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 |
|---|---|---|---|---|
| Blood clot lysis time CPT 85175 | $68.64 | $104.00 | $6.40 – $45.83 | 16 |
| Blood Clotting (PT/INR) Test CPT 85610 | $31.68 | $48.00 | $4.29 – $9.65 | 16 |
| Blood Clotting (PTT) Test CPT 85730 | $91.08 | $138.00 | $6.01 – $13.52 | 16 |
| Blood Count (CBC) Test CPT 85025 | $59.40 | $90.00 | $7.77 – $17.48 | 16 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $43.56 | $66.00 | $6.47 – $14.56 | 16 |
| Blood Culture Test CPT 87040 | $99.00 | $150.00 | $10.32 – $23.22 | 16 |
| Blood draw capillary 36416 CPT 36416 | $21.12 | $32.00 | $1.19 – $19.20 | 11 |
| Blood gases o2 saturation direct measurement CPT 82805 | $174.90 | $265.00 | $39.91 – $177.23 | 16 |
| Blood gases ph venous CPT 82800 | $67.32 | $102.00 | $11.00 – $24.75 | 16 |
| Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic CPT 82274 | $99.00 | $150.00 | $15.92 – $35.82 | 16 |
| Blood occult feces 1-3 determinations other than neoplasm screening qualitative CPT 82272 | $22.44 | $34.00 | $4.23 – $9.52 | 16 |
| Blood occult feces colorectal neoplasm screening qualitative CPT 82270 | $21.12 | $32.00 | $3.66 – $9.86 | 16 |
| Blood occult peroxidase activity qualitative gastric CPT 82271 | $24.42 | $37.00 | $4.26 – $11.97 | 16 |
| Blood smear microscopic w manual differential wbc count CPT 85007 | $31.02 | $47.00 | $3.80 – $8.55 | 16 |
| Blood typing abo CPT 86900 | $129.36 | $196.00 | $3.09 – $292.32 | 16 |
| Blood typing ag donor ea ag CPT 86902 | $361.02 | $547.00 | $5.37 – $787.54 | 16 |
| Blood typing patient serum CPT 86904 | $68.64 | $104.00 | $13.37 – $129.61 | 16 |
| Blood typing rbc ag non abo/rh ea CPT 86905 | $361.02 | $547.00 | $3.96 – $787.54 | 16 |
| Blood typing rh (d) CPT 86901 | $39.60 | $60.00 | $3.09 – $82.06 | 16 |
| Blood typing rh phenotype complete reference CPT 86906 | $66.00 | $100.00 | $8.01 – $82.06 | 16 |
| Bone biopsy open superficial CPT 20240 | not published | not published | not published | 0 |
| Bone Density Scan (DEXA) CPT 77080 | $592.02 | $897.00 | $34.86 – $456.60 | 16 |
| Bone imaging multiple areas CPT 78305 | $1,170.18 | $1,773.00 | $162.47 – $1,246.46 | 16 |
| Bone/joint imaging ltd area CPT 78300 | $951.06 | $1,441.00 | $162.47 – $1,246.46 | 16 |
| Bone marrow;aspiration only 38220 CPT 38220 | $1,871.10 | $2,835.00 | $732.42 – $3,628.70 | 14 |
| Bone marrow aspir bone grfg CPT 20939 | not published | not published | not published | 0 |
| Bone marrow biopsyneedle/trocar 38221 CPT 38221 | $1,871.10 | $2,835.00 | $732.42 – $3,628.70 | 14 |
| Bone marrow harvest autolog CPT 38232 | not published | not published | not published | 0 |
| Bone marrow interpretation CPT 85097 | $943.80 | $1,430.00 | $113.15 – $1,770.15 | 16 |
| Bone/skin graft iliac crest CPT 20970 | not published | not published | not published | 0 |
| Boot j walker l HCPCS L4386 | $237.60 | $360.00 | $227.89 – $512.75 | 9 |
| Boot walker genesis full shell 3-strap s HCPCS L4360 | $382.80 | $580.00 | $370.54 – $833.72 | 9 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | $118.14 | $179.00 | $17.03 – $38.32 | 16 |
| Borrelia miyamotoi amp prb CPT 87478 | $99.66 | $151.00 | $35.09 – $78.95 | 16 |
| Bowel imaging CPT 78290 | $1,243.44 | $1,884.00 | $162.47 – $1,246.46 | 16 |
| Brace ank air stirrup univ HCPCS L4350 | $145.20 | $220.00 | $139.12 – $313.02 | 9 |
| Brace m arm board HCPCS L3809 | $349.80 | $530.00 | $329.74 – $741.91 | 9 |
| Brace oths wrist hnd fngr without HCPCS L3807 | $168.96 | $256.00 | $256.00 – $618.61 | 9 |
| Brace wrist classic lft sm HCPCS L3908 | $113.52 | $172.00 | $84.20 – $189.45 | 9 |
| Brach/thor cath 1st CPT 36215 | $714.78 | $1,083.00 | $302.34 – $320.48 | 7 |
| Brach/thor cath 2nd CPT 36216 | $1,450.68 | $2,198.00 | $302.34 – $320.48 | 7 |
| Brach/thor cath 3rd CPT 36217 | $1,553.64 | $2,354.00 | $302.34 – $320.48 | 7 |
| Brach/thor cath addl CPT 36218 | $693.66 | $1,051.00 | $302.34 – $320.48 | 7 |
| Braf gene CPT 81210 | $475.20 | $720.00 | $143.40 – $394.65 | 16 |
| Brain image w/flow < 4 views CPT 78601 | $1,535.82 | $2,327.00 | $162.47 – $1,246.46 | 16 |
| Brain image w/flow 4 + views CPT 78606 | $1,828.86 | $2,771.00 | $162.47 – $1,246.46 | 16 |
| Brain MRA (blood vessel MRI, with and without contrast) CPT 70546 | $2,667.72 | $4,042.00 | $217.39 – $1,444.47 | 16 |
| Brain MRA (blood vessel MRI, with contrast) CPT 70545 | $2,425.50 | $3,675.00 | $217.39 – $1,444.47 | 16 |
| Brain MRA (blood vessel MRI, without contrast) CPT 70544 | $2,310.00 | $3,500.00 | $217.39 – $1,444.47 | 16 |
| Brain MRI (with and without contrast) CPT 70553 | $2,857.80 | $4,330.00 | $136.27 – $1,444.47 | 16 |
| Brain MRI (with contrast) CPT 70552 | $2,591.82 | $3,927.00 | $179.97 – $1,444.47 | 16 |
| Brain MRI (without contrast) CPT 70551 | $2,360.16 | $3,576.00 | $93.20 – $565.00 | 16 |
| Brcassure comprehensive panel-sendout CPT 81162 | $2,108.04 | $3,194.00 | $1,471.63 – $4,105.98 | 16 |
| Breast augmentation 19325 CPT 19325 | not published | not published | not published | 0 |
| Breast Biopsy (ultrasound-guided, percutaneous) CPT 19083 | $3,779.16 | $5,726.00 | $588.15 – $3,628.70 | 14 |
| Breast punct aspir cyst, bil CPT 19000 | $812.46 | $1,231.00 | $301.92 – $1,555.83 | 14 |
| Breast reconstruction 19357 CPT 19357 | not published | not published | not published | 0 |
| Breast reduction CPT 19318 | not published | not published | not published | 0 |
| Breath hydrogen test 91065 CPT 91065 | not published | not published | not published | 0 |
| Breath tst attain/anal c-14 CPT 78267 | $351.12 | $532.00 | $9.88 – $24.89 | 16 |
| Bronch ebus ivntj perph les 31654 CPT 31654 | $398.64 | $604.00 | $604.00 – $1,614.34 | 7 |
| Bronch ebus samplng 1/2 node CPT 31652 | $2,448.60 | $3,710.00 | $1,614.34 – $8,191.49 | 14 |
| Bronch ebus samplng 3/> node CPT 31653 | $3,457.74 | $5,239.00 | $1,614.34 – $8,191.49 | 14 |
| Bronchial allergy tests CPT 95070 | $613.14 | $929.00 | $20.53 – $819.86 | 16 |
| Bronchial challenge CPT 94070 | $925.32 | $1,402.00 | $45.62 – $819.86 | 16 |
| Bronchial valve addl insert CPT 31651 | $839.52 | $1,272.00 | $1,272.00 – $1,614.34 | 7 |
| Bronchial valve init insert CPT 31647 | $7,995.24 | $12,114.00 | $1,614.34 – $15,505.83 | 14 |
| Bronchial valve remov addl CPT 31649 | $1,991.88 | $3,018.00 | $1,614.34 – $3,910.59 | 14 |
| Bronchial valve remov init CPT 31648 | $4,258.32 | $6,452.00 | $1,614.34 – $8,191.49 | 14 |
| Bronchoscopy bronch stents CPT 31636 | $7,995.24 | $12,114.00 | $1,614.34 – $15,505.83 | 14 |
| Bronchoscopy clear airways 31645 CPT 31645 | not published | not published | not published | 0 |
| Bronchoscopy dilate w/stent CPT 31631 | $7,995.24 | $12,114.00 | $1,614.34 – $15,505.83 | 14 |
| Bronchoscopy/lung bx addl 31632 CPT 31632 | $2,200.44 | $3,334.00 | $792.34 – $839.88 | 7 |
| Bronchoscopy/lung bx each 31628 CPT 31628 | $4,258.32 | $6,452.00 | $792.34 – $8,191.49 | 14 |
| Bronchoscopy/needle bx addl 31633 CPT 31633 | $2,200.44 | $3,334.00 | $792.34 – $839.88 | 7 |
| Bronchoscopy/needle bx each 31629 CPT 31629 | $4,258.32 | $6,452.00 | $792.34 – $8,191.49 | 14 |
| Bronchoscopy revise stent CPT 31638 | $7,995.24 | $12,114.00 | $1,614.34 – $15,505.83 | 14 |
| Bronchoscopy stent add-on CPT 31637 | $1,259.28 | $1,908.00 | $1,614.34 – $1,711.20 | 7 |
| Bronchoscopy treat blockage CPT 31641 | $2,238.72 | $3,392.00 | $1,614.34 – $8,191.49 | 14 |
| Bronchoscopy w/biopsy(s) 31625 CPT 31625 | $2,028.84 | $3,074.00 | $792.34 – $3,910.59 | 14 |
| Bronchoscopy w/fb removal 31635 CPT 31635 | $2,238.72 | $3,392.00 | $792.34 – $3,910.59 | 14 |
| Bronchoscopy w/markers CPT 31626 | $7,995.24 | $12,114.00 | $792.34 – $15,505.83 | 14 |
| Bronch thermoplsty 1 lobe CPT 31660 | $7,995.24 | $12,114.00 | $1,614.34 – $15,505.83 | 14 |
| Bronch thermoplsty 2/> lobes CPT 31661 | $7,995.24 | $12,114.00 | $1,614.34 – $15,505.83 | 14 |
| Br punct aspir ea add, l CPT 19001 | $374.88 | $568.00 | $301.92 – $320.04 | 7 |
| Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr HCPCS J1939 | $16.17 | $24.50 | $0.59 – $1.05 | 5 |
| Bundled special stain group 1 microorganisms CPT 88312 | $317.46 | $481.00 | $14.25 – $288.60 | 16 |
| Bundled special stain group 2 CPT 88313 | $258.06 | $391.00 | $14.25 – $292.32 | 16 |
| Bundle his recording CPT 93600 | $8,764.14 | $13,279.00 | $2,816.70 – $17,136.51 | 14 |
| Bupivacaine 0.1 % epidural pca - 1 hour dose limit HCPCS J0665 | $3.23 | $4.90 | $0.02 – $0.02 | 5 |
| Buprenorphine 8 mg-naloxone 2 mg sublingual tablet HCPCS J0574 | $19.77 | $29.95 | $11.54 – $15.48 | 2 |
| Buprenorphine and metabolite - sendout CPT 80348 | $116.82 | $177.00 | $4.99 – $106.20 | 10 |
| Bur rotalink 2.15mm HCPCS C1724 | $1,690.92 | $2,562.00 | $1,104.40 – $1,104.40 | 1 |
| Bx bone trocar/ndl deep CPT 20225 | $2,470.38 | $3,743.00 | $791.17 – $3,628.70 | 14 |
| Bx breast 1st lesion mr imag CPT 19085 | $1,871.10 | $2,835.00 | $588.15 – $3,628.70 | 16 |
| Bx breast 1st lesion strtctc CPT 19081 | $3,192.42 | $4,837.00 | $308.36 – $3,628.70 | 16 |
| Bx breast add lesion mr imag CPT 19086 | $258.72 | $392.00 | $392.00 – $588.15 | 7 |
| Bx breast add lesion strtctc CPT 19082 | $231.00 | $350.00 | $350.00 – $588.15 | 7 |
| Bx breast add lesion Ultrasound imag CPT 19084 | $212.52 | $322.00 | $322.00 – $588.15 | 7 |
| Bx/exc lymph node/open/deep cervic 38510 CPT 38510 | 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.