SSM Health St. Mary's Hospital - Janesville
3400 East Racine Street, Janesville, WI · SSM Health · · NPI 1548654676
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $53.90 | $98.00 | $21.96 – $232.80 | 5 |
| 17-hydroxypregnenolone CPT 84143 | $53.90 | $98.00 | $17.11 – $181.43 | 5 |
| 17-ketosteroids CPT 83586 | $37.40 | $68.00 | $9.60 – $101.83 | 5 |
| 2019-ncov diagnostic p HCPCS U0001 | not published | not published | $26.94 – $209.92 | 5 |
| 24 hr ambulatory b/p monitor CPT 93786 | not published | not published | $100.51 – $134.01 | 2 |
| 2d tee w or without fol w/con,in HCPCS C8925 | not published | not published | $592.21 – $789.61 | 2 |
| 2d tte w or without fol w/con,co HCPCS C8923 | not published | not published | $592.21 – $789.61 | 2 |
| 2nd order venous cath CPT 36012 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| 3d anat seg imaging preop HCPCS C8001 | not published | not published | $97.20 – $129.61 | 2 |
| 3d bn img algor drvd fr MRI HCPCS G0566 | not published | not published | $97.20 – $129.61 | 2 |
| 3-d radiotherapy plan CPT 77295 | $5,066.05 | $9,211.00 | $1,045.63 – $2,090.52 | 3 |
| 3d recon without postprocess indpndt CPT 76376 | $1,980.55 | $3,601.00 | $101.32 – $101.32 | 1 |
| 5' nucleotidase - sendout CPT 83915 | $21.45 | $39.00 | $8.36 – $88.68 | 5 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $156.75 | $285.00 | $121.02 – $121.02 | 1 |
| Aa graft w/bp/aortic root replace 33863 CPT 33863 | not published | not published | $16,352.00 – $16,352.00 | 1 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | not published | not published | $34.39 – $84.54 | 5 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $59.95 | $109.00 | $9.01 – $46.24 | 5 |
| Abd aorta w/runoff s&i CPT 75630 | $5,639.70 | $10,254.00 | $638.52 – $3,180.39 | 3 |
| Abd exp/postop hem/throm/infec 35840 CPT 35840 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Abd/low ext cath 1st CPT 36245 | $1,921.15 | $3,493.00 | $1,704.00 – $1,704.00 | 1 |
| Abd/low ext cath 2nd CPT 36246 | $2,178.55 | $3,961.00 | $1,704.00 – $1,704.00 | 1 |
| Abd/low ext cath 3rd CPT 36247 | $2,261.05 | $4,111.00 | $1,704.00 – $1,704.00 | 1 |
| Abd/low ext cath addl CPT 36248 | $368.50 | $670.00 | $1,704.00 – $1,704.00 | 1 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $2,131.25 | $3,875.00 | $132.50 – $1,483.06 | 3 |
| Abdominal CT scan (with contrast) CPT 74160 | $2,032.25 | $3,695.00 | $132.50 – $1,289.24 | 3 |
| Abdominal CT scan (without contrast) CPT 74150 | $1,755.60 | $3,192.00 | $78.98 – $691.13 | 3 |
| Abdominal MRI (with and without contrast) CPT 74183 | $2,474.45 | $4,499.00 | $263.55 – $3,040.88 | 3 |
| Abdominal MRI (with contrast) CPT 74182 | $2,268.20 | $4,124.00 | $263.55 – $2,841.55 | 3 |
| Abdominal MRI (without contrast) CPT 74181 | $2,061.95 | $3,749.00 | $180.25 – $2,008.04 | 3 |
| Abdominal paracentesis w/image guidance CPT 49083 | $1,437.70 | $2,614.00 | $685.17 – $4,074.00 | 4 |
| Abdominal Ultrasound (complete) CPT 76700 | $1,334.85 | $2,427.00 | $78.98 – $641.27 | 3 |
| Abdominal Ultrasound (limited) CPT 76705 | $1,113.20 | $2,024.00 | $78.98 – $480.69 | 3 |
| Abdominoplasty 15830 CPT 15830 | not published | not published | $5,016.25 – $15,466.00 | 4 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $1,515.25 | $2,755.00 | $685.17 – $4,074.00 | 4 |
| Abl1 gene CPT 81170 | $1,134.65 | $2,063.00 | $225.00 – $1,923.50 | 5 |
| Ablate arrhythmia add on CPT 93655 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Ablate atria lmtd endo 33265 CPT 33265 | not published | not published | $15,466.00 – $15,466.00 | 1 |
| Ablate atria w/bypass exten 33256 CPT 33256 | not published | not published | $15,466.00 – $15,466.00 | 1 |
| Ablate atria x10sv add-on 33258 CPT 33258 | not published | not published | $15,466.00 – $15,466.00 | 1 |
| Ablate atria x10sv endo 33266 CPT 33266 | not published | not published | $15,466.00 – $15,466.00 | 1 |
| Ablate bone tumor(s) cryo perq 20983 CPT 20983 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Ablate bone tumor(s) perq CPT 20982 | $16,437.85 | $29,887.00 | $13,245.76 – $18,190.00 | 4 |
| Ablate heart dysrhythm focus CPT 93650 | not published | not published | $5,892.18 – $16,582.00 | 4 |
| Ablate inf turbinate submuc 30802 CPT 30802 | not published | not published | $1,172.13 – $4,321.00 | 4 |
| Ablate inf turbinate superf 30801 CPT 30801 | not published | not published | $1,172.13 – $4,321.00 | 4 |
| Ablate pulm tumor perq crybl CPT 32994 | $8,185.65 | $14,883.00 | $8,030.21 – $16,582.00 | 4 |
| Ablate pulm tumor perq rf CPT 32998 | $10,783.30 | $19,606.00 | $4,567.04 – $16,582.00 | 4 |
| Ablation cardiac vagal inputs atrium CPT 93799 | not published | not published | $97.20 – $1,704.00 | 3 |
| Ablation cryo abd perit om CPT 49999 | $1,643.40 | $2,988.00 | $685.17 – $13,711.00 | 4 |
| Ablation cryo adrenal tumor CPT 60699 | not published | not published | $4,567.04 – $16,582.00 | 4 |
| Ablation cryo pq chest wall tumor(s) w/guid CPT 23929 | not published | not published | $186.34 – $4,074.00 | 4 |
| Ablation cryo pq liver tumor(s) CPT 47383 | not published | not published | $8,030.21 – $16,582.00 | 4 |
| Ablation cryo retro lymph node CPT 38999 | not published | not published | $333.28 – $13,711.00 | 4 |
| Ablation cryo thigh/knee CPT 27599 | not published | not published | $186.34 – $13,711.00 | 4 |
| Ablation ire liver 1+ tumor(s) w/image pq CPT 47384 | not published | not published | $8,030.21 – $10,706.94 | 2 |
| Ablation of upper extremity nerves rf CPT 64999 | $1,478.95 | $2,689.00 | $231.88 – $13,711.00 | 4 |
| Abltj 1/+thyr ndul 1lobe prq CPT 60660 | not published | not published | $1,247.68 – $14,906.00 | 3 |
| Abltj mal prst8 tiss hifu CPT 55880 | not published | not published | $6,798.00 – $9,811.00 | 4 |
| Ablt trurl prst8 tis trnsdcr CPT 55882 | not published | not published | $9,966.87 – $13,711.00 | 3 |
| Abobotulinumtoxina HCPCS J0586 | not published | not published | $6.71 – $17.42 | 5 |
| Abortion CPT 59850 | not published | not published | $4,321.00 – $4,321.00 | 1 |
| Abortion (mpr) CPT 59866 | not published | not published | $230.21 – $4,074.00 | 4 |
| Abrasion lesions add-on CPT 15787 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Abrasion lesion single CPT 15786 | not published | not published | $151.57 – $4,074.00 | 4 |
| Abscess drain retroperitoneal surg code CPT 49406 | $1,945.90 | $3,538.00 | $1,247.68 – $4,321.00 | 4 |
| Access & clsr pq fem art endogft dlvry w/img uni CPT 34713 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Access thoracic lymph duct CPT 38794 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | not published | not published | $0.07 – $0.10 | 3 |
| Acetaminophen 120 mg rectal suppository HCPCS A9270 | $107.02 | $194.58 | not published | 0 |
| Acetaminophen level CPT 80143 | $294.25 | $535.00 | $13.98 – $108.82 | 5 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | not published | not published | $27.64 – $40.00 | 3 |
| Acetone qualitative CPT 82009 | $40.15 | $73.00 | $3.39 – $35.95 | 5 |
| Acetylcholine receptor modulating antibody CPT 86043 | $52.80 | $96.00 | $9.04 – $55.14 | 5 |
| Acetylcholinesterase assay CPT 82013 | $108.35 | $197.00 | $9.22 – $88.78 | 5 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | not published | not published | $0.65 – $1.02 | 3 |
| Acetylcysteine non-comp unit HCPCS J7608 | not published | not published | $12.24 – $16.89 | 3 |
| Acid perfusion of esophagus CPT 91030 | not published | not published | $281.90 – $1,704.00 | 3 |
| Acne surgery 10040 CPT 10040 | not published | not published | $151.57 – $4,074.00 | 4 |
| Aco annual medicare visit (awv), initial g0438aco HCPCS G0438 | not published | not published | $125.24 – $166.99 | 2 |
| Aco annual medicare visit (awv), subsq g0439aco HCPCS G0439 | not published | not published | $98.78 – $131.70 | 2 |
| Acoustic immitance testing CPT 92570 | not published | not published | $97.20 – $129.61 | 2 |
| Acoustic refl threshold tst CPT 92568 | not published | not published | $28.22 – $37.62 | 2 |
| Acromp/acromionectomy prtl CPT 23130 | not published | not published | $2,471.80 – $14,543.00 | 4 |
| Actigraphy testing CPT 95803 | not published | not published | $44.57 – $59.42 | 2 |
| Actinotherapy uv light CPT 96900 | not published | not published | $28.22 – $37.62 | 2 |
| Acup 1/> w/estim 1st 15 min CPT 97813 | not published | not published | $21.85 – $29.13 | 2 |
| Acup 1/> wo estim 1st 15 min CPT 97810 | not published | not published | $21.85 – $29.13 | 2 |
| Acute hepatitis panel CPT 80074 | $281.05 | $511.00 | $35.72 – $378.79 | 5 |
| Acute venous thrombus image CPT 78456 | not published | not published | $978.03 – $2,155.34 | 3 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | not published | not published | $0.06 – $0.09 | 3 |
| #acylcarnitineprfl CPT 82017 | $149.05 | $271.00 | $12.65 – $114.58 | 5 |
| Acylcarnitines qual CPT 82016 | $180.95 | $329.00 | $12.37 – $110.28 | 5 |
| Adapter b 8 channel 10cm HCPCS C1883 | $1,119.06 | $2,034.66 | not published | 0 |
| Adding walker to prev cast CPT 29440 | not published | not published | $122.76 – $4,074.00 | 4 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | not published | not published | $0.57 – $0.87 | 3 |
| Adenovirus ag ia CPT 87301 | not published | not published | $8.98 – $95.32 | 5 |
| Adenovirus antibody,serum - quest CPT 86603 | $86.90 | $158.00 | $9.65 – $46.24 | 5 |
| Adenovirus assay w/optic CPT 87809 | not published | not published | $16.32 – $95.32 | 5 |
| Adhesiolysis tube ovary 58740 CPT 58740 | not published | not published | $6,798.00 – $9,811.00 | 2 |
| Adh-sendout CPT 84588 | $42.90 | $78.00 | $25.46 – $269.93 | 5 |
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.