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 |
|---|---|---|---|---|
| Iron CPT 83540 | $143.55 | $261.00 | $4.85 – $51.48 | 5 |
| Iron binding capacity CPT 83550 | $94.05 | $171.00 | $6.56 – $69.52 | 5 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | not published | not published | $14.24 – $34.25 | 5 |
| Iron stain peripheral blood CPT 85536 | not published | not published | $5.16 – $51.42 | 5 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | not published | not published | $0.35 – $0.43 | 3 |
| Irradiation of blood product each unit reference CPT 86945 | $62.70 | $114.00 | $28.22 – $157.78 | 3 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | not published | not published | $44.57 – $59.42 | 2 |
| Irrigation sphenoid sinus CPT 31002 | not published | not published | $1,172.13 – $4,321.00 | 4 |
| Irrigation vagina and/or appl medicament tx disease CPT 57150 | not published | not published | $44.57 – $4,074.00 | 4 |
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | not published | not published | $66.12 – $157.43 | 5 |
| Island pedicle flap graft CPT 15740 | not published | not published | $1,558.69 – $4,321.00 | 4 |
| Ivc venogram s&i CPT 75825 | $4,178.90 | $7,598.00 | $621.90 – $3,180.39 | 3 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $126.50 | $230.00 | $54.39 – $72.52 | 2 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $126.50 | $230.00 | not published | 0 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $130.90 | $238.00 | $35.37 – $47.17 | 2 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $623.15 | $1,133.00 | $160.68 – $214.25 | 2 |
| IV inj ra drug dx study CPT 78808 | $273.35 | $497.00 | $302.00 – $402.67 | 3 |
| IV njx tst vasc flo flap/grf CPT 15860 | not published | not published | $337.47 – $4,074.00 | 4 |
| Ivp w/nephrotomography CPT 74415 | $1,537.80 | $2,796.00 | $132.50 – $865.58 | 3 |
| Ivp w/wo kub w/wo tomography CPT 74400 | not published | not published | $132.50 – $655.15 | 3 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | not published | not published | $104.82 – $263.48 | 5 |
| Jak2 targeted sequence analysis CPT 81279 | $350.35 | $637.00 | $138.90 – $1,081.09 | 5 |
| Jaw arthroscopy/surgery CPT 29800 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Jaw arthroscopy/surgery CPT 29804 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Jejunstmy tube plcmt CPT 44372 | not published | not published | $1,449.62 – $4,321.00 | 4 |
| John cunningham antibody CPT 86711 | not published | not published | $12.67 – $114.45 | 5 |
| J-tube placement CPT 44015 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Keratomileusis CPT 65760 | not published | not published | $6,798.00 – $10,498.00 | 2 |
| Keratophakia CPT 65765 | not published | not published | $6,798.00 – $10,498.00 | 2 |
| Keratoprosthesis CPT 65770 | not published | not published | $10,958.50 – $16,582.00 | 4 |
| Ketamine and metabolite screen - quest CPT 80357 | $400.40 | $728.00 | $137.83 – $137.83 | 1 |
| Ketogenic steroids fract CPT 83582 | not published | not published | $11.60 – $112.72 | 5 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $35.20 | $64.00 | $6.13 – $64.98 | 5 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | not published | not published | $0.21 – $1.39 | 5 |
| Kidney endoscopy CPT 50551 | not published | not published | $3,232.00 – $9,811.00 | 4 |
| Kidney endoscopy CPT 50553 | not published | not published | $4,050.52 – $9,811.00 | 4 |
| Kidney endoscopy CPT 50570 | not published | not published | $2,662.91 – $10,498.00 | 4 |
| Kidney endoscopy CPT 50575 | not published | not published | $4,050.52 – $14,543.00 | 4 |
| Kidney endoscopy & biopsy CPT 50555 | not published | not published | $3,232.00 – $9,811.00 | 4 |
| Kidney endoscopy & biopsy CPT 50574 | not published | not published | $2,662.91 – $4,321.00 | 4 |
| Kidney endoscopy & treatment CPT 50557 | not published | not published | $6,798.00 – $16,352.00 | 4 |
| Kidney endoscopy & treatment CPT 50561 | not published | not published | $4,050.52 – $9,811.00 | 4 |
| Kidney endoscopy & treatment CPT 50576 | not published | not published | $3,232.00 – $9,811.00 | 4 |
| Kidney endoscopy & treatment CPT 50580 | not published | not published | $3,232.00 – $9,811.00 | 4 |
| Kidney function study CPT 78725 | not published | not published | $302.00 – $719.34 | 3 |
| Kidney imaging morphology CPT 78700 | $459.80 | $836.00 | $302.00 – $1,206.69 | 3 |
| Kidney imag w/bld flow multi CPT 78709 | $1,636.80 | $2,976.00 | $410.18 – $2,382.40 | 3 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $965.80 | $1,756.00 | $410.18 – $1,497.44 | 3 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $1,190.75 | $2,165.00 | $78.98 – $594.22 | 3 |
| Kit case 4.2mm spinejack HCPCS C1062 | not published | not published | $18,190.00 – $18,190.00 | 1 |
| Kit gene analys d816 variant CPT 81273 | $616.00 | $1,120.00 | $93.65 – $728.94 | 5 |
| Kit lead specify 5-6-5 HCPCS C1778 | $5,073.07 | $9,223.76 | not published | 0 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | not published | not published | $33.71 – $125.35 | 5 |
| Knee Arthroscopy (Cartilage Repair) CPT 29877 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Knee arthroscopy/drainage CPT 29871 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Knee arthroscopy dx CPT 29870 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Knee Arthroscopy (Meniscus Repair) CPT 29881 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Knee arthroscopy/surgery CPT 29850 | not published | not published | $1,214.74 – $7,919.00 | 4 |
| Knee arthroscopy/surgery CPT 29851 | not published | not published | $1,214.74 – $16,582.00 | 4 |
| Knee arthroscopy/surgery CPT 29873 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Knee arthroscopy/surgery CPT 29874 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Knee arthroscopy/surgery CPT 29875 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Knee arthroscopy/surgery CPT 29876 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Knee arthroscopy/surgery CPT 29879 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Knee arthroscopy/surgery CPT 29880 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Knee arthroscopy/surgery CPT 29882 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Knee arthroscopy/surgery CPT 29883 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Knee arthroscopy/surgery CPT 29884 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Knee arthroscopy/surgery CPT 29886 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Knee arthroscopy/surgery CPT 29887 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Knee arthroscopy/surgery CPT 29888 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Knee arthroscopy/surgery CPT 29889 | not published | not published | $9,698.86 – $16,582.00 | 4 |
| Knee MRI (with and without contrast) CPT 73723 | $2,729.65 | $4,963.00 | $263.55 – $2,805.55 | 3 |
| Knee MRI (with contrast) CPT 73722 | not published | not published | $592.21 – $2,323.73 | 3 |
| Knee MRI (without contrast) CPT 73721 | $2,484.90 | $4,518.00 | $180.25 – $1,299.20 | 3 |
| Knee X-ray CPT 73564 | $436.15 | $793.00 | $78.98 – $217.64 | 3 |
| Kras gene addl variants CPT 81276 | $444.40 | $808.00 | $144.94 – $1,151.11 | 5 |
| Kras gene variants exon 2 CPT 81275 | $1,860.65 | $3,383.00 | $144.94 – $1,151.11 | 5 |
| Kyphectomy 1-2 segments CPT 22818 | not published | not published | $13,245.76 – $24,224.00 | 4 |
| Kyphectomy 3 or more CPT 22819 | not published | not published | $13,245.76 – $24,224.00 | 4 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | not published | not published | $0.54 – $0.74 | 3 |
| Labioplasty 56800 CPT 56800 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Lactate dehydrogenase (ldh) CPT 83615 | $95.70 | $174.00 | $4.53 – $48.00 | 5 |
| Lactated ringers intravenous solution HCPCS J7120 | not published | not published | $3.34 – $4.68 | 3 |
| Lactic acid CPT 83605 | $146.85 | $267.00 | $8.68 – $84.94 | 5 |
| Lactoferrin fecal qualitative CPT 83630 | $28.60 | $52.00 | $14.78 – $156.11 | 5 |
| Lactoferrin fecal quant CPT 83631 | $199.65 | $363.00 | $14.72 – $156.11 | 5 |
| Lam facetc/frmt arthrd lum 1 CPT 63052 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Lam facetec & foramot crv CPT 63045 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Lam facetec & foramot lumbar CPT 63047 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Lam facetec & foramot thrc CPT 63046 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Lam factc/frmt arthrd lum ea CPT 63053 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Lamie bx/exc idrl spine lesn lmbr 63282 CPT 63282 | not published | not published | $18,190.00 – $24,224.00 | 2 |
| Lamie bx/exc idrl spine lesn thrc 63281 CPT 63281 | not published | not published | $18,190.00 – $18,190.00 | 1 |
| Lamie excise intrspinl lesion thrc 63266 CPT 63266 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Laminotomy single cervical CPT 63040 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Laminotomy single lumbar CPT 63042 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Lamiotoiotiotinotomy addl cervical 63043 CPT 63043 | not published | not published | $7,919.00 – $7,919.00 | 1 |
| Lam w/cordotomy 1stg thrc CPT 63197 | not published | not published | $18,190.00 – $18,190.00 | 1 |
| Lanreotide 120 mg/0.5 ml subcutaneous syringe HCPCS J1930 | not published | not published | $28.07 – $83.21 | 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.