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 |
|---|---|---|---|---|
| Chromosome analys placenta CPT 88267 | $327.80 | $596.00 | $141.43 – $1,429.55 | 5 |
| Chromosome banding study CPT 88283 | not published | not published | $51.45 – $545.52 | 5 |
| Chromosome count additional CPT 88285 | not published | not published | $20.18 – $151.06 | 5 |
| Chromosome karyotype study CPT 88280 | $327.80 | $596.00 | $25.10 – $199.59 | 5 |
| Chromosome study additional CPT 88289 | $245.30 | $446.00 | $25.82 – $273.85 | 5 |
| Chronic urticaria - sendout CPT 86343 | not published | not published | $9.34 – $99.11 | 5 |
| Chylomicron screen, bf - sendout CPT 82664 | $205.15 | $373.00 | $46.12 – $273.20 | 5 |
| Cidofovir injection HCPCS J0740 | not published | not published | $401.80 – $1,005.81 | 5 |
| Cilastatin sodium injection HCPCS J0743 | not published | not published | $10.64 – $13.32 | 3 |
| Ciliary transsleral therapy CPT 66710 | not published | not published | $1,796.05 – $6,798.00 | 4 |
| Ciltacabtagene car-pos t HCPCS Q2056 | not published | not published | $440,983.32 – $1,051,419.78 | 5 |
| Cine/video x-rays CPT 76120 | not published | not published | $78.98 – $497.31 | 3 |
| Cine/video x-rays add-on CPT 76125 | not published | not published | $246.36 – $246.36 | 1 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | not published | not published | $1.54 – $4.41 | 3 |
| Circum 28 days or older CPT 54161 | not published | not published | $1,579.16 – $6,798.00 | 4 |
| Circumcise/surg/28 days or < 54160 CPT 54160 | not published | not published | $526.77 – $6,798.00 | 4 |
| Circumcision (newborn) CPT 54150 | $479.05 | $871.00 | $1,579.16 – $6,798.00 | 4 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | not published | not published | $3.70 – $4.98 | 3 |
| C-kit mutation liquid tumor - sendout CPT 81272 | $2,322.65 | $4,223.00 | $247.13 – $1,923.50 | 5 |
| Cladribine 10 mg/10 ml intravenous solution HCPCS J9065 | not published | not published | $6.14 – $20.85 | 5 |
| Claviculectomy partial CPT 23120 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Claviculectomy total CPT 23125 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Clean out mastoid cavity CPT 69222 | not published | not published | $407.43 – $4,074.00 | 4 |
| Clearance of airways CPT 31720 | $232.65 | $423.00 | $165.42 – $4,074.00 | 4 |
| Clearance of tear duct CPT 68530 | not published | not published | $239.78 – $4,074.00 | 4 |
| C-lens fitg corneosclrl lens CPT 92313 | not published | not published | $100.51 – $134.01 | 2 |
| C-lens fitg tech aphakia 1 CPT 92315 | not published | not published | $100.51 – $134.01 | 2 |
| C-lens fitg tech aphakia ou CPT 92316 | not published | not published | $100.51 – $134.01 | 2 |
| C-lens fitg tech corneosclrl CPT 92317 | not published | not published | $28.22 – $37.62 | 2 |
| Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 | not published | not published | $2.33 – $3.94 | 3 |
| Clip ligating vesolock lg HCPCS C1760 | $457.04 | $830.98 | not published | 0 |
| Clitoroplasty intersex state CPT 56805 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Clofarabine 1 mg/ml intravenous solution HCPCS J9027 | not published | not published | $12.18 – $27.96 | 5 |
| Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 | not published | not published | $23.49 – $33.58 | 3 |
| Close bronchial fistula 32815 CPT 32815 | not published | not published | $14,906.00 – $14,906.00 | 1 |
| Closed carpo/metacarpal disl thumb w/manip CPT 26641 | $937.20 | $1,704.00 | $186.34 – $4,074.00 | 4 |
| Closed carpo/metacarpal fx disl thumb w/manip CPT 26645 | $1,099.45 | $1,999.00 | $1,214.74 – $4,321.00 | 4 |
| Closed treatment of femoral fracture proximal end neck; wi CPT 27232 | not published | not published | $1,214.74 – $4,074.00 | 4 |
| Closed tx/acetabululm without manip 27220 CPT 27220 | not published | not published | $186.34 – $4,074.00 | 4 |
| Closed tx humerus fx with manip 23605 CPT 23605 | $1,272.70 | $2,314.00 | $1,214.74 – $6,798.00 | 4 |
| Closed tx humerus fx without manip 23600 CPT 23600 | not published | not published | $186.34 – $4,074.00 | 4 |
| Closed tx humerus fx w/manip 24505 CPT 24505 | $2,387.55 | $4,341.00 | $1,214.74 – $4,321.00 | 4 |
| Closed tx metatarsophalangeal jnt disl without anes CPT 28630 | $758.45 | $1,379.00 | $186.34 – $4,074.00 | 4 |
| Closed tx nose/jaw fx CPT 21345 | not published | not published | $1,172.13 – $4,321.00 | 4 |
| Closed tx orbit without manipulj CPT 21400 | not published | not published | $407.43 – $4,074.00 | 4 |
| Closed tx orbit w/manipulj CPT 21401 | not published | not published | $1,172.13 – $4,321.00 | 4 |
| Closed tx post hip arthroplasty disloc w/anes 27266 CPT 27266 | not published | not published | $1,214.74 – $4,321.00 | 4 |
| Closed tx septal&nose fx CPT 21337 | not published | not published | $2,504.63 – $4,321.00 | 4 |
| Closed tx sesamoid fx 28530 CPT 28530 | not published | not published | $186.34 – $4,074.00 | 4 |
| Closed tx/talus fracture without manip 28430 CPT 28430 | $523.05 | $951.00 | $186.34 – $4,074.00 | 4 |
| Closed tx vert fx w/manj CPT 22315 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Close lac/mouth vest/2.5 cm or < 40830 CPT 40830 | not published | not published | $178.93 – $4,074.00 | 4 |
| Close mastoid fistula CPT 69700 | not published | not published | $1,172.13 – $4,321.00 | 4 |
| Close median sternotomy separation 21750 CPT 21750 | not published | not published | $5,481.64 – $16,582.00 | 4 |
| Close tear duct opening CPT 68760 | not published | not published | $239.78 – $4,074.00 | 4 |
| Close tear duct opening CPT 68761 | not published | not published | $239.78 – $4,074.00 | 4 |
| Close tear system fistula CPT 68770 | not published | not published | $1,796.05 – $4,321.00 | 4 |
| Clostridium toxin a w/optic CPT 87803 | not published | not published | $12.00 – $95.32 | 5 |
| Clos txnose fx without stablz 21315 CPT 21315 | $1,311.75 | $2,385.00 | $1,172.13 – $4,321.00 | 4 |
| Closure enterostomy lg/sm intestine 44620 CPT 44620 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Closure enterostomy lg/sm intestine anast 44626 CPT 44626 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Closure enterostomy lg/sm intestine oth/thn 44625 CPT 44625 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Closure intestinal cutaneous fistula 44640 CPT 44640 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Closure laceration vestibule mouth > 2.5 cm cmplx CPT 40831 | not published | not published | $407.43 – $4,074.00 | 4 |
| Closure of eyelid by suture CPT 67875 | not published | not published | $753.08 – $4,321.00 | 4 |
| Closure of salivary fistula CPT 42600 | not published | not published | $2,504.63 – $4,321.00 | 4 |
| Closure of windpipe lesion 31820 CPT 31820 | not published | not published | $2,504.63 – $6,798.00 | 4 |
| Closure paravalvlr leak pq CPT 33999 | not published | not published | $473.89 – $13,711.00 | 4 |
| Clot factor fletcher fact CPT 85292 | not published | not published | $14.20 – $150.61 | 5 |
| Clot factor viii reltd antgn CPT 85244 | not published | not published | $15.32 – $162.41 | 5 |
| Clot factor wght kininogen CPT 85293 | not published | not published | $14.20 – $150.61 | 5 |
| Clot factor xii hageman CPT 85280 | $96.25 | $175.00 | $14.51 – $153.89 | 5 |
| Clot factor xiii fibrin scrn CPT 85291 | $47.30 | $86.00 | $6.83 – $70.75 | 5 |
| Clot factor xiii fibrin stab CPT 85290 | $258.50 | $470.00 | $12.26 – $129.95 | 5 |
| Clotting assay whole blood CPT 85396 | not published | not published | $119.70 – $119.70 | 1 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | $370.70 | $674.00 | $186.34 – $4,074.00 | 4 |
| Clsd tx bimalleol ank fx without manip 27808 CPT 27808 | not published | not published | $186.34 – $4,074.00 | 4 |
| Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 | not published | not published | $186.34 – $4,074.00 | 4 |
| Clsd tx clav dislc without manip 23520 CPT 23520 | not published | not published | $1,214.74 – $4,321.00 | 4 |
| Clsd tx clavicle dislocation without manip 23540 CPT 23540 | not published | not published | $186.34 – $4,074.00 | 4 |
| Clsd tx clavicle fracture w/manip 23505 CPT 23505 | not published | not published | $1,214.74 – $4,321.00 | 4 |
| Clsd tx/clavicular fx without manip 23500 CPT 23500 | $394.35 | $717.00 | $186.34 – $4,074.00 | 4 |
| Clsd tx coccygeal fracture 27200 CPT 27200 | $426.25 | $775.00 | $186.34 – $4,074.00 | 4 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | $426.25 | $775.00 | $186.34 – $4,074.00 | 4 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | $358.05 | $651.00 | $186.34 – $4,074.00 | 4 |
| Clsd tx/dis tib/wt bear no manip 27824 CPT 27824 | not published | not published | $186.34 – $4,074.00 | 4 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | $486.75 | $885.00 | $186.34 – $4,074.00 | 4 |
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | $3,110.80 | $5,656.00 | $1,214.74 – $4,321.00 | 4 |
| Clsd tx finger tendon w/wo perq pin 26432 CPT 26432 | not published | not published | $1,214.74 – $4,321.00 | 4 |
| Clsd tx fracture of radius 25500 CPT 25500 | not published | not published | $186.34 – $4,074.00 | 4 |
| Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 | $426.25 | $775.00 | $186.34 – $4,074.00 | 4 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $394.35 | $717.00 | $186.34 – $4,074.00 | 4 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | $572.55 | $1,041.00 | $186.34 – $4,074.00 | 4 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $1,106.05 | $2,011.00 | $1,214.74 – $4,321.00 | 4 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | not published | not published | $186.34 – $4,074.00 | 4 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $1,702.80 | $3,096.00 | $1,214.74 – $4,321.00 | 4 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | not published | not published | $186.34 – $4,074.00 | 4 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $523.05 | $951.00 | $186.34 – $4,074.00 | 4 |
| Clsd tx humeral fract without manip 24530 CPT 24530 | not published | not published | $186.34 – $4,074.00 | 4 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | not published | not published | $186.34 – $4,074.00 | 4 |
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.