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 |
|---|---|---|---|---|
| Ophthalmodynamometry CPT 92260 | not published | not published | $28.22 – $37.62 | 2 |
| Ophth Ultrasound b & quant a CPT 76510 | not published | not published | $100.51 – $635.76 | 3 |
| Oph Ultrasound dx ant sgm Ultrasound uni/bi CPT 76513 | not published | not published | $78.98 – $461.30 | 3 |
| Oph Ultrasound dx quan a-scan only CPT 76511 | not published | not published | $78.98 – $375.45 | 3 |
| Opn abltj 1/> rnl mas crysrg CPT 50250 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Opn ax/subcla art expos CPT 34715 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Opn exc/dst ntra-abd CPT 49189 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Opn exc/dst ntra-abd 10.1-20 CPT 49188 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Opn exc/dstr ntra-abd >30 cm CPT 49190 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Opn exc/dstr ntra-abd 5.1-10 CPT 49187 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Opn exc/dstr ntra-abd 5 cm/< CPT 49186 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Opn fem art expos cndt crtj 34714 CPT 34714 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Opn ilac art expos cndt crtj CPT 34833 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Opn impltj crnl nrv nea&pg CPT 64568 | not published | not published | $13,711.00 – $48,685.00 | 4 |
| Opn impltj nea neuromuscular CPT 64580 | not published | not published | $13,711.00 – $24,224.00 | 4 |
| Opn impltj nea perph nerve CPT 64575 | not published | not published | $8,417.64 – $24,224.00 | 4 |
| Opn impltj nea sacral nerve CPT 64581 | not published | not published | $4,814.42 – $24,224.00 | 4 |
| Opn mpltj hpglsl nstm ary pg CPT 64582 | not published | not published | $13,711.00 – $39,723.00 | 4 |
| Opn tx complx malar fx CPT 21365 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Opn tx complx malar w/grft CPT 21366 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Opn tx depress front sinus fx 21343 CPT 21343 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Opn tx dprsd zygomatic arch CPT 21356 | not published | not published | $4,472.08 – $9,811.00 | 4 |
| Opn tx nasomax fx multple CPT 21347 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Opn tx nasomax fx w/fixj CPT 21346 | not published | not published | $4,472.08 – $9,811.00 | 4 |
| Opn tx nasomax fx w/graft CPT 21348 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Opn tx orbit fx combined CPT 21387 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Opn tx orbit fx periorbital CPT 21386 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Opn tx orbit fx transantral CPT 21385 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Opn tx orbit fx w/bone grft CPT 21408 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Opn tx orbit fx w/implant CPT 21407 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Opn tx orbit fx without impl 21406 CPT 21406 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Opn tx orbit periorbtl implt CPT 21390 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Opn tx orbit periorbt w/grft CPT 21395 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Opps service,sched team conf HCPCS G0175 | not published | not published | $315.22 – $420.29 | 2 |
| Opscpy extnd on/mac draw CPT 92202 | not published | not published | $44.57 – $59.42 | 2 |
| Opscpy extnd rta draw uni/bi CPT 92201 | not published | not published | $44.57 – $59.42 | 2 |
| Optical endomicroscpy interp CPT 88375 | not published | not published | $284.13 – $284.13 | 1 |
| Optx acrclv dslc aq/chrn grf CPT 23552 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Optx acromclv dislc aqt/chrn CPT 23550 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Optx acute shoulder dislc CPT 23660 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Optx carpl scphd fx int fixj CPT 25628 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Optx clavicular fx w/int fix CPT 23515 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Optx complicated mndblr fx CPT 21470 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Optx cranfcl sep comp mlt CPT 21433 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Optx cranfcl sep w/wiring CPT 21432 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Optx crnfcl sep comp mlt int CPT 21436 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Optx crnfc sep comp int&/xtr CPT 21435 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Optx crpl fx oth/thn scph ea CPT 25645 | not published | not published | $2,471.80 – $16,582.00 | 4 |
| Optx gr hmrl tbrs fx int fix CPT 23630 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Optx lunate dislocation CPT 25695 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Optx medial ankle fx CPT 27766 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Optx mndblr cndylr fx CPT 21465 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Optx mndblr fx wo ntrdntl CPT 21461 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Optx mndblr fx xtrnl fixj CPT 21454 | not published | not published | $4,472.08 – $9,811.00 | 4 |
| Optx mndblr/max alv ridge fx CPT 21445 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Optx palatal/max fracture CPT 21422 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Optx palatal/max fx comp CPT 21423 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Optx partclr fx&/dslc elbw w CPT 24587 | not published | not published | $9,698.86 – $16,582.00 | 4 |
| Optx post ankle fx CPT 27769 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Optx prox humrl fx w/int fix CPT 23615 | not published | not published | $9,698.86 – $16,582.00 | 4 |
| Optx prx hmrl fx fix rpr rpl CPT 23616 | not published | not published | $13,245.76 – $17,661.01 | 4 |
| Optx radial shaft fracture CPT 25515 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Optx rad/uln dislc aqt/chrnc CPT 25676 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Optx rdcrpl/ntrcrpl dislc 1+ CPT 25670 | not published | not published | $5,481.64 – $10,498.00 | 4 |
| Optx rdl shft fx&cltx rad/ul CPT 25525 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Optx rdl shft fx&dstl rad/ul CPT 25526 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Optx rdl&uln shft fx rds&uln CPT 25575 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Optx rdl&uln shft fx rds/uln CPT 25574 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Optx scapular fx w/int fixj CPT 23585 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Optx sho dislc fx CPT 23670 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Optx sho dislc neck fx fixj CPT 23680 | not published | not published | $9,698.86 – $16,582.00 | 4 |
| Optx strclv dslc aq/chrn grf CPT 23532 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Optx strnclav dislc aqt/chrn CPT 23530 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Optx thigh fx CPT 27269 | not published | not published | $3,232.00 – $10,498.00 | 4 |
| Optx tmprmand dislocation CPT 21490 | not published | not published | $2,504.63 – $14,543.00 | 4 |
| Optx trns-scphprlnr fx dislc CPT 25685 | not published | not published | $5,481.64 – $10,498.00 | 4 |
| Optx ulnar shft fx int fixj CPT 25545 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Optx ulnar styloid fracture CPT 25652 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Oral aprepitant HCPCS J8501 | not published | not published | $4.41 – $5.29 | 3 |
| Oral everolimus HCPCS J7527 | not published | not published | $2.93 – $4.29 | 3 |
| Oral hiv-1/hiv-2 screen HCPCS G0435 | not published | not published | $8.98 – $95.32 | 5 |
| Oral methotrexate (jylamvo) HCPCS J8611 | not published | not published | $12.35 – $35.20 | 3 |
| Oral methotrexate (xatmep) HCPCS J8612 | not published | not published | $17.19 – $43.05 | 3 |
| Oral netupitant, palonosetro HCPCS J8655 | not published | not published | $355.53 – $778.09 | 5 |
| Orbitocranial approach/skull CPT 61584 | not published | not published | $18,190.00 – $18,190.00 | 1 |
| Orbitocranial approach/skull CPT 61585 | not published | not published | $18,190.00 – $18,190.00 | 1 |
| Orbitocranial approach/skull CPT 61592 | not published | not published | $18,190.00 – $18,190.00 | 1 |
| Orchiectomy partial CPT 54522 | not published | not published | $2,662.91 – $6,798.00 | 4 |
| Orchiopexy (fowler-stephens) CPT 54650 | not published | not published | $2,704.78 – $10,498.00 | 4 |
| Orchiopexy ingun/scrot appr CPT 54640 | not published | not published | $2,704.78 – $10,498.00 | 4 |
| Organic acids total quant ea spec CPT 83918 | not published | not published | $17.70 – $130.81 | 5 |
| Oritavancin 1,200 mg intravenous solution HCPCS J2406 | not published | not published | $35.56 – $80.14 | 5 |
| Oritavancin 400 mg intravenous solution HCPCS J2407 | not published | not published | $22.30 – $54.19 | 5 |
| Oropharyngeal biopsy 42800 CPT 42800 | not published | not published | $1,172.13 – $4,321.00 | 4 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | not published | not published | $17.88 – $25.88 | 3 |
| Ortho hnd/fngr without jnt cstm w/fit&adj HCPCS L3913 | $209.98 | $381.79 | not published | 0 |
| Orthopantogram CPT 70355 | not published | not published | $65.74 – $87.66 | 3 |
| Orthop traing supvj phys/qhp CPT 92066 | not published | not published | $44.57 – $59.42 | 2 |
| Orthosis lso rigd frm hyperex HCPCS L0472 | $967.81 | $1,759.65 | not published | 0 |
| Orthovisc inj per dose HCPCS J7324 | not published | not published | $75.25 – $185.63 | 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.