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 |
|---|---|---|---|---|
| Partial removal of heart sac 33030 CPT 33030 | not published | not published | $15,466.00 – $15,466.00 | 1 |
| Partial removal of larynx CPT 31367 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Partial removal of larynx CPT 31368 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Partial removal of larynx CPT 31370 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Partial removal of larynx CPT 31375 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Partial removal of larynx CPT 31380 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Partial removal of larynx CPT 31382 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Partial removal of lip CPT 40530 | not published | not published | $2,504.63 – $6,798.00 | 4 |
| Partial removal of liver CPT 47125 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Partial removal of liver CPT 47130 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Partial removal of lung 32480 CPT 32480 | not published | not published | $16,352.00 – $16,352.00 | 1 |
| Partial removal of nose CPT 30150 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Partial removal of pancreas CPT 48145 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Partial removal of pancreas CPT 48150 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Partial removal of penis CPT 54120 | not published | not published | $2,662.91 – $10,498.00 | 4 |
| Partial removal of pharynx 42890 CPT 42890 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Partial removal of radius CPT 25151 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Partial removal of radius CPT 25230 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Partial removal of rectum CPT 45111 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Partial removal of rectum CPT 45114 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Partial removal of rectum CPT 45116 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Partial removal of rib CPT 21600 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Partial removal of sternum CPT 21620 | not published | not published | $2,471.80 – $14,543.00 | 4 |
| Partial removal of thyroid CPT 60220 | not published | not published | $4,567.04 – $16,582.00 | 4 |
| Partial removal of thyroid CPT 60225 | not published | not published | $4,567.04 – $16,582.00 | 4 |
| Partial removal of tibia CPT 27640 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Partial removal of toe CPT 28160 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Partial removal of tongue CPT 41120 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Partial removal of tongue CPT 41130 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Partial removal of ulna CPT 25119 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Partial removal of ulna CPT 25150 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Partial removal of ulna CPT 25240 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Partial removal of vaginal wall 57106 CPT 57106 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Partial removal tear gland CPT 68505 | not published | not published | $2,969.94 – $10,498.00 | 4 |
| Partial thyroid excision CPT 60210 | not published | not published | $4,567.04 – $16,582.00 | 4 |
| Partial thyroid lobect w/contratlat stot lobec 60212 CPT 60212 | not published | not published | $4,567.04 – $16,582.00 | 4 |
| Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 | not published | not published | $3.70 – $4.85 | 3 |
| Part removal hip bone deep CPT 27071 | not published | not published | $2,471.80 – $16,582.00 | 4 |
| Part removal of metatarsal CPT 28110 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Part removal of metatarsal CPT 28113 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Part removal of metatarsal 28112 CPT 28112 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Part remove hip bone super CPT 27070 | not published | not published | $2,471.80 – $16,582.00 | 4 |
| Passy muir valve metal trach HCPCS L8501 | $164.37 | $298.85 | not published | 0 |
| Path clin consltj high 41-60 CPT 80505 | not published | not published | $128.70 – $556.90 | 3 |
| Path clin consltj mod 21-40 CPT 80504 | not published | not published | $128.70 – $307.69 | 3 |
| Path clin consltj prolng svc CPT 80506 | not published | not published | $250.57 – $250.57 | 1 |
| Path clin consltj sf 5-20 CPT 80503 | not published | not published | $39.37 – $154.21 | 3 |
| Pca3/klk3 antigen CPT 81313 | not published | not published | $191.29 – $1,519.26 | 5 |
| Pcv21 vaccine im CPT 90684 | not published | not published | $475.44 – $623.00 | 3 |
| Pdgfra gene CPT 81314 | not published | not published | $247.13 – $1,923.50 | 5 |
| Pdt dstr prmlg les phys/qhp CPT 96573 | not published | not published | $151.57 – $1,704.00 | 3 |
| Pedcle fh/ch/ch/m/n/ax/g/h/f CPT 15574 | not published | not published | $1,558.69 – $4,321.00 | 4 |
| Ped home apnea mntr att only CPT 94775 | not published | not published | $97.20 – $129.61 | 2 |
| Ped home apnea mntr dl&alys CPT 94776 | not published | not published | $97.20 – $129.61 | 2 |
| Pedicle enel/ntroral 15576 CPT 15576 | not published | not published | $1,558.69 – $4,321.00 | 4 |
| Pegaspargase injection HCPCS J9266 | not published | not published | $22,247.97 – $54,005.71 | 5 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | not published | not published | $28.97 – $143.23 | 5 |
| Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe HCPCS Q5122 | not published | not published | $102.68 – $250.87 | 5 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | not published | not published | $111.85 – $258.48 | 5 |
| Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5127 | not published | not published | $107.75 – $551.87 | 5 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | not published | not published | $50.27 – $231.81 | 5 |
| Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5130 | not published | not published | $78.83 – $339.51 | 5 |
| Pegloticase 8 mg/ml intravenous solution HCPCS J2507 | not published | not published | $2,947.00 – $6,913.84 | 5 |
| Pegunigalsidase alfa-iwxj HCPCS J2508 | not published | not published | $169.25 – $437.53 | 5 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $2,069.65 | $3,763.00 | $132.50 – $1,541.21 | 3 |
| Pelvic CT scan (with contrast) CPT 72193 | $1,914.00 | $3,480.00 | $132.50 – $1,294.77 | 3 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,689.05 | $3,071.00 | $78.98 – $702.21 | 3 |
| Pelvic exenteration CPT 45126 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Pelvic MRI (with and without contrast) CPT 72197 | $2,729.65 | $4,963.00 | $263.55 – $3,032.61 | 3 |
| Pelvic MRI (with contrast) CPT 72196 | not published | not published | $263.55 – $2,509.25 | 3 |
| Pelvic MRI (without contrast) CPT 72195 | $2,456.30 | $4,466.00 | $180.25 – $2,332.03 | 3 |
| Pelvic ring fracture uni/bil HCPCS G0413 | not published | not published | $5,481.64 – $10,498.00 | 4 |
| Pelvic ring fx treat int fix HCPCS G0414 | not published | not published | $5,481.64 – $16,582.00 | 4 |
| Pelvic Ultrasound (complete) CPT 76856 | $1,224.85 | $2,227.00 | $78.98 – $588.68 | 3 |
| Pelvic Ultrasound (limited) CPT 76857 | $413.05 | $751.00 | $78.98 – $176.08 | 3 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | not published | not published | $45.48 – $111.27 | 5 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | not published | not published | $5.21 – $9.75 | 5 |
| Peng benzathine/procaine inj HCPCS J0558 | not published | not published | $14.64 – $33.00 | 5 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | not published | not published | $24.44 – $55.67 | 5 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | not published | not published | $1.13 – $1.67 | 3 |
| Penile injection CPT 54235 | not published | not published | $188.75 – $4,074.00 | 4 |
| Penile vascular study CPT 93980 | not published | not published | $78.98 – $105.30 | 2 |
| Penile vascular study CPT 93981 | not published | not published | $78.98 – $105.30 | 2 |
| Penile venous occlusion CPT 37790 | not published | not published | $2,662.91 – $10,498.00 | 4 |
| Penis plastic surgery CPT 54360 | not published | not published | $2,662.91 – $14,543.00 | 4 |
| Penis study CPT 54240 | not published | not published | $163.12 – $4,074.00 | 4 |
| Pentamidine non-comp unit HCPCS J2545 | not published | not published | $115.28 – $156.50 | 3 |
| Pentostatin 10 mg intravenous solution HCPCS J9268 | not published | not published | $2,023.49 – $5,055.18 | 5 |
| Perc cryo ablate renal tum CPT 50593 | $7,966.20 | $14,484.00 | $8,030.21 – $16,582.00 | 4 |
| Perc d-e cor revasc chro add HCPCS C9608 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Perc d-e cor revasc chro sin HCPCS C9607 | not published | not published | $13,711.00 – $24,224.00 | 4 |
| Perc d-e cor revasc t cabg b HCPCS C9605 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Perc d-e cor revasc t cabg s HCPCS C9604 | not published | not published | $8,720.95 – $24,224.00 | 4 |
| Perc d-e cor stent ather br HCPCS C9603 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Perc d-e cor stent ather s HCPCS C9602 | not published | not published | $13,711.00 – $24,224.00 | 4 |
| Perc drug-el cor stent bran HCPCS C9601 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Perc drug-el cor stent sing HCPCS C9600 | not published | not published | $8,720.95 – $24,224.00 | 4 |
| Perc rf ablate renal tumor CPT 50592 | $4,949.45 | $8,999.00 | $4,567.04 – $16,582.00 | 4 |
| Percut ablate liver rf CPT 47382 | not published | not published | $4,567.04 – $16,582.00 | 4 |
| Percutaneous islet celltrans HCPCS G0341 | not published | not published | $14,906.00 – $14,906.00 | 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.