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 |
|---|---|---|---|---|
| Ghs fb removal - non-incisional CPT 20520 | $2,317.70 | $4,214.00 | $1,247.68 – $4,321.00 | 4 |
| Ghs febrile agglutinns(mayo) CPT 86000 | $101.20 | $184.00 | $5.24 – $55.52 | 5 |
| Ghs fish cytogen CPT 88271 | $840.40 | $1,528.00 | $16.06 – $115.12 | 5 |
| Ghs fish hybrid in situ 100-300 CPT 88275 | $409.75 | $745.00 | $38.39 – $319.31 | 5 |
| Ghs gastric intub aspiration lavage CPT 43753 | $295.90 | $538.00 | $163.12 – $4,074.00 | 4 |
| Ghs hcv amplificaiton CPT 87521 | not published | not published | $26.32 – $279.04 | 5 |
| Ghs heavy metals bld (ars,lead,merc) CPT 82715 | not published | not published | $17.23 – $51.03 | 5 |
| Ghs hepatitis c virus (hcv riba) CPT 86804 | not published | not published | $11.62 – $123.15 | 5 |
| Ghs hgb stability-thal CPT 83068 | $106.15 | $193.00 | $7.10 – $67.30 | 5 |
| Ghs histoplasma antigen CPT 87385 | $300.30 | $546.00 | $9.94 – $95.32 | 5 |
| Ghs HIV antibody CPT 86703 | not published | not published | $10.28 – $109.00 | 5 |
| Ghs hla-dr/dq, multiple antigens CPT 86817 | not published | not published | $79.60 – $511.95 | 5 |
| Ghs i and d abscess/hematoma scrotum CPT 54700 | not published | not published | $1,579.16 – $6,798.00 | 4 |
| Ghs i and d perirectal abscess 46040 CPT 46040 | $1,349.15 | $2,453.00 | $903.99 – $4,321.00 | 4 |
| Ghs i and d pilonidal cyst complex CPT 10081 | $1,757.25 | $3,195.00 | $534.95 – $4,074.00 | 4 |
| Ghs i and d pilonidal cyst simple CPT 10080 | $627.55 | $1,141.00 | $534.95 – $4,074.00 | 4 |
| Ghs immun0electrophoresis CPT 86320 | not published | not published | $22.44 – $178.20 | 5 |
| Ghs incision thrombosed ext hemorrhoid CPT 46083 | $545.60 | $992.00 | $188.75 – $4,074.00 | 4 |
| Ghs indirect laryngoscopy/w fb removal CPT 31511 | $154.00 | $280.00 | $150.79 – $4,074.00 | 4 |
| Ghs inf midline insertion CPT 36140 | $660.00 | $1,200.00 | $1,704.00 – $1,704.00 | 1 |
| Ghs inhibitor screen CPT 85335 | $574.75 | $1,045.00 | $9.65 – $102.35 | 5 |
| Ghs init tx 1st degree burn CPT 16000 | $455.95 | $829.00 | $151.57 – $4,074.00 | 4 |
| Ghs inj neurolytic intercostal nerve CPT 64620 | not published | not published | $668.17 – $4,074.00 | 4 |
| Ghs inj neurolytic other perph nerve CPT 64640 | not published | not published | $668.17 – $4,074.00 | 4 |
| Ghs inj tendon origin/insertion CPT 20551 | not published | not published | $231.88 – $4,074.00 | 4 |
| Ghs inj transforaminal cerv ea add bil CPT 64480 | $3,022.80 | $5,496.00 | $1,704.00 – $1,704.00 | 1 |
| Ghs inj transforaminal cerv single bil CPT 64479 | $3,626.70 | $6,594.00 | $668.17 – $4,074.00 | 4 |
| Ghs insertion of needle - bone CPT 36680 | $426.80 | $776.00 | $337.47 – $4,074.00 | 4 |
| Ghs intermed repair 12.6 - 20.0 cm-12035 CPT 12035 | $1,016.40 | $1,848.00 | $307.10 – $4,074.00 | 4 |
| Ghs intermed repair 20.1 - 30.0 cm-12036 CPT 12036 | $1,412.40 | $2,568.00 | $558.33 – $4,074.00 | 4 |
| Ghs intermed repair over 30 cm - 12037 CPT 12037 | $1,669.80 | $3,036.00 | $1,558.69 – $4,321.00 | 4 |
| Ghs intro needle/intracath vein - 36000 CPT 36000 | $89.10 | $162.00 | $1,704.00 – $1,704.00 | 1 |
| Ghs irrigate corpora cavernosa for priapism CPT 54220 | not published | not published | $188.75 – $4,074.00 | 4 |
| Ghs IV inf sq injection, on-body injector CPT 96377 | not published | not published | $35.37 – $47.17 | 2 |
| Ghs IV infusion bamlanivimab/etesevimab HCPCS M0245 | $474.10 | $862.00 | not published | 0 |
| Ghs IV infusion casirivimab/imdevimab HCPCS M0243 | $510.40 | $928.00 | not published | 0 |
| Ghs IV infusion sotrovimab HCPCS M0247 | $510.40 | $928.00 | not published | 0 |
| Ghs IV thrombolytics - cerebral CPT 37195 | $426.80 | $776.00 | $249.53 – $4,074.00 | 4 |
| Ghs lac repair mouth.ant tong 2.5cm/less CPT 41250 | not published | not published | $337.47 – $4,074.00 | 4 |
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | $518.65 | $943.00 | $307.10 – $4,074.00 | 4 |
| Ghs layer closure 2.5 cm or less - 12041 CPT 12041 | $531.30 | $966.00 | $307.10 – $4,074.00 | 4 |
| Ghs layer closure 2.5cm or less - 12051 CPT 12051 | $462.00 | $840.00 | $307.10 – $4,074.00 | 4 |
| Ghs layer closure 2.6 - 5.0 cm - 12052 CPT 12052 | $530.75 | $965.00 | $307.10 – $4,074.00 | 4 |
| Ghs layer closure 2.6 - 7.5 cm - 12042 CPT 12042 | $687.50 | $1,250.00 | $307.10 – $4,074.00 | 4 |
| Ghs layer closure 5.1 - 7.5 cm - 12053 CPT 12053 | $652.30 | $1,186.00 | $307.10 – $4,074.00 | 4 |
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | $991.65 | $1,803.00 | $307.10 – $4,074.00 | 4 |
| Ghs layer closure 7.6 - 12.5 cm - 12044 CPT 12044 | $808.50 | $1,470.00 | $558.33 – $4,074.00 | 4 |
| Ghs layer closure 7.6 - 12.5 cm - 12054 CPT 12054 | $780.45 | $1,419.00 | $307.10 – $4,074.00 | 4 |
| Ghs layered repair 12.6 - 20.0 cm -12045 CPT 12045 | $950.95 | $1,729.00 | $558.33 – $4,074.00 | 4 |
| Ghs layered repair 12.6 - 20.0 cm -12055 CPT 12055 | $1,126.95 | $2,049.00 | $307.10 – $4,074.00 | 4 |
| Ghs layered repair 20.1 - 30.0 cm -12046 CPT 12046 | $1,090.10 | $1,982.00 | $558.33 – $4,074.00 | 4 |
| Ghs layered repair 20.1 - 30.0 cm -12056 CPT 12056 | $1,327.15 | $2,413.00 | $307.10 – $4,074.00 | 4 |
| Ghs layered repair over 30.0 cm -12047 CPT 12047 | $1,256.75 | $2,285.00 | $1,558.69 – $4,321.00 | 4 |
| Ghs layered repair over 3.0 cm -12057 CPT 12057 | $1,500.40 | $2,728.00 | $307.10 – $4,074.00 | 4 |
| Ghs leukocyte alkaline phos (mayo) CPT 85540 | not published | not published | $6.45 – $68.40 | 5 |
| Ghs mbp CPT 83873 | $35.20 | $64.00 | $12.90 – $136.85 | 5 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $253.55 | $461.00 | not published | 0 |
| Ghs moderate sedation < 5 yr, 30 min, other CPT 99155 | $253.55 | $461.00 | not published | 0 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $253.55 | $461.00 | not published | 0 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $60.50 | $110.00 | not published | 0 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $60.50 | $110.00 | not published | 0 |
| Ghs nailbed repair/nail removal CPT 11760 | $693.55 | $1,261.00 | $558.33 – $4,074.00 | 4 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | $619.85 | $1,127.00 | $668.17 – $4,074.00 | 4 |
| Ghs nerve blk intercostal, single level CPT 64420 | $571.45 | $1,039.00 | $533.25 – $4,074.00 | 4 |
| Ghs nerve block axillary nerve CPT 64417 | not published | not published | $668.17 – $4,074.00 | 4 |
| Ghs nerve block brachial plexus CPT 64415 | $1,574.10 | $2,862.00 | $668.17 – $4,074.00 | 4 |
| Ghs nerve block celiac plexus CPT 64530 | not published | not published | $668.17 – $4,074.00 | 4 |
| Ghs nerve block interscaline CPT 64510 | not published | not published | $668.17 – $4,074.00 | 4 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $1,709.95 | $3,109.00 | $668.17 – $4,074.00 | 4 |
| Ghs nerve block sciatic nerve CPT 64445 | not published | not published | $533.25 – $4,074.00 | 4 |
| Ghs nerve block suprascapular CPT 64418 | $1,108.80 | $2,016.00 | $533.25 – $4,074.00 | 4 |
| Ghs ng placement w fluoro guidance CPT 43752 | $601.70 | $1,094.00 | $337.47 – $4,074.00 | 4 |
| Ghs o2 saturation CPT 82810 | $99.00 | $180.00 | $7.33 – $69.41 | 5 |
| Ghs o2 uptake rest & exercise CPT 94680 | not published | not published | $97.20 – $129.61 | 2 |
| Ghs o2 uptake rest & indirect CPT 94690 | not published | not published | $44.57 – $59.42 | 2 |
| Ghs ob unlisted IV or art inj or infusion CPT 96379 | not published | not published | $35.37 – $47.17 | 2 |
| Ghs opcc repair cvp without subq port CPT 36575 | not published | not published | $473.89 – $4,074.00 | 4 |
| Ghs opcc repair cvp w subq port CPT 36576 | not published | not published | $1,189.18 – $4,321.00 | 4 |
| Ghs optokenetic CPT 92544 | not published | not published | $97.20 – $129.61 | 2 |
| Ghs ot group caregiver training CPT 97552 | not published | not published | $6.80 – $9.07 | 2 |
| Ghs pacing - transcutaneous CPT 92953 | $854.70 | $1,554.00 | $499.30 – $2,672.00 | 3 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $811.25 | $1,475.00 | $1,704.00 – $1,704.00 | 1 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $746.35 | $1,357.00 | $1,704.00 – $1,704.00 | 1 |
| Ghs path - pap (papanicolau) smear - vagina CPT 88141 | $110.00 | $200.00 | $184.09 – $184.09 | 1 |
| Ghs peritonsillar abscess i andd CPT 42700 | $437.25 | $795.00 | $178.93 – $4,074.00 | 4 |
| Ghs phenylketonurid CPT 84030 | not published | not published | $4.12 – $43.73 | 5 |
| Ghs picc line insert < 5 CPT 36568 | $1,393.70 | $2,534.00 | $1,189.18 – $4,074.00 | 4 |
| Ghs plngl fx pm cl CPT 26725 | $579.15 | $1,053.00 | $186.34 – $4,074.00 | 4 |
| Ghs plt ct-manual CPT 85032 | not published | not published | $3.23 – $34.21 | 5 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | not published | not published | $648.73 – $864.97 | 2 |
| Ghs pos nystagmus CPT 92542 | not published | not published | $100.51 – $134.01 | 2 |
| Ghs ppd (tb intradermal) CPT 86580 | not published | not published | $21.85 – $43.15 | 3 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $23.65 | $43.00 | $7.24 – $76.82 | 5 |
| Ghs protein, misc fluid CPT 84160 | $23.65 | $43.00 | $4.21 – $31.87 | 5 |
| Ghs protoporphyrins fract CPT 84202 | $23.65 | $43.00 | $10.76 – $114.08 | 5 |
| Ghs pr without cont pulse ox CPT 94625 | $147.95 | $269.00 | $44.57 – $59.42 | 2 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | $18.15 | $33.00 | $9.19 – $97.38 | 5 |
| Ghs quinidine CPT 80194 | $23.10 | $42.00 | $10.95 – $116.13 | 5 |
| Ghs refill of implantable pump CPT 95990 | not published | not published | $249.53 – $1,704.00 | 3 |
| Ghs removal intranasal foreign body CPT 30300 | $363.55 | $661.00 | $100.51 – $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.