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 |
|---|---|---|---|---|
| Largsc w/njx augmentation CPT 31574 | not published | not published | $1,344.61 – $4,321.00 | 4 |
| Largsc w/removal lesion CPT 31578 | not published | not published | $2,816.54 – $10,498.00 | 4 |
| Largsc w/rmvl foreign bdy(s) CPT 31577 | not published | not published | $295.47 – $4,074.00 | 4 |
| Largsc w/ther injection CPT 31573 | not published | not published | $1,344.61 – $4,321.00 | 4 |
| Laronidase injection HCPCS J1931 | not published | not published | $31.12 – $75.77 | 5 |
| Laryngeal function studies CPT 92520 | not published | not published | $100.51 – $134.01 | 2 |
| Laryngoplasty cricoid split CPT 31587 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Laryngoplasty fx rdctj fixj CPT 31584 | not published | not published | $4,472.08 – $9,811.00 | 4 |
| Laryngoplasty laryngeal sten CPT 31551 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Laryngoplasty laryngeal sten CPT 31552 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Laryngoplasty laryngeal sten CPT 31553 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Laryngoplasty laryngeal sten CPT 31554 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Laryngoplasty laryngeal web CPT 31580 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Laryngoplasty medialization CPT 31591 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Laryngoscope w/vc inj CPT 31570 | not published | not published | $2,816.54 – $10,498.00 | 4 |
| Laryngoscop w/arytenoidectom CPT 31560 | not published | not published | $5,331.49 – $15,466.00 | 4 |
| Laryngoscop w/vc inj + scope CPT 31571 | not published | not published | $2,816.54 – $10,498.00 | 4 |
| Laryngoscopy and dilation CPT 31528 | not published | not published | $2,816.54 – $10,498.00 | 4 |
| Laryngoscopy and dilation CPT 31529 | not published | not published | $2,816.54 – $10,498.00 | 4 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | not published | not published | $1,344.61 – $4,321.00 | 4 |
| Laryngoscopy for treatment CPT 31527 | not published | not published | $2,816.54 – $10,498.00 | 4 |
| Laryngoscopy telescopic CPT 31579 | not published | not published | $295.47 – $4,074.00 | 4 |
| Laryngoscopy w/biopsy CPT 31535 | not published | not published | $2,816.54 – $10,498.00 | 4 |
| Laryngoscopy w/bx & op scope CPT 31536 | not published | not published | $2,816.54 – $10,498.00 | 4 |
| Laryngoscopy w/exc of tumor CPT 31540 | not published | not published | $2,816.54 – $10,498.00 | 4 |
| Laryngoscopy w/fb & op scope CPT 31531 | not published | not published | $2,816.54 – $10,498.00 | 4 |
| Laryngoscopy w/fb removal CPT 31530 | not published | not published | $1,344.61 – $4,321.00 | 4 |
| Laryngoscopy with biopsy CPT 31576 | not published | not published | $1,344.61 – $4,321.00 | 4 |
| Laryngoscopy with biopsy 31510 CPT 31510 | not published | not published | $2,816.54 – $10,498.00 | 4 |
| Laryngoscopy w/w/o tracheoscopy aspiration CPT 31515 | not published | not published | $295.47 – $4,074.00 | 4 |
| Larynscop remve cart + scop CPT 31561 | not published | not published | $5,331.49 – $15,466.00 | 4 |
| Larynscop w/tumr exc + scope CPT 31541 | not published | not published | $2,816.54 – $10,498.00 | 4 |
| Laser surgery eye strands CPT 67031 | not published | not published | $415.49 – $4,074.00 | 4 |
| Laser surgery of cervix 57513 CPT 57513 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Laser surgery of prostate CPT 52647 | not published | not published | $9,811.00 – $14,543.00 | 2 |
| Laser surgery of prostate CPT 52648 | not published | not published | $4,050.52 – $14,543.00 | 4 |
| Laser surg penis lesion(s) CPT 54057 | not published | not published | $1,558.69 – $4,321.00 | 4 |
| Laser treatment of retina CPT 67039 | not published | not published | $3,122.55 – $14,543.00 | 4 |
| Laser treatment of retina CPT 67040 | not published | not published | $3,122.55 – $14,543.00 | 4 |
| Lateral canthopexy CPT 21282 | not published | not published | $2,504.63 – $4,321.00 | 4 |
| Lat retinacular release open CPT 27425 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Lavage cannulation maxillary sinus CPT 31000 | not published | not published | $178.93 – $4,074.00 | 4 |
| Lavh >250 gms 58553 CPT 58553 | not published | not published | $8,030.21 – $16,582.00 | 4 |
| Lb with mastopexy 15839 CPT 15839 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Lead capillary CPT 83655 | $21.45 | $39.00 | $9.08 – $96.26 | 5 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $367.76 | $668.65 | not published | 0 |
| Lefort i-1 piece without graft CPT 21141 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Lefort i-2 piece without graft CPT 21142 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Lefort i-3/> piece with graft CPT 21147 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Lefort i-3/> piece without graft CPT 21143 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Lefort ii anterior intrusion CPT 21150 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Legion pneumo dna dir prob CPT 87540 | not published | not published | $15.04 – $159.48 | 5 |
| Legion pneumo dna quant CPT 87542 | not published | not published | $31.32 – $332.03 | 5 |
| Leg vein fusion 34530 CPT 34530 | not published | not published | $2,385.29 – $10,498.00 | 4 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $2,322.65 | $4,223.00 | $180.25 – $240.33 | 2 |
| Leishmania antibody CPT 86717 | not published | not published | $9.19 – $46.24 | 5 |
| Lengthening of hand tendon CPT 26478 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Lengthening of palate CPT 42227 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Lengthening of palate+pharyngeal flap 42226 CPT 42226 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Lengthening of thigh bone CPT 27466 | not published | not published | $5,481.64 – $16,582.00 | 4 |
| Lengthening of thigh tendon CPT 27393 | not published | not published | $5,481.64 – $10,498.00 | 4 |
| Lengthening of thigh tendons CPT 27394 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Lengthening of thigh tendons CPT 27395 | not published | not published | $2,471.80 – $14,543.00 | 4 |
| Lengthening or shortening - tibia and fibula 27715 CPT 27715 | not published | not published | $9,698.86 – $16,582.00 | 4 |
| Lengthen metacarpal/finger CPT 26568 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Lengthen radius or ulna CPT 25391 | not published | not published | $9,698.86 – $16,352.00 | 4 |
| Lengthen radius & ulna CPT 25393 | not published | not published | $5,481.64 – $14,543.00 | 4 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $237.37 | $431.58 | not published | 0 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | not published | not published | $5.09 – $7.70 | 3 |
| Leukacyte transfusion CPT 86950 | not published | not published | $128.70 – $409.47 | 3 |
| Leukocyte phagocytosis CPT 86344 | not published | not published | $7.79 – $63.50 | 5 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | not published | not published | $120.26 – $334.46 | 5 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | not published | not published | $1,380.95 – $3,300.48 | 5 |
| Leuprolide acetate injeciton HCPCS J9218 | not published | not published | $16.48 – $16.48 | 1 |
| Leuprolide depot cipla 7.5mg HCPCS J1954 | not published | not published | $320.07 – $687.29 | 5 |
| Leuprolide inj, camcevi, 1mg HCPCS J1952 | not published | not published | $31.54 – $103.43 | 5 |
| Levalbuterol non-comp con HCPCS J7612 | not published | not published | $0.41 – $0.57 | 3 |
| Levalbuterol non-comp unit HCPCS J7614 | not published | not published | $0.13 – $0.17 | 3 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | not published | not published | $0.07 – $0.09 | 3 |
| Levetiracetam therapeutic drug level CPT 80177 | $70.40 | $128.00 | $9.94 – $105.44 | 5 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | not published | not published | $1.49 – $3.72 | 3 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | not published | not published | $9.97 – $14.63 | 3 |
| L hrt cath chd nm/abn nt cnj CPT 93595 | not published | not published | $2,449.09 – $14,543.00 | 4 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | not published | not published | $0.01 – $0.02 | 3 |
| Lidocaine therapeutic drug level CPT 80176 | $127.05 | $231.00 | $11.02 – $116.80 | 5 |
| Ligate esophagus veins CPT 43400 | not published | not published | $9,811.00 – $16,582.00 | 2 |
| Ligate leg veins open CPT 37761 | not published | not published | $2,385.29 – $4,321.00 | 4 |
| Ligate leg veins radical 37760 CPT 37760 | not published | not published | $2,385.29 – $10,498.00 | 4 |
| Ligate oviduct(s) add-on 58611 CPT 58611 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Ligate/staple esophagus CPT 43405 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Ligate/strip long leg vein CPT 37722 | not published | not published | $2,385.29 – $10,498.00 | 4 |
| Ligate/strip short leg vein CPT 37718 | not published | not published | $2,385.29 – $10,498.00 | 4 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Ligation common iliac vein CPT 37660 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Ligation/divis of long saph vein 37700 CPT 37700 | not published | not published | $2,385.29 – $10,498.00 | 4 |
| Ligation external carotid artery 37600 CPT 37600 | not published | not published | $2,385.29 – $10,498.00 | 4 |
| Ligation internal/common carotid artery 37605 CPT 37605 | not published | not published | $2,385.29 – $10,498.00 | 4 |
| Ligation internal jugular vein 37565 CPT 37565 | not published | not published | $2,385.29 – $4,321.00 | 4 |
| Ligation major artery chest CPT 37616 | not published | not published | $10,498.00 – $10,498.00 | 1 |
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.