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 |
|---|---|---|---|---|
| Incision of urethra CPT 53010 | not published | not published | $4,050.52 – $9,811.00 | 4 |
| Incision of urethra CPT 53020 | not published | not published | $1,579.16 – $6,798.00 | 4 |
| Incision of urethra CPT 53025 | not published | not published | $1,579.16 – $6,798.00 | 4 |
| Incision of vagus nerve CPT 64760 | not published | not published | $4,321.00 – $4,321.00 | 1 |
| Incision of windpipe CPT 31601 | not published | not published | $4,472.08 – $9,811.00 | 4 |
| Incision of windpipe CPT 31610 | not published | not published | $4,472.08 – $9,811.00 | 4 |
| Incision of wrist capsule CPT 25085 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Incision secondary cataract CPT 66820 | not published | not published | $1,704.00 – $4,321.00 | 4 |
| Incision tendon sheath CPT 26055 | not published | not published | $1,214.74 – $4,321.00 | 4 |
| Incisn of toe tndn CPT 28010 | not published | not published | $1,214.74 – $6,798.00 | 4 |
| Incisn windpipe CPT 31600 | $2,618.55 | $4,761.00 | $2,504.63 – $6,798.00 | 4 |
| Incis spine 3 column adl seg CPT 22208 | not published | not published | $1,704.00 – $18,190.00 | 2 |
| Incis spine 3 column lumbar CPT 22207 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Incis spine 3 column thorac CPT 22206 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Incobotulinumtoxin a HCPCS J0588 | not published | not published | $3.96 – $10.08 | 5 |
| Inc&subq plmt crnl bone grf CPT 61316 | not published | not published | $18,190.00 – $18,190.00 | 1 |
| Induced ab 1+vag supp d&c CPT 59856 | not published | not published | $3,232.00 – $4,321.00 | 2 |
| Induced ab 1+vag supp hyst CPT 59857 | not published | not published | $4,321.00 – $4,321.00 | 1 |
| Induced ab 1+ vag sup w/dlv fetus CPT 59855 | not published | not published | $4,321.00 – $4,321.00 | 1 |
| Induced abortion 1+njx d&c CPT 59851 | not published | not published | $4,321.00 – $4,321.00 | 1 |
| Induced abortion 1+njx hyst CPT 59852 | not published | not published | $4,321.00 – $4,321.00 | 1 |
| Induced abortion d&c CPT 59840 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Induced abortion dilat&evac CPT 59841 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s) CPT 87626 | not published | not published | $52.65 – $308.88 | 5 |
| Infect ag drug suscept pheno predict CPT 87900 | $333.85 | $607.00 | $97.76 – $1,036.50 | 5 |
| Infect ag eia chlamydia trachomatis CPT 87320 | not published | not published | $11.25 – $95.32 | 5 |
| Infect ag eia influenza a or b ea CPT 87400 | not published | not published | $10.60 – $95.32 | 5 |
| Infect ag genotype na cytomegalovirus CPT 87910 | not published | not published | $193.09 – $2,047.15 | 5 |
| Infect ag genotype na dna hepatitis b CPT 87912 | $956.45 | $1,739.00 | $193.09 – $2,047.15 | 5 |
| Infect ag genotype na hiv-1 other region CPT 87906 | $333.85 | $607.00 | $96.55 – $1,023.60 | 5 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $893.75 | $1,625.00 | $193.09 – $2,047.15 | 5 |
| Infect ag ia direct hiv-1 antgn CPT 87806 | not published | not published | $24.58 – $191.47 | 5 |
| Infect ag ia optc obs chlamydia trach CPT 87810 | not published | not published | $26.47 – $95.32 | 5 |
| Infect ag ia optc obs influenza CPT 87804 | $99.55 | $181.00 | $12.41 – $95.32 | 5 |
| Infect ag if ea plyvlnt antsrm CPT 87300 | not published | not published | $8.98 – $95.32 | 5 |
| Infect ag if hep delta agent CPT 87380 | not published | not published | $13.77 – $130.54 | 5 |
| Infect ag if influenza a CPT 87276 | $28.60 | $52.00 | $12.05 – $95.32 | 5 |
| Infect ag if influenza b CPT 87275 | $24.20 | $44.00 | $9.19 – $95.32 | 5 |
| Infect ag if legionella pneumophila CPT 87278 | $59.95 | $109.00 | $11.70 – $95.32 | 5 |
| Infect ag if nos ea CPT 87299 | $29.70 | $54.00 | $12.08 – $95.32 | 5 |
| Infect ag if pneumocystis carinii CPT 87281 | $139.70 | $254.00 | $8.98 – $95.32 | 5 |
| Infect ag if varicella zoster CPT 87290 | $59.95 | $109.00 | $10.06 – $95.32 | 5 |
| Infect ag na chlamydia trachomatis qnt CPT 87492 | not published | not published | $40.10 – $277.98 | 5 |
| Infect ag na hep b amp CPT 87516 | not published | not published | $26.32 – $279.04 | 5 |
| Infect ag na herpes simplex quant CPT 87530 | not published | not published | $32.13 – $340.63 | 5 |
| Infect ag na hpv high-risk types CPT 87624 | $304.70 | $554.00 | $26.32 – $279.04 | 5 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $218.90 | $398.00 | $71.85 – $676.68 | 5 |
| Infect ag na influenza revr/amp ea type CPT 87501 | not published | not published | $38.48 – $408.03 | 5 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | $177.65 | $323.00 | $38.48 – $225.76 | 5 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $1,052.70 | $1,914.00 | $312.58 – $3,314.23 | 5 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | $572.00 | $1,040.00 | $366.50 – $3,885.65 | 5 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | $92.95 | $169.00 | $19.55 – $207.27 | 5 |
| Infectious agent antigen immunoassay direct optical observation sars-cov-2 CPT 87811 | not published | not published | $31.04 – $241.83 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $56.65 | $103.00 | $8.98 – $95.32 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | $34.10 | $62.00 | $10.06 – $95.32 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $99.00 | $180.00 | $10.36 – $95.32 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $91.85 | $167.00 | $8.98 – $95.32 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $125.95 | $229.00 | $10.78 – $114.37 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $117.70 | $214.00 | $7.75 – $82.14 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $67.10 | $122.00 | $7.75 – $82.14 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $223.85 | $407.00 | $18.06 – $191.47 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $335.50 | $610.00 | $8.98 – $95.32 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $174.90 | $318.00 | $8.98 – $95.32 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $38.50 | $70.00 | $8.98 – $95.32 | 5 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $1,138.50 | $2,070.00 | $26.32 – $279.04 | 5 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $132.55 | $241.00 | $26.32 – $279.04 | 5 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $205.15 | $373.00 | $27.95 – $279.04 | 5 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $750.20 | $1,364.00 | $312.58 – $3,337.40 | 5 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $289.30 | $526.00 | $26.32 – $279.04 | 5 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $63.80 | $116.00 | $26.32 – $279.04 | 5 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $682.00 | $1,240.00 | $31.26 – $279.04 | 5 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $130.90 | $238.00 | $26.32 – $279.04 | 5 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $188.10 | $342.00 | $38.48 – $299.87 | 5 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $79.20 | $144.00 | $106.97 – $833.57 | 5 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $277.75 | $505.00 | $106.97 – $833.57 | 5 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $201.30 | $366.00 | $26.32 – $279.04 | 5 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $167.20 | $304.00 | $26.32 – $279.04 | 5 |
| Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae CPT 87494 | not published | not published | $52.64 – $70.18 | 2 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $200.20 | $364.00 | $57.58 – $337.79 | 5 |
| Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets CPT 87627 | not published | not published | $509.83 – $679.77 | 2 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $1,243.00 | $2,260.00 | $312.58 – $3,314.23 | 5 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $243.10 | $442.00 | $96.22 – $1,020.16 | 5 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $484.00 | $880.00 | $197.24 – $1,697.20 | 5 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $611.60 | $1,112.00 | $32.13 – $340.63 | 5 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $256.85 | $467.00 | $32.13 – $340.63 | 5 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $237.05 | $431.00 | $32.13 – $340.63 | 5 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $605.00 | $1,100.00 | $63.82 – $676.68 | 5 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $205.15 | $373.00 | $106.97 – $1,020.16 | 5 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | not published | not published | $23.61 – $59.24 | 5 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | not published | not published | $23.12 – $39.68 | 5 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | not published | not published | $20.78 – $37.39 | 5 |
| Influenza dna amp prob addl CPT 87503 | not published | not published | $21.92 – $165.15 | 5 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | not published | not published | $121.06 – $158.63 | 3 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $41.86 – $54.85 | 3 |
| Infratemporal approach/skull CPT 61591 | not published | not published | $18,190.00 – $18,190.00 | 1 |
| Infratemporal approach/skull CPT 61590 | not published | not published | $18,190.00 – $18,190.00 | 1 |
| Infuse radioactive materials CPT 77750 | not published | not published | $291.37 – $878.81 | 3 |
| Ingest challenge ini 120 min CPT 95076 | not published | not published | $281.90 – $375.86 | 2 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $466.95 | $849.00 | $165.42 – $220.57 | 2 |
| Initial care training 30 m HCPCS G0539 | not published | not published | $29.44 – $39.26 | 2 |
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.