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 tulab francisella tularensis antibody igg CPT 86668 | $72.05 | $131.00 | $10.62 – $82.71 | 5 |
| Mayo valpg valproic acid free therapeutic drug level CPT 80165 | not published | not published | $10.16 – $107.75 | 5 |
| Mayo vasoactive intestinal peptide CPT 84586 | $94.05 | $171.00 | $26.50 – $101.41 | 5 |
| Mayo vitamin b-2 (riboflavin) CPT 84252 | $68.75 | $125.00 | $15.18 – $160.94 | 5 |
| Mayo vitamin b3 (niacin) CPT 84591 | $200.75 | $365.00 | $12.80 – $92.29 | 5 |
| Mayo vitamin k CPT 84597 | $99.00 | $180.00 | $10.29 – $109.12 | 5 |
| Mayo zonisamide therapeutic drug level CPT 80203 | $114.95 | $209.00 | $9.94 – $105.44 | 5 |
| Maze/extensive/w/card/pulm bypass 33259 CPT 33259 | not published | not published | $15,466.00 – $15,466.00 | 1 |
| Mcoln1 gene CPT 81290 | $221.65 | $403.00 | $29.48 – $220.64 | 5 |
| Mcp joint arthroscopy dx CPT 29900 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Mcp joint arthroscopy surg CPT 29901 | not published | not published | $2,471.80 – $16,582.00 | 4 |
| Mcp joint arthroscopysurg 29902 CPT 29902 | not published | not published | $1,214.74 – $7,919.00 | 4 |
| Mdfc flap w/prsrv vasc pedcl CPT 15730 | not published | not published | $2,677.07 – $10,498.00 | 4 |
| Meas lung vol thru 2 yrs CPT 94013 | not published | not published | $281.90 – $375.86 | 2 |
| Measure kidney pressure CPT 50396 | $839.30 | $1,526.00 | $526.77 – $4,074.00 | 4 |
| Measurement post void urine by ultrasound CPT 51798 | $198.00 | $360.00 | $44.57 – $1,704.00 | 3 |
| Measure ureter pressure CPT 50686 | not published | not published | $97.20 – $4,074.00 | 4 |
| #mec-opiates CPT 80356 | $205.70 | $374.00 | $137.83 – $137.83 | 1 |
| Mecp2 gene dup/delet variant CPT 81304 | not published | not published | $112.50 – $841.93 | 5 |
| Mecp2 gene full seq CPT 81302 | $258.50 | $470.00 | $395.90 – $2,962.93 | 5 |
| Mecp2 gene known variant CPT 81303 | not published | not published | $90.00 – $673.56 | 5 |
| Medial canthopexy CPT 21280 | not published | not published | $2,504.63 – $14,543.00 | 4 |
| Mediastinoscpy w/lmph nod bx CPT 39402 | not published | not published | $4,567.04 – $14,906.00 | 4 |
| Mediastinoscpy w/medstnl bx 39401 CPT 39401 | not published | not published | $4,567.04 – $14,906.00 | 4 |
| Med physic dos eval rad exps CPT 76145 | not published | not published | $281.90 – $6,538.54 | 3 |
| Meg evoked single CPT 95966 | not published | not published | $648.73 – $864.97 | 2 |
| Meg spontaneous CPT 95965 | not published | not published | $648.73 – $864.97 | 2 |
| Membrane affinity fresh amniotic 2.5x2.5cm -cost per sq cm HCPCS Q4159 | not published | not published | $94.01 – $487.20 | 5 |
| Membrane amnioband 2x2cm -cost per sq cm HCPCS Q4151 | not published | not published | $94.01 – $265.33 | 5 |
| Membrane amnio clarix 4x3cm 1k -cost per sq cm HCPCS Q4155 | not published | not published | $38.15 – $53.13 | 3 |
| Membrane amniotic barrier 4x4cm-q4163-cost per sq cm HCPCS Q4163 | not published | not published | $94.01 – $346.14 | 5 |
| Membrane placenta tiss biodfence g3 2x2cm-4sqcm-q4116-cost per sq cm HCPCS Q4140 | not published | not published | $94.01 – $317.85 | 5 |
| Membrane placenta tiss enverse sheet 2x3cm-cost per sq cm HCPCS Q4258 | not published | not published | $94.01 – $156.58 | 5 |
| Memoderm/derma/tranz/integup HCPCS Q4126 | not published | not published | $91.79 – $125.35 | 5 |
| Meniscal trnspl knee w/scpe CPT 29868 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | not published | not published | $12.88 – $29.82 | 3 |
| Mepolizumab 100 mg/ml subcutaneous auto-injector HCPCS J2182 | not published | not published | $24.21 – $59.52 | 5 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | not published | not published | $0.62 – $0.83 | 3 |
| Mesh/prosth/ pelvic floor rpr/vag 57267 CPT 57267 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Mesna 100 mg/ml intravenous solution HCPCS J9209 | not published | not published | $1.97 – $2.92 | 3 |
| Metabolic Blood Panel (Basic) CPT 80048 | $183.70 | $334.00 | $6.34 – $67.26 | 5 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $223.30 | $406.00 | $7.92 – $84.01 | 5 |
| Metabolic panel ionized ca CPT 80047 | $181.50 | $330.00 | $10.30 – $67.26 | 5 |
| Methacholine chloride 0.0625 mg/ml nebulization soln HCPCS J7674 | not published | not published | $2.36 – $3.28 | 3 |
| Methadone injection HCPCS J1230 | not published | not published | $30.32 – $43.54 | 3 |
| Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 | not published | not published | $9.09 – $12.15 | 3 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | not published | not published | $0.29 – $0.38 | 3 |
| Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 | not published | not published | $3.74 – $6.23 | 3 |
| Methotrexate therapeutic drug level CPT 80204 | $165.00 | $300.00 | $28.93 – $225.15 | 5 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | not published | not published | $30.87 – $41.91 | 3 |
| Methylphenidate CPT 80360 | $232.65 | $423.00 | $137.83 – $137.83 | 1 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | not published | not published | $0.35 – $0.46 | 3 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | not published | not published | $0.16 – $0.23 | 3 |
| Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 | not published | not published | $0.36 – $0.50 | 3 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | not published | not published | $1.64 – $1.91 | 3 |
| Metoprolol tartrate 5 mg/5 ml intravenous (wrapper) HCPCS J0616 | not published | not published | $0.25 – $0.25 | 1 |
| Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 | not published | not published | $0.04 – $0.06 | 3 |
| Metyrapone panel CPT 80436 | not published | not published | $68.37 – $724.90 | 5 |
| Mgmt promoter methylation analysis CPT 81287 | $403.15 | $733.00 | $93.48 – $485.02 | 5 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | not published | not published | $0.41 – $0.59 | 3 |
| Microalbumin urine screen CPT 82044 | not published | not published | $4.67 – $24.10 | 5 |
| Microbe susceptible mlc CPT 87187 | not published | not published | $30.13 – $82.45 | 5 |
| Microdissection laser CPT 88380 | not published | not published | $481.73 – $481.73 | 1 |
| Microdissection manual CPT 88381 | $1,161.60 | $2,112.00 | $511.69 – $511.69 | 1 |
| Microfluid analy tears CPT 83861 | not published | not published | $16.86 – $131.33 | 5 |
| Microsatellite instability CPT 81301 | $409.75 | $745.00 | $261.42 – $2,302.53 | 5 |
| Microsurg tehniq require use oper micro (add-on)69990 CPT 69990 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Microvolt t-wave assess CPT 93025 | not published | not published | $97.20 – $129.61 | 2 |
| Microwave bronch, 3d, ebus HCPCS C9751 | not published | not published | $14,543.00 – $16,352.00 | 2 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | not published | not published | $0.19 – $0.30 | 3 |
| Midazolam 1 mg/ml in sodium chloride IV infusion (wrapper) HCPCS J2251 | not published | not published | $0.25 – $0.32 | 3 |
| Middle cerebral artery echo CPT 76821 | not published | not published | $78.98 – $444.67 | 3 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | not published | not published | $2.28 – $2.67 | 3 |
| Miroderm HCPCS Q4175 | not published | not published | $94.01 – $128.66 | 5 |
| Mirvetuximab soravtansine-gynx 5 mg/ml intravenous solution HCPCS J9063 | not published | not published | $53.99 – $132.09 | 5 |
| Mitochondrial gene CPT 81440 | not published | not published | $2,493.00 – $18,657.50 | 5 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | not published | not published | $25.58 – $85.75 | 5 |
| Mitomycin instillation HCPCS J9281 | not published | not published | $247.45 – $603.10 | 5 |
| Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 | not published | not published | $22.28 – $112.52 | 5 |
| Mitral valve replacement w/bypass 33430 CPT 33430 | not published | not published | $16,352.00 – $16,352.00 | 1 |
| Mlh1 gene CPT 81288 | $355.85 | $647.00 | $144.24 – $931.90 | 5 |
| Mlh1 gene dup/delete variant CPT 81294 | $990.00 | $1,800.00 | $151.80 – $1,111.41 | 5 |
| Mlh1 gene full seq CPT 81292 | $990.00 | $1,800.00 | $506.55 – $3,766.69 | 5 |
| Mlh1 gene known variants CPT 81293 | not published | not published | $248.25 – $1,509.99 | 5 |
| Mlt osteot rlgnm imed rd hum CPT 24410 | not published | not published | $9,698.86 – $16,352.00 | 4 |
| Mnl appl strs jt radiography CPT 77071 | not published | not published | $65.74 – $376.79 | 3 |
| Mnl prep&insj dp rx dlvr dev CPT 20700 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Mnl prep&insj i-artic rx dev CPT 20704 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Mnl prep&insj imed rx dev CPT 20702 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Mnpj anes sho jt fixj aprats CPT 23700 | not published | not published | $1,214.74 – $4,321.00 | 4 |
| Mnpj elbow under anes CPT 24300 | not published | not published | $1,214.74 – $4,321.00 | 4 |
| Mnpj of tmj w/anesth CPT 21073 | not published | not published | $1,172.13 – $4,321.00 | 4 |
| Mobilization of colon 44139 CPT 44139 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Modification of contact lens CPT 92325 | not published | not published | $100.51 – $134.01 | 2 |
| Modified maze/limited 33254 CPT 33254 | not published | not published | $15,466.00 – $15,466.00 | 1 |
| Modified maze/limited /w other op 33257 CPT 33257 | not published | not published | $15,466.00 – $15,466.00 | 1 |
| Mog-igg1 antb flo cytmtry ea CPT 86363 | $577.50 | $1,050.00 | $28.30 – $70.28 | 5 |
| Mometasone sinus sinuva HCPCS J7402 | not published | not published | $8.51 – $21.56 | 5 |
| Monovisc inj per dose HCPCS J7327 | not published | not published | $423.96 – $1,044.60 | 5 |
| Mopath procedure level 1 CPT 81400 | $467.50 | $850.00 | $47.97 – $359.02 | 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.