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 |
|---|---|---|---|---|
| Ghs ppd (tb intradermal) CPT 86580 | $59.40 | $90.00 | $4.30 – $63.21 | 16 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $89.76 | $136.00 | $9.66 – $21.74 | 16 |
| Ghs protoporphyrins fract CPT 84202 | $72.60 | $110.00 | $14.35 – $32.29 | 16 |
| Ghs pr without cont pulse ox CPT 94625 | $137.94 | $209.00 | $15.65 – $128.93 | 14 |
| Ghs quinidine CPT 80194 | $88.44 | $134.00 | $14.60 – $32.85 | 16 |
| Ghs removal intranasal foreign body CPT 30300 | $345.84 | $524.00 | $77.65 – $290.78 | 14 |
| Ghs removal pharyngeal foreign body CPT 42809 | $460.68 | $698.00 | $77.65 – $976.31 | 14 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $1,878.36 | $2,846.00 | $598.01 – $3,514.26 | 14 |
| Ghs reticulocyte count CPT 85044 | $129.36 | $196.00 | $4.31 – $9.70 | 16 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $99.00 | $150.00 | $13.91 – $31.30 | 16 |
| Ghs sedimentation rate CPT 85651 | $40.92 | $62.00 | $4.01 – $9.61 | 16 |
| Ghs semen analysis fert CPT 89320 | $48.18 | $73.00 | $12.31 – $27.70 | 16 |
| Ghs semen analysis, post-vas CPT 89300 | $66.66 | $101.00 | $9.84 – $22.14 | 16 |
| Ghs sensitivity (per antimicro) CPT 87184 | $67.32 | $102.00 | $7.48 – $16.83 | 16 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $658.68 | $998.00 | $83.55 – $888.44 | 14 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $731.28 | $1,108.00 | $83.55 – $888.44 | 14 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $701.58 | $1,063.00 | $83.55 – $888.44 | 14 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $751.08 | $1,138.00 | $83.55 – $888.44 | 14 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $701.58 | $1,063.00 | $83.55 – $438.49 | 14 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $602.58 | $913.00 | $83.55 – $438.49 | 14 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $721.38 | $1,093.00 | $83.55 – $438.49 | 14 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $721.38 | $1,093.00 | $83.55 – $438.49 | 14 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $770.22 | $1,167.00 | $83.55 – $438.49 | 14 |
| Ghs sleep study unattended CPT 95800 | $345.18 | $523.00 | $69.60 – $471.90 | 16 |
| Ghs somatosensory testing lower extremit CPT 95926 | $906.18 | $1,373.00 | $60.77 – $885.08 | 16 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $1,431.54 | $2,169.00 | $60.77 – $1,876.77 | 16 |
| Ghs sphenopalatine ganglion block CPT 64505 | $1,162.26 | $1,761.00 | $182.86 – $1,215.09 | 16 |
| Ghs strapping shoulder - 29240 CPT 29240 | $246.18 | $373.00 | $34.70 – $290.78 | 14 |
| Ghs st - re-eval for alt comm CPT 92597 | $251.46 | $381.00 | $69.45 – $259.68 | 16 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $143.88 | $218.00 | $45.48 – $218.00 | 14 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $432.30 | $655.00 | $135.03 – $464.86 | 14 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $1,186.68 | $1,798.00 | $174.99 – $1,615.24 | 14 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $465.96 | $706.00 | $174.99 – $888.44 | 14 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $1,710.72 | $2,592.00 | $942.38 – $3,390.98 | 14 |
| Ghs trypsin (fecal) CPT 84488 | $74.58 | $113.00 | $7.30 – $16.43 | 16 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $701.58 | $1,063.00 | $210.86 – $539.09 | 14 |
| Ghs urine, hydroxproline total CPT 83505 | $144.54 | $219.00 | $24.30 – $54.68 | 16 |
| Ghs urine, porphyrins quant CPT 84120 | $134.64 | $204.00 | $14.71 – $33.10 | 16 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $4,775.10 | $7,235.00 | $205.42 – $815.54 | 16 |
| Ghs windowing of cast CPT 29730 | $655.38 | $993.00 | $82.42 – $355.14 | 14 |
| Gi inhouse confirmation CPT 87045 | $68.64 | $104.00 | $9.44 – $21.24 | 16 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | not published | 0 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $875.95 | $1,327.20 | $53.10 – $370.94 | 16 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $790.52 | $1,197.75 | $53.10 – $322.32 | 16 |
| Glucagon plasma - sendout CPT 82943 | $50.16 | $76.00 | $13.88 – $32.15 | 16 |
| Glucose 1 hr post dose CPT 82950 | $72.60 | $110.00 | $4.75 – $10.69 | 16 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $15.84 | $24.00 | $3.28 – $7.38 | 16 |
| Glucose blood quantitative CPT 82947 | $24.42 | $37.00 | $3.93 – $8.84 | 16 |
| Glucose body fluid CPT 82945 | $43.56 | $66.00 | $3.93 – $8.84 | 16 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $89.76 | $136.00 | $12.87 – $28.96 | 16 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $25.08 | $38.00 | $3.92 – $8.82 | 16 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $22.14 | $33.55 | $0.63 – $0.78 | 5 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $99.75 | $151.14 | $11.63 – $151.14 | 16 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $117.48 | $178.00 | $18.58 – $41.81 | 16 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $117.48 | $178.00 | $18.52 – $41.67 | 16 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $2,180.94 | $3,304.45 | $443.32 – $1,749.38 | 16 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $60.72 | $92.00 | $51.39 – $271.97 | 11 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $11,028.20 | $16,709.40 | $52.89 – $271.97 | 11 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $64.02 | $97.00 | $97.00 – $271.97 | 9 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $193.38 | $293.00 | $103.75 – $271.97 | 16 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $1,007.99 | $1,527.25 | $120.88 – $271.97 | 16 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $58.08 | $88.00 | $88.00 – $271.97 | 9 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $9,092.95 | $13,777.20 | $120.88 – $271.97 | 9 |
| Granisetron hcl injection HCPCS J1626 | $48.71 | $73.80 | $0.25 – $0.51 | 5 |
| Granulocyte pheresis ea unit HCPCS P9050 | $1,762.86 | $2,671.00 | $126.62 – $505.20 | 8 |
| Great toe with reduction 28495 CPT 28495 | $568.26 | $861.00 | $113.00 – $539.09 | 14 |
| Grfg autol soft tiss dir exc CPT 15769 | not published | not published | not published | 0 |
| G-tube reposition CPT 43761 | $830.28 | $1,258.00 | $178.30 – $546.04 | 16 |
| Gu dilat ureter/urethra s&i CPT 74485 | $2,366.10 | $3,585.00 | $92.68 – $4,568.53 | 16 |
| Guided cath fluid drainage 10030 CPT 10030 | $1,186.68 | $1,798.00 | $491.72 – $1,547.62 | 14 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $3,056.46 | $4,631.00 | $7.55 – $7.55 | 1 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $102.96 | $156.00 | $86.27 – $86.27 | 1 |
| Guid loc target vol rad tx CPT 77387 | $407.88 | $618.00 | $55.06 – $618.00 | 11 |
| Gw stiffened micro access kit HCPCS C1894 | $1,378.08 | $2,088.00 | $67.47 – $67.47 | 1 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $32.34 | $49.00 | $1.20 – $1.97 | 5 |
| Hand X-ray CPT 73130 | $388.74 | $589.00 | $25.74 – $456.60 | 16 |
| Haptoglobin quantitative CPT 83010 | $81.18 | $123.00 | $12.58 – $28.31 | 16 |
| Hba1/hba2 full gene sequence CPT 81259 | $698.94 | $1,059.00 | $480.00 – $1,350.00 | 16 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $684.42 | $1,037.00 | $161.92 – $455.40 | 16 |
| Hbb full gene sequence CPT 81364 | $374.88 | $568.00 | $259.66 – $730.31 | 16 |
| Hbb gene dup/del variants CPT 81363 | $641.52 | $972.00 | $161.92 – $455.40 | 16 |
| Hbot, full body chamber, 30m HCPCS G0277 | $543.84 | $824.00 | $133.66 – $300.75 | 14 |
| Hcg qualitative CPT 84703 | $62.04 | $94.00 | $7.52 – $16.92 | 16 |
| Hcg quantitative CPT 84702 | $91.08 | $138.00 | $15.05 – $33.86 | 16 |
| Hc metata joint dislocation anes CPT 28635 | $2,799.06 | $4,241.00 | $442.41 – $3,514.26 | 14 |
| Hc nm kidney imaging with flow CPT 78701 | $1,170.18 | $1,773.00 | $168.45 – $1,246.46 | 16 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | $2,641.32 | $4,002.00 | $216.69 – $2,025.50 | 16 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | $2,868.36 | $4,346.00 | $652.19 – $2,025.50 | 16 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | $3,018.84 | $4,574.00 | $652.19 – $2,025.50 | 16 |
| Head CT scan (with and without contrast) CPT 70470 | $1,818.96 | $2,756.00 | $139.35 – $1,215.09 | 16 |
| Head CT scan (with contrast) CPT 70460 | $1,770.12 | $2,682.00 | $139.35 – $1,215.09 | 16 |
| Head CT scan (without contrast) CPT 70450 | $1,259.28 | $1,908.00 | $101.55 – $1,215.09 | 16 |
| Helicobacter pylori antibody igm CPT 86677 | $79.86 | $121.00 | $8.17 – $37.91 | 16 |
| Hematocrit CPT 85014 | $15.84 | $24.00 | $2.37 – $5.33 | 16 |
| Hematopoietic nuclear tx CPT 79403 | $1,283.04 | $1,944.00 | $124.58 – $1,246.46 | 16 |
| Hemin 350 mg intravenous powder for solution HCPCS J1640 | $59.29 | $89.83 | $35.31 – $89.83 | 16 |
| Hemodialysis one evaluation CPT 90935 | $510.18 | $773.00 | $356.20 – $1,499.94 | 16 |
| Hemoglobin CPT 85018 | $143.22 | $217.00 | $2.37 – $5.33 | 16 |
| Hemoglobin fetal qualitative CPT 83033 | $44.22 | $67.00 | $8.00 – $18.00 | 16 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $54.12 | $82.00 | $4.12 – $18.45 | 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.