19 | 16 |
| Rbc count only automated CPT 85041 | $14.52 | $22.00 | $3.02 – $6.80 | 16 |
| Realignment of tendons CPT 26437 | not published | not published | not published | 0 |
| Recon, cta for surg plan HCPCS G0288 | $153.78 | $233.00 | $233.00 – $233.00 | 5 |
| Reconstruct ankle joint CPT 27702 | not published | not published | not published | 0 |
| Reconstruction ankle joint CPT 27703 | not published | not published | not published | 0 |
| Reconstruction knee CPT 27427 | not published | not published | not published | 0 |
| Reconstruction of urethra CPT 53410 | not published | not published | not published | 0 |
| Reconstruction of urethra CPT 53415 | not published | not published | not published | 0 |
| Reconstruct shoulder joint CPT 23470 | not published | not published | not published | 0 |
| Reconstruct shoulder joint CPT 23472 | not published | not published | not published | 0 |
| Red blood cells each unit HCPCS P9021 | $343.86 | $521.00 | $55.39 – $338.78 | 14 |
| Red blood cells leukocytes reduced cmv negative irradiated each unit HCPCS P9058 | $619.74 | $939.00 | $55.39 – $561.15 | 14 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $727.32 | $1,102.00 | $184.91 – $476.46 | 14 |
| Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 | $727.32 | $1,102.00 | $55.39 – $597.17 | 14 |
| Reduce testis torsion CPT 54600 | not published | not published | not published | 0 |
| Regadenoson 0.4 mg/5 ml intravenous syringe HCPCS J2785 | $36.53 | $55.35 | $4.42 – $5.76 | 5 |
| Reinforce tibia CPT 27745 | not published | not published | not published | 0 |
| Release of foot tendon 28225 CPT 28225 | not published | not published | not published | 0 |
| Release of lower leg tendon CPT 27680 | not published | not published | not published | 0 |
| Release palm contracture CPT 26123 | not published | not published | not published | 0 |
| Release palm contracture CPT 26125 | not published | not published | not published | 0 |
| Release palm contracture 26045 CPT 26045 | not published | not published | not published | 0 |
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.