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 |
|---|---|---|---|---|
| Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance CPT 20600 | $499.62 | $757.00 | $108.83 – $674.40 | 14 |
| Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides) CPT 20610 | $1,416.36 | $2,146.00 | $108.83 – $674.40 | 14 |
| Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604 CPT 20604 | $850.74 | $1,289.00 | $202.86 – $674.40 | 14 |
| Arthrodes/ant/cerv below c2 ea add 22552 CPT 22552 | not published | not published | not published | 0 |
| Arthrodesis/combine app/ea add 22634 CPT 22634 | not published | not published | not published | 0 |
| Arthrodesis pantalar CPT 28705 | not published | not published | not published | 0 |
| Arthrodesis/post interbdy/ea add 22632 CPT 22632 | not published | not published | not published | 0 |
| Arthrodesis/sng lev/ea add ver seg 22614 CPT 22614 | not published | not published | not published | 0 |
| Arthrodesis subtalar CPT 28725 | not published | not published | not published | 0 |
| Arthrodesis triple CPT 28715 | not published | not published | not published | 0 |
| Arthro shoulder surgical distal claviculectomy incl/distal art surf left (rest method ii cah) CPT 29824 | not published | not published | not published | 0 |
| Arthrotomy carpometacarpal joint 26070 CPT 26070 | not published | not published | not published | 0 |
| Arthrp ntrcrp/crp/mtcr ntrps CPT 25447 | not published | not published | not published | 0 |
| Arthrp ntrcrpl/crp/mtcrp ssp CPT 25448 | not published | not published | not published | 0 |
| Arthrt elbw jt expl bx rmvl CPT 24101 | not published | not published | not published | 0 |
| Arth shld srg decompr subacrml sp w/prt acrmplsty w/crccrml sep proc lt(rest method ii cah) CPT 29826 | not published | not published | not published | 0 |
| Asp core fat pad CPT 17999 | $199.32 | $302.00 | $72.99 – $440.81 | 14 |
| Asp & inj bone cyst CPT 20615 | $909.48 | $1,378.00 | $202.86 – $1,555.83 | 16 |
| Aspirate bladder/sprapubic cath 51102 CPT 51102 | $3,162.72 | $4,792.00 | $688.39 – $4,592.75 | 16 |
| Aspirate/inj ganglion cyst 20612 CPT 20612 | $483.78 | $733.00 | $108.83 – $674.40 | 14 |
| Aspirate pleura without imaging 32554 CPT 32554 | $1,087.02 | $1,647.00 | $166.81 – $1,378.24 | 16 |
| Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion CPT 10005 | $1,250.04 | $1,894.00 | $301.92 – $1,555.83 | 14 |
| Assay acid phosphatase CPT 84060 | $83.82 | $127.00 | $7.64 – $17.19 | 16 |
| Assay myeloperoxidase CPT 83876 | $100.98 | $153.00 | $19.54 – $114.44 | 16 |
| Assay of glucosidase CPT 82963 | $308.88 | $468.00 | $21.48 – $48.33 | 16 |
| Assay of glutathione CPT 82978 | $208.56 | $316.00 | $15.45 – $34.76 | 16 |
| Assay of interleukin-6 (il-6) CPT 83529 | $87.12 | $132.00 | $17.27 – $38.86 | 16 |
| Assay of leflunomide CPT 80193 | $120.12 | $182.00 | $38.57 – $86.78 | 16 |
| Assay of osteocalcin CPT 83937 | $59.40 | $90.00 | $29.85 – $67.16 | 16 |
| Assay of procainamide w/metab CPT 80192 | $92.40 | $140.00 | $16.75 – $37.69 | 16 |
| Assay of prostaglandin CPT 84150 | $324.72 | $492.00 | $35.09 – $93.98 | 16 |
| Assay of tyrosine CPT 84510 | $114.18 | $173.00 | $10.63 – $23.92 | 16 |
| Assay of urine sulfate CPT 84392 | $29.04 | $44.00 | $5.49 – $12.35 | 16 |
| Assay phosphatidylglycerol CPT 84081 | $350.46 | $531.00 | $16.52 – $37.17 | 16 |
| Assay phosphohexose enzymes CPT 84087 | $346.50 | $525.00 | $10.73 – $24.14 | 16 |
| Assay toxin or antitoxin CPT 87230 | $115.50 | $175.00 | $19.74 – $44.42 | 16 |
| Assess cyst contrast inject CPT 49424 | $660.00 | $1,000.00 | $69.99 – $495.60 | 11 |
| Assessment leukocyte fecal qualitative/semiquantitative CPT 89055 | $36.30 | $55.00 | $4.27 – $9.61 | 16 |
| Assist-bilat spinal disk surgery add-on 63035 CPT 63035 | not published | not published | not published | 0 |
| Ast/sgot CPT 84450 | $32.34 | $49.00 | $5.18 – $11.66 | 16 |
| Asxl1 full gene sequence CPT 81175 | $1,473.12 | $2,232.00 | $565.61 – $1,522.13 | 16 |
| Athrectomy fem/pop/unilateral 37225 CPT 37225 | $20,739.84 | $31,424.00 | $4,729.17 – $5,012.92 | 7 |
| Athrectomy tib/pero/unilat/ini ves 37229 CPT 37229 | $20,739.84 | $31,424.00 | $4,729.17 – $5,012.92 | 7 |
| Atropine 0.1 mg/ml injection syringe HCPCS J0461 | $0.83 | $1.25 | $0.14 – $0.18 | 5 |
| Attn at delivery+ 1 stabilization of newborn 99464 CPT 99464 | $252.12 | $382.00 | $382.00 – $382.00 | 1 |
| Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body CPT 22515 | $4,810.74 | $7,289.00 | $1,215.09 – $2,312.55 | 11 |
| Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic CPT 22513 | $8,251.32 | $12,502.00 | $1,215.09 – $15,942.51 | 16 |
| Autologous blood op salvage CPT 86891 | $943.80 | $1,430.00 | $37.44 – $1,770.15 | 16 |
| Autologous blood process CPT 86890 | $292.38 | $443.00 | $37.44 – $374.32 | 16 |
| Automated diff wbc count CPT 85004 | $38.28 | $58.00 | $6.47 – $14.56 | 16 |
| Avul nail plate addl CPT 11732 | $212.52 | $322.00 | $29.40 – $31.16 | 7 |
| Avulsion nail plate partial/complete simple single nail plate CPT 11730 | $404.00 | $404.00 | $29.40 – $440.81 | 14 |
| Azathioprine 50 mg tablet HCPCS J7500 | $2.64 | $4.00 | $0.10 – $3.11 | 5 |
| Azithromycin 500 mg intravenous solution HCPCS J0456 | $70.22 | $106.40 | $3.37 – $3.71 | 5 |
| Aztreonam 1 gram solution for injection HCPCS J0457 | $13.93 | $21.11 | $3.62 – $3.99 | 5 |
| Baclofen eval charges CPT 97750 | $80.52 | $122.00 | $16.89 – $122.00 | 12 |
| Bacterial meningitis antigen CPT 86403 | $82.50 | $125.00 | $11.54 – $25.97 | 16 |
| Bacterial vaginosis pcr CPT 87801 | $475.86 | $721.00 | $50.62 – $157.95 | 16 |
| Balloon dilate urtrl strix CPT 50706 | $617.10 | $935.00 | $935.00 – $3,012.50 | 7 |
| Bartonella dna pcr-sendout CPT 87471 | $351.12 | $532.00 | $35.09 – $78.95 | 16 |
| B cells total count CPT 86355 | $256.74 | $389.00 | $37.73 – $84.89 | 16 |
| Bebtelovimab injection HCPCS M0222 | $404.58 | $613.00 | $20.47 – $21.70 | 7 |
| Benign lesion paring 2-4 CPT 11056 | $227.04 | $344.00 | $72.99 – $440.81 | 14 |
| #_benzodiazconfur CPT 80346 | $131.34 | $199.00 | $4.99 – $39.00 | 10 |
| Beta 2 glycoprotein 1 antibody iga CPT 86146 | $74.58 | $113.00 | $8.17 – $57.26 | 16 |
| Beta-2 microglobulin CPT 82232 | $99.00 | $150.00 | $16.18 – $36.41 | 16 |
| Bilateral n block inj occipital 64405 CPT 64405 | $919.38 | $1,393.00 | $176.37 – $674.40 | 14 |
| Bilateral n block inj trigeminal 64400 CPT 64400 | $742.50 | $1,125.00 | $176.37 – $674.40 | 14 |
| Bilicheck CPT 88720 | $31.02 | $47.00 | $3.63 – $11.30 | 16 |
| Bilirubin direct CPT 82248 | $35.64 | $54.00 | $4.70 – $11.30 | 16 |
| Bilirubin total CPT 82247 | $35.64 | $54.00 | $4.24 – $11.30 | 16 |
| Binder abdominal lg 12 x 62-74 HCPCS L0625 | $54.12 | $82.00 | $45.46 – $102.29 | 9 |
| Biopsy abdominal mass CPT 49180 | $1,627.56 | $2,466.00 | $318.99 – $3,628.70 | 14 |
| Biopsy bone trocar/needle superficial CPT 20220 | $1,871.10 | $2,835.00 | $301.92 – $3,628.70 | 14 |
| Biopsy cervixsingle/multiple 57500 CPT 57500 | $1,087.02 | $1,647.00 | $95.40 – $2,023.63 | 14 |
| Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides) CPT 38222 | $2,874.30 | $4,355.00 | $732.42 – $6,381.90 | 14 |
| Biopsy muscle percutaneous needle CPT 20206 | $1,871.10 | $2,835.00 | $301.92 – $3,628.70 | 14 |
| Biopsy needle liver percutaneous CPT 47000 | $1,627.56 | $2,466.00 | $318.99 – $3,628.70 | 16 |
| Biopsy needle lymph node superficial CPT 38505 | $2,046.00 | $3,100.00 | $534.68 – $3,628.70 | 14 |
| Biopsy of penis 54100 CPT 54100 | not published | not published | not published | 0 |
| Biopsy of prostate CPT 55700 | $2,366.10 | $3,585.00 | $752.65 – $797.81 | 7 |
| Biopsy of salivary gland 42400 CPT 42400 | $1,087.02 | $1,647.00 | $102.05 – $1,555.83 | 16 |
| Biopsy of testis CPT 54505 | not published | not published | not published | 0 |
| Biopsy/removal lymph nodes CPT 38525 | not published | not published | not published | 0 |
| Biopsy renal percutaneous trocar/needle (both sides) CPT 50200 | $1,627.56 | $2,466.00 | $647.32 – $3,628.70 | 16 |
| Biopsy skin incisional single lesion CPT 11106 | $706.86 | $1,071.00 | $185.89 – $1,623.80 | 14 |
| Biopsy/soft tissue/neck or thorax 21550 CPT 21550 | $2,175.36 | $3,296.00 | $1,023.67 – $3,628.70 | 14 |
| Biospy of bladder CPT 53899 | $1,082.40 | $1,640.00 | $243.97 – $686.16 | 14 |
| Biotinidase - quest CPT 82261 | $102.30 | $155.00 | $16.87 – $37.96 | 16 |
| Bivalirudin HCPCS J0583 | $7.36 | $11.15 | $0.26 – $42.87 | 11 |
| Bladder irrigate/lavage/instill 51700 CPT 51700 | $474.54 | $719.00 | $38.07 – $548.94 | 14 |
| Bld prd mix CPT 86965 | $198.00 | $300.00 | $37.44 – $374.32 | 16 |
| Blepharoplasty upper 15822 CPT 15822 | not published | not published | not published | 0 |
| Blepharoplasty upper eyelid 15823 CPT 15823 | not published | not published | not published | 0 |
| Bln 1.2 mono emrg 15x1.2 HCPCS C1725 | $3,620.10 | $5,485.00 | $400.95 – $400.95 | 1 |
| Bln 30frx10mmx12cm renal nephromax HCPCS C1726 | $3,267.00 | $4,950.00 | $36.14 – $36.14 | 1 |
| Block brachial plexus w/cath plmt w/img CPT 64416 | $2,269.08 | $3,438.00 | $565.72 – $1,943.26 | 14 |
| Block femoral nerve cont infusion cath w/img CPT 64448 | $1,028.28 | $1,558.00 | $565.72 – $1,943.26 | 14 |
| Block tap inj(s) w/wo img bi CPT 64488 | $962.94 | $1,459.00 | $565.72 – $599.67 | 7 |
| Block tap inj(s) w/wo img uni CPT 64486 | $869.88 | $1,318.00 | $176.37 – $186.95 | 7 |
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.