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 |
|---|---|---|---|---|
| Mopath procedure level 3 CPT 81402 | $924.55 | $1,681.00 | $112.75 – $843.80 | 5 |
| Mopath procedure level 5 CPT 81404 | $1,161.60 | $2,112.00 | $206.12 – $1,542.60 | 5 |
| Mopath procedure level 6 CPT 81405 | $1,637.35 | $2,977.00 | $226.01 – $1,691.48 | 5 |
| Mopath procedure level 7 CPT 81406 | $1,320.00 | $2,400.00 | $212.16 – $1,587.80 | 5 |
| Mopath procedure level 8 CPT 81407 | not published | not published | $634.70 – $4,750.10 | 5 |
| Mopath procedure level 9 CPT 81408 | not published | not published | $1,500.00 – $11,225.94 | 5 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | not published | not published | $6.71 – $8.64 | 3 |
| Morphine 4 mg/ml injection (wrapper)|discarded drug not administered HCPCS J2272 | not published | not published | $7.51 – $15.45 | 3 |
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | not published | not published | $14.24 – $21.37 | 3 |
| Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 | not published | not published | $128.70 – $1,670.97 | 3 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted CPT 88361 | $398.75 | $725.00 | $270.78 – $492.52 | 3 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $1,050.50 | $1,910.00 | $128.70 – $362.73 | 3 |
| Mosunetuzumab-axgb 1 mg/ml intravenous solution HCPCS J9350 | not published | not published | $505.87 – $1,240.22 | 5 |
| Motion analysis video/3d CPT 96000 | not published | not published | $281.90 – $375.86 | 2 |
| Motion test w/ft press meas CPT 96001 | not published | not published | $648.73 – $864.97 | 2 |
| Mouth vestibule bx/w complex rpr 40814 CPT 40814 | not published | not published | $2,504.63 – $6,798.00 | 4 |
| M/phmtrc alys ishquant/semiq CPT 88373 | not published | not published | $299.59 – $299.59 | 1 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $3,904.45 | $7,099.00 | $128.70 – $1,925.79 | 3 |
| M/phmtrc alysishquant/semiq CPT 88369 | $737.00 | $1,340.00 | $426.61 – $426.61 | 1 |
| M/phmtrc alys skeletal musc CPT 88355 | not published | not published | $128.70 – $412.63 | 3 |
| Mpl gene analysis common variants CPT 81338 | $924.00 | $1,680.00 | $112.75 – $877.54 | 5 |
| M.pneumon dna dir probe CPT 87580 | not published | not published | $15.04 – $159.48 | 5 |
| M.pneumon dna quant CPT 87582 | not published | not published | $226.96 – $529.59 | 5 |
| MRA abdomen post contrast CPT 74185 | not published | not published | $2,423.42 – $2,423.42 | 1 |
| MRA aorta thoracic w/wo contrast CPT 71555 | not published | not published | $2,379.09 – $2,379.09 | 1 |
| MRA chest w IV cont HCPCS C8909 | not published | not published | $263.55 – $351.40 | 2 |
| MRA chest wo IV cont HCPCS C8910 | not published | not published | $180.25 – $240.33 | 2 |
| MRA chest wwo IV cont HCPCS C8911 | $2,784.65 | $5,063.00 | $263.55 – $351.40 | 2 |
| MRA ext low(run-off)pst cntrst CPT 73725 | $2,784.65 | $5,063.00 | $2,406.79 – $2,406.79 | 1 |
| MRA pelvis CPT 72198 | not published | not published | $2,404.02 – $2,404.02 | 1 |
| MRA pelvis w IV cont HCPCS C8918 | not published | not published | $263.55 – $351.40 | 2 |
| MRA pelvis wo IV cont HCPCS C8919 | not published | not published | $180.25 – $240.33 | 2 |
| MRA spinal canal CPT 72159 | not published | not published | $2,523.10 – $2,523.10 | 1 |
| MRA upper extremity post contrast-bil CPT 73225 | not published | not published | $2,470.51 – $2,470.51 | 1 |
| MRA w/cont, abd HCPCS C8900 | not published | not published | $263.55 – $351.40 | 2 |
| MRA w/cont, lwr ext HCPCS C8912 | not published | not published | $263.55 – $351.40 | 2 |
| Mra, w/dye, spinal canal HCPCS C8931 | not published | not published | $263.55 – $351.40 | 2 |
| Mra, w/dye, upper extremity HCPCS C8934 | not published | not published | $263.55 – $351.40 | 2 |
| MRA without cont, abd HCPCS C8901 | not published | not published | $180.25 – $240.33 | 2 |
| MRA without cont, lwr ext HCPCS C8913 | $440.00 | $800.00 | $180.25 – $240.33 | 2 |
| Mra, without dye, spinal canal HCPCS C8932 | not published | not published | $180.25 – $240.33 | 2 |
| Mra, without dye, upper extr HCPCS C8935 | not published | not published | $180.25 – $240.33 | 2 |
| MRA without fol w/cont, abd HCPCS C8902 | $2,335.85 | $4,247.00 | $263.55 – $351.40 | 2 |
| MRA without fol w/cont, lwr ext HCPCS C8914 | $5,514.30 | $10,026.00 | $263.55 – $351.40 | 2 |
| MRA without fol w/cont, pelvis HCPCS C8920 | not published | not published | $263.55 – $351.40 | 2 |
| Mra, w/o&w/dye, spinal canal HCPCS C8933 | not published | not published | $263.55 – $351.40 | 2 |
| Mra, w/o&w/dye, upper extr HCPCS C8936 | $2,784.65 | $5,063.00 | $263.55 – $351.40 | 2 |
| Mr elastography CPT 76391 | not published | not published | $180.25 – $1,407.82 | 3 |
| Mrgfus strtctc ablt trgt icr CPT 61715 | not published | not published | $8,417.64 – $16,352.00 | 3 |
| MRI brain w/dye CPT 70558 | not published | not published | $132.50 – $10,564.01 | 3 |
| MRI brain without dye CPT 70557 | not published | not published | $412.78 – $9,964.62 | 3 |
| MRI brain without & w/dye CPT 70559 | not published | not published | $132.50 – $9,964.62 | 3 |
| MRI breast c- unilateral CPT 77046 | $304.15 | $553.00 | $180.25 – $1,374.52 | 3 |
| MRI breast c-+ w/cad uni CPT 77048 | not published | not published | $2,263.47 – $2,263.47 | 1 |
| MRI breast without cont bi CPT 77047 | $608.30 | $1,106.00 | $180.25 – $1,366.18 | 3 |
| MRI breast w IV cont bi CPT 77049 | not published | not published | $2,252.36 – $2,252.36 | 1 |
| MRI cardiac morph & func wo IV cont CPT 75557 | not published | not published | $180.25 – $1,560.59 | 3 |
| MRI cardiac morph & func wwo IV cont CPT 75561 | not published | not published | $263.55 – $2,276.65 | 3 |
| MRI cardiac morph & func wwo IV cont w/stress img CPT 75563 | not published | not published | $592.21 – $2,744.62 | 3 |
| MRI chest without contrast CPT 71550 | $2,586.10 | $4,702.00 | $180.25 – $2,639.41 | 3 |
| MRI chest without & w/contrast CPT 71552 | $2,729.65 | $4,963.00 | $263.55 – $3,604.66 | 3 |
| MRI chest w IV cont CPT 71551 | not published | not published | $592.21 – $2,877.54 | 3 |
| MRI fetal ea addl gestation CPT 74713 | $708.95 | $1,289.00 | $1,095.41 – $1,095.41 | 1 |
| MRI fetal sngl/1st gestation CPT 74712 | $1,380.50 | $2,510.00 | $180.25 – $2,556.32 | 3 |
| MRI guid ndl plc s&i CPT 77021 | not published | not published | $2,543.61 – $2,543.61 | 1 |
| MRI guid parenchymal tiss ablation CPT 77022 | not published | not published | $3,646.00 – $3,646.00 | 1 |
| MRI loex nonjt w IV cont CPT 73719 | $2,702.15 | $4,913.00 | $263.55 – $2,498.17 | 3 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $2,456.30 | $4,466.00 | $180.25 – $2,298.81 | 3 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $2,947.45 | $5,359.00 | $263.55 – $3,054.76 | 3 |
| MRI orbit/face/neck without contrast CPT 70540 | $1,305.70 | $2,374.00 | $180.25 – $2,254.50 | 3 |
| MRI orbit/face/neck without & w/contrast CPT 70543 | $2,048.75 | $3,725.00 | $263.55 – $2,974.45 | 3 |
| MRI orbit fac&nck w IV cont CPT 70542 | not published | not published | $263.55 – $2,481.58 | 3 |
| MRI tmj CPT 70336 | $2,586.10 | $4,702.00 | $180.25 – $1,908.38 | 3 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $2,275.90 | $4,138.00 | $180.25 – $2,298.81 | 3 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $2,530.00 | $4,600.00 | $263.55 – $3,032.61 | 3 |
| MRI upper extremity w/dye CPT 73219 | not published | not published | $263.55 – $2,498.17 | 3 |
| MRI w/cont, breast, bi HCPCS C8906 | not published | not published | $263.55 – $351.40 | 2 |
| MRI w/cont, breast, uni HCPCS C8903 | not published | not published | $132.50 – $176.67 | 2 |
| MRI without fol w/cont, breast HCPCS C8908 | not published | not published | $263.55 – $351.40 | 2 |
| MRI without fol w/cont, brst, un HCPCS C8905 | not published | not published | $263.55 – $351.40 | 2 |
| Mr safety determination physician/other qhp CPT 76016 | not published | not published | $65.74 – $458.93 | 3 |
| Mr safety implant elec prepj CPT 76018 | not published | not published | $71.82 – $723.15 | 3 |
| Mr safety implant&/fb assmt clin staff ea add 30 CPT 76015 | not published | not published | $325.71 – $325.71 | 1 |
| Mr safety implt pos&/immoblj CPT 76019 | not published | not published | $44.57 – $938.62 | 3 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | not published | not published | $21.85 – $67.65 | 3 |
| Mr sfty med physics xm cstmz CPT 76017 | not published | not published | $180.25 – $1,412.24 | 3 |
| Mr spectroscopy CPT 76390 | not published | not published | $65.74 – $2,914.64 | 3 |
| Msh2 gene dup/delete variant CPT 81297 | $1,625.80 | $2,956.00 | $159.98 – $884.26 | 5 |
| Msh2 gene full seq CPT 81295 | $1,626.35 | $2,957.00 | $286.28 – $884.26 | 5 |
| Msh2 gene known variants CPT 81296 | not published | not published | $253.30 – $755.03 | 5 |
| Msh6 gene dup/delete variant CPT 81300 | $990.00 | $1,800.00 | $178.50 – $942.41 | 5 |
| Msh6 gene full seq CPT 81298 | $990.00 | $1,800.00 | $481.39 – $1,677.71 | 5 |
| Msh6 gene known variants CPT 81299 | not published | not published | $231.00 – $939.84 | 5 |
| Mt bone graft microvasc CPT 20957 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Mthfr gene analy common variants CPT 81291 | $228.25 | $415.00 | $49.00 – $347.08 | 5 |
| M.tuberculo dna dir probe CPT 87555 | not published | not published | $20.16 – $159.48 | 5 |
| M.tuberculo dna quant CPT 87557 | not published | not published | $32.13 – $340.63 | 5 |
| Mucin synovial fluid CPT 83872 | not published | not published | $4.40 – $46.57 | 5 |
| Mucopolysaccharides CPT 83864 | $205.15 | $373.00 | $21.38 – $158.35 | 5 |
| Mucormycosis antibody CPT 86732 | not published | not published | $11.25 – $104.89 | 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.