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 |
|---|---|---|---|---|
| Hocm 350-399mg/ml iodine,1ml HCPCS Q9963 | not published | not published | $0.32 – $0.41 | 3 |
| Homocysteine CPT 83090 | $35.20 | $64.00 | $13.44 – $134.13 | 5 |
| Homogenization tissue CPT 87176 | $53.35 | $97.00 | $4.41 – $46.77 | 5 |
| Homovanillic acid (hva) CPT 83150 | $49.50 | $90.00 | $16.81 – $110.96 | 5 |
| Ho post-op hip abduction HCPCS L1686 | $2,122.26 | $3,858.65 | not published | 0 |
| Hpa-15 genotyping CPT 81112 | not published | not published | $91.66 – $846.96 | 5 |
| Hpa-1 genotyping CPT 81105 | not published | not published | $91.66 – $846.96 | 5 |
| Hpa-2 genotyping CPT 81106 | not published | not published | $91.66 – $846.96 | 5 |
| Hpa-3 genotyping CPT 81107 | not published | not published | $91.66 – $846.96 | 5 |
| Hpa-4 genotyping CPT 81108 | not published | not published | $91.66 – $846.96 | 5 |
| Hpa-5 genotyping CPT 81109 | not published | not published | $91.66 – $846.96 | 5 |
| Hpa-6 genotyping CPT 81110 | not published | not published | $91.66 – $846.96 | 5 |
| Hpa-9 genotyping CPT 81111 | not published | not published | $91.66 – $846.96 | 5 |
| Hpv combo assay ca screen HCPCS G0476 | not published | not published | $26.32 – $281.03 | 5 |
| Hpv low-risk types CPT 87623 | not published | not published | $26.32 – $279.04 | 5 |
| Hpv types 16 & 18 only CPT 87625 | $160.60 | $292.00 | $30.41 – $279.04 | 5 |
| H pylori ag ia CPT 87339 | not published | not published | $12.00 – $95.32 | 5 |
| H pylori (c-13) blood CPT 83009 | not published | not published | $50.52 – $535.60 | 5 |
| H pylori (c-13) breath CPT 83013 | $113.30 | $206.00 | $50.52 – $535.60 | 5 |
| H pylori drug admin CPT 83014 | not published | not published | $5.90 – $62.51 | 5 |
| Hrdtry brst ca-rlatd do 5+ CPT 81432 | not published | not published | $977.96 – $5,437.49 | 5 |
| Hrdtry brst ca-rlatd dsordrs CPT 81433 | not published | not published | $548.66 – $3,514.75 | 3 |
| Hrdtry cardmypy gene panel CPT 81439 | not published | not published | $438.68 – $4,683.59 | 5 |
| Hrdtry perph neurphy panel CPT 81448 | not published | not published | $438.68 – $4,053.12 | 5 |
| Hrv skn cll ssp agrft 1st 25 CPT 15011 | not published | not published | $1,558.69 – $4,321.00 | 3 |
| Hsv dna dir probe CPT 87528 | not published | not published | $15.04 – $159.48 | 5 |
| Htt gene charac alleles CPT 81274 | not published | not published | $206.12 – $1,604.32 | 5 |
| Htt gene detc abnor alleles CPT 81271 | $313.50 | $570.00 | $102.75 – $799.73 | 5 |
| Human epididymis protein 4 (he4) CPT 86305 | not published | not published | $15.61 – $165.48 | 5 |
| Hyaluronidase 150 unit/ml injection solution HCPCS J3470 | not published | not published | $46.65 – $59.95 | 3 |
| Hyaluronidase 200 units/ml inj HCPCS J3471 | not published | not published | $0.73 – $0.95 | 2 |
| Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 | not published | not published | $0.52 – $0.69 | 3 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | not published | not published | $6.38 – $9.86 | 3 |
| Hydration IV infusion each additional hour CPT 96361 | $126.50 | $230.00 | $35.37 – $47.17 | 2 |
| Hydration IV infusion initial 31minutes - 1 hour CPT 96360 | $611.60 | $1,112.00 | $160.68 – $214.25 | 2 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | not published | not published | $29.84 – $40.28 | 3 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | not published | not published | $0.16 – $0.20 | 3 |
| Hydroxocobalamin im 10mcg HCPCS J3425 | not published | not published | $0.01 – $0.02 | 3 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | not published | not published | $22.77 – $32.16 | 3 |
| Hydrxycorticsterds 17- (17-ohcs) CPT 83491 | $80.30 | $146.00 | $13.42 – $139.35 | 5 |
| Hymenotomy CPT 56442 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Hymovis injection 1 mg HCPCS J7322 | not published | not published | $13.60 – $33.14 | 5 |
| Hyoid myotomy & suspension CPT 21685 | not published | not published | $4,472.08 – $9,811.00 | 4 |
| #hypersens-actinomyces ab CPT 86602 | not published | not published | $7.64 – $46.24 | 5 |
| Hyperthermia ext gen deep CPT 77605 | not published | not published | $526.15 – $5,336.95 | 3 |
| Hyperthermia ext gen supfc CPT 77600 | not published | not published | $291.37 – $2,642.67 | 3 |
| Hyperthermia gen intrcv prb CPT 77620 | not published | not published | $417.41 – $2,360.23 | 3 |
| Hyperthermia ntrstl prb 5/< CPT 77610 | not published | not published | $417.41 – $7,086.98 | 3 |
| Hyperthermia ntrstl prb>5 CPT 77615 | not published | not published | $417.41 – $7,449.60 | 3 |
| Hyqvia 100mg immuneglobulin HCPCS J1575 | not published | not published | $13.76 – $34.93 | 5 |
| Hysterectomy/bladder repair CPT 51925 | not published | not published | $14,906.00 – $14,906.00 | 1 |
| Hysterectomy/revise vagina 58275 CPT 58275 | not published | not published | $7,919.00 – $14,906.00 | 2 |
| Hysterectomy/revise vagina 58280 CPT 58280 | not published | not published | $7,919.00 – $14,906.00 | 2 |
| Hysteroplasty 58540 CPT 58540 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Hysterorrhaphy of ruptured uterus 59350 CPT 59350 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Hysterosalpingography s&i CPT 74740 | $767.25 | $1,395.00 | $180.25 – $430.84 | 3 |
| Hysteroscopy ablation CPT 58563 | not published | not published | $3,779.05 – $9,811.00 | 4 |
| Hysteroscopy biopsy CPT 58558 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Hysteroscopy dx sep proc CPT 58555 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Hysteroscopy lysis CPT 58559 | not published | not published | $3,779.05 – $9,811.00 | 4 |
| Hysteroscopy remove fb CPT 58562 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Hysteroscopy remove myoma CPT 58561 | not published | not published | $3,779.05 – $9,811.00 | 4 |
| Hysteroscopy resect septum CPT 58560 | not published | not published | $3,779.05 – $9,811.00 | 4 |
| Hysterotomy abdominal 59100 CPT 59100 | not published | not published | $3,779.05 – $6,798.00 | 4 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | $114.40 | $208.00 | not published | 0 |
| Iaadi respiratory synctial virus CPT 87280 | $28.60 | $52.00 | $10.06 – $95.32 | 5 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | not published | not published | $26.32 – $279.04 | 5 |
| Ia infect ag ab qual/semiquant sgl step CPT 86318 | not published | not published | $13.57 – $102.92 | 5 |
| Ia nfct ab sarscov2 covid19 CPT 86328 | not published | not published | $33.96 – $264.63 | 5 |
| Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 | not published | not published | $32.22 – $58.52 | 3 |
| Ibmfs seq alys pnl 30 genes CPT 81441 | not published | not published | $1,836.42 – $14,304.98 | 5 |
| Ibuprofen injection HCPCS J1741 | not published | not published | $2.44 – $5.78 | 5 |
| Icatibant injection HCPCS J1744 | not published | not published | $181.71 – $181.71 | 1 |
| Icut allergy test-delayed CPT 95028 | not published | not published | $28.22 – $37.62 | 2 |
| Icut allergy test drug/bug CPT 95024 | not published | not published | $44.57 – $59.42 | 2 |
| Icut allergy titrate-airborn CPT 95027 | not published | not published | $21.85 – $29.13 | 2 |
| I&d abscess posterior spine l/s/ls-22015 CPT 22015 | not published | not published | $4,321.00 – $16,582.00 | 4 |
| I&d abscss rtrphryngl/paraphryngl intraorl apprch CPT 42720 | not published | not published | $2,504.63 – $4,321.00 | 4 |
| Idarubicin hcl injection HCPCS J9211 | not published | not published | $63.09 – $86.58 | 3 |
| I&d/bursa/foot 28001 CPT 28001 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Idecabtagene vicleucel car HCPCS Q2055 | not published | not published | $425,983.34 – $1,028,394.85 | 5 |
| Identify sperm tissue CPT 89264 | not published | not published | $39.37 – $52.49 | 2 |
| Idet 1 or more levels CPT 22527 | not published | not published | $7,919.00 – $10,498.00 | 2 |
| Idet single level CPT 22526 | not published | not published | $7,919.00 – $10,498.00 | 2 |
| I&d frarm&/wrst deep absc/hematoma CPT 25028 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Idh1 common variants CPT 81120 | $675.95 | $1,229.00 | $144.94 – $1,084.71 | 5 |
| Idh2 common variants CPT 81121 | $675.95 | $1,229.00 | $221.84 – $1,660.27 | 5 |
| I&d intramural/intramuscular/submuc abscess transanal anes CPT 46045 | not published | not published | $2,096.85 – $6,798.00 | 4 |
| I&d lacrimal gland CPT 68400 | not published | not published | $753.08 – $4,321.00 | 4 |
| I&d lacrimal sac CPT 68420 | not published | not published | $1,796.05 – $4,321.00 | 4 |
| I&d upper arm/elbow deep abscess/hematoma CPT 23930 | not published | not published | $2,194.34 – $6,798.00 | 4 |
| Idursulfase injection HCPCS J1743 | not published | not published | $427.53 – $1,061.26 | 5 |
| I & d vag hematoma non-ob 57023 CPT 57023 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| I&d vag hemtma obst/postpart CPT 57022 | not published | not published | $2,194.34 – $4,321.00 | 4 |
| Ifnl3 gene CPT 81283 | not published | not published | $55.03 – $423.46 | 5 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | not published | not published | $35.70 – $46.38 | 3 |
| Igh@/bcl2 translocation alys CPT 81278 | not published | not published | $155.48 – $1,210.16 | 5 |
| Igh gene rearrang dir probe CPT 81262 | not published | not published | $51.41 – $347.08 | 5 |
| Igh gene rearrange amp meth CPT 81261 | $726.55 | $1,321.00 | $148.49 – $1,574.38 | 5 |
| Igh@ var region somatic mutation analy CPT 81263 | $1,705.55 | $3,101.00 | $220.89 – $2,341.94 | 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.