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 |
|---|---|---|---|---|
| Ther nma rdctj intus/obstrcj CPT 74283 | $704.22 | $1,067.00 | $52.32 – $456.60 | 16 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $24.24 | $36.72 | $2.99 – $3.30 | 5 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | $1,364.88 | $2,068.00 | $206.23 – $1,378.24 | 16 |
| Thor rib belt custom fabrica HCPCS L0220 | $128.04 | $194.00 | $165.81 – $373.07 | 9 |
| Thrombectmy crnry perq mechanical CPT 92973 | $3,218.82 | $4,877.00 | $3,625.53 – $3,843.06 | 7 |
| Thrombectomy/inf pq dialysis circuit CPT 36904 | $10,075.56 | $15,266.00 | $1,628.87 – $12,504.84 | 14 |
| Thrombectomy/inf pq dialysis circuit w/pta CPT 36905 | $20,413.80 | $30,930.00 | $2,731.45 – $25,363.55 | 14 |
| Thrombectomy/inf pq dialysis circuit w/stent plcmnt CPT 36906 | $32,652.84 | $49,474.00 | $4,729.17 – $40,276.14 | 14 |
| Thrombin time CPT 85670 | $89.10 | $135.00 | $1.59 – $12.98 | 16 |
| Thromboplastin inhibition CPT 85705 | $49.50 | $75.00 | $8.17 – $21.67 | 16 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $68.64 | $104.00 | $6.47 – $14.56 | 16 |
| Thyroglobulin antibody CPT 86800 | $108.90 | $165.00 | $15.91 – $35.80 | 16 |
| Thyroid imaging CPT 78013 | $694.98 | $1,053.00 | $162.47 – $1,053.00 | 16 |
| Thyroid mets imag whole body CPT 78018 | $1,493.58 | $2,263.00 | $162.47 – $1,246.46 | 16 |
| Thyroid (TSH) Test CPT 84443 | $99.00 | $150.00 | $16.80 – $37.80 | 16 |
| Thyroid Ultrasound CPT 76536 | $552.42 | $837.00 | $24.16 – $521.52 | 16 |
| Thyroid uptake measurement CPT 78012 | $463.98 | $703.00 | $162.47 – $878.33 | 16 |
| Thyroxine binding globulin (tbg) CPT 84442 | $65.34 | $99.00 | $14.78 – $33.26 | 16 |
| Tib/per revasc stent & ather 37231 CPT 37231 | $20,739.84 | $31,424.00 | $4,729.17 – $5,012.92 | 7 |
| Tib/per revasc stnt & ather CPT 37235 | $8,332.50 | $12,625.00 | $4,729.17 – $5,012.92 | 7 |
| Tib/per revasc w/ather add-on 37233 CPT 37233 | $5,332.80 | $8,080.00 | $4,729.17 – $5,012.92 | 7 |
| Tilt table study CPT 93660 | $1,745.04 | $2,644.00 | $73.27 – $819.86 | 14 |
| Tissue culture placenta CPT 88235 | $483.78 | $733.00 | $70.04 – $338.18 | 16 |
| Tissue culture skin/biopsy CPT 88233 | $735.24 | $1,114.00 | $70.04 – $316.64 | 16 |
| Tissue culture tumor CPT 88239 | $520.74 | $789.00 | $70.04 – $331.92 | 16 |
| Tissue exam koh skin/hair/nails CPT 87220 | $47.52 | $72.00 | $4.27 – $9.61 | 16 |
| Tissue transglutaminase iga CPT 86364 | $32.34 | $49.00 | $11.53 – $25.94 | 16 |
| Tixagev and cilgav inj HCPCS M0220 | $80.52 | $122.00 | $122.00 – $150.50 | 7 |
| Tlh w/t/o 250 g or less CPT 58571 | not published | not published | not published | 0 |
| Tnot opn elbw to sho ea tdn CPT 24310 | not published | not published | not published | 0 |
| Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 | $27.06 | $41.00 | $3.42 – $4.06 | 5 |
| Tobramycin peak therapeutic drug level CPT 80200 | $77.88 | $118.00 | $16.13 – $36.29 | 16 |
| Tocilizumab 162 mg/0.9 ml subcutaneous pen injector HCPCS J3262 | $17.88 | $27.09 | $5.61 – $427.58 | 16 |
| Tonsillectomy (age 12+) CPT 42826 | not published | not published | not published | 0 |
| Total hip arthroplasty CPT 27132 | not published | not published | not published | 0 |
| Total Hip Replacement CPT 27130 | not published | not published | not published | 0 |
| Total Knee Replacement CPT 27447 | not published | not published | not published | 0 |
| Total tau CPT 84394 | $468.60 | $710.00 | $128.92 – $290.07 | 11 |
| Tot disc arthrp 1ntrspc crv CPT 22856 | not published | not published | not published | 0 |
| Tot disc arthrp ant appr disc 2nd level cervi 22858 CPT 22858 | not published | not published | not published | 0 |
| Toxoplasma antibody igg CPT 86777 | $99.00 | $150.00 | $14.39 – $32.38 | 16 |
| Toxoplasma antibody igm CPT 86778 | $89.10 | $135.00 | $14.41 – $32.42 | 16 |
| Tp53 gene full gene sequence CPT 81351 | $1,083.72 | $1,642.00 | $513.48 – $1,444.16 | 16 |
| Tp53 gene trgt sequence alys CPT 81352 | $790.68 | $1,198.00 | $329.51 – $741.40 | 16 |
| Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution HCPCS J3290 | $0.17 | $0.25 | $0.21 – $0.21 | 1 |
| Transcath biopsy CPT 37200 | $6,243.60 | $9,460.00 | $1,628.87 – $12,225.64 | 14 |
| Transcath closure of asd CPT 93580 | $18,034.50 | $27,325.00 | $6,378.61 – $40,276.14 | 14 |
| Transcatheter bx s&i CPT 75970 | $2,337.72 | $3,542.00 | $89.39 – $953.54 | 11 |
| Transcath occlusion cns CPT 61624 | $5,532.12 | $8,382.00 | $6,215.80 – $40,276.14 | 14 |
| Transcath occlusion non-cns CPT 61626 | $13,098.36 | $19,846.00 | $6,215.80 – $25,363.55 | 14 |
| Transcath rmvl perm ldss pmkr rv CPT 33275 | $5,018.64 | $7,604.00 | $3,083.22 – $6,937.25 | 14 |
| Transferrin CPT 84466 | $43.56 | $66.00 | $12.76 – $28.71 | 16 |
| Transfusion blood/blood component(s) CPT 36430 | $883.74 | $1,339.00 | $178.54 – $969.30 | 14 |
| Transplant forearm tendon CPT 25310 | not published | not published | not published | 0 |
| Transplant hand tendon CPT 26480 | not published | not published | not published | 0 |
| Trauma partial team response w/critical care services level 4 HCPCS G0390 | $2,693.46 | $4,081.00 | $1,301.56 – $2,244.55 | 2 |
| Treat big toe fracture CPT 28505 | not published | not published | not published | 0 |
| Treat ectopic pregnancy CPT 59151 | not published | not published | not published | 0 |
| Treat elbow dislocation CPT 24605 | $1,848.66 | $2,801.00 | $426.70 – $3,532.89 | 14 |
| Treat elbow dislocation CPT 24615 | not published | not published | not published | 0 |
| Treat elbow fracture CPT 24620 | not published | not published | not published | 0 |
| Treat finger fracture each CPT 26727 | not published | not published | not published | 0 |
| Treat finger fracture each CPT 26742 | $1,848.66 | $2,801.00 | $203.37 – $3,532.89 | 14 |
| Treat fracture of radius CPT 25505 | $3,712.50 | $5,625.00 | $203.37 – $3,532.89 | 14 |
| Treat fracture of radius CPT 25520 | $3,754.08 | $5,688.00 | $203.37 – $3,532.89 | 14 |
| Treat hand dislocation CPT 26685 | not published | not published | not published | 0 |
| Treat heel fracture CPT 28415 | not published | not published | not published | 0 |
| Treat hip dislocation CPT 27252 | $1,848.66 | $2,801.00 | $426.70 – $3,532.89 | 14 |
| Treat humerus fracture CPT 24515 | not published | not published | not published | 0 |
| Treat humerus fracture CPT 24582 | not published | not published | not published | 0 |
| Treat kneecap fracture CPT 27524 | not published | not published | not published | 0 |
| Treat knee fracture CPT 27540 | not published | not published | not published | 0 |
| Treat knuckle dislocation CPT 26715 | not published | not published | not published | 0 |
| Treat lower leg fracture CPT 27827 | not published | not published | not published | 0 |
| Treat lower leg fracture CPT 27828 | not published | not published | not published | 0 |
| Treat lower leg joint CPT 27829 | not published | not published | not published | 0 |
| Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah) CPT 25608 | not published | not published | not published | 0 |
| Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah) CPT 25609 | not published | not published | not published | 0 |
| Treatment fx radial distal open w/internal fixation left (restricted method ii cah) CPT 25607 | not published | not published | not published | 0 |
| Treatment incomplete abortion completed surgically any trimester CPT 59812 | not published | not published | not published | 0 |
| Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour CPT 94644 | $240.90 | $365.00 | $25.49 – $292.32 | 16 |
| Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour CPT 94645 | $39.60 | $60.00 | $25.49 – $60.00 | 10 |
| Treatment inhalation pressurized/nonpressurized acute airway obstruction CPT 94640 | $266.64 | $404.00 | $25.49 – $481.11 | 16 |
| Treatment of ankle fracture CPT 27792 | not published | not published | not published | 0 |
| Treatment of ankle fracture CPT 27814 | not published | not published | not published | 0 |
| Treatment of ankle fracture CPT 27822 | not published | not published | not published | 0 |
| Treatment of ankle fracture CPT 27823 | not published | not published | not published | 0 |
| Treatment of foot infection CPT 28002 | not published | not published | not published | 0 |
| Treatment of penis lesion CPT 54110 | not published | not published | not published | 0 |
| Treatment of penis lesion CPT 54115 | $6,753.12 | $10,232.00 | $871.34 – $6,381.90 | 14 |
| Treatment of tibia fracture CPT 27759 | not published | not published | not published | 0 |
| Treatment of toe fracture 28510 CPT 28510 | $629.64 | $954.00 | $203.37 – $541.95 | 14 |
| Treatment radiation delivery level 2 CPT 77407 | $867.24 | $1,314.00 | $79.49 – $1,314.00 | 16 |
| Treat metacarpal fracture CPT 26608 | not published | not published | not published | 0 |
| Treat metacarpal fracture CPT 26615 | not published | not published | not published | 0 |
| Treat metatarsal fracture CPT 28485 | not published | not published | not published | 0 |
| Treat penis lesion graft CPT 54111 | not published | not published | not published | 0 |
| Treat penis lesion graft CPT 54112 | not published | not published | not published | 0 |
| Treat thigh fracture CPT 27235 | not published | not published | not published | 0 |
| Treat toe dislocation CPT 28666 | 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.