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 |
|---|---|---|---|---|
| Repair lip full thkns =<one-half vert height CPT 40652 | $988.02 | $1,497.00 | $74.89 – $1,184.95 | 14 |
| Repair lip full thkns >one-half vert height/cmplx CPT 40654 | $1,710.72 | $2,592.00 | $618.42 – $3,408.96 | 14 |
| Repair lower leg tendons CPT 27675 | not published | not published | not published | 0 |
| Repair lower leg tendons CPT 27676 | not published | not published | not published | 0 |
| Repair multi-comp penis pros CPT 54408 | not published | not published | not published | 0 |
| Repair of achilles tendon CPT 27654 | not published | not published | not published | 0 |
| Repair of ankle ligament CPT 27695 | not published | not published | not published | 0 |
| Repair of ankle ligament CPT 27698 | not published | not published | not published | 0 |
| Repair of ankle ligaments CPT 27696 | not published | not published | not published | 0 |
| Repair of digit nerve hand/foot 1 nerve CPT 64831 | not published | not published | not published | 0 |
| Repair of eye wound CPT 65285 | not published | not published | not published | 0 |
| Repair of foot tendon CPT 28200 | not published | not published | not published | 0 |
| Repair of kneecap tendon CPT 27380 | $9,804.30 | $14,855.00 | $1,383.03 – $15,942.51 | 14 |
| Repair of knee ligament CPT 27405 | not published | not published | not published | 0 |
| Repair of leg tendon each CPT 27658 | not published | not published | not published | 0 |
| Repair of leg tendon each CPT 27659 | not published | not published | not published | 0 |
| Repair of metatarsals CPT 28322 | not published | not published | not published | 0 |
| Repair of penis CPT 54440 | not published | not published | not published | 0 |
| Repair of ruptured tendon CPT 24342 | not published | not published | not published | 0 |
| Repair of sperm duct CPT 55400 | not published | not published | not published | 0 |
| Repair of thigh muscle CPT 27385 | not published | not published | not published | 0 |
| Repair pm/icd lead dual CPT 33220 | $6,358.44 | $9,634.00 | $693.47 – $8,210.41 | 14 |
| Repair pm/icd lead sgl CPT 33218 | $6,358.44 | $9,634.00 | $693.47 – $8,210.41 | 14 |
| Repair & revise nerve add-on CPT 64874 | not published | not published | not published | 0 |
| Repair/revise wrist joint CPT 25320 | not published | not published | not published | 0 |
| Repair rotator cuff acute CPT 23410 | not published | not published | not published | 0 |
| Repair rotator cuff chronic CPT 23412 | not published | not published | not published | 0 |
| Repair rpr lac tongue floor mouth > 2.6 cm/cmplx CPT 41252 | $568.26 | $861.00 | $74.89 – $520.38 | 14 |
| Repair rpr lip full thickness vermilion only CPT 40650 | $988.02 | $1,497.00 | $74.89 – $1,184.95 | 14 |
| Repair tendon/muscle forearm/wrist prime sngl ea CPT 25260 | not published | not published | not published | 0 |
| Repair upper arm/elbow tendon/muscle ea CPT 24341 | not published | not published | not published | 0 |
| Repair uro sphincter CPT 53449 | not published | not published | not published | 0 |
| Repair webbed toe(s) CPT 28345 | not published | not published | not published | 0 |
| Replace duod/jej tube perc CPT 49451 | $1,364.88 | $2,068.00 | $165.33 – $1,992.72 | 16 |
| Replace g/c tube perc CPT 49450 | $2,228.82 | $3,377.00 | $122.32 – $1,992.72 | 16 |
| Replace g-j tube perc CPT 49452 | $1,250.04 | $1,894.00 | $171.97 – $1,992.72 | 14 |
| Replace tissue expander w/perm prost 11970 CPT 11970 | not published | not published | not published | 0 |
| Replace tunneled cv cath CPT 36578 | $2,728.44 | $4,134.00 | $325.87 – $6,937.25 | 14 |
| Reposition pm/icd lead CPT 33215 | $3,635.28 | $5,508.00 | $693.47 – $6,937.25 | 14 |
| Repos lv lead pm/icd CPT 33226 | $3,635.28 | $5,508.00 | $3,083.22 – $6,937.25 | 14 |
| Repos sq defib eltrd CPT 33273 | $4,203.54 | $6,369.00 | $693.47 – $8,210.41 | 14 |
| Reptilase test CPT 85635 | $108.90 | $165.00 | $9.85 – $22.16 | 16 |
| Rerepair ing hernia reduce CPT 49520 | not published | not published | not published | 0 |
| Resect foot/toe tumor 3 cm/> CPT 28047 | not published | not published | not published | 0 |
| Respirator motion mgmt simul CPT 77293 | $582.12 | $882.00 | $53.11 – $882.00 | 10 |
| #resp virpnl dfa-adenovirus CPT 87260 | $75.24 | $114.00 | $14.43 – $32.47 | 16 |
| #resp virpnl dfa-parainfluenza CPT 87279 | $75.24 | $114.00 | $16.43 – $36.97 | 16 |
| Resuscitation cardiopulmonary CPT 92950 | $601.92 | $912.00 | $210.85 – $912.00 | 16 |
| Reticulated platelet assay CPT 85055 | $178.86 | $271.00 | $18.97 – $80.42 | 16 |
| Reticulocyte automated CPT 85045 | $30.36 | $46.00 | $3.99 – $8.98 | 16 |
| Revasc intra lithotrip-ather HCPCS C9766 | $20,739.84 | $31,424.00 | $2,731.45 – $40,276.14 | 14 |
| Revasc intra lithotrip-stent HCPCS C9765 | $20,739.84 | $31,424.00 | $2,731.45 – $40,276.14 | 14 |
| Revasc intravasc lithotripsy HCPCS C9764 | $13,098.36 | $19,846.00 | $1,628.87 – $25,363.55 | 14 |
| Revasc lithotr-ather tib/per HCPCS C9774 | $18,078.06 | $27,391.00 | $4,729.17 – $40,276.14 | 14 |
| Revasc lithotrip-stent-ather HCPCS C9767 | $20,739.84 | $31,424.00 | $4,729.17 – $40,276.14 | 14 |
| Revasc lithotrip tibi/perone HCPCS C9772 | $7,914.72 | $11,992.00 | $2,731.45 – $25,363.55 | 14 |
| Revasc lithotr-stent tib/per HCPCS C9773 | $18,078.06 | $27,391.00 | $4,729.17 – $40,276.14 | 14 |
| Revasc lith-sten-ath tib/per HCPCS C9775 | $18,078.06 | $27,391.00 | $4,729.17 – $40,276.14 | 14 |
| Revise aqueous shunt eye CPT 66185 | not published | not published | not published | 0 |
| Revise arm/leg nerve CPT 64708 | not published | not published | not published | 0 |
| Revise breast reconst 19380 CPT 19380 | not published | not published | not published | 0 |
| Revise hip joint replacement CPT 27138 | not published | not published | not published | 0 |
| Revise kneecap with implant CPT 27438 | not published | not published | not published | 0 |
| Revise knuckle joint CPT 26530 | not published | not published | not published | 0 |
| Revise knuckle with implant CPT 26531 | not published | not published | not published | 0 |
| Revise lower leg tendon CPT 27690 | not published | not published | not published | 0 |
| Revise lower leg tendon CPT 27691 | not published | not published | not published | 0 |
| Revise/replace knee joint CPT 27486 | not published | not published | not published | 0 |
| Revise/replace knee joint CPT 27487 | not published | not published | not published | 0 |
| Revise spermatic cord veins CPT 55535 | not published | not published | not published | 0 |
| Revise ulnar nerve at wrist CPT 64719 | not published | not published | not published | 0 |
| Revision of calf tendon CPT 27687 | not published | not published | not published | 0 |
| Revision of foot CPT 28116 | not published | not published | not published | 0 |
| Revision of foot bones CPT 28737 | not published | not published | not published | 0 |
| Revision of foot fascia 28250 CPT 28250 | not published | not published | not published | 0 |
| Revision of foot tendon CPT 28238 | not published | not published | not published | 0 |
| Revision of foot tendon CPT 28261 | not published | not published | not published | 0 |
| Revision of hip bones CPT 27156 | not published | not published | not published | 0 |
| Revision of knee joint CPT 27446 | not published | not published | not published | 0 |
| Revision of penis CPT 54300 | not published | not published | not published | 0 |
| Revision of scrotum CPT 55175 | not published | not published | not published | 0 |
| Revision of thigh muscles CPT 27430 | not published | not published | not published | 0 |
| Revision of unstable kneecap CPT 27422 | not published | not published | not published | 0 |
| Revision of urethra CPT 53450 | not published | not published | not published | 0 |
| Revision tips CPT 37183 | $10,876.14 | $16,479.00 | $2,731.45 – $12,504.84 | 14 |
| Revis reconst shoulder joint CPT 23473 | not published | not published | not published | 0 |
| Revis reconst shoulder joint CPT 23474 | not published | not published | not published | 0 |
| Rev-rem impl neurostim gen-rec CPT 63688 | not published | not published | not published | 0 |
| Revsc opn/prq tib/pero stent CPT 37234 | $6,666.00 | $10,100.00 | $4,729.17 – $5,012.92 | 7 |
| Rf abltj nrv nrvtg si jt CPT 64625 | $3,262.38 | $4,943.00 | $595.28 – $4,290.30 | 14 |
| Rheumatoid factor qualitative CPT 86430 | $42.24 | $64.00 | $6.14 – $13.82 | 16 |
| Rheumatoid factor quantitative CPT 86431 | $38.94 | $59.00 | $5.67 – $12.76 | 16 |
| Rho d immune globulin inj HCPCS J2790 | $94.94 | $143.85 | $42.87 – $131.44 | 10 |
| Rmvl esophgl sphnctr dev CPT 43285 | not published | not published | not published | 0 |
| Rmvl ext fixj sys under anes CPT 20694 | not published | not published | not published | 0 |
| Rmvl fb upr arm/elbow deep CPT 24201 | not published | not published | not published | 0 |
| Rmvl icd by tv extr CPT 33244 | $4,203.54 | $6,369.00 | $693.47 – $8,210.41 | 14 |
| Rmvl icd gen w/rplc icd gen dual lead sys CPT 33263 | $11,482.68 | $17,398.00 | $9,799.05 – $48,871.00 | 14 |
| Rmvl icd gen w/rplc icd gen mlt lead sys CPT 33264 | $15,016.32 | $22,752.00 | $9,799.05 – $68,963.96 | 14 |
| Rmvl icd gen w/rplc icd gen sgl lead sys CPT 33262 | $11,482.68 | $17,398.00 | $9,799.05 – $48,871.00 | 14 |
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.