HSHS St. Vincent Hospital
835 S. Van Buren St., Green Bay, WI · Hshs · · NPI 1114908001
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 |
|---|---|---|---|---|
| Diagnostic anoscopy spx 46600 CPT 46600 | $160.38 | $243.00 | $129.23 – $290.78 | 14 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $344.52 | $522.00 | $77.65 – $436.24 | 14 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $224.40 | $340.00 | $77.65 – $436.24 | 14 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $369.60 | $560.00 | $21.87 – $237.33 | 14 |
| Diagnostic Mammogram (one breast) CPT 77065 | $310.20 | $470.00 | $21.87 – $185.27 | 14 |
| Diagnostic radio unlisted proc CPT 76499 | $258.72 | $392.00 | $25.74 – $392.00 | 16 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $6,662.04 | $10,094.00 | $4,903.29 – $5,197.49 | 7 |
| Dialysis one evaluation CPT 90945 | $489.72 | $742.00 | $356.20 – $911.93 | 14 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $0.32 | $0.48 | $0.12 – $0.13 | 5 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $59.96 | $90.85 | $9.27 – $11.98 | 5 |
| Dicyclomine injection HCPCS J0500 | $409.46 | $620.40 | $18.69 – $34.56 | 5 |
| Diffusing capacity CPT 94729 | $286.44 | $434.00 | $26.43 – $434.00 | 10 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $32.34 | $49.00 | $12.19 – $17.13 | 5 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $12,409.16 | $18,801.75 | $2,032.07 – $11,625.73 | 16 |
| Digoxin total therapeutic drug level CPT 80162 | $114.18 | $173.00 | $13.28 – $29.88 | 16 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $491.40 | $744.55 | $80.09 – $102.17 | 5 |
| Dilate biliary duct/ampulla CPT 47542 | $2,312.64 | $3,504.00 | $252.19 – $2,634.40 | 11 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | not published | 0 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | $2,444.64 | $3,704.00 | $3,704.00 – $3,926.24 | 7 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | $1,640.76 | $2,486.00 | $2,486.00 – $2,635.16 | 7 |
| Dilate ic vasospasm init CPT 61640 | $1,640.76 | $2,486.00 | $2,486.00 – $2,635.16 | 7 |
| Dilate urethra stricture CPT 53600 | $492.36 | $746.00 | $39.48 – $546.04 | 14 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | not published | 0 |
| Dilator fascial 10fx20cm HCPCS C2627 | $147.84 | $224.00 | $123.87 – $123.87 | 1 |
| Dilat xst trc ndurlgc px CPT 50436 | $8,539.08 | $12,938.00 | $671.16 – $7,703.84 | 14 |
| Dilat xst trc new access rcs CPT 50437 | $8,714.64 | $13,204.00 | $671.16 – $7,703.84 | 14 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $0.65 | $0.98 | $0.05 – $0.05 | 4 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $32.34 | $49.00 | $1.17 – $1.55 | 5 |
| Disability dlco CPT 94727 | $276.54 | $419.00 | $26.43 – $471.90 | 16 |
| Disaccharidases CPT 82657 | $207.24 | $314.00 | $22.17 – $49.88 | 16 |
| Discography cerv/thor spine CPT 72285 | $1,911.36 | $2,896.00 | $150.43 – $4,267.68 | 16 |
| Dist revas ligation hemo CPT 36838 | not published | not published | not published | 0 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | $2,469.72 | $3,742.00 | $3,742.00 – $3,966.52 | 7 |
| Dmd dup/delet analysis CPT 81161 | $368.28 | $558.00 | $140.01 – $627.75 | 16 |
| Dmpk gene detc abnor allele CPT 81234 | $368.94 | $559.00 | $109.60 – $308.25 | 16 |
| Dna antibody native/double stranded CPT 86225 | $89.10 | $135.00 | $13.74 – $30.92 | 16 |
| Dna gardnerella CPT 87510 | $138.60 | $210.00 | $20.05 – $45.11 | 16 |
| Dna trichomonas CPT 87660 | $138.60 | $210.00 | $20.05 – $45.11 | 16 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $129.99 | $196.95 | $12.89 – $14.36 | 5 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $3.70 | $5.61 | $1.07 – $5.95 | 11 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $9.75 | $14.78 | $1.32 – $1.43 | 5 |
| Doppler echo complete CPT 93320 | $456.06 | $691.00 | $198.51 – $548.60 | 10 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $1,496.88 | $2,268.00 | $775.93 – $822.49 | 7 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $582.12 | $882.00 | $75.96 – $472.83 | 16 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $410.52 | $622.00 | $25.05 – $472.83 | 16 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | $452.98 | $686.34 | $247.44 – $686.34 | 16 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $158.16 | $239.63 | $4.59 – $5.54 | 5 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $1,497.74 | $2,269.30 | $104.01 – $268.96 | 16 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $1.23 | $1.86 | $0.17 – $0.18 | 4 |
| Dpyd gene common variants CPT 81232 | $822.36 | $1,246.00 | $61.22 – $393.32 | 16 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $1,663.86 | $2,521.00 | $548.43 – $1,547.62 | 14 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $1,325.28 | $2,008.00 | $77.65 – $1,547.62 | 14 |
| Drainage external ear complex 69005 CPT 69005 | $1,871.10 | $2,835.00 | $641.19 – $3,609.56 | 14 |
| Drainage external ear simple 69000 CPT 69000 | $812.46 | $1,231.00 | $77.65 – $1,547.62 | 14 |
| Drainage mouth roof lesion CPT 42000 | $460.68 | $698.00 | $77.65 – $517.64 | 14 |
| Drainage of arm bursa 23931 CPT 23931 | $1,871.10 | $2,835.00 | $820.29 – $3,609.56 | 14 |
| Drainage of kidney lesion CPT 50390 | $1,384.02 | $2,097.00 | $184.96 – $1,547.62 | 16 |
| Drainage of mouth lesion CPT 41008 | $167.64 | $254.00 | $254.00 – $7,245.93 | 14 |
| Drainage of mouth lesion CPT 41016 | not published | not published | not published | 0 |
| Drainage of rectal abscess 45020 CPT 45020 | not published | not published | not published | 0 |
| Drainage of urethra abscess 53060 CPT 53060 | $2,366.10 | $3,585.00 | $1,313.29 – $4,568.53 | 14 |
| Drain blood from under nail 11740 CPT 11740 | $149.16 | $226.00 | $30.48 – $290.78 | 14 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | $2,220.24 | $3,364.00 | $330.73 – $3,609.56 | 16 |
| Drain cath image guided visceral pq CPT 49405 | $1,871.10 | $2,835.00 | $330.73 – $3,609.56 | 16 |
| Drain cerebro spinal fluid 62272 CPT 62272 | $819.72 | $1,242.00 | $164.57 – $1,542.70 | 16 |
| Drain finger abscess;simple 26010 CPT 26010 | $395.34 | $599.00 | $75.67 – $438.49 | 14 |
| Drain neck/chest lesion 21501 CPT 21501 | not published | not published | not published | 0 |
| Drain ovarn cyst abd CPT 58805 | $3,672.24 | $5,564.00 | $500.00 – $7,074.73 | 16 |
| Drain thigh/knee lesion 27301 CPT 27301 | $5,360.52 | $8,122.00 | $820.29 – $6,348.25 | 14 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $434.28 | $658.00 | $83.55 – $438.49 | 14 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $374.88 | $568.00 | $83.55 – $438.49 | 14 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $524.04 | $794.00 | $174.99 – $888.44 | 14 |
| Drill hole implt ventricular cath/device 61107 CPT 61107 | $318.78 | $483.00 | $483.00 – $511.98 | 7 |
| Drng of eyelid abscess 67700 CPT 67700 | $513.48 | $778.00 | $132.45 – $693.69 | 14 |
| Drng of finger abscess comp 26011 CPT 26011 | $3,873.54 | $5,869.00 | $491.72 – $3,609.56 | 14 |
| Drng of scrotum abscess 55100 CPT 55100 | $1,871.10 | $2,835.00 | $1,084.66 – $3,609.56 | 14 |
| Drng salivary gland simple 42300 CPT 42300 | $1,582.02 | $2,397.00 | $548.43 – $3,390.98 | 14 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $51.81 | $78.50 | $11.85 – $13.31 | 5 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $23.10 | $35.00 | $20.04 – $271.97 | 11 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | $2,544.61 | $3,855.47 | $84.20 – $271.97 | 11 |
| Drug admin & hemodynmic meas CPT 93463 | $397.32 | $602.00 | $21.23 – $22.50 | 7 |
| Drug assay caffeine CPT 80155 | $125.40 | $190.00 | $15.44 – $86.78 | 16 |
| Drug assay posaconazole CPT 80187 | $130.02 | $197.00 | $21.69 – $61.00 | 16 |
| Drug assay vedolizumab CPT 80280 | $308.88 | $468.00 | $30.85 – $86.78 | 16 |
| Drug assay voriconazole CPT 80285 | $100.98 | $153.00 | $21.69 – $61.00 | 16 |
| Drug of abuse screen urine CPT 80305 | $120.78 | $183.00 | $12.60 – $28.35 | 16 |
| Drug screening tapentadol CPT 80372 | $36.30 | $55.00 | $5.17 – $39.00 | 10 |
| Drug screen quant tiagabine CPT 80199 | $83.82 | $127.00 | $19.70 – $61.00 | 16 |
| Drug/substance nos 4-6 CPT 80376 | $49.50 | $75.00 | $5.17 – $45.00 | 10 |
| Drug test def 15-21 classes HCPCS G0482 | $244.86 | $371.00 | $132.80 – $447.17 | 16 |
| Drug test def 1-7 classes HCPCS G0480 | $230.34 | $349.00 | $63.95 – $257.47 | 16 |
| Drug test def 22+ classes HCPCS G0483 | $699.60 | $1,060.00 | $172.18 – $555.57 | 16 |
| Drug test def 8-14 classes HCPCS G0481 | $188.76 | $286.00 | $98.39 – $352.33 | 16 |
| Drug test prsmv instrmnt CPT 80306 | $209.88 | $318.00 | $17.14 – $38.57 | 16 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $258.72 | $392.00 | $62.14 – $139.82 | 16 |
| Dry needling (97799) CPT 97799 | $258.72 | $392.00 | $14.71 – $111.00 | 10 |
| Ductogram sgl duct CPT 77053 | $691.68 | $1,048.00 | $54.25 – $521.46 | 16 |
| Duplex scan bilateral study 93985 CPT 93985 | $552.42 | $837.00 | $50.10 – $521.46 | 16 |
| Duplex scan unilateral study 93986 CPT 93986 | $149.82 | $227.00 | $50.10 – $228.48 | 16 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $489.72 | $742.00 | $50.10 – $472.83 | 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.