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 |
|---|---|---|---|---|
| Crisis psychotherapy additional 30 mins 90840 CPT 90840 | $108.90 | $165.00 | $70.84 – $75.09 | 7 |
| Critical care 30-74 minutes CPT 99291 | $2,445.96 | $3,706.00 | $802.35 – $1,805.28 | 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 |
| Csf leakage imaging CPT 78650 | $1,828.86 | $2,771.00 | $403.45 – $2,829.45 | 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 | $170.26 – $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 | $68.15 – $1,215.09 | 16 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $2,002.44 | $3,034.00 | $170.26 – $1,215.09 | 16 |
| Cta neck without &/or w/contrast CPT 70498 | $1,126.62 | $1,707.00 | $170.26 – $1,215.09 | 16 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $3,358.08 | $5,088.00 | $135.55 – $1,215.09 | 16 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $1,859.88 | $2,818.00 | $68.15 – $1,215.09 | 16 |
| CT Angiogram of the Head CPT 70496 | $2,091.54 | $3,169.00 | $170.26 – $1,215.09 | 16 |
| CT angio hrt w/3d image CPT 75574 | $1,259.28 | $1,908.00 | $170.26 – $1,215.09 | 16 |
| CT angio pelvis CPT 72191 | $1,818.96 | $2,756.00 | $170.26 – $1,215.09 | 16 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $1,818.96 | $2,756.00 | $170.26 – $1,215.09 | 16 |
| CT colonography dx CPT 74261 | $1,119.36 | $1,696.00 | $48.92 – $1,215.09 | 16 |
| CT guidance for needle placement CPT 77012 | $1,263.24 | $1,914.00 | $37.74 – $1,273.00 | 11 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $1,215.06 | $1,841.00 | $92.68 – $495.60 | 11 |
| CT guid cryo ablat intramuscular CPT 20999 | $2,590.50 | $3,925.00 | $239.60 – $1,215.09 | 16 |
| CT guid parench tis ablat CPT 77013 | $1,189.32 | $1,802.00 | $37.74 – $1,273.00 | 11 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | $1,259.28 | $1,908.00 | $139.35 – $1,215.09 | 16 |
| CT hrt w/3d image CPT 75572 | $1,448.04 | $2,194.00 | $139.35 – $1,308.14 | 16 |
| CT limited or localized follow-up study CPT 76380 | $769.56 | $1,166.00 | $48.92 – $1,166.00 | 16 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $1,574.76 | $2,386.00 | $139.35 – $1,215.09 | 16 |
| CT lower extremity without contrast (both sides) CPT 73700 | $1,430.88 | $2,168.00 | $48.92 – $1,215.09 | 16 |
| CT lwr extremity w/o&w/dye CPT 73702 | $1,818.96 | $2,756.00 | $139.35 – $1,215.09 | 16 |
| CT neck soft tissue w/contrast CPT 70491 | $1,595.22 | $2,417.00 | $139.35 – $1,215.09 | 16 |
| CT neck soft tissue without contrast CPT 70490 | $1,259.28 | $1,908.00 | $48.92 – $1,215.09 | 16 |
| CT neck soft tissue without & w/contrast CPT 70492 | $2,091.54 | $3,169.00 | $139.35 – $1,215.09 | 16 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $1,818.96 | $2,756.00 | $139.35 – $1,215.09 | 16 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $1,770.12 | $2,682.00 | $139.35 – $1,215.09 | 16 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $1,351.02 | $2,047.00 | $48.92 – $1,215.09 | 16 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | $322.74 | $489.00 | $77.65 – $517.64 | 14 |
| CT scan for localization CPT 77011 | $1,189.32 | $1,802.00 | $37.74 – $1,273.00 | 11 |
| CT scan for therapy guide CPT 77014 | $1,189.32 | $1,802.00 | $37.74 – $1,273.00 | 11 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $3,550.14 | $5,379.00 | $135.55 – $1,215.09 | 16 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $3,016.86 | $4,571.00 | $69.68 – $1,215.09 | 16 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $2,544.96 | $3,856.00 | $92.70 – $1,215.09 | 16 |
| CT thoracic spine w/contrast CPT 72129 | $1,539.12 | $2,332.00 | $139.35 – $1,215.09 | 16 |
| CT thoracic spine without contrast CPT 72128 | $1,448.04 | $2,194.00 | $48.92 – $1,215.09 | 16 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $769.56 | $1,166.00 | $40.62 – $1,166.00 | 16 |
| CT t-spine w /wo contrast CPT 72130 | $1,818.96 | $2,756.00 | $139.35 – $1,215.09 | 16 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $1,770.12 | $2,682.00 | $139.35 – $1,215.09 | 16 |
| CT upper extremity without contrast (both sides) CPT 73200 | $1,335.18 | $2,023.00 | $48.92 – $1,215.09 | 16 |
| CT uppr extremity w/o&w/dye CPT 73202 | $1,846.68 | $2,798.00 | $139.35 – $1,215.09 | 16 |
| Culture aerobic additional method definitive id each CPT 87077 | $59.40 | $90.00 | $8.08 – $18.18 | 16 |
| Culture afb any source CPT 87116 | $143.22 | $217.00 | $10.80 – $24.30 | 16 |
| Culture anaerobic additional method definitive id each CPT 87076 | $59.40 | $90.00 | $8.08 – $18.18 | 16 |
| Culture anaerobic except blood CPT 87075 | $89.10 | $135.00 | $9.47 – $21.31 | 16 |
| Culture bact stool aero addl path ea CPT 87046 | $59.40 | $90.00 | $3.40 – $21.24 | 16 |
| Culture body fluid CPT 87070 | $237.60 | $360.00 | $8.62 – $19.40 | 16 |
| Culture fungi definitive id mold CPT 87107 | $68.64 | $104.00 | $10.32 – $23.22 | 16 |
| Culture fungi definitive id yeast CPT 87106 | $117.48 | $178.00 | $10.32 – $23.22 | 16 |
| Culture fungi other (except blood) CPT 87102 | $68.64 | $104.00 | $8.41 – $18.92 | 16 |
| Culture fungi skin/hair/nail CPT 87101 | $118.14 | $179.00 | $7.71 – $17.35 | 16 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $138.60 | $210.00 | $14.61 – $32.87 | 16 |
| Culture mycoplasma any source CPT 87109 | $79.86 | $121.00 | $14.01 – $34.63 | 16 |
| Culture screening strep group a CPT 87081 | $49.50 | $75.00 | $6.63 – $14.92 | 16 |
| Culture typing glc/hplc CPT 87143 | $97.68 | $148.00 | $12.52 – $28.17 | 16 |
| Culture typing immunologic CPT 87147 | $117.48 | $178.00 | $5.18 – $11.66 | 16 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | $483.78 | $733.00 | $12.05 – $337.50 | 16 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $219.78 | $333.00 | $35.09 – $78.95 | 16 |
| Culture urine each isolate CPT 87088 | $59.40 | $90.00 | $8.09 – $18.20 | 16 |
| Cutter lead HCPCS C1773 | $390.72 | $592.00 | $327.38 – $327.38 | 1 |
| Cv line/pic reposition CPT 36597 | $1,878.36 | $2,846.00 | $337.86 – $3,440.31 | 14 |
| Cyanocobalamin unsat binding capacity CPT 82608 | $13.20 | $20.00 | $14.32 – $32.22 | 16 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $35.51 | $53.80 | $1.06 – $1.89 | 5 |
| Cyclic citrullinated peptide antibody CPT 86200 | $89.10 | $135.00 | $12.95 – $29.14 | 16 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | $10.85 | $16.44 | $0.59 – $1.32 | 11 |
| Cyclosporine 2 hour CPT 80158 | $69.96 | $106.00 | $18.05 – $40.61 | 16 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | $3.09 | $4.68 | $0.87 – $1.36 | 5 |
| Cyclosporine oral 100 mg HCPCS J7502 | $12.34 | $18.70 | $2.99 – $3.72 | 5 |
| Cyp2d6 gene com variants CPT 81226 | $1,585.32 | $2,402.00 | $133.58 – $1,014.55 | 16 |
| Cystatin c CPT 82610 | $99.00 | $150.00 | $18.52 – $41.67 | 16 |
| Cystine urine quantitative CPT 82131 | $136.62 | $207.00 | $21.01 – $51.71 | 16 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $785.40 | $1,190.00 | $51.15 – $762.46 | 16 |
| Cysto impl 4 or more HCPCS C9740 | not published | not published | not published | 0 |
| Cysto, litho, vacuum kidney HCPCS C9761 | not published | not published | not published | 0 |
| Cysto rx balo cath urtl strx CPT 52284 | not published | not published | not published | 0 |
| Cystoscopy and radiotracer CPT 52250 | not published | not published | not published | 0 |
| Cystoscopy and treatment CPT 52214 | not published | not published | not published | 0 |
| Cystoscopy and treatment CPT 52224 | not published | not published | not published | 0 |
| Cystoscopy and treatment CPT 52234 | not published | not published | not published | 0 |
| Cystoscopy and treatment CPT 52235 | not published | not published | not published | 0 |
| Cystoscopy and treatment CPT 52240 | not published | not published | not published | 0 |
| Cystoscopy and treatment CPT 52260 | not published | not published | not published | 0 |
| Cystoscopy and treatment CPT 52276 | not published | not published | not published | 0 |
| Cystoscopy and treatment CPT 52283 | not published | not published | not published | 0 |
| Cystoscopy and treatment CPT 52290 | not published | not published | not published | 0 |
| Cystoscopy and treatment CPT 52301 | not published | not published | not published | 0 |
| Cystoscopy and treatment CPT 52310 | $3,036.66 | $4,601.00 | $713.73 – $4,568.53 | 14 |
| Cystoscopy and treatment CPT 52315 | not published | not published | not published | 0 |
| Cystoscopy and treatment CPT 52320 | not published | not published | not published | 0 |
| Cystoscopy (Bladder Scope) CPT 52000 | $1,171.50 | $1,775.00 | $113.00 – $1,523.94 | 14 |
| Cystoscopy chemodenervation CPT 52287 | not published | not published | not published | 0 |
| Cystoscopy implant stent CPT 52282 | 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.