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 |
|---|---|---|---|---|
| Expose art endoprosth iliac 34820 CPT 34820 | $1,515.25 | $2,755.00 | $10,498.00 – $10,498.00 | 1 |
| Expose endoprosth brachial 34834 CPT 34834 | not published | not published | $4,321.00 – $4,321.00 | 1 |
| Exp w remove/deep fb/forearm/wrist 25248 CPT 25248 | not published | not published | $1,214.74 – $6,798.00 | 4 |
| Ex sq tumor/face or scalp < 2 cm 21011 CPT 21011 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Ex sq tumor/face or scalp 2 cm/> 21012 CPT 21012 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Ext antenna phren nerve stim HCPCS L8696 | not published | not published | $200.14 – $266.86 | 2 |
| Ext ecg>48hr<7d scan a/r CPT 93243 | not published | not published | $100.51 – $134.01 | 2 |
| Ext ecg>7d<15d scan a/r CPT 93247 | not published | not published | $100.51 – $134.01 | 2 |
| Extended culture of oocytes CPT 89272 | not published | not published | $608.64 – $811.52 | 2 |
| Extended visual field xm CPT 92083 | not published | not published | $100.51 – $134.01 | 2 |
| Extensive ear canal surgery 69150 CPT 69150 | not published | not published | $4,472.08 – $9,811.00 | 4 |
| Extensive ear/neck surgery 69155 CPT 69155 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Extensive hand surgery CPT 26250 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Extensive hysterectomy CPT 58285 | not published | not published | $14,906.00 – $14,906.00 | 1 |
| Extensive jaw surgery CPT 21045 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Extensive mastoid surgery CPT 69511 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Extensive mastoid surgery CPT 69530 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Extensive prostate surgery CPT 55810 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Extensive prostate surgery CPT 55812 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Extensive prostate surgery CPT 55815 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Extensive prostate surgery CPT 55840 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Extensive prostate surgery CPT 55842 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Extensive prostate surgery CPT 55845 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Extensive prostate surgery CPT 55862 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Extensive prostate surgery CPT 55865 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Extensive removal of liver CPT 47122 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Extensive sternum surgery CPT 21632 | not published | not published | $10,498.00 – $16,582.00 | 2 |
| Extensive surgery of throat CPT 42842 | not published | not published | $4,472.08 – $9,811.00 | 4 |
| Extensive surgery of throat CPT 42844 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Extensive surgery of throat CPT 42845 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Extensive testis surgery CPT 54535 | not published | not published | $2,662.91 – $10,498.00 | 4 |
| Extensive thyroid surgery CPT 60254 | not published | not published | $6,798.00 – $9,811.00 | 2 |
| Extensive vulva surgery CPT 56632 | not published | not published | $9,811.00 – $24,224.00 | 2 |
| External cannula declotting CPT 36860 | not published | not published | $1,189.18 – $4,074.00 | 4 |
| External chromosome analysis 20-25 cells CPT 88264 | $491.70 | $894.00 | $108.46 – $991.13 | 5 |
| External newborn metabolic screening panel HCPCS S3620 | $292.60 | $532.00 | not published | 0 |
| External ocular photography CPT 92285 | not published | not published | $28.22 – $37.62 | 2 |
| External pretreatment of serum for use in antibody identification by dilution CPT 86976 | $24.75 | $45.00 | $21.85 – $189.75 | 3 |
| External profiling gene expression oncology (breast) mrna 21 genes CPT 81519 | $7,565.25 | $13,755.00 | $2,904.75 – $19,960.81 | 5 |
| External recharg sys intern HCPCS L8689 | $1,640.72 | $2,983.12 | not published | 0 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $491.70 | $894.00 | $107.81 – $396.07 | 5 |
| Extnd color vision xm CPT 92283 | not published | not published | $44.57 – $59.42 | 2 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $99.00 | $180.00 | $13.45 – $142.59 | 5 |
| Extraction of lens CPT 66930 | not published | not published | $3,122.55 – $9,811.00 | 4 |
| Extraction of lens CPT 66940 | not published | not published | $1,743.42 – $4,321.00 | 4 |
| Extraction of lens 66920 CPT 66920 | not published | not published | $1,743.42 – $6,798.00 | 4 |
| Extrnl counterpulse, per tx HCPCS G0166 | not published | not published | $100.51 – $134.01 | 2 |
| Eye allergy tests CPT 95060 | not published | not published | $100.51 – $134.01 | 2 |
| Eye implant band 40 HCPCS C1784 | $4,043.56 | $7,351.92 | not published | 0 |
| Eye photodynamic ther add-on CPT 67225 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Eye surgery follow-up add-on CPT 67331 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Eye suture during surgery CPT 67335 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Ezh2 gene common variants CPT 81237 | not published | not published | $131.55 – $1,023.90 | 5 |
| Ezh2 gene full gene sequence CPT 81236 | not published | not published | $212.16 – $1,651.31 | 5 |
| F9 full gene sequence CPT 81238 | not published | not published | $450.00 – $3,367.78 | 5 |
| Face bone graft CPT 21210 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Facial bones <3 CPT 70140 | $248.60 | $452.00 | $65.74 – $145.63 | 3 |
| Facility svs dental rehab HCPCS G0330 | not published | not published | $2,504.63 – $3,339.51 | 2 |
| Factor ix CPT 85250 | $99.00 | $180.00 | $14.28 – $151.43 | 5 |
| Factor ix alprolix recomb HCPCS J7201 | not published | not published | $2.78 – $6.89 | 5 |
| Factor ix complex HCPCS J7194 | not published | not published | $1.31 – $3.24 | 5 |
| Factor ix idelvion inj HCPCS J7202 | not published | not published | $4.13 – $10.15 | 5 |
| Factor ix non-recombinant HCPCS J7193 | not published | not published | $1.05 – $2.54 | 5 |
| Factor ix recomb gly rebinyn HCPCS J7203 | not published | not published | $3.51 – $8.70 | 5 |
| Factor ix recombinan rixubis HCPCS J7200 | not published | not published | $1.29 – $3.05 | 5 |
| Factor ix recombinant nos HCPCS J7195 | not published | not published | $1.40 – $3.56 | 5 |
| Factor viia recomb sevenfact HCPCS J7212 | not published | not published | $1.65 – $4.56 | 5 |
| Factor viii CPT 85240 | $96.80 | $176.00 | $13.42 – $55.64 | 5 |
| Factor viii HCPCS J7190 | not published | not published | $0.93 – $2.15 | 5 |
| Factor viii fc fusion recomb HCPCS J7205 | not published | not published | $1.93 – $4.60 | 5 |
| Factor viii nuwiq recomb 1iu HCPCS J7209 | not published | not published | $0.92 – $2.29 | 5 |
| Factor viii pegylated recomb HCPCS J7207 | not published | not published | $1.59 – $4.09 | 5 |
| Factor viii recombinant nos HCPCS J7192 | not published | not published | $1.18 – $2.92 | 5 |
| Factor viii recomb novoeight HCPCS J7182 | not published | not published | $1.08 – $2.88 | 5 |
| Factor viii recomb obizur HCPCS J7188 | not published | not published | $2.43 – $6.14 | 5 |
| Factor xiii anti-hem factor HCPCS J7180 | not published | not published | $8.43 – $20.48 | 5 |
| Factor xiii recomb a-subunit HCPCS J7181 | not published | not published | $14.34 – $34.76 | 5 |
| Fallopian tube recnl CPT 58345 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | not published | not published | $0.01 – $0.02 | 2 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | not published | not published | $24.66 – $57.00 | 5 |
| Fancc gene CPT 81242 | $990.00 | $1,800.00 | $27.46 – $205.55 | 5 |
| Fasciotomy hip/thigh any typ CPT 27025 | not published | not published | $2,471.80 – $16,582.00 | 4 |
| Fat/lipids feces qualitative CPT 82705 | $23.10 | $42.00 | $3.82 – $40.45 | 5 |
| Fatty acids nonesterified CPT 82725 | $530.75 | $965.00 | $14.08 – $105.83 | 5 |
| Fecal bilirubin test CPT 82252 | not published | not published | $3.42 – $36.20 | 5 |
| Fecal microbiota, live-jslm 150 ml rectal suspension enema HCPCS J1440 | not published | not published | $49.20 – $121.66 | 5 |
| Fecal microbiota prep instil HCPCS G0455 | not published | not published | $702.53 – $936.70 | 2 |
| #fecal-sodium CPT 84302 | $23.10 | $42.00 | $3.64 – $38.71 | 5 |
| Feeding tube reposition CPT 74355 | not published | not published | $805.48 – $805.48 | 1 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | $35.75 | $65.00 | $13.98 – $108.82 | 5 |
| Femoral endovas graft add-on 34813 CPT 34813 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Fem/popl revasc w/stent CPT 37226 | $6,887.65 | $12,523.00 | $16,352.00 – $24,224.00 | 2 |
| Feno poc CPT 95012 | not published | not published | $28.22 – $37.62 | 2 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | not published | not published | $1.22 – $1.83 | 3 |
| Fern test HCPCS Q0114 | $76.45 | $139.00 | $7.30 – $56.92 | 5 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | not published | not published | $0.85 – $2.17 | 5 |
| Ferritin CPT 82728 | $13.75 | $25.00 | $10.22 – $108.40 | 5 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | not published | not published | $0.28 – $0.70 | 5 |
| Ferumoxytol, esrd use HCPCS Q0139 | not published | not published | $0.28 – $0.70 | 5 |
| Fetal aneuploidy trisom risk CPT 81507 | $1,244.65 | $2,263.00 | $596.25 – $4,462.32 | 5 |
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.