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 |
|---|---|---|---|---|
| Colonoscopy stoma w/snare 44394 CPT 44394 | not published | not published | not published | 0 |
| Colonoscopy submucous njx CPT 45381 | not published | not published | not published | 0 |
| Colonoscopy thru stoma spx CPT 44388 | not published | not published | not published | 0 |
| Colonoscopy w/ablation CPT 45388 | not published | not published | not published | 0 |
| Colonoscopy w/band ligation CPT 45398 | not published | not published | not published | 0 |
| Colonoscopy w/control bleed CPT 45382 | not published | not published | not published | 0 |
| Colonoscopy w/endoscope Ultrasound CPT 45391 | not published | not published | not published | 0 |
| Colonoscopy w/endoscopic fnb CPT 45392 | not published | not published | not published | 0 |
| Colonoscopy (with biopsy) CPT 45380 | not published | not published | not published | 0 |
| Colonoscopy with biopsy CPT 44389 | not published | not published | not published | 0 |
| Colonoscopy (with polyp removal) CPT 45385 | not published | not published | not published | 0 |
| Colonoscopy w/resection CPT 45390 | $5,139.42 | $7,787.00 | $895.71 – $6,098.36 | 14 |
| Colporrhapy/vag injury sut/non ob 57200 CPT 57200 | $7,072.56 | $10,716.00 | $1,077.01 – $7,112.24 | 14 |
| Compatibility test each unit antiglobulin technique CPT 86922 | $172.26 | $261.00 | $58.11 – $374.32 | 16 |
| Compatibility test each unit electronic CPT 86923 | $172.26 | $261.00 | $43.86 – $374.32 | 16 |
| Compatibility test each unit immediate spin technique CPT 86920 | $172.26 | $261.00 | $54.69 – $374.32 | 16 |
| Compatibility test incubate CPT 86921 | $94.38 | $143.00 | $49.28 – $374.32 | 16 |
| Complement antigen each component c3 CPT 86160 | $79.86 | $121.00 | $12.00 – $27.00 | 16 |
| Complement fixation each CPT 86171 | $281.16 | $426.00 | $10.01 – $22.52 | 16 |
| Complex repair trunk 1.1-2.5cm 13120 CPT 13120 | $898.92 | $1,362.00 | $185.89 – $893.15 | 14 |
| Complex repair trunk 2.6-7.5cm 13101 CPT 13101 | $898.92 | $1,362.00 | $185.89 – $1,623.80 | 14 |
| Compl oph exam general anes CPT 92018 | not published | not published | not published | 0 |
| Complx repair enel 1.1-2.5 cm 13151 CPT 13151 | $1,186.68 | $1,798.00 | $185.89 – $1,623.80 | 14 |
| Complx repair enel 2.6-7.5 cm 13152 CPT 13152 | $1,285.02 | $1,947.00 | $185.89 – $1,623.80 | 14 |
| Complx repair enel addl 5cm/< 13153 CPT 13153 | $681.12 | $1,032.00 | $534.68 – $566.76 | 7 |
| Complx repair fccmnaxghf 13131 CPT 13131 | $1,186.68 | $1,798.00 | $185.89 – $893.15 | 14 |
| Complx repair fccmnaxghf 13132 CPT 13132 | $1,285.02 | $1,947.00 | $185.89 – $893.15 | 14 |
| Complx repair fccmnaxghf 13133 CPT 13133 | $494.34 | $749.00 | $185.89 – $197.04 | 7 |
| Complx repair sal addl 5 cm/> 13122 CPT 13122 | $494.34 | $749.00 | $185.89 – $197.04 | 7 |
| Complx repair trunk 1.1-2.5 cm 13100 CPT 13100 | $898.92 | $1,362.00 | $185.89 – $1,623.80 | 14 |
| Complx repair trunk addl 5cm/< 13102 CPT 13102 | $494.34 | $749.00 | $185.89 – $197.04 | 7 |
| Concentration infection agents any type CPT 87015 | $40.92 | $62.00 | $5.25 – $15.03 | 16 |
| Condylomata destruction 56420 CPT 56420 | $463.98 | $703.00 | $93.40 – $444.19 | 14 |
| Consultation pathology during surgery CPT 88329 | $353.10 | $535.00 | $36.94 – $321.00 | 16 |
| Consultation pathology during surgery cytological exam initial site CPT 88333 | $820.38 | $1,243.00 | $36.94 – $1,770.15 | 16 |
| Consultation pathology during surgery frozen section each additional block CPT 88332 | $168.30 | $255.00 | $30.10 – $153.00 | 11 |
| Consultation pathology during surgery frozen section first tissue block CPT 88331 | $262.68 | $398.00 | $36.94 – $374.32 | 16 |
| Consultation/report referred material w/preparation of slides CPT 88323 | $366.96 | $556.00 | $36.94 – $333.60 | 16 |
| Consultation/report referred slides prepared elsewhere CPT 88321 | $456.72 | $692.00 | $36.47 – $415.20 | 16 |
| Consult comp w/report rfrd material CPT 88325 | $993.96 | $1,506.00 | $36.94 – $903.60 | 16 |
| Contrast exam abdominl aorta 75625-26 CPT 75625 | $3,833.94 | $5,809.00 | $117.12 – $6,937.25 | 16 |
| Contrast exam thoracic aorta 75605-26 CPT 75605 | $6,243.60 | $9,460.00 | $133.02 – $12,225.64 | 16 |
| Contrast x-ray of ankle CPT 73615 | $1,242.78 | $1,883.00 | $52.32 – $766.50 | 16 |
| Contrast x-ray of elbow CPT 73085 | $900.90 | $1,365.00 | $52.32 – $766.50 | 16 |
| Contrast x-ray of hip CPT 73525 | $1,657.92 | $2,512.00 | $52.32 – $766.50 | 16 |
| Contrast x-ray of knee joint CPT 73580 | $955.68 | $1,448.00 | $52.32 – $766.50 | 16 |
| Contrast x-ray of wrist CPT 73115 | $830.94 | $1,259.00 | $52.32 – $766.50 | 16 |
| Control nosebleed pack+caut 30905 CPT 30905 | $411.84 | $624.00 | $74.89 – $292.32 | 14 |
| Control of nosebleed ant comp 30903 CPT 30903 | $434.28 | $658.00 | $74.89 – $292.32 | 14 |
| Control of nosebleedantersmpl 30901 CPT 30901 | $357.72 | $542.00 | $74.89 – $292.32 | 14 |
| Conversion ext bil drg cath CPT 47535 | $4,076.16 | $6,176.00 | $365.43 – $7,866.44 | 16 |
| Convert nephrostomy catheter CPT 50434 | $6,106.32 | $9,252.00 | $647.32 – $4,592.75 | 14 |
| Coombs direct CPT 86880 | $59.40 | $90.00 | $5.57 – $129.61 | 16 |
| Coombs indirect qualitative each reagent red cell reference CPT 86885 | $172.26 | $261.00 | $5.91 – $374.32 | 16 |
| Coombs indirect titer reference CPT 86886 | $172.26 | $261.00 | $5.35 – $374.32 | 16 |
| Core ndl bx lng/med perq CPT 32408 | $4,041.18 | $6,123.00 | $440.45 – $3,628.70 | 14 |
| Cor hlx vlgs double osteot CPT 28299 | not published | not published | not published | 0 |
| Cor hlx vlgs dstl mtar osteo CPT 28296 | not published | not published | not published | 0 |
| Cor hlx vlgs prx phlx osteot CPT 28298 | not published | not published | not published | 0 |
| Coronary angio/cath placement bypass graft/lv gram/lt heart CPT 93459 | $7,242.84 | $10,974.00 | $1,066.54 – $7,122.80 | 14 |
| Coronary angio/lv gram/lt heart CPT 93458 | $8,833.44 | $13,384.00 | $533.27 – $3,561.40 | 14 |
| Coronary angio/lv gram/rt< heart CPT 93460 | $7,684.38 | $11,643.00 | $1,066.54 – $7,122.80 | 14 |
| Coronary art/grft angio s&i CPT 93455 | $8,833.44 | $13,384.00 | $1,066.54 – $7,122.80 | 14 |
| Coronary catheterization w/angiography supervision & interpretation CPT 93454 | $9,716.52 | $14,722.00 | $1,066.54 – $7,122.80 | 14 |
| Coronary thrombolysis/iv infusion 92977 CPT 92977 | $603.24 | $914.00 | $204.01 – $216.25 | 7 |
| Correct bunion/keller/mcbride/mayo 28292 CPT 28292 | not published | not published | not published | 0 |
| Correct inverted nipple(s) CPT 19355 | not published | not published | not published | 0 |
| Corrj halux rigdus without implt CPT 28289 | not published | not published | not published | 0 |
| Cortisol total am CPT 82533 | $99.00 | $150.00 | $16.30 – $36.68 | 16 |
| Cosyntropin 0.25 mg solution for injection HCPCS J0834 | $350.33 | $530.80 | $34.07 – $36.96 | 5 |
| Counseling smoke cess interm >10mins CPT 99407 | $52.80 | $80.00 | $10.20 – $82.32 | 16 |
| #coxa-coxsackie a serotype a16 CPT 86658 | $129.36 | $196.00 | $8.17 – $29.32 | 16 |
| C-peptide CPT 84681 | $81.18 | $123.00 | $7.34 – $46.82 | 16 |
| Crbrospnl fld flw imag cistern CPT 78630 | $1,828.86 | $2,771.00 | $389.13 – $1,246.46 | 16 |
| C-reactive protein CPT 86140 | $39.60 | $60.00 | $5.18 – $11.66 | 16 |
| C-reactive protein high sensitivity CPT 86141 | $147.84 | $224.00 | $12.95 – $29.14 | 16 |
| C-reactive protein, quantitative CPT 86406 | $71.28 | $108.00 | $9.85 – $23.94 | 16 |
| Creatine kinase CPT 82550 | $42.24 | $64.00 | $6.51 – $14.65 | 16 |
| Creatine kinase isoenzymes CPT 82552 | $73.92 | $112.00 | $13.39 – $30.13 | 16 |
| Creatine kinase mb CPT 82553 | $54.12 | $82.00 | $8.66 – $25.99 | 16 |
| Creatine - sendout CPT 82540 | $33.66 | $51.00 | $4.64 – $10.44 | 16 |
| Creatinine CPT 82565 | $31.68 | $48.00 | $5.12 – $11.52 | 16 |
| Creatinine 24 hour urine CPT 82570 | $66.66 | $101.00 | $5.18 – $11.66 | 16 |
| Creatinine clearance urine CPT 82575 | $72.60 | $110.00 | $9.46 – $21.29 | 16 |
| #creutz-prot.,western blot CPT 84182 | $361.68 | $548.00 | $25.31 – $65.72 | 16 |
| Critical care 30-74 minutes CPT 99291 | $2,028.84 | $3,074.00 | $806.60 – $1,814.85 | 9 |
| Cryofibrinogen qualitative - sendout CPT 82585 | $42.24 | $64.00 | $9.02 – $31.82 | 16 |
| Cryoprecipitate each unit HCPCS P9012 | $155.10 | $235.00 | $71.95 – $161.89 | 14 |
| Cryptosporidium antigen CPT 87272 | $89.10 | $135.00 | $11.98 – $26.96 | 16 |
| Crystal identification light microscopy CPT 89060 | $49.50 | $75.00 | $7.33 – $16.49 | 16 |
| Cstb gene full gene sequence CPT 81189 | $317.46 | $481.00 | $219.86 – $618.37 | 16 |
| CT 3d report other modality w/workstation CPT 76377 | $724.68 | $1,098.00 | $1,098.00 – $1,098.00 | 5 |
| Cta abdomen without & /or w/contrast CPT 74175 | $1,994.52 | $3,022.00 | $164.22 – $1,215.09 | 16 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $1,907.40 | $2,890.00 | $68.51 – $1,215.09 | 16 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $2,002.44 | $3,034.00 | $164.22 – $1,215.09 | 16 |
| Cta neck without &/or w/contrast CPT 70498 | $1,126.62 | $1,707.00 | $164.22 – $1,215.09 | 16 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $3,358.08 | $5,088.00 | $136.27 – $1,215.09 | 16 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $1,859.88 | $2,818.00 | $68.51 – $1,215.09 | 16 |
| CT Angiogram of the Head CPT 70496 | $2,091.54 | $3,169.00 | $164.22 – $1,215.09 | 16 |
| CT angio hrt w/3d image CPT 75574 | $1,259.28 | $1,908.00 | $164.22 – $1,308.14 | 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.