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 |
|---|---|---|---|---|
| Grfg autol fat lipo ea addl CPT 15772 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Grfg autol soft tiss dir exc CPT 15769 | not published | not published | $2,677.07 – $10,498.00 | 4 |
| Group train without patient HCPCS G0543 | not published | not published | $21.85 – $29.13 | 2 |
| Growth hormone antibody CPT 86277 | not published | not published | $11.80 – $125.14 | 5 |
| Growth hormone panel CPT 80428 | not published | not published | $50.02 – $530.37 | 5 |
| Growth hormone panel CPT 80430 | not published | not published | $97.00 – $624.09 | 5 |
| Growth stimulation gene 2 CPT 83006 | not published | not published | $56.70 – $174.88 | 5 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Gstr rstcv oth/thn v-band CPT 43843 | not published | not published | $10,498.00 – $14,543.00 | 2 |
| Gstr rstcv px shrt roux-en-y CPT 43846 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Gstr rstcv px sm int rcnstj CPT 43847 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Gstr rstcv px v-banded gstp CPT 43842 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $1,449.62 – $6,798.00 | 4 |
| G-tube reposition CPT 43761 | $528.00 | $960.00 | $188.75 – $4,074.00 | 4 |
| Gu dilat ureter/urethra s&i CPT 74485 | not published | not published | $511.14 – $2,105.55 | 3 |
| Guided cath fluid drainage 10030 CPT 10030 | $1,281.50 | $2,330.00 | $534.95 – $4,074.00 | 4 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $1,096.77 | $1,994.12 | not published | 0 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $205.16 | $373.02 | not published | 0 |
| Guid loc target vol rad tx CPT 77387 | $597.85 | $1,087.00 | $501.45 – $501.45 | 1 |
| Gum graft CPT 41870 | not published | not published | $1,172.13 – $4,321.00 | 4 |
| Gw stiffened micro access kit HCPCS C1894 | $241.23 | $438.60 | not published | 0 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $2,957.88 – $10,498.00 | 4 |
| Hair analysis HCPCS P2031 | not published | not published | $6.19 – $34.29 | 3 |
| Hair removal by electrolysis 17380 CPT 17380 | not published | not published | $558.33 – $4,074.00 | 4 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $307.10 – $4,074.00 | 4 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $307.10 – $4,074.00 | 4 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | not published | not published | $6.68 – $10.27 | 3 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | not published | not published | $1.13 – $2.24 | 3 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | $35.75 | $65.00 | not published | 0 |
| Handpiece aquabeam hp2000 HCPCS C2596 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Hand tendon reconstruction CPT 26500 | not published | not published | $3,232.00 – $18,190.00 | 4 |
| Hand tendon reconstruction CPT 26502 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Hand X-ray CPT 73130 | $387.75 | $705.00 | $65.74 – $167.79 | 3 |
| Haptoglobin quantitative CPT 83010 | $189.75 | $345.00 | $9.44 – $99.99 | 5 |
| Harvest allogeneic stem cell CPT 38205 | not published | not published | $1,704.00 – $9,811.00 | 2 |
| Harvest auto stem cells CPT 38206 | not published | not published | $1,176.54 – $4,321.00 | 4 |
| Harvest cultured skin graft 15040 CPT 15040 | not published | not published | $1,558.69 – $4,321.00 | 4 |
| Harvest eye tissue alograft CPT 68371 | not published | not published | $1,796.05 – $6,798.00 | 4 |
| Harvest femoropopliteal vein 35572 CPT 35572 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Harvest stem cell concentrte CPT 38215 | not published | not published | $333.28 – $4,074.00 | 4 |
| Harvest vein for bypass 35500 CPT 35500 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Hast w/i&r phys/qhp CPT 94452 | not published | not published | $100.51 – $134.01 | 2 |
| Hast w/oxygen titrate CPT 94453 | not published | not published | $100.51 – $134.01 | 2 |
| Hba1/hba2 full gene sequence CPT 81259 | $1,444.30 | $2,626.00 | $450.00 – $3,367.78 | 5 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $2,418.90 | $4,398.00 | $151.80 – $1,136.06 | 5 |
| Hba1/hba2 gene fam vrnt CPT 81258 | not published | not published | $281.44 – $2,106.27 | 5 |
| Hbb full gene sequence CPT 81364 | $1,263.90 | $2,298.00 | $243.44 – $1,821.84 | 5 |
| Hbb gene com variants CPT 81361 | not published | not published | $131.11 – $981.20 | 5 |
| Hbb gene dup/del variants CPT 81363 | $1,288.10 | $2,342.00 | $151.80 – $1,136.06 | 5 |
| Hbb gene known fam variant CPT 81362 | not published | not published | $281.44 – $2,106.27 | 5 |
| Hb glycosylated a1c home dev CPT 83037 | not published | not published | $7.28 – $77.18 | 5 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | $1,223.20 | $2,224.00 | $132.50 – $2,975.56 | 3 |
| Hcg free betachain test CPT 84704 | $39.60 | $72.00 | $11.47 – $119.74 | 5 |
| Hcg qualitative CPT 84703 | $146.85 | $267.00 | $5.64 – $59.78 | 5 |
| Hcg quantitative CPT 84702 | $172.15 | $313.00 | $11.29 – $119.74 | 5 |
| Hc metata joint dislocation anes CPT 28635 | not published | not published | $1,214.74 – $4,321.00 | 4 |
| Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks CPT 17311 | not published | not published | $558.33 – $4,074.00 | 4 |
| Hc mohs micrographic h/n/h/f/g each addl stage CPT 17312 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Hc mohs trunk/arm/leg 1st stage 5 blocks CPT 17313 | not published | not published | $558.33 – $4,074.00 | 4 |
| Hc mohs trunk/arm/leg ea addl block any stage CPT 17315 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Hc mohs trunk/arm/leg ea stage after 1st stage CPT 17314 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | not published | not published | $410.18 – $1,022.29 | 3 |
| Hc nm fusion spect CT unlisted CPT 78999 | not published | not published | $302.00 – $402.67 | 2 |
| Hc nm kidney imaging with flow CPT 78701 | not published | not published | $302.00 – $1,508.50 | 3 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | not published | not published | $410.18 – $1,466.97 | 3 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | not published | not published | $978.03 – $2,771.26 | 3 |
| Hc transcatheter placement and sbsq removal cepd perq CPT 33370 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | not published | not published | $526.15 – $1,715.05 | 3 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | not published | not published | $526.15 – $3,123.87 | 3 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | not published | not published | $526.15 – $4,929.18 | 3 |
| Hdr rdncl skn surf brachytx CPT 77767 | not published | not published | $291.37 – $1,325.74 | 3 |
| Hdr rdncl skn surf brachytx CPT 77768 | not published | not published | $291.37 – $2,179.13 | 3 |
| Head CT scan (with and without contrast) CPT 70470 | $1,684.65 | $3,063.00 | $132.50 – $984.66 | 3 |
| Head CT scan (with contrast) CPT 70460 | $1,574.10 | $2,862.00 | $132.50 – $810.21 | 3 |
| Head CT scan (without contrast) CPT 70450 | $1,040.05 | $1,891.00 | $78.98 – $563.75 | 3 |
| Hearing loss dup/del analys CPT 81431 | not published | not published | $509.68 – $3,814.40 | 5 |
| Hearing loss sequence analys CPT 81430 | not published | not published | $1,218.75 – $9,121.07 | 5 |
| Heart first pass add-on CPT 78496 | not published | not published | $159.47 – $159.47 | 1 |
| Heart first pass multiple CPT 78483 | not published | not published | $410.18 – $1,375.58 | 3 |
| Heart image spect CPT 78494 | not published | not published | $302.00 – $1,345.14 | 3 |
| Heart infarct image CPT 78466 | $493.35 | $897.00 | $302.00 – $1,275.89 | 3 |
| Heart infarct image (ef) CPT 78468 | not published | not published | $410.18 – $1,278.68 | 3 |
| Heart revascularize (tmr) CPT 33140 | not published | not published | $15,466.00 – $15,466.00 | 1 |
| Heart tmr w/other procedure 33141 CPT 33141 | not published | not published | $15,466.00 – $15,466.00 | 1 |
| Heavy metal qual any number CPT 83015 | not published | not published | $15.70 – $149.73 | 5 |
| Heinz bodies direct CPT 85441 | not published | not published | $3.15 – $33.46 | 5 |
| Heinz bodies induced CPT 85445 | not published | not published | $5.12 – $54.24 | 5 |
| Helicobacter pylori antibody igm CPT 86677 | $39.05 | $71.00 | $12.64 – $46.24 | 5 |
| Helicoll, per square cm HCPCS Q4164 | not published | not published | $94.01 – $3,117.77 | 4 |
| Hemagglutination inhibition CPT 86280 | not published | not published | $6.14 – $62.02 | 5 |
| Hematocrit CPT 85014 | $39.05 | $71.00 | $1.78 – $18.87 | 5 |
| Hematopoietic nuclear tx CPT 79403 | not published | not published | $176.27 – $639.04 | 3 |
| Hemicrt intrclry algrft prtl CPT 20933 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Hemiepiphyseal arrest CPT 24470 | not published | not published | $2,471.80 – $14,543.00 | 4 |
| Hemin 350 mg intravenous powder for solution HCPCS J1640 | not published | not published | $26.87 – $64.91 | 5 |
| Hemodialysis one evaluation CPT 90935 | $1,043.35 | $1,897.00 | not published | 0 |
| Hemoglobin CPT 85018 | $39.05 | $71.00 | $1.78 – $18.87 | 5 |
| Hemoglobin copper sulfate CPT 83026 | not published | not published | $3.01 – $18.80 | 5 |
| Hemoglobin fetal qualitative CPT 83033 | $17.60 | $32.00 | $6.00 – $47.39 | 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.