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 |
|---|---|---|---|---|
| Injection px peyronie ds CPT 54200 | not published | not published | $188.75 – $4,074.00 | 4 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $804.65 | $1,463.00 | $302.00 – $4,074.00 | 4 |
| Injection, renflexis HCPCS Q5104 | not published | not published | $19.96 – $48.58 | 5 |
| Injection, ruconest HCPCS J0596 | not published | not published | $28.37 – $69.80 | 5 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | $2,620.75 | $4,765.00 | $533.25 – $4,074.00 | 4 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $1,991.00 | $3,620.00 | $533.25 – $4,074.00 | 4 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $840.40 | $1,528.00 | $533.25 – $4,074.00 | 4 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $3,626.70 | $6,594.00 | $668.17 – $4,074.00 | 4 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $3,022.80 | $5,496.00 | $1,704.00 – $1,704.00 | 1 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $4,030.95 | $7,329.00 | $668.17 – $4,074.00 | 4 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $3,022.80 | $5,496.00 | $1,704.00 – $1,704.00 | 1 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $2,417.25 | $4,395.00 | $668.17 – $4,074.00 | 4 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $1,670.90 | $3,038.00 | $533.25 – $4,074.00 | 4 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $1,646.70 | $2,994.00 | $533.25 – $4,074.00 | 4 |
| Injection, siltuximab HCPCS J2860 | not published | not published | $130.55 – $307.71 | 5 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $400.95 | $729.00 | $231.88 – $4,074.00 | 4 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $539.55 | $981.00 | $231.88 – $4,074.00 | 4 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | not published | not published | $231.88 – $4,074.00 | 4 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $188.65 | $343.00 | $35.37 – $47.17 | 2 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $188.65 | $343.00 | not published | 0 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $221.10 | $402.00 | $160.68 – $214.25 | 2 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $160.60 | $292.00 | $54.39 – $72.52 | 2 |
| Injection treatment of eye CPT 66020 | not published | not published | $1,743.42 – $4,321.00 | 4 |
| Injection treatment of eye CPT 66030 | not published | not published | $1,743.42 – $4,321.00 | 4 |
| Injection treatment of nerve CPT 64605 | not published | not published | $1,475.17 – $6,798.00 | 4 |
| Injection treatment of nerve CPT 64610 | not published | not published | $1,475.17 – $6,798.00 | 4 |
| Injection treatment of nerve CPT 64681 | not published | not published | $668.17 – $4,074.00 | 4 |
| Injection treatment of nose CPT 30200 | not published | not published | $407.43 – $4,074.00 | 4 |
| Inject sacroiliac joint CPT 27096 | not published | not published | $1,704.00 – $4,074.00 | 2 |
| Inject/treat eye socket CPT 67500 | not published | not published | $239.78 – $4,074.00 | 4 |
| Inject/treat eye socket CPT 67505 | not published | not published | $239.78 – $4,074.00 | 4 |
| Inject/treat eye socket CPT 67515 | not published | not published | $239.78 – $4,074.00 | 4 |
| Inj efgart-alfa 2mg hya-qvfc HCPCS J9334 | not published | not published | $25.69 – $64.10 | 5 |
| Inj eflapegrastim-xnst 0.1mg HCPCS J1449 | not published | not published | $28.92 – $40.96 | 5 |
| Inj., emapalumab-lzsg, 1 mg HCPCS J9210 | not published | not published | $294.58 – $725.12 | 5 |
| Inj., emicizumab-kxwh 0.5 mg HCPCS J7170 | not published | not published | $43.52 – $109.12 | 5 |
| Inj epidural sgl cerv-thor without img CPT 62320 | not published | not published | $533.25 – $4,074.00 | 4 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | not published | not published | $668.17 – $4,074.00 | 4 |
| Inj, epinephrine (belcher) HCPCS J0173 | not published | not published | $3.26 – $4.40 | 2 |
| Inj., eravacycline, 1 mg HCPCS J0122 | not published | not published | $1.04 – $2.45 | 5 |
| Inj, evinacumab-dgnb, 5mg HCPCS J1305 | not published | not published | $148.22 – $360.53 | 5 |
| Inj., evomela, 1 mg HCPCS J9246 | not published | not published | $13.53 – $33.30 | 5 |
| Inj, factor x, (human), 1iu HCPCS J7175 | not published | not published | $7.46 – $18.83 | 5 |
| Inj, faricimab-svoa, 0.1mg HCPCS J2777 | not published | not published | $24.29 – $65.51 | 5 |
| Inj. fe derisomaltose 10 mg HCPCS J1437 | not published | not published | $15.81 – $38.42 | 5 |
| Inj fensolvi 0.25 mg HCPCS J1951 | not published | not published | $108.98 – $266.81 | 5 |
| Inj., fibryga, 1 mg HCPCS J7177 | not published | not published | $0.92 – $2.30 | 5 |
| Inj fluphenazine hcl 1.25 mg HCPCS J2679 | not published | not published | $10.37 – $14.23 | 3 |
| Inj, focinvez, 1mg HCPCS J1434 | not published | not published | $1.84 – $5.45 | 4 |
| Inj for ext venography CPT 36005 | $154.00 | $280.00 | $1,704.00 – $1,704.00 | 1 |
| Inj for mammo ductogram CPT 19030 | $508.75 | $925.00 | $1,704.00 – $1,704.00 | 1 |
| Inj, fosaprepitant (teva) HCPCS J1456 | not published | not published | $0.03 – $2.15 | 5 |
| Inj fosnetupitant, palonoset HCPCS J1454 | not published | not published | $377.89 – $1,217.49 | 5 |
| Inj, fulvestrant (fresenius) HCPCS J9394 | not published | not published | $4.81 – $27.11 | 5 |
| Inj, gadopiclenol, 1 ml HCPCS A9573 | not published | not published | $5.03 – $6.62 | 3 |
| Inj gemcitabine hcl (accord) HCPCS J9196 | not published | not published | $10.05 – $17.28 | 3 |
| Inj givosiran 0.5 mg HCPCS J0223 | not published | not published | $90.69 – $222.66 | 5 |
| Inj glofitamab gxbm, 2.5 mg HCPCS J9286 | not published | not published | $2,148.51 – $5,264.08 | 5 |
| Inj glycopyrrolate fres kabi HCPCS J1598 | not published | not published | $2.41 – $3.74 | 3 |
| Inj, granisetron, xr, 0.1 mg HCPCS J1627 | not published | not published | $2.41 – $10.19 | 5 |
| Inj., guselkumab, 1 mg HCPCS J1628 | not published | not published | $50.19 – $142.24 | 5 |
| Inj heparin, pfizer, 1000u HCPCS J1643 | not published | not published | $4.26 – $6.51 | 3 |
| Inj. herceptin hylecta, 10mg HCPCS J9356 | not published | not published | $43.76 – $119.65 | 5 |
| Inj, hercessi, 10 mg HCPCS Q5146 | not published | not published | $24.34 – $144.74 | 3 |
| Inj herzuma 10 mg HCPCS Q5113 | not published | not published | $41.21 – $147.23 | 5 |
| Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Inj hrt cath w/s&i sel hrt ang CPT 93563 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Inj hrt cath w/s&i sel hrt art CPT 93564 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Inj hrt cath w/s&i sel left vent CPT 93565 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Inj hrt cath w/s&i sel right vent CPT 93566 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Inj human fibrinogen con nos HCPCS J7178 | not published | not published | $1.12 – $2.89 | 5 |
| Inj., ibalizumab-uiyk, 10 mg HCPCS J1746 | not published | not published | $59.63 – $150.83 | 5 |
| Inj imip 4 cilas 4 releb 2mg HCPCS J0742 | not published | not published | $3.63 – $4.96 | 3 |
| Inj, imm glob bivigam, 500mg HCPCS J1556 | not published | not published | $60.93 – $146.81 | 5 |
| Inj, immphentiv, 20 mcg HCPCS J2373 | not published | not published | $0.20 – $0.26 | 3 |
| Inj. inebilizumab-cdon, 1 mg HCPCS J1823 | not published | not published | $382.99 – $939.42 | 5 |
| Inj/inf neurolyt sbst spinal canal lesion 62282 CPT 62282 | not published | not published | $668.17 – $4,074.00 | 4 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | not published | not published | $151.57 – $4,074.00 | 4 |
| Inj intralesional > 7 lsns CPT 11901 | not published | not published | $151.57 – $4,074.00 | 4 |
| Inj, invega hafyera/trinza HCPCS J2427 | not published | not published | $9.95 – $24.61 | 5 |
| Inj ivig privigen 500 mg HCPCS J1459 | not published | not published | $38.41 – $95.82 | 5 |
| Inj, ixinity, 1 i.u HCPCS J7213 | not published | not published | $1.45 – $4.07 | 5 |
| Inj. jivi 1 iu HCPCS J7208 | not published | not published | $2.07 – $5.04 | 5 |
| Inj, kovaltry, 1 i.u HCPCS J7211 | not published | not published | $1.20 – $3.00 | 5 |
| Inj labetalol hcl hikma, 5mg HCPCS J1921 | not published | not published | $2.00 – $2.63 | 3 |
| Inj., lanadelumab-flyo, 1 mg HCPCS J0593 | not published | not published | $66.16 – $165.19 | 4 |
| Inj, lanreotide, (cipla) 1mg HCPCS J1932 | not published | not published | $15.25 – $56.76 | 5 |
| Inj, lecanemab-irmb, 1 mg HCPCS J0174 | not published | not published | $1.01 – $2.52 | 5 |
| Inj, lenacapavir, 1 mg HCPCS J1961 | not published | not published | $17.20 – $41.85 | 5 |
| Inj levocarnitine per 1 gm HCPCS J1955 | not published | not published | $35.35 – $47.29 | 3 |
| Inj levoleucovorin nos 0.5mg HCPCS J0641 | not published | not published | $0.03 – $0.07 | 3 |
| Inj, levothyroxine, freskabi HCPCS J0651 | not published | not published | $5.13 – $13.48 | 5 |
| Inj, levothyroxine, hikma HCPCS J0652 | not published | not published | $7.45 – $9.76 | 3 |
| Inj, linezolid (hospira) HCPCS J2021 | not published | not published | $9.19 – $15.30 | 3 |
| Inj. lumasiran, 0.5 mg HCPCS J0224 | not published | not published | $252.73 – $625.30 | 5 |
| Inj marstacim-hncq, 0.5 mg HCPCS J7172 | not published | not published | $38.39 – $96.36 | 3 |
| Inj melpha hydroch nos 50 mg HCPCS J9245 | not published | not published | $78.67 – $247.33 | 5 |
| Inj melphalan (hepzato) 1 mg HCPCS J9248 | not published | not published | $601.11 – $1,496.80 | 5 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | not published | not published | $5.26 – $7.26 | 3 |
| Inj, meropenem (b. braun) HCPCS J2184 | not published | not published | $3.03 – $3.94 | 3 |
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.