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 |
|---|---|---|---|---|
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | not published | not published | $60.73 – $78.28 | 3 |
| Pericardial drain w/cath pq w/ct guid CPT 33019 | $1,395.90 | $2,538.00 | $4,321.00 – $4,321.00 | 1 |
| Pericardiectomy/sub or com/w bypas 33031 CPT 33031 | not published | not published | $15,466.00 – $15,466.00 | 1 |
| Pericardiocentesis wwo imaging CPT 33016 | $1,057.65 | $1,923.00 | $1,189.18 – $4,321.00 | 4 |
| Pericardiotomy/clot/for bod remove 33020 CPT 33020 | not published | not published | $15,466.00 – $15,466.00 | 1 |
| Peri-implt capslc brst compl CPT 19371 | not published | not published | $2,957.88 – $10,498.00 | 4 |
| Perineoplasty rpr per nonob CPT 56810 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Peripheral vascular rehab CPT 93668 | $91.85 | $167.00 | $44.57 – $59.42 | 2 |
| Peritoneal cath sub q resv per CPT 49419 | not published | not published | $4,203.64 – $16,582.00 | 4 |
| Peritoneogram rs&i CPT 74190 | $702.35 | $1,277.00 | $261.03 – $550.38 | 3 |
| Perit-vens shunt pat tst CPT 78291 | $851.40 | $1,548.00 | $302.00 – $1,691.26 | 3 |
| Perq art m-thrombect &/nfs CPT 61645 | not published | not published | $15,466.00 – $15,466.00 | 1 |
| Perq clsr tcat l atr apndge CPT 33340 | not published | not published | $16,352.00 – $16,352.00 | 1 |
| Perq dev breast 1st mr guide CPT 19287 | not published | not published | $534.95 – $4,074.00 | 4 |
| Perq dev breast 1st strtctc CPT 19283 | not published | not published | $534.95 – $4,074.00 | 4 |
| Perq nl/pl lithotrp cplx>2cm CPT 50081 | not published | not published | $7,151.35 – $16,352.00 | 4 |
| Perq nl/pl lithotrp smpl<2cm CPT 50080 | not published | not published | $7,151.35 – $16,352.00 | 4 |
| Perq p-art revsc 1 abnor bi CPT 33903 | not published | not published | $8,720.95 – $24,224.00 | 4 |
| Perq p-art revsc 1 abnor uni CPT 33902 | not published | not published | $13,711.00 – $24,224.00 | 4 |
| Perq p-art revsc 1 nm nt bi CPT 33901 | not published | not published | $8,720.95 – $24,224.00 | 4 |
| Perq p-art revsc 1 nm nt uni CPT 33900 | not published | not published | $8,720.95 – $24,224.00 | 4 |
| Perq p-art revsc each addl CPT 33904 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Perq plmt bile duct stent CPT 47538 | $5,862.45 | $10,659.00 | $4,567.04 – $16,582.00 | 4 |
| Perq plmt bile duct stent CPT 47539 | $8,693.85 | $15,807.00 | $4,567.04 – $16,582.00 | 4 |
| Perq plmt bile duct stent CPT 47540 | $8,971.60 | $16,312.00 | $4,567.04 – $16,582.00 | 4 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | $647.35 | $1,177.00 | $188.75 – $4,074.00 | 4 |
| Perq skel fix rad/uln dislc CPT 25671 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Perq skel fix ulnar styld fx CPT 25651 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Perq transcath closure each CPT 93592 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Perq transcath closure pda CPT 93582 | not published | not published | $13,711.00 – $38,635.00 | 4 |
| Perq transcath cls aortic CPT 93591 | not published | not published | $13,711.00 – $39,723.00 | 4 |
| Perq transcath cls mitral CPT 93590 | not published | not published | $13,711.00 – $39,723.00 | 4 |
| Perq transcath septal reduxn CPT 93583 | not published | not published | $13,711.00 – $13,711.00 | 1 |
| Perq trluml angp nt/recr coa CPT 33897 | not published | not published | $16,352.00 – $16,352.00 | 1 |
| Perq tx big toe fracture w/manip 28496 CPT 28496 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Perq tx malar fracture CPT 21355 | not published | not published | $2,504.63 – $14,543.00 | 4 |
| Perq tx mndblr fx xtrnl fixj CPT 21452 | not published | not published | $3,232.00 – $9,811.00 | 4 |
| Perq tx nasoethmoid fx CPT 21340 | not published | not published | $2,504.63 – $14,543.00 | 4 |
| Pertussis ag if CPT 87265 | not published | not published | $8.98 – $95.32 | 5 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | not published | not published | $12.90 – $32.09 | 5 |
| Pertuzu, trastuzu, 10 mg HCPCS J9316 | not published | not published | $44.92 – $120.44 | 5 |
| Pet CT skull-mid thgh initial CPT 78815 | not published | not published | $1,080.24 – $6,460.29 | 3 |
| Pet CT whole body initial CPT 78816 | not published | not published | $1,080.24 – $6,516.64 | 3 |
| Pet fdg brain metoblic eval sb CPT 78608 | not published | not published | $1,080.24 – $3,906.35 | 3 |
| Pet image full body CPT 78813 | not published | not published | $1,080.24 – $5,125.11 | 3 |
| Pet image ltd area CPT 78811 | not published | not published | $978.03 – $4,042.76 | 3 |
| Pet image skull-thigh CPT 78812 | not published | not published | $1,080.24 – $5,105.99 | 3 |
| Pet image w/ct lmtd CPT 78814 | not published | not published | $1,080.24 – $5,821.82 | 3 |
| Pet not otherwise specified HCPCS G0235 | not published | not published | $302.00 – $402.67 | 2 |
| Pet scan brain perf study CPT 78609 | not published | not published | $598.42 – $598.42 | 1 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $1,476.05 | $2,683.72 | not published | 0 |
| Ph1 assmt&mgmt nqhp 11-20 CPT 98967 | not published | not published | $14.60 – $19.47 | 2 |
| Ph1 assmt&mgmt nqhp 21-30 CPT 98968 | not published | not published | $21.34 – $28.46 | 2 |
| Ph1 assmt&mgmt nqhp 5-10 CPT 98966 | not published | not published | $7.54 – $10.05 | 2 |
| Phalangectomy ea toe 28150 CPT 28150 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Ph body fluid CPT 83986 | $99.00 | $180.00 | $2.68 – $28.48 | 5 |
| Phencyclidine (pcp) CPT 83992 | $350.35 | $637.00 | $116.86 – $116.86 | 1 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | not published | not published | $42.69 – $56.91 | 3 |
| Phenobarbital therapeutic drug level CPT 80184 | $57.20 | $104.00 | $11.48 – $91.07 | 5 |
| Phentolaine mesylate inj HCPCS J2760 | not published | not published | $216.47 – $829.36 | 5 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | not published | not published | $0.01 – $0.01 | 1 |
| Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 | not published | not published | $0.75 – $1.25 | 3 |
| Phenytoin total therapeutic drug level CPT 80185 | $149.60 | $272.00 | $9.94 – $105.44 | 5 |
| Phlebotomy therapeutic CPT 99195 | $158.95 | $289.00 | $100.51 – $134.01 | 2 |
| Phleb veins 1 extrm 10-20 stab CPT 37765 | not published | not published | $2,385.29 – $10,498.00 | 4 |
| Phleb veins 1 extrm >20 stab CPT 37766 | not published | not published | $2,385.29 – $10,498.00 | 4 |
| Phosphorus CPT 84100 | $45.65 | $83.00 | $3.56 – $37.71 | 5 |
| Phosphorus 24 hour urine CPT 84105 | $16.50 | $30.00 | $4.34 – $41.15 | 5 |
| Photchmtx tar&uvb/ptrltm&uvb CPT 96910 | not published | not published | $44.57 – $59.42 | 2 |
| Photochemotherapy puva CPT 96912 | not published | not published | $44.57 – $59.42 | 2 |
| Photochemotherapy uv-a or b CPT 96913 | not published | not published | $307.10 – $409.46 | 2 |
| Photodynamic tx addl 15 min CPT 96571 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Photodynmc tx 30 min add-on CPT 96570 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Photo patch test CPT 95052 | not published | not published | $44.57 – $59.42 | 2 |
| Photopheresis CPT 36522 | not published | not published | $3,290.32 – $14,543.00 | 4 |
| Photosensitivity tests CPT 95056 | not published | not published | $100.51 – $134.01 | 2 |
| Phys blood bank serv authrj CPT 86079 | not published | not published | $39.37 – $318.36 | 3 |
| Phys blood bank serv reactj CPT 86078 | not published | not published | $128.70 – $322.35 | 3 |
| Phys blood bank serv xmatch CPT 86077 | not published | not published | $21.85 – $322.35 | 3 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | not published | not published | $3.55 – $5.40 | 3 |
| Pik3ca gene trgt seq alys CPT 81309 | not published | not published | $206.12 – $1,604.42 | 5 |
| Pild/placebo control clin tr HCPCS G0276 | not published | not published | $5,481.64 – $16,582.00 | 3 |
| Pinch graft 1/mlt c> sm ulcer tip/oth area 2cm 15050 CPT 15050 | not published | not published | $558.33 – $4,074.00 | 4 |
| Pin finger dislocation CPT 26776 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Pin finger fracture each CPT 26756 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Pin hand dislocation CPT 26676 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Pin knuckle dislocation CPT 26706 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Pinworm exam CPT 87172 | $84.70 | $154.00 | $3.20 – $33.98 | 5 |
| Pinworm examinations HCPCS Q0113 | not published | not published | $3.20 – $43.01 | 5 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | not published | not published | $1.62 – $2.11 | 3 |
| Pituitary evaluation panel CPT 80418 | not published | not published | $434.61 – $4,608.87 | 5 |
| Place breast cath for rad CPT 19297 | not published | not published | $16,582.00 – $16,582.00 | 1 |
| Place breast rad tube/caths CPT 19298 | not published | not published | $10,410.69 – $16,582.00 | 4 |
| Place cath intracranial art CPT 36228 | $2,797.30 | $5,086.00 | $1,704.00 – $1,704.00 | 1 |
| Place cath xtrnl carotid CPT 36227 | $14,418.25 | $26,215.00 | $1,704.00 – $1,704.00 | 1 |
| Place cecostomy tube perc CPT 49442 | $2,321.00 | $4,220.00 | $903.99 – $4,321.00 | 4 |
| Place device/marker, non pro HCPCS C9728 | not published | not published | $1,045.63 – $4,321.00 | 3 |
| Place duod/jej tube perc CPT 49441 | $2,696.65 | $4,903.00 | $1,449.62 – $4,321.00 | 4 |
| Place endorectal app HCPCS C9725 | not published | not published | $702.53 – $2,672.00 | 3 |
| Place gastrostomy tube open 43832 CPT 43832 | not published | not published | $10,498.00 – $10,498.00 | 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.