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 |
|---|---|---|---|---|
| Dest mal lesion feenlm 0.6-1cm 17281 CPT 17281 | not published | not published | $151.57 – $4,074.00 | 4 |
| Dest mal lesion feenlm 1.1 - 2.0 cm 17282 CPT 17282 | not published | not published | $151.57 – $4,074.00 | 4 |
| Dest mal lesion snhfg <0.5cm 17270 CPT 17270 | not published | not published | $151.57 – $4,074.00 | 4 |
| Dest mal lesion snhfg 0.6-1cm 17271 CPT 17271 | not published | not published | $151.57 – $4,074.00 | 4 |
| Dest mal lesion snhfg 1.1-2cm 17272 CPT 17272 | not published | not published | $151.57 – $4,074.00 | 4 |
| Dest mal lesion tal <0.5 17260 CPT 17260 | not published | not published | $151.57 – $4,074.00 | 4 |
| Dest mal lesion tal 0.6-1.0cm 17261 CPT 17261 | not published | not published | $151.57 – $4,074.00 | 4 |
| Dest mal lesion tal 1.1-2.0cm 17262 CPT 17262 | not published | not published | $151.57 – $4,074.00 | 4 |
| Dest mal lesion tal 2.1-3.0cm 17263 CPT 17263 | not published | not published | $151.57 – $4,074.00 | 4 |
| Destroy cervthor facet jnt 64633 CPT 64633 | $2,960.10 | $5,382.00 | $1,475.17 – $6,798.00 | 4 |
| Destroy cth facet jnt addl 64634 CPT 64634 | $1,070.30 | $1,946.00 | $1,704.00 – $1,704.00 | 1 |
| Destroy internal hemorrhoids destroy 46930 CPT 46930 | not published | not published | $903.99 – $4,321.00 | 4 |
| Destroy premlg lesns;1st lesn 17000 CPT 17000 | $210.65 | $383.00 | $151.57 – $4,074.00 | 4 |
| Destroy vulva lesion extensive 56515 CPT 56515 | not published | not published | $1,558.69 – $4,321.00 | 4 |
| Destroy vulva lesion simple 56501 CPT 56501 | not published | not published | $1,558.69 – $4,321.00 | 4 |
| Destruct ben lesion 15/> 17111 CPT 17111 | not published | not published | $151.57 – $4,074.00 | 4 |
| Destruct cut vasl lesions 10-50cm 17107 CPT 17107 | not published | not published | $558.33 – $4,074.00 | 4 |
| Destruct cut vasl lesions <10cm 17106 CPT 17106 | not published | not published | $307.10 – $4,074.00 | 4 |
| Destruct cut vasl lesions >50cm 17108 CPT 17108 | not published | not published | $1,558.69 – $4,321.00 | 4 |
| Destruction 2-14 lesions 17003 CPT 17003 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Destruction anal lesion(s) CPT 46910 | not published | not published | $1,558.69 – $4,321.00 | 4 |
| Destruction anal lesion(s) CPT 46924 | not published | not published | $2,096.85 – $6,798.00 | 4 |
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | not published | not published | $307.10 – $4,074.00 | 4 |
| Destruction benign lesions < 14 lesions CPT 17110 | not published | not published | $151.57 – $4,074.00 | 4 |
| Destruction by injection tx of nerve 64630 CPT 64630 | not published | not published | $668.17 – $4,074.00 | 4 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | $955.90 | $1,738.00 | $1,704.00 – $1,704.00 | 1 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | $2,664.20 | $4,844.00 | $1,475.17 – $6,798.00 | 4 |
| Destruction ciliary body CPT 66700 | not published | not published | $1,743.42 – $4,321.00 | 4 |
| Destruction ciliary body CPT 66720 | not published | not published | $1,796.05 – $6,798.00 | 4 |
| Destruction ciliary body CPT 66740 | not published | not published | $1,796.05 – $6,798.00 | 4 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | not published | not published | $151.57 – $4,074.00 | 4 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | not published | not published | $2,096.85 – $6,798.00 | 4 |
| Destruction les conjunctiva CPT 68135 | not published | not published | $1,796.05 – $6,798.00 | 4 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | $307.10 – $4,074.00 | 4 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | $307.10 – $4,074.00 | 4 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | not published | not published | $307.10 – $4,074.00 | 4 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | not published | not published | $307.10 – $4,074.00 | 4 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | not published | not published | $307.10 – $4,074.00 | 4 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | $1,558.69 – $4,321.00 | 4 |
| Destruction premal lesions 15/> 17004 CPT 17004 | not published | not published | $307.10 – $4,074.00 | 4 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $2,096.85 – $6,798.00 | 4 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Destruction vag lesions simple 57061 CPT 57061 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $1,558.69 – $4,321.00 | 4 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $22.52 – $159.48 | 5 |
| Detect agnt mult dna direc CPT 87800 | not published | not published | $32.75 – $318.98 | 5 |
| Devel tst phys/qhp 1st hr CPT 96112 | not published | not published | $97.20 – $129.61 | 2 |
| Device ablt adv novasure HCPCS C1886 | $6,811.79 | $12,385.08 | not published | 0 |
| Device sut capio slim opn HCPCS C2631 | $976.62 | $1,775.67 | not published | 0 |
| Device tiss remov myosure reach HCPCS C1782 | $1,665.50 | $3,028.19 | not published | 0 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | not published | not published | $65.74 – $131.78 | 3 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | not published | not published | $67.51 – $208.96 | 5 |
| Dexamethasone 4 mg tablet HCPCS J8540 | not published | not published | $0.03 – $0.11 | 3 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | not published | not published | $0.13 – $0.23 | 3 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $152.74 – $390.02 | 5 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | not published | not published | $31.08 – $149.63 | 5 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | not published | not published | $1.81 – $2.57 | 3 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | not published | not published | $2.64 – $3.85 | 3 |
| Dextrose 5 % IV bolus HCPCS J7070 | not published | not published | $5.28 – $6.66 | 3 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $13.75 | $25.00 | $16.67 – $176.83 | 5 |
| Diabetes (HbA1c) Test CPT 83036 | $180.40 | $328.00 | $7.28 – $77.18 | 5 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $1,344.61 – $4,321.00 | 4 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $4,567.04 – $14,906.00 | 4 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $337.47 – $4,074.00 | 4 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $903.99 – $4,321.00 | 4 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $385.55 | $701.00 | $100.51 – $4,074.00 | 4 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | not published | not published | $910.35 – $910.35 | 1 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | not published | not published | $713.72 – $713.72 | 1 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $140.80 | $256.00 | $150.79 – $4,074.00 | 4 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $303.05 | $551.00 | $150.79 – $4,074.00 | 4 |
| Diagnostic Mammogram (both breasts) CPT 77066 | not published | not published | $79.11 – $938.25 | 3 |
| Diagnostic Mammogram (one breast) CPT 77065 | not published | not published | $61.76 – $733.12 | 3 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $65.74 – $87.66 | 2 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $3,087.70 | $5,614.00 | $1,704.00 – $1,704.00 | 1 |
| Dialysis one evaluation CPT 90945 | not published | not published | $315.22 – $420.29 | 2 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | not published | not published | $0.12 – $0.14 | 3 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | not published | not published | $8.40 – $15.82 | 3 |
| Dicyclomine injection HCPCS J0500 | not published | not published | $18.65 – $27.57 | 3 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | not published | not published | $7.08 – $16.32 | 3 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | not published | not published | $4,037.49 – $9,440.30 | 5 |
| Digoxin total therapeutic drug level CPT 80162 | $130.90 | $238.00 | $9.96 – $105.60 | 5 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | not published | not published | $75.92 – $184.44 | 3 |
| Dilate biliary duct/ampulla CPT 47542 | $3,094.85 | $5,627.00 | $1,704.00 – $1,704.00 | 1 |
| Dilate esophagus CPT 43453 | not published | not published | $1,449.62 – $4,321.00 | 4 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $685.17 – $4,074.00 | 4 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | $1,950.85 | $3,547.00 | $18,190.00 – $18,190.00 | 1 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | $1,950.85 | $3,547.00 | $18,190.00 – $18,190.00 | 1 |
| Dilate ic vasospasm init CPT 61640 | $3,661.90 | $6,658.00 | $18,190.00 – $18,190.00 | 1 |
| Dilate tear duct opening CPT 68801 | not published | not published | $337.47 – $4,074.00 | 4 |
| Dilate urethra stricture CPT 53600 | not published | not published | $188.75 – $4,074.00 | 4 |
| Dilate urethra stricture CPT 53601 | not published | not published | $100.51 – $4,074.00 | 4 |
| Dilate urethra stricture CPT 53605 | not published | not published | $2,662.91 – $4,321.00 | 4 |
| Dilate urethra stricture CPT 53621 | not published | not published | $188.75 – $4,074.00 | 4 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $97.20 – $4,074.00 | 4 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $903.99 – $4,321.00 | 4 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $903.99 – $4,321.00 | 4 |
| Dilation of salivary duct CPT 42660 | $590.15 | $1,073.00 | $407.43 – $4,074.00 | 4 |
| Dilation of urethra CPT 53661 | not published | not published | $100.51 – $4,074.00 | 4 |
| Dilation of urethra CPT 53665 | not published | not published | $1,579.16 – $6,798.00 | 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.