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 |
|---|---|---|---|---|
| Ligation/major artery/extremity 37618 CPT 37618 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Ligation major artery neck CPT 37615 | not published | not published | $2,385.29 – $4,321.00 | 4 |
| Ligation nasal sinus artery CPT 30915 | not published | not published | $2,385.29 – $10,498.00 | 4 |
| Ligation of abdomen artery 37617 CPT 37617 | not published | not published | $4,203.64 – $10,498.00 | 4 |
| Ligation of femoral vein CPT 37650 | not published | not published | $2,385.29 – $10,498.00 | 4 |
| Ligation of inf vena cava CPT 37619 | not published | not published | $4,203.64 – $16,582.00 | 4 |
| Ligation of neck artery CPT 37606 | not published | not published | $2,385.29 – $10,498.00 | 4 |
| Ligation of salivary duct CPT 42665 | not published | not published | $2,504.63 – $6,798.00 | 4 |
| Ligation of shunt CPT 49428 | not published | not published | $3,232.00 – $10,498.00 | 2 |
| Ligation upper jaw artery CPT 30920 | not published | not published | $2,385.29 – $10,498.00 | 4 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | not published | not published | $2,385.29 – $10,498.00 | 4 |
| Lig/band angioaccess av fistula CPT 37607 | not published | not published | $2,385.29 – $10,498.00 | 4 |
| Lig&div&compl strpg saph vn CPT 37735 | not published | not published | $2,385.29 – $10,498.00 | 4 |
| Limb exercise test CPT 95875 | not published | not published | $97.20 – $129.61 | 2 |
| Limb nerve surgery add-on CPT 64783 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Limited autopsy CPT 88036 | not published | not published | $647.13 – $647.13 | 1 |
| Limited autopsy CPT 88037 | not published | not published | $575.21 – $575.21 | 1 |
| Limited visual field xm CPT 92081 | not published | not published | $44.57 – $59.42 | 2 |
| Lincomycin injection HCPCS J2010 | not published | not published | $9.05 – $12.45 | 3 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | not published | not published | $5.03 – $6.59 | 3 |
| Lipase CPT 83690 | $101.75 | $185.00 | $5.17 – $54.76 | 5 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $2,504.63 – $6,798.00 | 4 |
| Lipoprotein blood high res frac & quant CPT 83701 | $170.50 | $310.00 | $25.40 – $197.43 | 5 |
| Lipoprotein blood quant CPT 83704 | $116.60 | $212.00 | $25.64 – $250.90 | 5 |
| Lipoprotein direct measurement hdl CPT 83718 | $113.30 | $206.00 | $6.14 – $65.15 | 5 |
| Lipoprotein direct measurement ldl CPT 83721 | $33.55 | $61.00 | $7.88 – $75.90 | 5 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $25.64 – $204.67 | 5 |
| Lip surgery procedure CPT 40799 | not published | not published | $178.93 – $13,711.00 | 4 |
| Lisocabtagene mara car pos t HCPCS Q2054 | not published | not published | $434,677.96 – $1,029,107.75 | 5 |
| Listeria monocytogenes CPT 86723 | not published | not published | $9.89 – $46.24 | 5 |
| Lithium therapeutic drug level CPT 80178 | $145.20 | $264.00 | $4.96 – $52.60 | 5 |
| Litt icr 1 traj 1 smpl les CPT 61736 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Litt icr mlt trj mlt/cplx ls CPT 61737 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | $4,321.00 – $4,321.00 | 1 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | not published | not published | $132.14 – $806.25 | 5 |
| Liver elastography 91200 CPT 91200 | not published | not published | $97.20 – $129.61 | 3 |
| Liver Function Test CPT 80076 | $158.40 | $288.00 | $6.13 – $64.98 | 5 |
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Liver imaging CPT 78201 | $843.70 | $1,534.00 | $410.18 – $1,339.59 | 3 |
| Liver imag w/vasclr flow CPT 78202 | not published | not published | $410.18 – $1,430.97 | 3 |
| Liver/spleen imag static only CPT 78215 | $1,363.45 | $2,479.00 | $302.00 – $1,372.83 | 3 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $302.00 – $788.57 | 3 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $1,796.05 – $6,798.00 | 3 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | not published | not published | $1.35 – $3.42 | 3 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | not published | not published | $169.96 – $411.81 | 5 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | not published | not published | $2.28 – $2.50 | 3 |
| Low back disk surgery CPT 63030 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Low cost skin substitute app HCPCS C5271 | not published | not published | $1,704.00 – $4,074.00 | 2 |
| Low cost skin substitute app HCPCS C5273 | not published | not published | $3,232.00 – $4,321.00 | 2 |
| Low cost skin substitute app HCPCS C5275 | not published | not published | $1,704.00 – $4,074.00 | 2 |
| Low cost skin substitute app HCPCS C5277 | not published | not published | $1,704.00 – $4,074.00 | 2 |
| Low cost skin substitute app HCPCS C5272 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Low cost skin substitute app HCPCS C5274 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Low cost skin substitute app HCPCS C5276 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Low cost skin substitute app HCPCS C5278 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,349.05 | $4,271.00 | $132.50 – $1,599.36 | 3 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,152.15 | $3,913.00 | $263.55 – $1,292.00 | 3 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,956.90 | $3,558.00 | $78.98 – $998.49 | 3 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $3,102.55 | $5,641.00 | $263.55 – $2,032.98 | 3 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,844.60 | $5,172.00 | $263.55 – $1,783.76 | 3 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,586.10 | $4,702.00 | $180.25 – $1,142.48 | 3 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $445.50 | $810.00 | $78.98 – $181.64 | 3 |
| Lower jaw bone graft CPT 21215 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Low frequency non-thermal Ultrasound CPT 97610 | not published | not published | $151.57 – $202.09 | 2 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $8,030.21 – $16,582.00 | 4 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $8,030.21 – $16,582.00 | 4 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $8,030.21 – $16,582.00 | 4 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $8,030.21 – $16,582.00 | 4 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $16.49 – $174.83 | 5 |
| Lumbar diskogram s&i CPT 72295 | $1,109.35 | $2,017.00 | $428.08 – $1,966.89 | 3 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $13,245.76 – $17,661.01 | 4 |
| Lumizyme injection HCPCS J0221 | not published | not published | $158.35 – $392.57 | 5 |
| Lung function test (mbc/mvv) CPT 94200 | not published | not published | $44.57 – $59.42 | 2 |
| Lung Function Test (Spirometry) CPT 94010 | $117.15 | $213.00 | not published | 0 |
| Lung perfusion imaging CPT 78580 | $1,581.80 | $2,876.00 | $302.00 – $1,635.87 | 3 |
| Lung transplant double CPT 32853 | not published | not published | $13,711.00 – $13,711.00 | 1 |
| Lung transplant single CPT 32851 | not published | not published | $13,711.00 – $13,711.00 | 1 |
| Lung transplant with bypass CPT 32852 | not published | not published | $13,711.00 – $13,711.00 | 1 |
| Lung transplant with bypass CPT 32854 | not published | not published | $13,711.00 – $13,711.00 | 1 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $16,352.00 – $16,352.00 | 1 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | not published | not published | $161.96 – $391.64 | 5 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | not published | not published | $32.64 – $79.73 | 5 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $21.85 – $4,074.00 | 4 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $15.04 – $159.48 | 5 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $6,174.51 – $16,582.00 | 4 |
| Lymphatics/lymph node imaging CPT 78195 | $1,178.10 | $2,142.00 | $410.18 – $2,396.24 | 3 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $27.42 – $448.97 | 5 |
| Lymphocyte transformation mitogen CPT 86353 | not published | not published | $36.77 – $389.89 | 5 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $142.13 – $415.80 | 5 |
| Lymphocytotoxicity assay CPT 86806 | not published | not published | $35.69 – $378.46 | 5 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $473.89 – $1,596.21 | 3 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $1,189.18 – $1,585.57 | 3 |
| Lymph vessel x-ray trunk CPT 75805 | not published | not published | $1,704.45 – $3,180.39 | 3 |
| Lymph vessel x-ray trunk CPT 75807 | not published | not published | $1,646.24 – $3,180.39 | 3 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $407.43 – $4,074.00 | 4 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $1,579.16 – $6,798.00 | 4 |
| Lyumjev for insulin pump use HCPCS J1813 | not published | not published | $22.23 – $29.02 | 3 |
| Macro exam dissect molec study ea CPT 88387 | not published | not published | $51.13 – $51.13 | 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.