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 |
|---|---|---|---|---|
| Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution HCPCS J0166 | not published | not published | $4.34 – $4.34 | 1 |
| Epiphysl arrst dstl rds&ulna CPT 25455 | not published | not published | $2,471.80 – $14,543.00 | 4 |
| Epiphysl arrst dstl rds/ulna CPT 25450 | not published | not published | $2,471.80 – $14,543.00 | 4 |
| Epirubicin 200 mg/100 ml intravenous solution HCPCS J9178 | not published | not published | $2.35 – $3.02 | 3 |
| Episiotomy/vag rpr oth/thn attending phys 59300 CPT 59300 | $8,760.40 | $15,928.00 | $2,445.46 – $6,798.00 | 4 |
| Epoetin alfa, 100 units esrd HCPCS Q4081 | not published | not published | $1.03 – $1.46 | 3 |
| Epoetin alfa-epbx 40,000 unit/ml injection solution HCPCS Q5106 | not published | not published | $5.98 – $14.38 | 5 |
| Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr HCPCS J0885 | not published | not published | $5.16 – $14.58 | 5 |
| Epoetin beta non esrd HCPCS J0888 | not published | not published | $1.83 – $2.69 | 3 |
| Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr HCPCS J1325 | not published | not published | $23.32 – $30.78 | 3 |
| Epstein barr early antigen antibody CPT 86663 | $25.30 | $46.00 | $9.84 – $104.33 | 5 |
| Epstein barr nuclear antigen antibody CPT 86664 | $25.30 | $46.00 | $11.47 – $121.65 | 5 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $25.30 | $46.00 | $13.60 – $144.31 | 5 |
| Eptinezumab-jjmr 100 mg/ml intravenous solution HCPCS J3032 | not published | not published | $15.83 – $37.71 | 5 |
| Ercp biliary & pancreas CPT 74330 | $729.85 | $1,327.00 | $947.21 – $947.21 | 1 |
| Ercp bil/panc duct; each stent plcmt 43274 CPT 43274 | not published | not published | $4,586.20 – $9,811.00 | 4 |
| Ercp ea duct/ampulla dilate CPT 43277 | not published | not published | $2,912.58 – $10,498.00 | 4 |
| Ercp lesion ablate w/dilate 43278 CPT 43278 | not published | not published | $2,912.58 – $10,498.00 | 4 |
| Ercp lithotripsy calculi CPT 43265 | not published | not published | $4,586.20 – $9,811.00 | 4 |
| Ercp remove duct calculi 43264 CPT 43264 | $2,312.75 | $4,205.00 | $2,912.58 – $10,498.00 | 4 |
| Ercp remove forgn body duct 43275 CPT 43275 | not published | not published | $1,449.62 – $10,498.00 | 4 |
| Ercp sphincter pressure meas CPT 43263 | not published | not published | $1,449.62 – $10,498.00 | 4 |
| Ercp stent exchange w/dilate CPT 43276 | not published | not published | $4,586.20 – $9,811.00 | 4 |
| Ercp w/specimen collection CPT 43260 | $2,312.75 | $4,205.00 | $2,912.58 – $10,498.00 | 4 |
| Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution HCPCS J9179 | not published | not published | $44.98 – $246.64 | 5 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | not published | not published | $13.31 – $20.37 | 3 |
| ER Visit (level 1, minor) CPT 99281 | $249.70 | $454.00 | $63.70 – $84.94 | 2 |
| ER Visit (level 2) CPT 99282 | $460.90 | $838.00 | $115.99 – $154.66 | 2 |
| ER Visit (level 3) CPT 99283 | $663.30 | $1,206.00 | $206.22 – $274.96 | 2 |
| ER Visit (level 4) CPT 99284 | $1,063.15 | $1,933.00 | $315.22 – $420.29 | 2 |
| ER Visit (level 5, high severity) CPT 99285 | $1,598.85 | $2,907.00 | $449.89 – $599.85 | 2 |
| Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1364 | not published | not published | $95.64 – $142.60 | 3 |
| Esd endoscopy or colonoscopy HCPCS C9779 | not published | not published | $2,912.58 – $6,798.00 | 4 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) in sterile water intravenous soln HCPCS J1806 | not published | not published | $0.59 – $0.79 | 3 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only HCPCS J1805 | not published | not published | $0.39 – $0.54 | 3 |
| Esophageal dilat s&i CPT 74360 | $534.60 | $972.00 | $696.98 – $696.98 | 1 |
| Esophageal lengthening add on code 43338 CPT 43338 | not published | not published | $14,906.00 – $14,906.00 | 1 |
| Esophageal motility CPT 78258 | not published | not published | $302.00 – $1,491.90 | 3 |
| Esophageal recording CPT 93615 | not published | not published | $919.78 – $3,232.00 | 3 |
| Esophageal recording CPT 93616 | not published | not published | $919.78 – $3,232.00 | 3 |
| Esophagomyotomy abdominal 43330 CPT 43330 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Esophagomyotomy thoracic 43331 CPT 43331 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Esophagosc dilate balloon 30 CPT 43214 | not published | not published | $1,449.62 – $4,321.00 | 4 |
| Esophagosc flex trnsn biopsy CPT 43198 | not published | not published | $685.17 – $4,074.00 | 4 |
| Esophagoscop mucosal resect CPT 43211 | not published | not published | $1,449.62 – $4,321.00 | 4 |
| Esophagoscop stent placement CPT 43212 | not published | not published | $4,586.20 – $9,811.00 | 4 |
| Esophagoscop ultrasound exam CPT 43231 | not published | not published | $1,449.62 – $4,321.00 | 4 |
| Esophagoscopy balloon <30mm CPT 43220 | not published | not published | $1,449.62 – $4,321.00 | 4 |
| Esophagoscopy control bleed CPT 43227 | not published | not published | $1,449.62 – $4,321.00 | 4 |
| Esophagoscopy flex biopsy CPT 43202 | not published | not published | $1,449.62 – $4,321.00 | 4 |
| Esophagoscopy/flex/diagnostic 43200 CPT 43200 | not published | not published | $685.17 – $4,074.00 | 4 |
| Esophagoscopy flex dx brush CPT 43197 | not published | not published | $685.17 – $4,074.00 | 4 |
| Esophagoscopy flex remove fb CPT 43215 | not published | not published | $1,449.62 – $4,321.00 | 4 |
| Esophagoscopy lesion ablate CPT 43229 | not published | not published | $2,912.58 – $10,498.00 | 4 |
| Esophagoscopy lesion removal CPT 43216 | not published | not published | $1,449.62 – $6,798.00 | 4 |
| Esophagoscopy retro balloon CPT 43213 | not published | not published | $1,449.62 – $4,321.00 | 4 |
| Esophagoscopy rigid balloon CPT 43195 | not published | not published | $2,912.58 – $10,498.00 | 4 |
| Esophagoscopy/rigid/diagnostic 43191 CPT 43191 | not published | not published | $1,449.62 – $4,321.00 | 4 |
| Esophagoscopy rigid trnso 43180 CPT 43180 | not published | not published | $4,472.08 – $9,811.00 | 4 |
| Esophagoscopy snare les remv CPT 43217 | not published | not published | $1,449.62 – $4,321.00 | 4 |
| Esophagoscopy w/us needle bx CPT 43232 | not published | not published | $1,449.62 – $4,321.00 | 4 |
| Esophagoscp guide wire dilat 43196 CPT 43196 | not published | not published | $1,449.62 – $10,498.00 | 4 |
| Esophagoscp rig trnso biopsy CPT 43193 | not published | not published | $1,449.62 – $4,321.00 | 4 |
| Esophagoscp rig trnso inject CPT 43192 | not published | not published | $1,449.62 – $4,321.00 | 4 |
| Esophagoscp rig trnso rem fb CPT 43194 | not published | not published | $1,449.62 – $4,321.00 | 4 |
| Esophagus endoscopy/ligation CPT 43205 | not published | not published | $1,449.62 – $4,321.00 | 4 |
| Esophagus motility study CPT 91010 | not published | not published | $281.90 – $1,704.00 | 3 |
| Esoph balloon distension tst CPT 91040 | not published | not published | $281.90 – $1,704.00 | 3 |
| Esoph egd dilation <30 mm CPT 43249 | not published | not published | $1,449.62 – $4,321.00 | 4 |
| Esoph endoscopy dilation CPT 43226 | not published | not published | $1,449.62 – $4,321.00 | 4 |
| Esoph fundoplasty lap 43327 CPT 43327 | not published | not published | $14,906.00 – $14,906.00 | 1 |
| Esoph fundoplasty thor 43328 CPT 43328 | not published | not published | $14,906.00 – $14,906.00 | 1 |
| Esophgl motil w/stim/perfus CPT 91013 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Esoph imped function test CPT 91037 | not published | not published | $163.12 – $1,704.00 | 3 |
| Esoph imped funct test > 1hr CPT 91038 | not published | not published | $281.90 – $1,704.00 | 3 |
| Esoph optical endomicroscopy CPT 43206 | not published | not published | $1,449.62 – $4,321.00 | 4 |
| Esoph scope w/sclerosis inj CPT 43204 | not published | not published | $1,449.62 – $4,321.00 | 4 |
| Esoph scope w/submucous inj CPT 43201 | not published | not published | $1,449.62 – $4,321.00 | 4 |
| Esphg dstl 2/3 w/laps moblj 43287 CPT 43287 | not published | not published | $14,906.00 – $14,906.00 | 1 |
| Essure 58565 CPT 58565 | not published | not published | $3,779.05 – $14,543.00 | 4 |
| Establish access to aorta CPT 36160 | $300.85 | $547.00 | $1,704.00 – $1,704.00 | 1 |
| Establish access to artery CPT 36100 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Establish brain cavity shunt CPT 62223 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Established Patient Office Visit (level 1) CPT 99211 | $69.85 | $127.00 | not published | 0 |
| Established Patient Office Visit (level 2) CPT 99212 | $92.40 | $168.00 | not published | 0 |
| Established Patient Office Visit (level 3) CPT 99213 | $113.30 | $206.00 | not published | 0 |
| Established Patient Office Visit (level 4) CPT 99214 | $124.30 | $226.00 | not published | 0 |
| Established Patient Office Visit (level 5) CPT 99215 | $165.00 | $300.00 | not published | 0 |
| Estradiol total CPT 82670 | $346.50 | $630.00 | $20.96 – $222.16 | 5 |
| Estradiol valerate 10 mg inj HCPCS J1380 | not published | not published | $10.59 – $14.69 | 3 |
| Estrogens total-sendout CPT 82672 | $53.90 | $98.00 | $16.28 – $172.56 | 5 |
| Ethanolamine oleate 100 mg HCPCS J1430 | not published | not published | $410.45 – $987.08 | 5 |
| Ethmoidectomy extranasal total 31205 CPT 31205 | not published | not published | $2,504.63 – $6,798.00 | 4 |
| Ethylene glycol -sendout CPT 82693 | $57.75 | $105.00 | $11.18 – $44.95 | 5 |
| Etoposide 20 mg/ml intravenous solution HCPCS J9181 | not published | not published | $1.55 – $2.48 | 3 |
| Etoposide 50 mg cap HCPCS J8560 | not published | not published | $66.04 – $143.95 | 5 |
| Euflexxa inj per dose HCPCS J7323 | not published | not published | $73.60 – $223.26 | 5 |
| Euglobulin lysis CPT 85360 | not published | not published | $6.31 – $66.84 | 5 |
| Evacuate mole of uterus CPT 59870 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Eval aud rehab status/first hr 92626 CPT 92626 | not published | not published | $97.20 – $129.61 | 2 |
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.