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 |
|---|---|---|---|---|
| Initiation & management bipap/cpap initial day CPT 94660 | $370.70 | $674.00 | $165.42 – $220.57 | 2 |
| Inj, abilify asimtufii, 1 mg HCPCS J0402 | not published | not published | $4.64 – $11.46 | 5 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | not published | not published | $5.60 – $13.75 | 5 |
| Inj acetaminoph 10mg/ibu 3mg HCPCS J0138 | not published | not published | $0.07 – $0.41 | 4 |
| Inj, acetaminophen (b braun) HCPCS J0136 | not published | not published | $0.07 – $0.09 | 3 |
| Inj acetaminophen -fresenius HCPCS J0134 | not published | not published | $0.07 – $0.11 | 3 |
| Inj, acetaminophen (hikma) HCPCS J0137 | not published | not published | $0.04 – $0.10 | 3 |
| Inj. acthar gel to 40 units HCPCS J0801 | not published | not published | $3,100.09 – $7,956.11 | 5 |
| Inj, adstiladrin, per tx dos HCPCS J9029 | not published | not published | $48,248.71 – $120,519.00 | 5 |
| Inj, aducanumab-avwa, 2 mg HCPCS J0172 | not published | not published | $8.67 – $11.36 | 3 |
| Inj, adzynma, 10 iu HCPCS J7171 | not published | not published | $27.16 – $67.61 | 5 |
| Inj, aflibercept-ayyh, 1 mg HCPCS Q5147 | not published | not published | $602.44 – $1,651.26 | 4 |
| Inj, aflibercept hd, 1 mg HCPCS J0177 | not published | not published | $224.01 – $608.76 | 5 |
| Inj, afstyla, 1 i.u HCPCS J7210 | not published | not published | $1.21 – $3.00 | 5 |
| Inj allopurinol sodium 1 mg HCPCS J0206 | not published | not published | $3.06 – $8.63 | 5 |
| Inj, alyglo, 500 mg HCPCS J1552 | not published | not published | $91.16 – $271.75 | 5 |
| Inj alymsys 10 mg HCPCS Q5126 | not published | not published | $59.96 – $107.73 | 5 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | not published | not published | $13.88 – $34.40 | 5 |
| Inj. (ani), up to 40 units HCPCS J0802 | not published | not published | $2,756.01 – $6,739.91 | 5 |
| Inj., aristada initio, 1 mg HCPCS J1943 | not published | not published | $2.60 – $6.18 | 5 |
| Inj. asceniv HCPCS J1554 | not published | not published | $381.85 – $943.36 | 5 |
| Inj, aspara, rylaze, 0.1 mg HCPCS J9021 | not published | not published | $44.02 – $105.07 | 5 |
| Inj atezolizumb 5mg hya-tqjs HCPCS J9024 | not published | not published | $24.42 – $60.11 | 4 |
| Inj avacincaptad pegol 0.1mg HCPCS J2782 | not published | not published | $77.40 – $201.20 | 5 |
| Inj aval alfa-nqpt 4mg HCPCS J0219 | not published | not published | $62.96 – $153.43 | 5 |
| Inj., benralizumab, 1 mg HCPCS J0517 | not published | not published | $124.17 – $319.45 | 5 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | not published | not published | $29.87 – $75.67 | 5 |
| Inj bimatoprost itc imp1mcg HCPCS J7351 | not published | not published | $160.32 – $403.49 | 5 |
| Inj, biorphen, 20 micrograms HCPCS J2372 | not published | not published | $0.26 – $0.32 | 3 |
| Inj, bortezomib, hospira HCPCS J9049 | not published | not published | $2.07 – $2.94 | 3 |
| Inj, brixadi, 7 days or less HCPCS J0577 | not published | not published | $322.93 – $803.37 | 5 |
| Inj brixadi, more than 7 day HCPCS J0578 | not published | not published | $1,291.73 – $3,213.48 | 5 |
| Inj, brolucizumab-dbll, 1 mg HCPCS J0179 | not published | not published | $269.78 – $657.77 | 5 |
| Inj, bupivacaine liposome HCPCS J0666 | not published | not published | $1.09 – $2.84 | 5 |
| Inj. byooviz, 0.1 mg HCPCS Q5124 | not published | not published | $118.09 – $313.02 | 5 |
| Inj cefazolin sodium, baxter HCPCS J0689 | not published | not published | $1.81 – $2.53 | 3 |
| Inj cefazolin sodium, hikma HCPCS J0688 | not published | not published | $1.42 – $1.85 | 3 |
| Inj cefazolin (wg crit care) HCPCS J0687 | not published | not published | $1.41 – $2.05 | 3 |
| Inj. cefepime hcl (baxter) HCPCS J0701 | not published | not published | $8.41 – $11.15 | 3 |
| Inj, cefepime hcl (b braun) HCPCS J0703 | not published | not published | $7.31 – $9.64 | 3 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | not published | not published | $1.91 – $4.56 | 5 |
| Inj ceftolozane tazobactam HCPCS J0695 | not published | not published | $7.53 – $17.34 | 5 |
| Inj. cetirizine hcl 0.5mg HCPCS J1201 | not published | not published | $12.87 – $31.15 | 5 |
| Inj, cimerli, 0.1 mg HCPCS Q5128 | not published | not published | $61.90 – $312.17 | 5 |
| Inj, cipaglucosidase, 5 mg HCPCS J1203 | not published | not published | $72.23 – $170.61 | 5 |
| Inj, clindamycin (baxter) HCPCS J0737 | not published | not published | $3.26 – $4.83 | 3 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $351.45 | $639.00 | $1,704.00 – $1,704.00 | 1 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | not published | not published | $1,513.15 – $1,983.86 | 3 |
| Inj cutaquig 100 mg HCPCS J1551 | not published | not published | $10.52 – $26.99 | 5 |
| Inj cuvitru, 100 mg HCPCS J1555 | not published | not published | $13.61 – $33.42 | 5 |
| Inj, cyclophos (baxter) 5mg HCPCS J9076 | not published | not published | $3.29 – $9.55 | 3 |
| Inj cyclophos dr.reddy's 5mg HCPCS J9072 | not published | not published | $6.69 – $17.11 | 4 |
| Inj cyclophosphamd auromedic HCPCS J9071 | not published | not published | $0.37 – $1.49 | 5 |
| Inj cyclophosphamd (ingenus) HCPCS J9073 | not published | not published | $0.37 – $4.05 | 5 |
| Inj, cyclophosphamd, sandoz HCPCS J9074 | not published | not published | $2.58 – $8.05 | 5 |
| Inj, daptomycin (baxter) HCPCS J0874 | not published | not published | $0.10 – $0.13 | 3 |
| Inj, daptomycin (hospira) HCPCS J0877 | not published | not published | $0.07 – $0.11 | 3 |
| Inj daptomycin (xellia) HCPCS J0873 | not published | not published | $0.04 – $0.08 | 3 |
| Inj daxibotulinumtoxina-lanm HCPCS J0589 | not published | not published | $2.30 – $5.91 | 4 |
| Inj, decitabine (sun pharma) HCPCS J0893 | not published | not published | $1.13 – $1.48 | 2 |
| Inj disk cerv-thor ea lev CPT 62291 | $303.60 | $552.00 | $1,704.00 – $1,704.00 | 1 |
| Inj, donanemab-azbt, 2 mg HCPCS J0175 | not published | not published | $3.12 – $7.87 | 5 |
| Inj dupuytren cord w/enzyme CPT 20527 | not published | not published | $231.88 – $4,074.00 | 4 |
| Inj, durolane 1 mg HCPCS J7318 | not published | not published | $4.68 – $12.70 | 5 |
| Inj dx for sinogram CPT 20501 | $305.80 | $556.00 | $1,704.00 – $1,704.00 | 1 |
| Inject for sacroiliac joint HCPCS G0259 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | not published | not published | $533.25 – $4,074.00 | 4 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $264.55 | $481.00 | $1,704.00 – $1,704.00 | 1 |
| Injection, belinostat, 10mg HCPCS J9032 | not published | not published | $40.83 – $98.88 | 5 |
| Injection, burosumab-twza 1m HCPCS J0584 | not published | not published | $385.03 – $914.98 | 5 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | not published | not published | $231.88 – $4,074.00 | 4 |
| Injection, daratumumab 10 mg HCPCS J9145 | not published | not published | $55.33 – $132.69 | 5 |
| Injection, doxercalciferol HCPCS J1270 | not published | not published | $0.55 – $0.71 | 3 |
| Injection during cath supravalvular aortography CPT 93567 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Injection, edaravone, 1 mg HCPCS J1301 | not published | not published | $4.85 – $40.11 | 5 |
| Injection epidural blood patch or clot CPT 62273 | $2,549.80 | $4,636.00 | $533.25 – $4,074.00 | 4 |
| Injection eye drug CPT 67028 | not published | not published | $249.53 – $4,074.00 | 4 |
| Injection for arthrography wrist (both sides) CPT 25246 | $264.55 | $481.00 | $1,704.00 – $1,704.00 | 1 |
| Injection for bladder x-ray CPT 51600 | $264.55 | $481.00 | $1,704.00 – $1,704.00 | 1 |
| Injection for hip x-ray CPT 27095 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $273.35 | $497.00 | $1,704.00 – $1,704.00 | 1 |
| Injection for spleen x-ray CPT 38200 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Injection for tear sac x-ray CPT 68850 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Injection for ureter x-ray CPT 50684 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Injection for ureter x-ray CPT 50690 | $680.90 | $1,238.00 | $1,704.00 – $1,704.00 | 1 |
| Injection, fulvestrant HCPCS J9395 | not published | not published | $10.01 – $13.26 | 3 |
| Injection, inclisiran, 1 mg HCPCS J1306 | not published | not published | $9.68 – $23.47 | 5 |
| Injection into brain canal CPT 61026 | not published | not published | $533.25 – $4,074.00 | 4 |
| Injection into brain canal CPT 61055 | not published | not published | $231.88 – $4,074.00 | 4 |
| Injection into hemorrhoid(s) CPT 46500 | not published | not published | $702.53 – $4,074.00 | 4 |
| Injection into spinal artery CPT 62294 | not published | not published | $668.17 – $4,074.00 | 4 |
| Injection into vocal cord CPT 31513 | not published | not published | $295.47 – $4,074.00 | 4 |
| Injection intraop add-on CPT 48400 | not published | not published | $4,074.00 – $4,074.00 | 1 |
| Injection jaw joint x-ray CPT 21116 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Injection jugular CPT 36299 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Injection, khapzory, 0.5 mg HCPCS J0642 | not published | not published | $1.71 – $2.50 | 3 |
| Injection, necitumumab, 1 mg HCPCS J9295 | not published | not published | $4.30 – $10.89 | 5 |
| Injection of HIV prep drug HCPCS G0012 | not published | not published | $54.39 – $72.52 | 2 |
| Injection of sinus tract CPT 20500 | $1,311.75 | $2,385.00 | $1,172.13 – $4,321.00 | 4 |
| Injection,onabotulinumtoxina HCPCS J0585 | not published | not published | $4.88 – $12.35 | 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.