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 |
|---|---|---|---|---|
| Cryoprecipitate each unit HCPCS P9012 | $364.65 | $663.00 | not published | 0 |
| Cryopreservation embryo(s) CPT 89258 | not published | not published | $608.64 – $811.52 | 2 |
| Cryopreservation oocyte(s) CPT 89337 | not published | not published | $128.70 – $171.61 | 2 |
| Cryopreservation sperm CPT 89259 | not published | not published | $128.70 – $171.61 | 2 |
| Cryopreserve stem cells CPT 38207 | not published | not published | $333.28 – $4,074.00 | 4 |
| Cryopreserve testicular tiss CPT 89335 | not published | not published | $39.37 – $52.49 | 2 |
| Cryosurg ablate fa each CPT 19105 | not published | not published | $2,957.88 – $10,498.00 | 4 |
| Cryosurgery penis lesion(s) 54056 CPT 54056 | not published | not published | $151.57 – $4,074.00 | 4 |
| Cryotherapy of acne 17340 CPT 17340 | not published | not published | $44.57 – $4,074.00 | 4 |
| Cryptococcus abs qn - sendout CPT 86641 | not published | not published | $10.81 – $46.24 | 5 |
| Cryptosporidium antigen CPT 87272 | not published | not published | $8.98 – $95.32 | 5 |
| Crystal identification light microscopy CPT 89060 | $97.90 | $178.00 | $5.50 – $56.92 | 5 |
| C-Section Delivery (full care) CPT 59510 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| C-section delivery incl p/p care 59515 CPT 59515 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Csf leakage imaging CPT 78650 | $1,097.25 | $1,995.00 | $978.03 – $2,412.86 | 3 |
| Csf shunt reprogram 62252 CPT 62252 | not published | not published | $232.02 – $4,074.00 | 4 |
| Csf ventriculography CPT 78635 | not published | not published | $410.18 – $2,484.83 | 3 |
| CT 3d report other modality w/workstation CPT 76377 | $1,980.55 | $3,601.00 | $189.94 – $189.94 | 1 |
| Cta abdomen without & /or w/contrast CPT 74175 | $3,183.40 | $5,788.00 | $132.50 – $1,667.46 | 3 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $3,211.45 | $5,839.00 | $132.50 – $2,012.48 | 3 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $2,228.60 | $4,052.00 | $132.50 – $1,984.80 | 3 |
| Cta neck without &/or w/contrast CPT 70498 | $2,148.85 | $3,907.00 | $132.50 – $1,587.15 | 3 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $4,110.70 | $7,474.00 | $263.55 – $2,152.04 | 3 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $3,125.65 | $5,683.00 | $132.50 – $1,609.32 | 3 |
| CT Angiogram of the Head CPT 70496 | $2,478.85 | $4,507.00 | $132.50 – $1,598.23 | 3 |
| CT angio hrt w/3d image CPT 75574 | $1,654.40 | $3,008.00 | $263.55 – $2,319.83 | 3 |
| CT angio pelvis CPT 72191 | $3,183.40 | $5,788.00 | $132.50 – $1,659.15 | 3 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $2,231.90 | $4,058.00 | $132.50 – $1,833.59 | 3 |
| CT bone density axial CPT 77078 | not published | not published | $65.74 – $782.51 | 3 |
| CT cerebral perf w cont & prcssng CPT 70473 | not published | not published | $132.50 – $176.67 | 2 |
| CT colonography dx CPT 74261 | not published | not published | $78.98 – $2,822.16 | 3 |
| CT colonography dx w/dye CPT 74262 | not published | not published | $132.50 – $3,209.82 | 3 |
| CT colonography screening CPT 74263 | not published | not published | $180.25 – $4,982.00 | 3 |
| CT guidance for needle placement CPT 77012 | $1,616.45 | $2,939.00 | $516.70 – $516.70 | 1 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $679.80 | $1,236.00 | $480.69 – $480.69 | 1 |
| CT guid cryo ablat intramuscular CPT 20999 | not published | not published | $186.34 – $13,711.00 | 4 |
| CT guid parench tis ablat CPT 77013 | $1,676.40 | $3,048.00 | $2,680.55 – $2,680.55 | 1 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $145.75 | $265.00 | $65.74 – $552.68 | 3 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | not published | not published | $263.55 – $2,041.28 | 3 |
| CT hrt w/3d image CPT 75572 | not published | not published | $263.55 – $1,520.70 | 3 |
| CT limited or localized follow-up study CPT 76380 | $900.90 | $1,638.00 | $65.74 – $746.52 | 3 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $1,398.65 | $2,543.00 | $132.50 – $1,297.55 | 3 |
| CT lower extremity without contrast (both sides) CPT 73700 | $1,271.05 | $2,311.00 | $78.98 – $995.72 | 3 |
| CT lwr extremity w/o&w/dye CPT 73702 | $1,525.70 | $2,774.00 | $132.50 – $1,654.75 | 3 |
| CT neck soft tissue w/contrast CPT 70491 | $1,309.55 | $2,381.00 | $132.50 – $1,283.70 | 3 |
| CT neck soft tissue without contrast CPT 70490 | $970.75 | $1,765.00 | $78.98 – $992.97 | 3 |
| CT neck soft tissue without & w/contrast CPT 70492 | $1,395.90 | $2,538.00 | $132.50 – $1,585.53 | 3 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $1,349.15 | $2,453.00 | $132.50 – $1,769.92 | 3 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $1,320.00 | $2,400.00 | $132.50 – $1,599.36 | 3 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $1,202.30 | $2,186.00 | $78.98 – $1,305.84 | 3 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | $451.55 | $821.00 | $178.93 – $4,074.00 | 4 |
| CT scan for therapy guide CPT 77014 | $851.40 | $1,548.00 | $574.83 – $574.83 | 1 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $4,091.45 | $7,439.00 | $263.55 – $1,947.16 | 3 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $3,749.90 | $6,818.00 | $263.55 – $1,699.06 | 3 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $3,408.90 | $6,198.00 | $180.25 – $865.58 | 3 |
| CT thoracic spine w/contrast CPT 72129 | $2,254.45 | $4,099.00 | $132.50 – $1,300.31 | 3 |
| CT thoracic spine without contrast CPT 72128 | $2,049.85 | $3,727.00 | $78.98 – $1,004.04 | 3 |
| CT thorax low dose for lung screening without contrast CPT 71271 | not published | not published | $78.98 – $762.88 | 3 |
| CT t-spine w /wo contrast CPT 72130 | $2,459.60 | $4,472.00 | $132.50 – $1,615.98 | 3 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $1,706.10 | $3,102.00 | $263.55 – $1,269.86 | 3 |
| CT upper extremity without contrast (both sides) CPT 73200 | $1,333.75 | $2,425.00 | $78.98 – $992.97 | 3 |
| CT uppr extremity w/o&w/dye CPT 73202 | $2,315.50 | $4,210.00 | $132.50 – $1,674.16 | 3 |
| Cultr oocyte/embryo <4 days CPT 89250 | not published | not published | $128.70 – $5,848.19 | 3 |
| Cultr oocyte/embryo <4 days CPT 89251 | not published | not published | $128.70 – $6,081.88 | 3 |
| Cult skin graft fnhfg 15155 CPT 15155 | not published | not published | $2,677.07 – $10,498.00 | 4 |
| Cult skin grft t/arm/leg CPT 15150 | not published | not published | $1,558.69 – $4,321.00 | 4 |
| Culture aerobic additional method definitive id each CPT 87077 | $256.30 | $466.00 | $6.06 – $64.22 | 5 |
| Culture afb any source CPT 87116 | $242.00 | $440.00 | $8.10 – $85.85 | 5 |
| Culture anaerobic additional method definitive id each CPT 87076 | $474.65 | $863.00 | $6.06 – $64.22 | 5 |
| Culture anaerobic except blood CPT 87075 | $257.40 | $468.00 | $7.10 – $75.31 | 5 |
| Culture bact stool aero addl path ea CPT 87046 | $77.00 | $140.00 | $7.08 – $75.07 | 5 |
| Culture body fluid CPT 87070 | $227.70 | $414.00 | $6.46 – $68.54 | 5 |
| Culture fungi definitive id mold CPT 87107 | $41.80 | $76.00 | $7.74 – $82.14 | 5 |
| Culture fungi definitive id yeast CPT 87106 | $142.45 | $259.00 | $7.74 – $82.14 | 5 |
| Culture fungi other (except blood) CPT 87102 | $62.70 | $114.00 | $6.31 – $66.84 | 5 |
| Culture fungi skin/hair/nail CPT 87101 | $163.90 | $298.00 | $5.78 – $61.29 | 5 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $243.65 | $443.00 | $10.96 – $87.04 | 5 |
| Culture mycoplasma any source CPT 87109 | $122.65 | $223.00 | $11.54 – $79.22 | 5 |
| Culture quantitative aerobic other source CPT 87071 | not published | not published | $7.42 – $75.07 | 5 |
| Culture screening strep group a CPT 87081 | $217.25 | $395.00 | $4.97 – $52.71 | 5 |
| Culture typing added method CPT 87158 | $119.35 | $217.00 | $5.80 – $41.63 | 5 |
| Culture typing immunologic CPT 87147 | $138.05 | $251.00 | $3.88 – $41.15 | 5 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | $430.10 | $782.00 | $163.54 – $1,271.80 | 5 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $367.40 | $668.00 | $26.32 – $279.04 | 5 |
| Culture urine each isolate CPT 87088 | $187.00 | $340.00 | $6.07 – $64.39 | 5 |
| Culture virus isolation CPT 87250 | not published | not published | $14.67 – $155.56 | 5 |
| Curette/treat cornea CPT 65435 | not published | not published | $753.08 – $4,321.00 | 4 |
| Curette/treat cornea CPT 65436 | not published | not published | $1,796.05 – $6,798.00 | 4 |
| Cutter lead HCPCS C1773 | $872.68 | $1,586.70 | not published | 0 |
| Cv line/pic reposition CPT 36597 | $1,276.55 | $2,321.00 | $1,189.18 – $4,321.00 | 4 |
| Cyanocobalamin unsat binding capacity CPT 82608 | not published | not published | $10.74 – $113.88 | 5 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | not published | not published | $0.97 – $2.35 | 3 |
| Cyclic citrullinated peptide antibody CPT 86200 | $59.40 | $108.00 | $9.71 – $102.92 | 5 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | not published | not published | $0.43 – $1.63 | 5 |
| Cyclophosphamide 25 mg capsule HCPCS J8530 | not published | not published | $1.55 – $3.77 | 3 |
| Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 | not published | not published | $103.53 – $138.11 | 3 |
| Cyclosporine 2 hour CPT 80158 | $42.35 | $77.00 | $13.54 – $143.53 | 5 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | not published | not published | $1.07 – $1.54 | 3 |
| Cyclosporine oral 100 mg HCPCS J7502 | not published | not published | $2.93 – $4.07 | 3 |
| Cyp2c19 gene com variants CPT 81225 | not published | not published | $218.52 – $1,700.81 | 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.