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 |
|---|---|---|---|---|
| Urinalysis microscopic only CPT 81015 | $21.78 | $33.00 | $3.05 – $6.86 | 16 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | $64.68 | $98.00 | $2.17 – $4.88 | 16 |
| Urinalysis (with microscopy) CPT 81001 | $38.28 | $58.00 | $3.17 – $7.13 | 16 |
| Urinalysis (without microscopy) CPT 81003 | $35.64 | $54.00 | $2.25 – $5.06 | 16 |
| Urine Culture Test CPT 87086 | $59.40 | $90.00 | $8.07 – $18.16 | 16 |
| Urine pregnancy test CPT 81025 | $59.40 | $90.00 | $8.61 – $19.37 | 16 |
| Urography, antegrade CPT 74425 | $616.44 | $934.00 | $52.32 – $766.50 | 16 |
| Urography inf drip &/or bolus CPT 74410 | $747.78 | $1,133.00 | $52.32 – $456.60 | 16 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $100.12 | $151.70 | $9.41 – $41.56 | 16 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | $706.27 | $1,070.10 | $117.71 – $560.09 | 16 |
| Vaccine rabies im CPT 90675 | $1,084.28 | $1,642.85 | $49.76 – $719.43 | 16 |
| Vaccine tdap >=7 years im CPT 90715 | $146.03 | $221.25 | $9.41 – $71.05 | 11 |
| Valproic acid total therapeutic drug level CPT 80164 | $77.88 | $118.00 | $13.54 – $30.47 | 16 |
| Valvuloplasty aortic CPT 92986 | $6,585.48 | $9,978.00 | $3,625.53 – $12,504.84 | 14 |
| Valvuloplasty mitral CPT 92987 | $13,098.36 | $19,846.00 | $3,625.53 – $25,363.55 | 14 |
| Vancomycin 1,000 mg intravenous injection HCPCS J3373 | $1.52 | $2.30 | $0.05 – $0.05 | 4 |
| Vancomycin 750 mg intravenous solution HCPCS J3374 | $0.79 | $1.19 | $0.17 – $0.18 | 4 |
| Vancomycin peak therapeutic drug level CPT 80202 | $95.70 | $145.00 | $13.54 – $30.47 | 16 |
| Varicella zoster antibody igg CPT 86787 | $68.64 | $104.00 | $8.17 – $28.98 | 16 |
| Vasopressin 20 unit/ml intravenous solution HCPCS J2598 | $17.27 | $26.17 | $0.87 – $3.28 | 5 |
| Veeg unmon 12-26 hrs CPT 95714 | $4,505.16 | $6,826.00 | $198.12 – $819.86 | 16 |
| Veeg unmon 2-12 hrs CPT 95711 | $2,432.76 | $3,686.00 | $146.51 – $474.40 | 16 |
| Vein x-ray adrenal gland CPT 75840 | $3,635.28 | $5,508.00 | $146.08 – $6,937.25 | 16 |
| Vein x-ray adrenal glands CPT 75842 | $6,243.60 | $9,460.00 | $172.86 – $2,071.40 | 11 |
| Vein x-ray eye socket CPT 75880 | $1,346.40 | $2,040.00 | $145.43 – $1,378.24 | 16 |
| Vein x-ray kidney CPT 75831 | $3,635.28 | $5,508.00 | $133.66 – $6,937.25 | 16 |
| Vein x-ray liver CPT 75891 | $5,139.42 | $7,787.00 | $142.17 – $6,937.25 | 16 |
| Vein x-ray liver w/hemodynam CPT 75885 | $3,635.28 | $5,508.00 | $140.86 – $6,937.25 | 16 |
| Vein x-ray liver w/hemodynam CPT 75889 | $6,076.62 | $9,207.00 | $140.88 – $6,937.25 | 16 |
| Vein x-ray skull CPT 75870 | $3,635.28 | $5,508.00 | $191.14 – $6,937.25 | 16 |
| Vein x-ray skull epidural CPT 75872 | $2,176.02 | $3,297.00 | $146.08 – $1,378.24 | 16 |
| Vein x-ray spleen/liver CPT 75810 | $3,635.28 | $5,508.00 | $456.60 – $6,937.25 | 16 |
| Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture) CPT 36410 | $114.84 | $174.00 | $33.22 – $35.21 | 7 |
| Venipuncture <3 yrs other vein CPT 36406 | $27.72 | $42.00 | $1.19 – $1.26 | 7 |
| Venogram ext bil s&i CPT 75822 | $1,794.54 | $2,719.00 | $128.23 – $3,458.55 | 16 |
| Venogram extremity supervision & interpretation unilateral CPT 75820 | $1,794.54 | $2,719.00 | $115.80 – $3,458.55 | 16 |
| Venous mech thrombectomy CPT 37187 | $11,389.62 | $17,257.00 | $1,628.87 – $25,363.55 | 14 |
| Venous m-thrombectomy add-on CPT 37188 | $3,635.28 | $5,508.00 | $1,628.87 – $6,937.25 | 14 |
| Venous sampling s&i CPT 75893 | $6,243.60 | $9,460.00 | $155.88 – $12,225.64 | 16 |
| Version cephalic external CPT 59412 | $3,474.24 | $5,264.00 | $255.06 – $7,112.24 | 14 |
| Very long chain fatty acids CPT 82726 | $225.06 | $341.00 | $19.75 – $44.44 | 16 |
| Visit established high 40-54 minutes/level 5 HCPCS G0463 | not published | not published | not published | 0 |
| Vital capacity test CPT 94150 | $180.84 | $274.00 | $25.49 – $282.71 | 16 |
| Vitamin b-12 CPT 82607 | $89.76 | $136.00 | $15.08 – $33.93 | 16 |
| Vitamin D Test CPT 82306 | $180.18 | $273.00 | $29.60 – $66.60 | 16 |
| Volume measurement urine timed CPT 81050 | $22.44 | $34.00 | $3.64 – $8.19 | 16 |
| Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr HCPCS J3465 | $20.90 | $31.66 | $1.19 – $1.34 | 5 |
| Warde 1003990 aldosterone CPT 82088 | $252.12 | $382.00 | $40.75 – $91.69 | 16 |
| Warde 1005020 citrate 24 hour urine CPT 82507 | $162.36 | $246.00 | $27.80 – $62.55 | 16 |
| Warde 1005055 5-hiaa 24 hour urine CPT 83497 | $81.18 | $123.00 | $12.90 – $29.03 | 16 |
| Warde 1006955 catecholamines fractionated 24 hour urine CPT 82384 | $152.46 | $231.00 | $25.25 – $56.81 | 16 |
| Warde 1007138 vanillymandelic acid 24 hour urine CPT 84585 | $89.76 | $136.00 | $15.50 – $34.88 | 16 |
| Warde 1015200 kappa light chain free CPT 83521 | $81.18 | $123.00 | $17.27 – $38.86 | 16 |
| Warde 3004000 immunoglobulin subclass 1 CPT 82787 | $33.00 | $50.00 | $5.90 – $18.05 | 16 |
| Warde 3008005 oligoclonal bands CPT 83916 | $117.48 | $178.00 | $27.39 – $61.63 | 16 |
| Warde 3016000 west nile virus antibody CPT 86788 | $68.64 | $104.00 | $8.17 – $37.91 | 16 |
| Warde 3016000 west nile virus antibody igg CPT 86789 | $79.86 | $121.00 | $14.39 – $32.38 | 16 |
| Warde 3016300 saccharomyces cerevisiae iga antibody CPT 86671 | $130.02 | $197.00 | $7.15 – $27.56 | 16 |
| Warde 3400652 ova & parasites direct smear concentration and id CPT 87177 | $59.40 | $90.00 | $8.90 – $20.03 | 16 |
| Warde 3400652 smear complex special stain ova/parasites CPT 87209 | $79.86 | $121.00 | $17.98 – $40.46 | 16 |
| Warde 3400852 arsenic CPT 82175 | $72.60 | $110.00 | $18.97 – $42.68 | 16 |
| Warde 3708165 mercury urine CPT 83825 | $81.18 | $123.00 | $16.26 – $36.59 | 16 |
| Warde acetylcholine receptor blocking antibody CPT 86042 | $89.10 | $135.00 | $14.72 – $41.40 | 16 |
| Warde actin (smooth muscle) antibody each CPT 86015 | $67.32 | $102.00 | $11.53 – $27.11 | 16 |
| Warde adenosine deaminase pleural fluid CPT 84311 | $170.94 | $259.00 | $8.10 – $18.23 | 16 |
| Warde adrenocorticotropic hormone (acth) CPT 82024 | $233.64 | $354.00 | $38.62 – $86.90 | 16 |
| Warde aldolase CPT 82085 | $54.12 | $82.00 | $9.71 – $21.85 | 16 |
| Warde amino acids 6 or more quantitative each specimen CPT 82139 | $900.90 | $1,365.00 | $16.87 – $37.96 | 16 |
| Warde amiodarone therapeutic drug level CPT 80151 | $21.78 | $33.00 | $14.91 – $41.94 | 16 |
| Warde analysis gene hfe common variants CPT 81256 | $426.36 | $646.00 | $65.36 – $147.06 | 16 |
| Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative CPT 81206 | $753.06 | $1,141.00 | $163.96 – $368.91 | 16 |
| Warde anti-mullerian hormone CPT 82166 | $81.18 | $123.00 | $38.62 – $86.90 | 16 |
| Warde apolipoprotein b CPT 82172 | $96.36 | $146.00 | $21.09 – $47.45 | 16 |
| Warde bile acids CPT 82239 | $34.32 | $52.00 | $17.12 – $38.52 | 16 |
| Warde cadmium blood CPT 82300 | $72.60 | $110.00 | $23.64 – $53.19 | 16 |
| Warde calcitonin CPT 82308 | $126.06 | $191.00 | $26.79 – $60.28 | 16 |
| Warde calculus (stone) infrared CPT 82365 | $95.04 | $144.00 | $12.90 – $29.03 | 16 |
| Warde clozapine therapeutic drug level CPT 80159 | $69.96 | $106.00 | $20.15 – $45.34 | 16 |
| Warde cobalt heavy metal quantitative each nes CPT 83018 | $99.00 | $150.00 | $21.96 – $49.41 | 16 |
| Warde collagen cross links c-telopeptide CPT 82523 | $99.00 | $150.00 | $14.65 – $42.03 | 16 |
| Warde complement total hemolytic CPT 86162 | $129.36 | $196.00 | $20.32 – $45.72 | 16 |
| Warde copper CPT 82525 | $72.60 | $110.00 | $12.41 – $27.92 | 16 |
| Warde cryoglobulin CPT 82595 | $134.64 | $204.00 | $6.47 – $14.56 | 16 |
| Warde erythropoietin CPT 82668 | $89.76 | $136.00 | $18.79 – $42.28 | 16 |
| Warde estrogen fractionated CPT 82671 | $132.00 | $200.00 | $32.30 – $72.68 | 16 |
| Warde fluorescent antibody screen endomysial iga CPT 86231 | $29.70 | $45.00 | $12.05 – $27.20 | 16 |
| Warde folic acid rbc CPT 82747 | $73.26 | $111.00 | $16.37 – $39.71 | 16 |
| Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative CPT 82955 | $346.50 | $525.00 | $9.70 – $21.83 | 16 |
| Warde gastrin CPT 82941 | $81.18 | $123.00 | $17.63 – $39.67 | 16 |
| Warde growth hormone (hgh) CPT 83003 | $81.18 | $123.00 | $16.67 – $37.51 | 16 |
| Warde haloperidol therapeutic drug level CPT 80173 | $33.66 | $51.00 | $15.78 – $35.51 | 16 |
| Warde helminth antibody strongyloides igg CPT 86682 | $141.24 | $214.00 | $8.17 – $29.27 | 16 |
| Warde hemoglobin fractionation/quantitation electrophoresis CPT 83020 | $118.14 | $179.00 | $6.41 – $28.96 | 16 |
| Warde hepatitis a antibody CPT 86708 | $68.64 | $104.00 | $12.39 – $27.88 | 16 |
| Warde hepatitis be antibody CPT 86707 | $68.64 | $104.00 | $11.57 – $26.03 | 16 |
| Warde hepatitis delta agent antibody CPT 86692 | $116.82 | $177.00 | $17.16 – $38.61 | 16 |
| Warde immunofixation electrophoresis urine CPT 86335 | $198.00 | $300.00 | $29.35 – $66.04 | 16 |
| Warde infectious agent antigen immunoassay ql/sq multi step hepatitis be agn CPT 87350 | $59.40 | $90.00 | $11.53 – $25.94 | 16 |
| Warde infectious agent nucleic acid genotype hepatitis c CPT 87902 | $1,387.32 | $2,102.00 | $257.45 – $579.26 | 16 |
| Warde islet cell antibody zinc transporter 8 CPT 86341 | $227.70 | $345.00 | $19.88 – $53.03 | 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.