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 |
|---|---|---|---|---|
| Dilation of vagina CPT 57400 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $1,172.13 – $4,321.00 | 4 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $526.77 – $4,074.00 | 4 |
| Dilat xst trc ndurlgc px CPT 50436 | $3,408.35 | $6,197.00 | $2,662.91 – $6,798.00 | 4 |
| Dilat xst trc new access rcs CPT 50437 | $5,732.65 | $10,423.00 | $2,662.91 – $10,498.00 | 4 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | not published | not published | $0.07 – $0.07 | 1 |
| Dimenhydrinate injection HCPCS J1240 | not published | not published | $12.11 – $16.04 | 3 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | not published | not published | $561.66 – $1,411.50 | 5 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | not published | not published | $0.96 – $1.72 | 3 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $28.22 – $37.62 | 2 |
| Disaccharidases CPT 82657 | $527.78 | $959.60 | $16.63 – $143.58 | 5 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $1,558.69 – $4,321.00 | 4 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | not published | not published | $18,190.00 – $18,190.00 | 1 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $4,321.00 – $4,321.00 | 1 |
| Discography cerv/thor spine CPT 72285 | $1,023.00 | $1,860.00 | $411.47 – $1,966.89 | 3 |
| Dise eval slp do brth flx dx CPT 42975 | not published | not published | $1,344.61 – $4,321.00 | 4 |
| Dissolve clot heart vessel CPT 92975 | not published | not published | $4,074.00 – $4,074.00 | 1 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $4,203.64 – $16,582.00 | 4 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Division of fallopian tube 58605 CPT 58605 | not published | not published | $3,232.00 – $9,811.00 | 2 |
| #d/lmeth-l-methamphetamine CPT 80374 | not published | not published | $137.83 – $137.83 | 1 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | not published | not published | $15,466.00 – $15,466.00 | 1 |
| Dmd dup/delet analysis CPT 81161 | not published | not published | $209.25 – $818.06 | 5 |
| Dmpk gene detc abnor allele CPT 81234 | not published | not published | $102.75 – $799.73 | 5 |
| Dna antibody native/double stranded CPT 86225 | $335.50 | $610.00 | $10.30 – $109.21 | 5 |
| Dna gardnerella CPT 87510 | $55.00 | $100.00 | $15.04 – $159.48 | 5 |
| Dna probe chlamydia CPT 87490 | not published | not published | $17.06 – $159.48 | 5 |
| Dna probe gc CPT 87590 | not published | not published | $20.16 – $159.48 | 5 |
| Dna trichomonas CPT 87660 | $55.00 | $100.00 | $15.04 – $159.48 | 5 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | not published | not published | $11.82 – $15.16 | 3 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | not published | not published | $0.72 – $1.35 | 3 |
| Docetaxel (docivyx), 1 mg HCPCS J9172 | not published | not published | $34.72 – $96.59 | 5 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | not published | not published | $1.03 – $1.42 | 3 |
| Doppler echo complete CPT 93320 | $525.80 | $956.00 | not published | 0 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | not published | not published | $100.51 – $134.01 | 2 |
| Dornase alfa non-comp unit HCPCS J7639 | not published | not published | $77.71 – $104.80 | 3 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | not published | not published | $188.47 – $463.26 | 5 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | not published | not published | $4.57 – $6.14 | 3 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | not published | not published | $87.45 – $251.69 | 5 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | not published | not published | $0.17 – $0.22 | 2 |
| Dpyd gene common variants CPT 81232 | $647.35 | $1,177.00 | $131.11 – $981.20 | 5 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | not published | not published | $534.95 – $4,074.00 | 4 |
| Drainage ext aud canal abscess 69020 CPT 69020 | not published | not published | $534.95 – $4,074.00 | 4 |
| Drainage external ear complex 69005 CPT 69005 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Drainage external ear simple 69000 CPT 69000 | not published | not published | $534.95 – $4,074.00 | 4 |
| Drainage lymph node lesion 38300 CPT 38300 | not published | not published | $2,194.34 – $4,321.00 | 4 |
| Drainage lymph node lesion 38305 CPT 38305 | not published | not published | $2,194.34 – $6,798.00 | 4 |
| Drainage mouth roof lesion CPT 42000 | not published | not published | $178.93 – $4,074.00 | 4 |
| Drainage of arm bursa 23931 CPT 23931 | $1,321.10 | $2,402.00 | $1,247.68 – $4,321.00 | 4 |
| Drainage of bladder abscess CPT 51080 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Drainage of eye CPT 65800 | not published | not published | $1,704.00 – $4,321.00 | 4 |
| Drainage of eye CPT 65810 | not published | not published | $1,743.42 – $6,798.00 | 4 |
| Drainage of eye CPT 65815 | not published | not published | $1,743.42 – $6,798.00 | 4 |
| Drainage of forearm bursa CPT 25031 | not published | not published | $1,214.74 – $6,798.00 | 4 |
| Drainage of kidney lesion CPT 50390 | $639.10 | $1,162.00 | $534.95 – $4,074.00 | 4 |
| Drainage of mouth lesion CPT 41005 | not published | not published | $178.93 – $4,074.00 | 4 |
| Drainage of mouth lesion CPT 41006 | not published | not published | $1,172.13 – $4,321.00 | 4 |
| Drainage of mouth lesion CPT 41007 | not published | not published | $1,172.13 – $4,321.00 | 4 |
| Drainage of mouth lesion CPT 41008 | not published | not published | $2,504.63 – $4,321.00 | 4 |
| Drainage of mouth lesion CPT 41009 | not published | not published | $407.43 – $4,074.00 | 4 |
| Drainage of mouth lesion CPT 41015 | not published | not published | $407.43 – $4,074.00 | 4 |
| Drainage of mouth lesion CPT 41016 | not published | not published | $4,472.08 – $9,811.00 | 4 |
| Drainage of mouth lesion CPT 41017 | not published | not published | $2,504.63 – $4,321.00 | 4 |
| Drainage of mouth lesion CPT 41018 | not published | not published | $1,172.13 – $4,321.00 | 4 |
| Drainage of nose lesion int 30000 CPT 30000 | not published | not published | $178.93 – $4,074.00 | 4 |
| Drainage of nose lesion sept 30020 CPT 30020 | not published | not published | $407.43 – $4,074.00 | 4 |
| Drainage of pelvis bursa CPT 26991 | not published | not published | $1,214.74 – $6,798.00 | 4 |
| Drainage of pelvis lesion 26990 CPT 26990 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Drainage of prostate abscess CPT 52700 | not published | not published | $2,662.91 – $10,498.00 | 4 |
| Drainage of prostate abscess CPT 55720 | not published | not published | $2,662.91 – $6,798.00 | 4 |
| Drainage of prostate abscess CPT 55725 | not published | not published | $2,662.91 – $10,498.00 | 4 |
| Drainage of rectal abscess CPT 45005 | not published | not published | $903.99 – $4,321.00 | 4 |
| Drainage of rectal abscess 45020 CPT 45020 | not published | not published | $2,096.85 – $4,321.00 | 4 |
| Drainage of salivary gland CPT 42305 | not published | not published | $2,504.63 – $6,798.00 | 4 |
| Drainage of salivary gland CPT 42320 | not published | not published | $407.43 – $4,074.00 | 4 |
| Drainage of throat abscess CPT 42725 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Drainage of urethra abscess CPT 53040 | not published | not published | $2,662.91 – $6,798.00 | 4 |
| Drainage of urethra abscess 53060 CPT 53060 | not published | not published | $1,579.16 – $6,798.00 | 4 |
| Drainage of urinary leakage CPT 53080 | not published | not published | $526.77 – $6,798.00 | 4 |
| Drainage of urinary leakage CPT 53085 | not published | not published | $1,579.16 – $6,798.00 | 4 |
| Drain bladder by trocar/cath CPT 51101 | not published | not published | $648.73 – $4,321.00 | 4 |
| Drain blood from under nail 11740 CPT 11740 | $177.10 | $322.00 | $100.51 – $4,074.00 | 4 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | $1,945.90 | $3,538.00 | $1,247.68 – $4,321.00 | 4 |
| Drain cath image guided visceral pq CPT 49405 | $2,383.15 | $4,333.00 | $1,247.68 – $4,321.00 | 4 |
| Drain cerebro spinal fluid 62272 CPT 62272 | $948.75 | $1,725.00 | $533.25 – $4,074.00 | 4 |
| Drain chest lesion CPT 21502 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Drain finger abscess;simple 26010 CPT 26010 | $652.30 | $1,186.00 | $151.57 – $4,074.00 | 4 |
| Drain lower leg bursa CPT 27604 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Drain lower leg lesion 27603 CPT 27603 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Drain neck/chest lesion 21501 CPT 21501 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Drain open lung lesion 32200 CPT 32200 | not published | not published | $14,906.00 – $14,906.00 | 1 |
| Drain ovarn cyst abd CPT 58805 | $2,165.35 | $3,937.00 | $2,445.46 – $6,798.00 | 4 |
| Drain ovary abscess open CPT 58820 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Drain pancreatic pseudocyst 48510 CPT 48510 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Drain penis lesion CPT 54015 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Drain shoulder bone lesion CPT 23035 | not published | not published | $1,214.74 – $6,798.00 | 4 |
| Drain shoulder bursa 23031 CPT 23031 | not published | not published | $2,194.34 – $6,798.00 | 4 |
| Drain shoulder lesion CPT 23030 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Drain thigh/knee lesion 27301 CPT 27301 | not published | not published | $2,194.34 – $10,498.00 | 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.