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 |
|---|---|---|---|---|
| Antistreptolysin o titer CPT 86060 | $48.95 | $89.00 | $5.48 – $58.08 | 5 |
| Antithrombin iii activity CPT 85300 | $67.10 | $122.00 | $8.89 – $94.28 | 5 |
| Antithrombin iii injection HCPCS J7197 | not published | not published | $3.13 – $7.76 | 5 |
| Anti-thymocyte glob (equine)(1:1000) intradermal test dose HCPCS J7504 | not published | not published | $4,161.72 – $9,524.91 | 5 |
| Antithymocyte globuln rabbit HCPCS J7511 | not published | not published | $793.34 – $1,893.14 | 5 |
| Ant/post colporrhap/enterocele rpr 57265 CPT 57265 | not published | not published | $3,779.05 – $14,543.00 | 4 |
| Ant sgm img ir flrscn angrph CPT 92287 | not published | not published | $100.51 – $134.01 | 2 |
| Ant sgm img i&r speclr mic CPT 92286 | not published | not published | $100.51 – $134.01 | 2 |
| Aortic circulation assist 33971 CPT 33971 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Aortic dysfunction/dilation CPT 81410 | not published | not published | $378.00 – $2,828.94 | 5 |
| Aortic dysfunction/dilation CPT 81411 | not published | not published | $1,012.64 – $7,578.56 | 5 |
| Aortic hemiarch graft 33866 CPT 33866 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Apc gene dup/delet variants CPT 81203 | not published | not published | $150.00 – $1,122.60 | 5 |
| Apc gene full sequence CPT 81201 | $990.00 | $1,800.00 | $585.00 – $4,378.12 | 5 |
| Apc gene known fam variants CPT 81202 | not published | not published | $210.00 – $1,571.62 | 5 |
| Aphakia prosth service temp CPT 92358 | not published | not published | $44.57 – $59.42 | 2 |
| Apheresis immunoads slctv CPT 36516 | not published | not published | $3,290.32 – $14,543.00 | 4 |
| Apheresis plasma CPT 36514 | not published | not published | $1,176.54 – $4,321.00 | 4 |
| Apheresis platelets CPT 36513 | not published | not published | $333.28 – $4,074.00 | 4 |
| Apheresis rbc CPT 36512 | not published | not published | $1,176.54 – $4,321.00 | 4 |
| Apheresis wbc CPT 36511 | not published | not published | $1,176.54 – $4,321.00 | 4 |
| Apl(pml-rara) quant - sendout CPT 81315 | $1,516.90 | $2,758.00 | $155.48 – $1,648.50 | 5 |
| Appendectomy CPT 44950 | not published | not published | $4,890.59 – $10,498.00 | 4 |
| Appendectomy add-on 44955 CPT 44955 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Appendectomy/open/rup/w/absc/peri 44960 CPT 44960 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Appendix Removal (Laparoscopic) CPT 44970 | not published | not published | $4,567.04 – $16,582.00 | 4 |
| App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm CPT 15277 | not published | not published | $1,558.69 – $4,321.00 | 4 |
| App high cost ss f/n/g/h/f >100sq cm addl 100sq cm CPT 15278 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| App high cost ss f/n/g/h/f <100sq cm addl <25sq cm CPT 15276 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| App high cost ss t/a/l >100sq cm 1st 100sq cm CPT 15273 | not published | not published | $1,558.69 – $10,498.00 | 4 |
| App high cost ss t/a/l >100sq cm addl 100sq cm CPT 15274 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| App high cost ss t/a/l <100sq cm addl <25sq cm CPT 15272 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Appl bdy cst sho to hip 1thi CPT 29044 | not published | not published | $122.76 – $4,074.00 | 4 |
| Appl bdy cst sho to hip b th CPT 29046 | not published | not published | $211.29 – $4,074.00 | 4 |
| Appl bdy cst sho to hip head CPT 29040 | not published | not published | $211.29 – $4,074.00 | 4 |
| Appl body cast sho to hips CPT 29035 | not published | not published | $211.29 – $4,074.00 | 4 |
| Appl cast figure-of-eight CPT 29049 | not published | not published | $211.29 – $4,074.00 | 4 |
| Appl cast plaster velpeau CPT 29058 | not published | not published | $211.29 – $4,074.00 | 4 |
| Appl cast shoulder spica CPT 29055 | not published | not published | $211.29 – $4,074.00 | 4 |
| Appl halo type body cast CPT 29000 | not published | not published | $211.29 – $4,074.00 | 4 |
| Appl hip spica cast1&1/2 CPT 29325 | not published | not published | $211.29 – $4,074.00 | 4 |
| Appl hip spica cast 1 leg CPT 29305 | not published | not published | $211.29 – $4,074.00 | 4 |
| Application clubfoot cast CPT 29450 | not published | not published | $122.76 – $4,074.00 | 4 |
| Application finger splntstatic 29130 CPT 29130 | $362.45 | $659.00 | $100.51 – $4,074.00 | 4 |
| Application halo femoral CPT 20663 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Application halo pelvic CPT 20662 | not published | not published | $1,214.74 – $6,798.00 | 4 |
| Application long leg splint 29505 CPT 29505 | $455.95 | $829.00 | $122.76 – $4,074.00 | 4 |
| Application lower leg splint 29515 CPT 29515 | $407.00 | $740.00 | $122.76 – $4,074.00 | 4 |
| Application multi layer compression below knee (both sides) CPT 29581 | not published | not published | $122.76 – $4,074.00 | 4 |
| Application of body cast CPT 29010 | not published | not published | $211.29 – $4,074.00 | 4 |
| Application of body cast CPT 29015 | not published | not published | $211.29 – $4,074.00 | 4 |
| Application of cylinder cast 29365 CPT 29365 | not published | not published | $211.29 – $4,074.00 | 4 |
| Application of forearm cast 29075 CPT 29075 | $508.20 | $924.00 | $211.29 – $4,074.00 | 4 |
| Application of long arm cast 29065 CPT 29065 | not published | not published | $211.29 – $4,074.00 | 4 |
| Application of long leg cast CPT 29355 | not published | not published | $211.29 – $4,074.00 | 4 |
| Application of long leg cast 29345 CPT 29345 | not published | not published | $211.29 – $4,074.00 | 4 |
| Application of paste boot 29580 CPT 29580 | not published | not published | $122.76 – $4,074.00 | 4 |
| Application short leg cast 29405 CPT 29405 | not published | not published | $211.29 – $4,074.00 | 4 |
| Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm CPT 15275 | not published | not published | $558.33 – $4,321.00 | 4 |
| Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm CPT 15271 | not published | not published | $558.33 – $4,321.00 | 4 |
| Appl long leg cast brace CPT 29358 | not published | not published | $211.29 – $4,074.00 | 4 |
| Appl mltpln uni ext fixj sys CPT 20692 | not published | not published | $7,919.00 – $16,352.00 | 4 |
| Appl modality 1+lllt po pain CPT 97037 | not published | not published | $28.22 – $37.62 | 2 |
| Appl multlay comprs arm/hand CPT 29584 | not published | not published | $122.76 – $4,074.00 | 4 |
| Appl patllr tdn bearing cast CPT 29435 | not published | not published | $211.29 – $4,074.00 | 4 |
| Appl unipln uni ext fixj sys CPT 20690 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Apply finger cast 29086 CPT 29086 | not published | not published | $122.76 – $4,074.00 | 4 |
| Apply forearm splintdynamic 29126 CPT 29126 | not published | not published | $100.51 – $4,074.00 | 4 |
| Apply halo w/removal cranial CPT 20661 | not published | not published | $1,214.74 – $4,321.00 | 4 |
| Apply hand/wrist cast 29085 CPT 29085 | not published | not published | $122.76 – $4,074.00 | 4 |
| Apply interstit radiat compl CPT 77778 | not published | not published | $526.15 – $2,860.72 | 3 |
| Apply intrcav radiat compl CPT 77763 | not published | not published | $526.15 – $2,221.69 | 3 |
| Apply intrcav radiat interm CPT 77762 | not published | not published | $417.41 – $1,718.35 | 3 |
| Apply intrcav radiat simple CPT 77761 | not published | not published | $417.41 – $1,497.94 | 3 |
| Apply of finger splint 29131 CPT 29131 | $160.60 | $292.00 | $44.57 – $4,074.00 | 4 |
| Apply rem fixation device CPT 20660 | not published | not published | $1,214.74 – $4,321.00 | 4 |
| Apply rigid leg cast 29445 CPT 29445 | not published | not published | $211.29 – $4,074.00 | 4 |
| Apply short leg castambul type 29425 CPT 29425 | not published | not published | $211.29 – $4,074.00 | 4 |
| Apply surf ldr radionuclide CPT 77789 | not published | not published | $77.08 – $472.38 | 3 |
| App mltpln uni xtrnl fix 1st CPT 20696 | not published | not published | $7,919.00 – $27,330.85 | 4 |
| App mltpln uni xtrnl fix xch CPT 20697 | not published | not published | $1,214.74 – $4,321.00 | 4 |
| App skn cll ssp f/n/g/hf 1st CPT 15017 | not published | not published | $1,558.69 – $4,321.00 | 3 |
| App skn cl ssp agrft t/a/l 1 CPT 15015 | not published | not published | $1,558.69 – $4,321.00 | 3 |
| Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion HCPCS J0185 | not published | not published | $1.19 – $3.37 | 5 |
| #aptt mix-1:1 incubated CPT 87532 | not published | not published | $26.32 – $279.04 | 5 |
| Aqaprn-4 antb flo cytmtry ea CPT 86053 | $616.00 | $1,120.00 | $28.30 – $70.28 | 5 |
| Aquaporin-4 antibody cba each CPT 86052 | not published | not published | $9.04 – $70.28 | 5 |
| Aquaporin-4 antibody elisa CPT 86051 | not published | not published | $8.65 – $67.26 | 5 |
| Aquatic exercise - group charge CPT 97150 | $68.20 | $124.00 | not published | 0 |
| Aqueous shunt eye w/graft CPT 66180 | not published | not published | $4,019.93 – $14,543.00 | 4 |
| Aqueous shunt eye without graft CPT 66179 | not published | not published | $4,019.93 – $14,543.00 | 4 |
| Argatroban nonesrd (auromed) HCPCS J0898 | not published | not published | $1.94 – $2.76 | 2 |
| Argatroban nonesrd use 1mg HCPCS J0883 | not published | not published | $0.65 – $1.40 | 4 |
| Aripiprazole 441 mg/1.6 ml inj HCPCS J1944 | not published | not published | $2.67 – $6.33 | 5 |
| Arsenic trioxide 2 mg/ml intravenous solution HCPCS J9017 | not published | not published | $6.95 – $11.13 | 3 |
| Art byp aor celiac msn and renal 35631 CPT 35631 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Art byp aortofemoral 35647 CPT 35647 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Art byp aortoiliac 35637 CPT 35637 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Art bypass aorsubcl/carot/innom 35626 CPT 35626 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Art bypass aortobifemoral 35646 CPT 35646 | not published | not published | $9,811.00 – $9,811.00 | 1 |
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.