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 |
|---|---|---|---|---|
| Mayo factor vii CPT 85230 | $193.60 | $352.00 | $13.42 – $142.37 | 5 |
| Mayo factor viii vw factor antigen CPT 85246 | $112.20 | $204.00 | $17.20 – $182.42 | 5 |
| Mayo factor viii vw factor multimetric analysis CPT 85247 | $93.50 | $170.00 | $17.20 – $182.42 | 5 |
| Mayo factor viii vw factor ristocetin cofactor CPT 85245 | $282.70 | $514.00 | $17.20 – $182.42 | 5 |
| Mayo factor x CPT 85260 | $63.80 | $116.00 | $13.42 – $142.37 | 5 |
| Mayo factor xi CPT 85270 | $92.95 | $169.00 | $13.42 – $142.37 | 5 |
| Mayo fat/lipids feces quantitative CPT 82710 | $41.25 | $75.00 | $12.60 – $133.62 | 5 |
| Mayo fbl culture fungi blood CPT 87103 | $358.60 | $652.00 | $15.34 – $71.68 | 5 |
| Mayo fdp/fsp paracoagulation CPT 85366 | $256.30 | $466.00 | $60.34 – $140.81 | 5 |
| Mayo ffspg allergen clam igg CPT 86001 | $59.95 | $109.00 | $5.86 – $25.80 | 5 |
| Mayo fibrinogen antigen CPT 85385 | not published | not published | $10.84 – $67.55 | 5 |
| Mayo gabapentin bld/srm/plasma therapeutic drug level CPT 80171 | $41.25 | $75.00 | $16.25 – $105.44 | 5 |
| Mayo gamma-globin full gene sequencing CPT 81479 | $2,215.40 | $4,028.00 | not published | 0 |
| Mayo hemosiderin qualitative urine CPT 83070 | $21.45 | $39.00 | $3.56 – $37.77 | 5 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative CPT 87535 | $199.10 | $362.00 | $26.32 – $279.04 | 5 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-2 CPT 87538 | $669.35 | $1,217.00 | $26.32 – $279.04 | 5 |
| Mayo hiser histoplasma antibodies immunodiffusion CPT 86698 | $30.25 | $55.00 | $10.34 – $89.26 | 5 |
| Mayo hla typing a/b/c single antigen CPT 86812 | $85.25 | $155.00 | $19.36 – $205.24 | 5 |
| Mayo hvdip HIV 1 antibody CPT 86701 | $190.30 | $346.00 | $6.67 – $70.70 | 5 |
| Mayo hvdip HIV 2 antibody CPT 86702 | $289.30 | $526.00 | $10.14 – $107.47 | 5 |
| Mayo hydroxyprogesterone 17-d CPT 83498 | $53.90 | $98.00 | $20.38 – $216.04 | 5 |
| Mayo immunoassay c1 esterase inhibitor antibody quantitative CPT 83520 | $383.35 | $697.00 | $12.95 – $102.92 | 5 |
| Mayo immunoassay infectious agent antibody quantitative diptheria igg CPT 86317 | $704.55 | $1,281.00 | $11.24 – $119.19 | 5 |
| Mayo immunoassay tumor antigen quantitative ca 27.29 CPT 86300 | $52.25 | $95.00 | $15.61 – $165.48 | 5 |
| Mayo immunoassay tumor antigen quantitative chromogranin a CPT 86316 | $105.05 | $191.00 | $15.61 – $165.48 | 5 |
| Mayo inf agt nucleic acid amp prb helicobacter pylori clarithromycin resistance CPT 87513 | not published | not published | $26.32 – $154.40 | 5 |
| Mayo infectious agent antigen immunoassay direct optical observation cryptococcus CPT 87899 | $149.60 | $272.00 | $12.05 – $95.32 | 5 |
| Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal CPT 87305 | $213.95 | $389.00 | $8.98 – $95.32 | 5 |
| Mayo infectious agent nucleic acid amplified probe enterovirus CPT 87498 | $137.50 | $250.00 | $26.32 – $279.04 | 5 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma genitalium urine CPT 87563 | $216.70 | $394.00 | $26.32 – $204.85 | 5 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae CPT 87581 | $140.80 | $256.00 | $26.32 – $279.04 | 5 |
| Mayo infectious agent nucleic acid amplified probe pneumocystis jirovecii CPT 87594 | $242.00 | $440.00 | $26.32 – $154.40 | 5 |
| Mayo infectious agent nucleic acid quantification cytomegalovirus CPT 87497 | $177.65 | $323.00 | $32.13 – $340.63 | 5 |
| Mayo infectious disease hepatitis c chronic six biochemical assays CPT 81596 | $228.80 | $416.00 | $54.14 – $421.42 | 5 |
| Mayo infliximab therapeutic drug level CPT 80230 | $299.75 | $545.00 | $28.93 – $225.15 | 5 |
| Mayo inhab inhibin a CPT 86336 | $157.30 | $286.00 | $11.69 – $123.93 | 5 |
| Mayo insft insulin free CPT 83527 | not published | not published | $9.71 – $102.99 | 5 |
| Mayo insulin antibodies CPT 86337 | $101.75 | $185.00 | $16.06 – $170.22 | 5 |
| Mayo iodine CPT 83789 | $517.55 | $941.00 | $18.08 – $143.58 | 5 |
| Mayo itraconazole therapeutic drug level CPT 80189 | $116.05 | $211.00 | $20.33 – $158.27 | 5 |
| Mayo lacosamide therapeutic drug level CPT 80235 | $172.70 | $314.00 | $20.33 – $158.27 | 5 |
| Mayo lamotrigine therapeutic drug level CPT 80175 | $46.20 | $84.00 | $9.94 – $105.44 | 5 |
| Mayo ld_i lactate dehydrogenase isoenzymes CPT 83625 | $18.70 | $34.00 | $9.59 – $101.74 | 5 |
| Mayo legionella antibody CPT 86713 | $57.20 | $104.00 | $11.48 – $121.71 | 5 |
| Mayo leptospira antibody igm CPT 86720 | $73.70 | $134.00 | $12.15 – $46.24 | 5 |
| Mayo lipoprotein electrophoresis CPT 83700 | $39.60 | $72.00 | $8.44 – $89.49 | 5 |
| Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory CPT 86617 | $96.25 | $175.00 | $11.62 – $123.15 | 5 |
| Mayo manganese CPT 83785 | $23.65 | $43.00 | $19.99 – $195.61 | 5 |
| Mayo metanephrines plasma CPT 83835 | $133.65 | $243.00 | $12.70 – $134.68 | 5 |
| Mayo methadone definitive assay confirmation urine CPT 80358 | $166.10 | $302.00 | $137.83 – $137.83 | 1 |
| Mayo mgle voltage-gated calcium channel antibody each CPT 86596 | $105.05 | $191.00 | $9.04 – $107.31 | 5 |
| Mayo mgrm acetylcholine receptor binding antibody CPT 86041 | $59.40 | $108.00 | $13.80 – $84.20 | 5 |
| Mayo microsomal antibody liver-kidney CPT 86376 | $38.50 | $70.00 | $10.91 – $115.70 | 5 |
| Mayo mitotane (lysodren) therapeutic drug level CPT 80299 | $1,517.45 | $2,759.00 | $13.98 – $108.93 | 5 |
| Mayo molecular pathology procedure level 2 apoe genotype CPT 81401 | $1,159.40 | $2,108.00 | $102.75 – $768.98 | 5 |
| Mayo mpl sequence analysis exon 10 CPT 81339 | not published | not published | $138.90 – $1,081.09 | 5 |
| Mayo muramidase CPT 85549 | $19.25 | $35.00 | $14.06 – $149.10 | 5 |
| Mayo muscle-specific kinase (musk) antibody CPT 86366 | $468.60 | $852.00 | $13.80 – $84.20 | 5 |
| Mayo mycophenolic acid therapeutic drug level CPT 80180 | $57.20 | $104.00 | $13.54 – $143.53 | 5 |
| Mayo myoglobin CPT 83874 | $122.65 | $223.00 | $9.69 – $102.68 | 5 |
| Mayo nickel CPT 83885 | not published | not published | $18.38 – $194.83 | 5 |
| Mayo opatu opiates definitive assay >=1 CPT 80361 | $202.95 | $369.00 | $137.83 – $137.83 | 1 |
| Mayo opatu opioid/analogs definitive assay 1 or 2 CPT 80362 | $315.70 | $574.00 | $137.83 – $137.83 | 1 |
| Mayo opatu oxycodone definitive assay CPT 80365 | $347.60 | $632.00 | $137.83 – $137.83 | 1 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $52.25 | $95.00 | $15.91 – $130.81 | 5 |
| Mayo organic acids qualitative each specimen CPT 83919 | $89.10 | $162.00 | $12.34 – $130.81 | 5 |
| Mayo oxalate 24 hour urine CPT 83945 | $112.20 | $204.00 | $10.84 – $102.35 | 5 |
| Mayo pancreatic elastase fecal qualitative or semi quantitative CPT 82656 | not published | not published | $8.65 – $91.70 | 5 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | $43.45 | $79.00 | $11.27 – $119.53 | 5 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | $1,109.35 | $2,017.00 | $9.04 – $95.79 | 5 |
| Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme) CPT 87476 | $150.70 | $274.00 | $26.32 – $279.04 | 5 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | $361.90 | $658.00 | $13.48 – $142.97 | 5 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $23.10 | $42.00 | $10.32 – $93.35 | 5 |
| Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 | $55.00 | $100.00 | $6.33 – $67.13 | 5 |
| Mayo pregnenolone CPT 84140 | $53.90 | $98.00 | $15.50 – $164.38 | 5 |
| Mayo prmb primidone therapeutic drug level CPT 80188 | $11.55 | $21.00 | $12.44 – $131.99 | 5 |
| Mayo proinsulin CPT 84206 | $42.90 | $78.00 | $20.02 – $141.62 | 5 |
| Mayo psaft prostate specific antigen free CPT 84154 | $53.90 | $98.00 | $13.79 – $146.29 | 5 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | $537.35 | $977.00 | $13.80 – $107.41 | 5 |
| Mayo rbcme osmotic fragility rbc incubated CPT 85557 | $112.75 | $205.00 | $10.02 – $106.22 | 5 |
| Mayo receptor assay transferrin soluble CPT 84238 | $31.90 | $58.00 | $27.43 – $290.84 | 5 |
| Mayo renin CPT 84244 | $23.65 | $43.00 | $16.49 – $174.88 | 5 |
| Mayo repu protein electrophoresis urine CPT 84166 | $211.75 | $385.00 | $13.37 – $141.80 | 5 |
| Mayo selenium CPT 84255 | $23.65 | $43.00 | $19.15 – $203.03 | 5 |
| Mayo semb semen analysis volume/count/motility/differential strict morphologic criteria CPT 89322 | not published | not published | $11.62 – $123.25 | 5 |
| Mayo serotonin CPT 84260 | $67.10 | $122.00 | $23.24 – $246.36 | 5 |
| Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 | $40.15 | $73.00 | $14.51 – $153.94 | 5 |
| Mayo sirolimus therapeutic drug level CPT 80195 | $65.45 | $119.00 | $10.30 – $109.21 | 5 |
| Mayo streptococcus pneumoniae antibody igg 23 serotypes multiplex immunoassay quantitative CPT 86581 | $103.95 | $189.00 | $69.02 – $92.03 | 2 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | $116.05 | $211.00 | $3.20 – $33.98 | 5 |
| Mayo tau phosphorylated 217 each CPT 84393 | $275.00 | $500.00 | $96.69 – $128.92 | 2 |
| Mayo tcgr analysis gene rearrangement trb@ abnormal clonal population(s) amplification CPT 81340 | $632.50 | $1,150.00 | $156.69 – $1,661.30 | 5 |
| Mayo tgrp testosterone free CPT 84402 | $45.65 | $83.00 | $19.10 – $202.51 | 5 |
| Mayo tgrp testosterone total CPT 84403 | $93.50 | $170.00 | $19.36 – $200.41 | 5 |
| Mayo thiopurine s-methyltransferase CPT 84433 | $102.85 | $187.00 | $16.63 – $129.52 | 5 |
| Mayo thyroglobulin CPT 84432 | $509.30 | $926.00 | $12.04 – $127.72 | 5 |
| Mayo ticks anaplasma phagocytophilum antibody igg CPT 86666 | $32.45 | $59.00 | $7.64 – $46.24 | 5 |
| Mayo ticks babesia microti antibody igg CPT 86753 | $46.75 | $85.00 | $9.29 – $46.24 | 5 |
| Mayo tramadol definitive assay w metabolite quantitative urine CPT 80373 | $113.85 | $207.00 | $137.83 – $137.83 | 1 |
| Mayo ttfb testosterone bioavailable direct CPT 84410 | $56.64 | $102.98 | $38.46 – $423.51 | 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.