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 |
|---|---|---|---|---|
| Formoterol fumarate, inh HCPCS J7606 | not published | not published | $2.47 – $3.74 | 3 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | not published | not published | $0.17 – $0.22 | 3 |
| Foscarnet sodium injection HCPCS J1455 | not published | not published | $29.61 – $70.82 | 3 |
| Fractionation ketosteroids CPT 83593 | not published | not published | $21.38 – $209.09 | 5 |
| Fracture assessment via dxa CPT 77086 | not published | not published | $65.74 – $206.56 | 3 |
| _fragile x methylation-sendout CPT 81244 | $778.25 | $1,415.00 | $33.67 – $251.98 | 5 |
| Fragmenting of kidney stone CPT 50590 | not published | not published | $2,662.91 – $16,582.00 | 4 |
| Free fascial flap microvasc CPT 15758 | not published | not published | $6,798.00 – $10,498.00 | 2 |
| Freeing of bowel adhesion 44005 CPT 44005 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Free jejunum flap microvasc CPT 43496 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Free myo/skin flap microvasc CPT 15756 | not published | not published | $6,798.00 – $10,498.00 | 2 |
| Free omental flap microvasc CPT 49906 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Free/remove chest lining 32320 CPT 32320 | not published | not published | $14,906.00 – $14,906.00 | 1 |
| Free skin flap microvasc CPT 15757 | not published | not published | $6,798.00 – $10,498.00 | 2 |
| Frenectomy 41115 CPT 41115 | not published | not published | $1,172.13 – $4,321.00 | 4 |
| Frenotomy 40806 CPT 40806 | not published | not published | $407.43 – $4,074.00 | 4 |
| Frenulotomy of penis CPT 54164 | not published | not published | $1,579.16 – $6,798.00 | 4 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $354.20 | $644.00 | not published | 0 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $338.80 | $616.00 | not published | 0 |
| Fresh frozen plasma thawing ea un CPT 86927 | not published | not published | $107.87 – $171.61 | 3 |
| Frozen blood freeze/thaw CPT 86932 | not published | not published | $28.22 – $535.28 | 3 |
| Frozen blood prep CPT 86930 | not published | not published | $128.70 – $629.16 | 3 |
| Frozen blood thaw CPT 86931 | not published | not published | $128.70 – $471.37 | 3 |
| Frozen cell preparation CPT 88241 | not published | not published | $9.07 – $55.59 | 5 |
| Fructosamine glycated protein CPT 82985 | $20.35 | $37.00 | $12.57 – $93.97 | 5 |
| Fth/gft fr n/e/e/l each addl CPT 15261 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Fth/gft fr trnk each addl CPT 15201 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Ftl cgen abnor 3 proteins CPT 81509 | not published | not published | $1,115.53 – $8,348.57 | 5 |
| Ftl cgen abnor five anal CPT 81512 | not published | not published | $52.14 – $390.23 | 5 |
| Ftl cgen abnor four anal CPT 81511 | $112.75 | $205.00 | $115.12 – $861.61 | 5 |
| Ftl cgen abnor three anal CPT 81510 | $52.25 | $95.00 | $41.66 – $311.74 | 5 |
| Ftl cgen abnor two proteins CPT 81508 | not published | not published | $40.72 – $304.79 | 5 |
| Full mouth x-ray of teeth CPT 70320 | not published | not published | $180.25 – $311.77 | 3 |
| Full thick gft/nose/ear/lid/lip/20sqcm or< 15260 CPT 15260 | not published | not published | $1,558.69 – $4,321.00 | 4 |
| Full thick gft/scalp/arm/leg/20sqcm or< 15220 CPT 15220 | not published | not published | $1,558.69 – $4,321.00 | 4 |
| Full thick gft/scalp/arm/leg/add 20sqcm 15221 CPT 15221 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | not published | not published | $1,558.69 – $4,321.00 | 4 |
| Fundus photography with i&r 92250 CPT 92250 | not published | not published | $100.51 – $134.01 | 2 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | not published | not published | $0.03 – $0.04 | 2 |
| Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr HCPCS J1940 | not published | not published | $0.72 – $0.72 | 1 |
| Fuse bile ducts and bowel 47785 CPT 47785 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Fuse esophagus & intestine CPT 43340 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Fuse esophagus & intestine CPT 43341 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Fuse esophagus & stomach CPT 43320 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Fuse gallbladder & bowel CPT 47740 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Fuse gallbladder & bowel CPT 47741 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Fuse/graft added joint CPT 26863 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Fuse liver duct & intestine CPT 47802 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Fuse liver ducts & bowel CPT 47765 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Fuse pancreas and bowel CPT 48548 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Fuse pancreas cyst and bowel CPT 48540 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Fuse pancreas cyst and bowel 48520 CPT 48520 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Fuse upper gi structures CPT 47721 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Fusion/graft of finger joint CPT 26862 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Fusion/graft of hand joint CPT 26844 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Fusion of ankle joint open CPT 27870 | not published | not published | $9,698.86 – $16,582.00 | 4 |
| Fusion of big toe joint CPT 28750 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Fusion of big toe joint CPT 28755 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Fusion of facial/other nerve CPT 64866 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Fusion of finger jnt add-on CPT 26861 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Fusion of finger joint CPT 26860 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Fusion of finger tendons CPT 26471 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Fusion of finger tendons CPT 26474 | not published | not published | $1,214.74 – $4,321.00 | 4 |
| Fusion of foot bones CPT 28730 | not published | not published | $9,698.86 – $16,582.00 | 4 |
| Fusion of foot bones CPT 28735 | not published | not published | $9,698.86 – $16,582.00 | 4 |
| Fusion of foot bones CPT 28740 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Fusion of hand joint CPT 26843 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Fusion of knee CPT 27580 | not published | not published | $9,698.86 – $16,582.00 | 4 |
| Fusion of knuckle CPT 26850 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Fusion of knuckle joint CPT 26516 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Fusion of knuckle joints CPT 26517 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Fusion of knuckle joints CPT 26518 | not published | not published | $5,481.64 – $10,498.00 | 4 |
| Fusion of knuckle with graft CPT 26852 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Fusion of skull arteries CPT 61711 | not published | not published | $18,190.00 – $18,190.00 | 1 |
| Fusion of spermatic ducts CPT 54900 | not published | not published | $1,579.16 – $6,798.00 | 4 |
| Fusion of spermatic ducts CPT 54901 | not published | not published | $2,662.91 – $10,498.00 | 4 |
| Fusion of tendons at wrist CPT 25300 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Fusion of tendons at wrist CPT 25301 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Fusion of thumb CPT 26841 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Fusion of tibiofibular joint CPT 27871 | not published | not published | $9,698.86 – $16,582.00 | 4 |
| Fusion of toes CPT 28280 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Fusion of ureter & bowel CPT 50810 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Fusion of ureter & kidney CPT 50740 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Fusion of ureter & kidney CPT 50750 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Fxn gene charac alleles CPT 81285 | not published | not published | $206.12 – $1,604.32 | 5 |
| Fxn gene detc abnor alleles CPT 81284 | not published | not published | $102.75 – $799.73 | 5 |
| Fxn gene full gene sequence CPT 81286 | not published | not published | $206.12 – $1,604.32 | 5 |
| Fxn gene known famil variant CPT 81289 | not published | not published | $138.90 – $1,081.09 | 5 |
| G6pc gene CPT 81250 | not published | not published | $43.87 – $328.29 | 5 |
| G6pd full gene sequence CPT 81249 | $1,320.00 | $2,400.00 | $450.00 – $3,367.78 | 5 |
| G6pd gene alys cmn variant CPT 81247 | not published | not published | $131.11 – $981.20 | 5 |
| G6pd known familial variant CPT 81248 | not published | not published | $281.44 – $2,106.27 | 5 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | $86.90 | $158.00 | not published | 0 |
| Gabapentin non-blood CPT 80355 | $53.90 | $98.00 | $137.83 – $137.83 | 1 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | not published | not published | $0.38 – $0.52 | 3 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | not published | not published | $2.16 – $2.80 | 3 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | not published | not published | $0.17 – $0.22 | 3 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | not published | not published | $21.33 – $27.94 | 3 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | not published | not published | $15.80 – $167.53 | 5 |
| Galactokinase - sendout CPT 82759 | not published | not published | $16.11 – $170.86 | 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.