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 |
|---|---|---|---|---|
| Dalteparin sodium HCPCS J1645 | not published | not published | $23.26 – $34.28 | 3 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | not published | not published | $0.04 – $0.07 | 3 |
| Daptomycin (xellia) unrefrig HCPCS J0872 | not published | not published | $0.07 – $0.10 | 3 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | not published | not published | $42.79 – $103.87 | 5 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | not published | not published | $2.19 – $5.69 | 5 |
| Darbepoetin alfa, esrd use HCPCS J0882 | not published | not published | $2.19 – $5.69 | 5 |
| Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 | not published | not published | $204.66 – $484.67 | 5 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | not published | not published | $37.55 – $43.51 | 3 |
| Dbrdmt prmlg les w/pdt CPT 96574 | not published | not published | $151.57 – $4,074.00 | 4 |
| D&c after delivery 59160 CPT 59160 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| D&c/diagnostic/therapeutic/non ob 58120 CPT 58120 | $3,092.65 | $5,623.00 | $2,445.46 – $6,798.00 | 4 |
| Dch glucoscan CPT 82948 | $6.60 | $12.00 | $3.78 – $25.23 | 5 |
| Dch pulmonary stress test CPT 94621 | not published | not published | $281.90 – $375.86 | 2 |
| Dch validity tests CPT 81002 | $16.50 | $30.00 | $2.61 – $20.32 | 5 |
| Dcm pq ndl dsk sgl/mlt lv lmbr w/guide CPT 62287 | $7,630.70 | $13,874.00 | $1,475.17 – $9,811.00 | 4 |
| Dcmprn orbit only transcrnl CPT 61330 | not published | not published | $2,504.63 – $14,543.00 | 4 |
| Dcmprn plantar digital nerve CPT 64726 | not published | not published | $1,475.17 – $6,798.00 | 4 |
| D&c of cervical stump CPT 57558 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Deamidated gliadin antibody iga CPT 86258 | $20.90 | $38.00 | $9.04 – $67.26 | 5 |
| Debr g/per/abd wall 11006 CPT 11006 | not published | not published | $4,074.00 – $4,074.00 | 1 |
| Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 | $525.80 | $956.00 | $307.10 – $4,074.00 | 4 |
| Debridement (>20 cm) charge pt CPT 97598 | $190.85 | $347.00 | $1,704.00 – $1,704.00 | 1 |
| Debridement bone <= 20 sq cm CPT 11044 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | not published | not published | $307.10 – $4,074.00 | 4 |
| Debride nail1-5 11720 CPT 11720 | not published | not published | $44.57 – $4,074.00 | 4 |
| Debride nail6 or more 11721 CPT 11721 | not published | not published | $44.57 – $4,074.00 | 4 |
| Debride/rmv fb/open fx/skin/sq/musc11011 CPT 11011 | not published | not published | $534.95 – $4,074.00 | 4 |
| Debride skin bone at fx site CPT 11012 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Debride skn/sq/musc/abd wall 11004 CPT 11004 | not published | not published | $4,074.00 – $4,074.00 | 1 |
| Debride skn/sq t/m/f necro infctj abdl wall 11005 CPT 11005 | not published | not published | $4,074.00 – $4,074.00 | 1 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Debrid mastoidectomy cavity simple 69220 CPT 69220 | not published | not published | $151.57 – $4,074.00 | 4 |
| Debrid/rmv fgn bdy/open fx/skin/sq 11010 CPT 11010 | not published | not published | $534.95 – $4,074.00 | 4 |
| Debr inf skin add-on 11001 CPT 11001 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | not published | not published | $558.33 – $4,074.00 | 4 |
| Decalcification CPT 88311 | $40.15 | $73.00 | $47.12 – $47.12 | 1 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | not published | not published | $2.57 – $4.31 | 3 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $403.15 | $733.00 | $249.53 – $4,074.00 | 4 |
| Decomp fasct leg ant+/lat+pst cmprt 27602 CPT 27602 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Decomp forearm 1 space 25020 CPT 25020 | not published | not published | $1,214.74 – $7,919.00 | 4 |
| Decomp forearm 2 spaces w/debrid 25025 CPT 25025 | not published | not published | $1,214.74 – $6,798.00 | 4 |
| Decompress fasciotomyhand 26037 CPT 26037 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Decompress fingers/hand CPT 26035 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Decompress forearm 1 space CPT 25023 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Decompress forearm 2 spaces CPT 25024 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Decompression fasct forearm CPT 24495 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Decompression of leg CPT 27892 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Decompression of leg CPT 27893 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Decompression of leg CPT 27894 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Decompression of lower leg CPT 27600 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Decompression of lower leg CPT 27601 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Decompression of thigh/knee CPT 27496 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Decompression of thigh/knee CPT 27497 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Decompression of thigh/knee CPT 27498 | not published | not published | $1,214.74 – $7,919.00 | 4 |
| Decompression of thigh/knee CPT 27499 | not published | not published | $5,481.64 – $13,711.00 | 4 |
| Decompression of tibia nerve CPT 28035 | not published | not published | $1,475.17 – $6,798.00 | 4 |
| Decompression unspecified nerve 64722 CPT 64722 | not published | not published | $1,475.17 – $6,798.00 | 4 |
| Decompressive craniotomy CPT 61322 | not published | not published | $18,190.00 – $18,190.00 | 1 |
| Decompress optic nerve CPT 67570 | not published | not published | $2,969.94 – $10,498.00 | 4 |
| Decompres spinal cord;thoracic 63055 CPT 63055 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Decompress small bowel CPT 44021 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Decompress spinal cord lmbr CPT 63056 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Decompress spinal cord thrc CPT 63064 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Decomp spinal cord/transped/ad seg 63057 CPT 63057 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Deep muscle biopsy 20205 CPT 20205 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | not published | not published | $11.90 – $17.13 | 3 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | not published | not published | $3.36 – $8.28 | 5 |
| Delayed breast prosthesis 19342 CPT 19342 | not published | not published | $6,174.51 – $16,582.00 | 4 |
| Delay flap arms/legs CPT 15610 | not published | not published | $1,558.69 – $6,798.00 | 4 |
| Delay flap eye/nos/ear/lip CPT 15630 | not published | not published | $1,558.69 – $4,321.00 | 4 |
| Delay flap fccnaxghf 15620 CPT 15620 | not published | not published | $1,558.69 – $4,321.00 | 4 |
| Delay flap trunk 15600 CPT 15600 | not published | not published | $2,677.07 – $10,498.00 | 4 |
| Delivery of placenta 59414 CPT 59414 | $3,320.35 | $6,037.00 | $2,445.46 – $6,798.00 | 4 |
| Delivery only failed vbac 59620 CPT 59620 | not published | not published | $4,321.00 – $4,321.00 | 1 |
| Delivery only/pp care/failed vbac 59622 CPT 59622 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Delivery transcath fxtn dvc to endogrft w/s&i CPT 34712 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $210.65 | $383.00 | $165.42 – $220.57 | 2 |
| Denervation of hip joint CPT 27035 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | not published | not published | $22.58 – $55.55 | 5 |
| Dentoalveolar/drain abs/cyst/hema 41800 CPT 41800 | $132.00 | $240.00 | $100.51 – $4,074.00 | 4 |
| Depo-estradiol cypionate inj HCPCS J1000 | not published | not published | $61.36 – $89.13 | 3 |
| Dermabrasion other than face CPT 15782 | not published | not published | $2,194.34 – $4,321.00 | 4 |
| Dermabrasion segmental face 15781 CPT 15781 | not published | not published | $534.95 – $4,074.00 | 4 |
| Dermabrasion suprfl any site CPT 15783 | not published | not published | $307.10 – $4,074.00 | 4 |
| Dermabrasion total face CPT 15780 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Derma-fat-fascia graft 15770 CPT 15770 | not published | not published | $2,677.07 – $10,498.00 | 4 |
| Dermal filler injection(s) HCPCS G0429 | not published | not published | $1,558.69 – $2,078.25 | 2 |
| Derm autograft face/nck/hf/g CPT 15135 | not published | not published | $2,677.07 – $10,498.00 | 4 |
| Derm autograft trnk/arm/leg CPT 15130 | not published | not published | $1,558.69 – $6,798.00 | 4 |
| Descend thora aorta rpr/lt sub art 33880 CPT 33880 | $5,328.40 | $9,688.00 | $16,352.00 – $16,352.00 | 1 |
| Design custom breast implant CPT 19396 | not published | not published | $2,957.88 – $10,498.00 | 4 |
| Design mlc device for imrt CPT 77338 | $2,532.20 | $4,604.00 | $282.86 – $2,225.10 | 3 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | not published | not published | $6.51 – $9.16 | 3 |
| Desoxycorticosterone CPT 82633 | not published | not published | $23.24 – $246.36 | 5 |
| Des thora aorta/ea add prox prosth 33884 CPT 33884 | $1,258.95 | $2,289.00 | $16,352.00 – $16,352.00 | 1 |
| Des thora aorta rpr without left sub art 33881 CPT 33881 | $4,445.65 | $8,083.00 | $16,352.00 – $16,352.00 | 1 |
| Des thor aorta/prox ext prosth/ini 33883 CPT 33883 | $3,388.00 | $6,160.00 | $16,352.00 – $16,352.00 | 1 |
| Dest mal lesion feenlm <0.5cm 17280 CPT 17280 | not published | not published | $151.57 – $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.