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 |
|---|---|---|---|---|
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $121.55 | $221.00 | $73.58 – $512.19 | 5 |
| Evaluation heart device CPT 93640 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Evaluation of speech fluency 92521 CPT 92521 | $258.50 | $470.00 | not published | 0 |
| Evaluation psychiatric diagnostic CPT 90791 | $443.30 | $806.00 | not published | 0 |
| Evasc prlng admn rx agnt 1st CPT 61650 | $8,421.60 | $15,312.00 | $15,466.00 – $15,466.00 | 1 |
| Evasc prlng admn rx agnt add CPT 61651 | not published | not published | $15,466.00 – $15,466.00 | 1 |
| Evasc repair of iliac artery; endograft 34718 CPT 34718 | not published | not published | $16,352.00 – $16,352.00 | 1 |
| Evasc rpr a-ao ndgft 34701 CPT 34701 | not published | not published | $16,352.00 – $16,352.00 | 1 |
| Evasc rpr a-ao ndgft rpt 34702 CPT 34702 | not published | not published | $16,352.00 – $16,352.00 | 1 |
| Evasc rpr a-biiliac ndgft rptr CPT 34706 | not published | not published | $16,352.00 – $16,352.00 | 1 |
| Evasc rpr a-iliac ndgft 34717 CPT 34717 | not published | not published | $16,352.00 – $16,352.00 | 1 |
| Evasc rpr a-unilac ndgft 34703 CPT 34703 | not published | not published | $16,352.00 – $16,352.00 | 1 |
| Evasc rpr a-unilac ndgft rpt CPT 34704 | not published | not published | $16,352.00 – $16,352.00 | 1 |
| Evasc rpr ilio-iliac ndgft CPT 34707 | not published | not published | $15,466.00 – $15,466.00 | 1 |
| Evasc rpr ilio-iliac rpt CPT 34708 | not published | not published | $15,466.00 – $15,466.00 | 1 |
| Evasc st rpr thrc/aa acrs br CPT 33894 | not published | not published | $16,352.00 – $16,352.00 | 1 |
| Evasc st rpr thrc/aa x crsg CPT 33895 | not published | not published | $16,352.00 – $16,352.00 | 1 |
| Event monitor CPT 93270 | $333.30 | $606.00 | not published | 0 |
| Evoked auditory tst complete CPT 92588 | not published | not published | $281.90 – $375.86 | 2 |
| Evoked potentials auditory screening automated analysis CPT 92650 | $174.35 | $317.00 | not published | 0 |
| Exam of vagina w/scope 57420 CPT 57420 | not published | not published | $230.21 – $4,074.00 | 4 |
| Exam plvc w/anes othr thn lcl CPT 57410 | $4,590.85 | $8,347.00 | $2,445.46 – $6,798.00 | 4 |
| Ex arm/elbow tum deep < 5 cm CPT 24076 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Ex arm/elbow tum deep 5 cm/> CPT 24073 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc abd les sc 3 cm/> CPT 22903 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc abdl tum deep < 5 cm CPT 22900 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc abdl tum deep 5 cm/> CPT 22901 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc abd tum 5 cm or less 49203 CPT 49203 | not published | not published | $6,798.00 – $10,498.00 | 2 |
| Exc abd tum over 10 cm 49205 CPT 49205 | not published | not published | $10,498.00 – $16,582.00 | 2 |
| Exc arm/elbo les sc >=3cm 24071 CPT 24071 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc arm/elbo les sc <3cm 24075 CPT 24075 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Exc aurl glomus tum trnscanl CPT 69550 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Exc aurl glomus tum trnsmstd CPT 69552 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Exc back les sbq <3 cm 21930 CPT 21930 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Exc back tum deep 5 cm/> CPT 21933 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc bartholins gland/cyst CPT 56740 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Exc benign feenlm 3.1-4.0cm 11444 CPT 11444 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Exc benign feenlm >4.0cm 11446 CPT 11446 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc benign snhfg 3.1-4.0cm 11424 CPT 11424 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Exc benign tal 0.5 < cm 11400 CPT 11400 | not published | not published | $534.95 – $4,074.00 | 4 |
| Exc ben+marg excep skin tag feenlm <0.5cm 11440 CPT 11440 | not published | not published | $534.95 – $4,074.00 | 4 |
| Exc ben+marg excep skin tag feenlm 1.1-2cm 11442 CPT 11442 | not published | not published | $534.95 – $4,074.00 | 4 |
| Exc ben+marg excep skin tag feenlm 2.1-3cm 11443 CPT 11443 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 CPT 11421 | not published | not published | $534.95 – $4,074.00 | 4 |
| Exc ben+marg excep skin tag snhfg 2.1-3cm 11423 CPT 11423 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Exc ben+marg excep skin tag snhfg >4cm 11426 CPT 11426 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | not published | not published | $307.10 – $4,074.00 | 4 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | not published | not published | $534.95 – $4,074.00 | 4 |
| Exc breast duct fistula 19112 CPT 19112 | not published | not published | $2,957.88 – $10,498.00 | 4 |
| Exc carotid body tumor without exc art 60600 CPT 60600 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Exc cervix repair bowel 57556 CPT 57556 | not published | not published | $3,779.05 – $14,543.00 | 4 |
| Exc cervix/repair pelvis 57545 CPT 57545 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Exc cervix/repair vagina 57555 CPT 57555 | not published | not published | $3,779.05 – $9,811.00 | 4 |
| Exc chest wall tumor w/ribs 21601 CPT 21601 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc coccygl pr ulc flap clsr CPT 15922 | not published | not published | $2,677.07 – $10,498.00 | 4 |
| Exc coccygl pr ulc prim sutr CPT 15920 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc constrict ring finger w/mlt z-plasties 26596 CPT 26596 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Exc/crtg b1 cst/b9 tum rds CPT 24120 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Exc/crtg b1 cst/tum hum agrf CPT 24115 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Exc/crtg b1 cst/tum hum algr CPT 24116 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Exc/crtg b1 cst/tum rds agrf CPT 24125 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Exc/crtg b1 cst/tum rds algr CPT 24126 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Exc/curetg cst/tum tarsal/metar w/iliac/agrf 28106 CPT 28106 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Exc/curtg b1 cst/b9 tum hum CPT 24110 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Exc/destruct open intra-abd tumors cysts or endometriomas CPT 49204 | not published | not published | $10,498.00 – $16,582.00 | 2 |
| Exc excessive skin buttock CPT 15835 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc excessive skin hip CPT 15834 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc excessive skin leg CPT 15833 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc excessive skin thigh CPT 15832 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc excsv skin forearm/hand CPT 15837 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc excsv submental fat pad CPT 15838 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc ext ear/partial/simple repair 69110 CPT 69110 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc face tum deep < 2 cm CPT 21013 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Exc face tum deep 2cm/> 21014 CPT 21014 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc feenl mal+mrg 0.6-1 11641 CPT 11641 | not published | not published | $534.95 – $4,074.00 | 4 |
| Exc feenl mal+mrg 2.1-3 11643 CPT 11643 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Exc foot/toe tum dep 1.5cm/> CPT 28041 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc foot/toe tum subq < 1.5 cm 28043 CPT 28043 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Exc forearm les sc 3 cm/> CPT 25071 | not published | not published | $1,247.68 – $6,798.00 | 4 |
| Exc forearm tum deep < 3 cm CPT 25076 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Exc forearm tum deep 3 cm/> CPT 25073 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc hand les sc < 1.5 cm CPT 26115 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Exc hand tum deep 1.5 cm/> CPT 26113 | not published | not published | $1,247.68 – $6,798.00 | 4 |
| Exc hand tum deep < 1.5 cm 26116 CPT 26116 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Exchange biliary drg cath CPT 47536 | $2,513.50 | $4,570.00 | $2,704.78 – $10,498.00 | 4 |
| Exchange blood transfusion newborn 36450 CPT 36450 | not published | not published | $333.28 – $4,074.00 | 4 |
| Exchange drainage catheter CPT 49423 | $1,202.85 | $2,187.00 | $1,449.62 – $4,321.00 | 4 |
| Exchange lens prosthesis CPT 66986 | not published | not published | $1,743.42 – $6,798.00 | 4 |
| Exchange nephrostomy cath CPT 50435 | $3,649.80 | $6,636.00 | $1,579.16 – $4,321.00 | 4 |
| Exc hidradenitis ing simpl 11462 CPT 11462 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc hidradenitis peri/umb comp 11471 CPT 11471 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc hidradenitis peri/umb int 11470 CPT 11470 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc hip/pelv tum deep < 5 cm CPT 27048 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc hip/pelv tum deep 5 cm/> CPT 27045 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Excimer lsr psriasis 250-500 CPT 96921 | not published | not published | $151.57 – $4,074.00 | 3 |
| Excimer lsr psriasis<250sqcm CPT 96920 | not published | not published | $151.57 – $4,074.00 | 3 |
| Excimer lsr psriasis>500sqcm CPT 96922 | not published | not published | $307.10 – $4,074.00 | 3 |
| Exc im tumor/back/flank/ < 5 cm 21932 CPT 21932 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc im tumor/foot/toe < 1.5 cm 28045 CPT 28045 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Exc im tumor/shoulder area 5cm/> 23073 CPT 23073 | 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.