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 |
|---|---|---|---|---|
| Fetal biophys profile w/nst 76818 CPT 76818 | not published | not published | $78.98 – $526.64 | 3 |
| Fetal chrmoml microdeltj CPT 81422 | not published | not published | $569.29 – $4,683.59 | 5 |
| Fetal chrom aneuploidy gsa panel CPT 81420 | $939.95 | $1,709.00 | $569.29 – $4,683.59 | 5 |
| Fetal contract stress test 59020 - 26 CPT 59020 | $1,026.85 | $1,867.00 | $152.73 – $1,704.00 | 3 |
| Fetal cord puncture prenatal CPT 59012 | $383.35 | $697.00 | $230.21 – $4,074.00 | 4 |
| Fetal fibronectin CPT 82731 | $470.25 | $855.00 | $48.31 – $512.19 | 5 |
| Fetal fluid drainage w/us CPT 59074 | not published | not published | $230.21 – $4,074.00 | 4 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $140.25 | $255.00 | $5.80 – $61.55 | 5 |
| Fetal hemoglobin rosette CPT 85461 | $52.80 | $96.00 | $7.02 – $52.77 | 5 |
| Fetal lung maturity assess lam body dnst CPT 83664 | $110.55 | $201.00 | $14.49 – $150.37 | 5 |
| Fetal monitor w/report CPT 59050 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Fetal non stress test CPT 59025 | $561.55 | $1,021.00 | $152.73 – $1,704.00 | 3 |
| Fetal scalp blood sampling 59030 CPT 59030 | not published | not published | $230.21 – $1,704.00 | 3 |
| Fetal shunt placement w/us CPT 59076 | not published | not published | $230.21 – $4,074.00 | 4 |
| #_fet/norfentcnfrmur CPT 80354 | $175.45 | $319.00 | $137.83 – $137.83 | 1 |
| Fiasp for insulin pump use HCPCS J1811 | not published | not published | $9.67 – $14.75 | 3 |
| Fibrin degradation d dimer quantitative CPT 85379 | $87.45 | $159.00 | $7.64 – $64.44 | 5 |
| Fibrin degradation products CPT 85362 | $118.25 | $215.00 | $5.17 – $54.76 | 5 |
| Fibrin degrade semiquant CPT 85378 | not published | not published | $7.29 – $56.74 | 5 |
| Fibrin degradj d-dimer CPT 85380 | not published | not published | $7.64 – $64.44 | 5 |
| Fibrinogen activity CPT 85384 | $127.60 | $232.00 | $7.29 – $67.55 | 5 |
| Fibrinogen test CPT 85370 | not published | not published | $9.32 – $64.44 | 5 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $80.30 | $146.00 | $11.61 – $41.11 | 5 |
| Fibrinolytic antiplasmin CPT 85410 | not published | not published | $5.78 – $61.29 | 5 |
| Fibrinolytic plasmin CPT 85400 | not published | not published | $5.78 – $70.35 | 5 |
| Fibrinolytic plasminogen CPT 85415 | not published | not published | $12.89 – $136.73 | 5 |
| Fibrinolytic plasminogen CPT 85421 | not published | not published | $7.64 – $81.03 | 5 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | $73.15 | $133.00 | $4.90 – $51.96 | 5 |
| Fibula bone graft microvasc CPT 20955 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | not published | not published | $0.24 – $0.54 | 5 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | not published | not published | $0.75 – $1.87 | 5 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | not published | not published | $0.26 – $0.70 | 5 |
| Filleted finger/toe flap CPT 14350 | not published | not published | $1,558.69 – $4,321.00 | 4 |
| Filtered speech hearing test CPT 92571 | not published | not published | $28.22 – $37.62 | 2 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $1,682.11 | $3,058.38 | not published | 0 |
| Filter vena cava fem denali HCPCS C1880 | $2,213.64 | $4,024.80 | not published | 0 |
| Fimbrioplasty 58760 CPT 58760 | not published | not published | $7,919.00 – $9,811.00 | 2 |
| Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 CPT 10007 | $1,732.50 | $3,150.00 | $534.95 – $4,074.00 | 4 |
| Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008 CPT 10008 | $686.95 | $1,249.00 | $1,704.00 – $1,704.00 | 1 |
| Fine needle aspiration biopsy without img gdn; ea addtl 10004 CPT 10004 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 | $789.80 | $1,436.00 | $1,704.00 – $1,704.00 | 1 |
| Fine needle asp without image guide 10021 CPT 10021 | $393.80 | $716.00 | $307.10 – $4,074.00 | 4 |
| Finger tendon transfer CPT 26497 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Finger tendon transfer CPT 26498 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Fistula repair & colostomy CPT 57307 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Fistula repair transperine 57308 CPT 57308 | not published | not published | $6,798.00 – $9,811.00 | 2 |
| Fit aphakia spectcl monofocl CPT 92352 | not published | not published | $44.57 – $59.42 | 2 |
| Fit aphakia spectcl multifoc CPT 92353 | not published | not published | $44.57 – $59.42 | 2 |
| Fitg spect low vis 1system CPT 92354 | not published | not published | $28.22 – $37.62 | 2 |
| Fitg spect lw vis cmpnd lens CPT 92355 | not published | not published | $28.22 – $37.62 | 2 |
| Fitting of diaphragm/cap 57170 CPT 57170 | not published | not published | $152.73 – $4,074.00 | 4 |
| Fixation of ankle joint CPT 27860 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Fixation of knee joint CPT 27570 | not published | not published | $1,214.74 – $4,321.00 | 4 |
| Fixation of shoulder blade CPT 23400 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Fix g/colon tube w/device CPT 49460 | $624.80 | $1,136.00 | $685.17 – $4,074.00 | 4 |
| Fixtn pq skel dstl rad fx/epiphysl sep CPT 25606 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Flecainide (tambocor)-sendout CPT 80181 | $35.75 | $65.00 | $13.98 – $108.82 | 5 |
| Fl exam g/colon tube w contrast CPT 49465 | $327.25 | $595.00 | $180.25 – $4,074.00 | 4 |
| Flexible Sigmoidoscopy CPT 45330 | not published | not published | $702.53 – $4,074.00 | 4 |
| Flexor-plasty elbow CPT 24330 | not published | not published | $5,481.64 – $16,582.00 | 4 |
| Flexor-plasty elbw w/advmnt CPT 24331 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Floor of mouth biopsy 41108 CPT 41108 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Flow cytometry interp 16 or more CPT 88189 | not published | not published | $650.01 – $650.01 | 1 |
| Flow cytometry marker each additional CPT 88185 | $258.50 | $470.00 | $257.66 – $257.66 | 1 |
| Flow cytometry one marker technical component CPT 88184 | $1,173.70 | $2,134.00 | $270.78 – $424.62 | 3 |
| Floweramniopatch, per sq cm HCPCS Q4178 | not published | not published | $94.01 – $176.91 | 5 |
| #flow interp 9 - 15 markers CPT 88188 | not published | not published | $525.89 – $525.89 | 1 |
| Floxuridine injection HCPCS J9200 | not published | not published | $3,297.37 – $7,838.55 | 5 |
| Flt3 gene CPT 81245 | $990.00 | $1,800.00 | $124.13 – $967.16 | 5 |
| Flt3 gene analysis CPT 81246 | $451.00 | $820.00 | $62.25 – $484.75 | 5 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | not published | not published | $4.29 – $5.19 | 3 |
| Fludarabine 50 mg intravenous solution HCPCS J9185 | not published | not published | $86.32 – $311.36 | 3 |
| Fluid pressure muscle 20950 CPT 20950 | not published | not published | $534.95 – $4,074.00 | 4 |
| Fluocinol acet intravit imp HCPCS J7313 | not published | not published | $387.30 – $945.81 | 5 |
| Fluocinolone acetonide implt HCPCS J7311 | not published | not published | $254.10 – $645.55 | 5 |
| Fluorescein angioscopy i&r CPT 92230 | not published | not published | $281.90 – $375.86 | 2 |
| Fluorescent antibody titer dna CPT 86256 | $759.00 | $1,380.00 | $9.04 – $95.79 | 5 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $689.70 | $1,254.00 | $433.61 – $433.61 | 1 |
| Fluoroguide needle placement CPT 77002 | $781.00 | $1,420.00 | $502.82 – $502.82 | 1 |
| Fluoro polarize fetal lung CPT 83663 | not published | not published | $14.18 – $150.37 | 5 |
| Fluoroscopy up to 1 hour CPT 76000 | $503.80 | $916.00 | $180.25 – $297.92 | 3 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | not published | not published | $3.20 – $4.13 | 3 |
| Fluphenazine decanoate 25 mg/ml injection solution HCPCS J2680 | not published | not published | $12.80 – $17.41 | 3 |
| Fmri brain by phys/psych CPT 70555 | not published | not published | $180.25 – $4,768.69 | 3 |
| Fmri brain by tech CPT 70554 | $1,267.20 | $2,304.00 | $180.25 – $2,663.19 | 3 |
| Fna bx w/ct gdn 1st les CPT 10009 | $1,884.85 | $3,427.00 | $534.95 – $4,074.00 | 4 |
| Fna bx w/ct gdn ea addl CPT 10010 | $686.95 | $1,249.00 | $1,704.00 – $1,704.00 | 1 |
| Fna bx w/mr gdn 1st les CPT 10011 | not published | not published | $534.95 – $4,074.00 | 4 |
| Fna bx w/mr gdn ea addl CPT 10012 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Foam stability fetal lung CPT 83662 | not published | not published | $14.18 – $150.37 | 5 |
| Folic acid CPT 82746 | $62.15 | $113.00 | $11.02 – $116.92 | 5 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | not published | not published | $0.09 – $0.11 | 2 |
| Follow-up angiography CPT 75898 | not published | not published | $341.09 – $3,180.39 | 3 |
| Follow-up surgery of eye CPT 66250 | not published | not published | $1,796.05 – $6,798.00 | 4 |
| Fondaparinux sodium HCPCS J1652 | not published | not published | $1.24 – $1.37 | 3 |
| Foot X-ray CPT 73630 | $395.45 | $719.00 | $65.74 – $159.47 | 3 |
| Forehead flap w/vasc pedicle 15731 CPT 15731 | not published | not published | $2,677.07 – $10,498.00 | 4 |
| Forensic autopsy (necropsy) CPT 88040 | not published | not published | $3,595.22 – $3,595.22 | 1 |
| Forensic cytopathology CPT 88125 | not published | not published | $39.37 – $53.11 | 3 |
| Foreskn manip w/lss preputial ads+stretching 54450 CPT 54450 | not published | not published | $188.75 – $4,074.00 | 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.