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 |
|---|---|---|---|---|
| Pr debridement open wound topical appl/wound asmt per session 20 sq cm/< CPT 97597 | $212.30 | $386.00 | $151.57 – $4,074.00 | 4 |
| Prealbumin CPT 84134 | $172.15 | $313.00 | $10.94 – $44.42 | 5 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | not published | not published | $0.52 – $1.05 | 3 |
| Prednisone 1 mg tablet HCPCS J7512 | not published | not published | $0.01 – $0.02 | 3 |
| Pregabalin - sendout CPT 80366 | $95.70 | $174.00 | $137.83 – $137.83 | 1 |
| Pr egd flexible transoral w/placement percutaneous gastrostomy tube CPT 43246 | $1,431.65 | $2,603.00 | $1,449.62 – $4,321.00 | 4 |
| Pregnancy associated plasma protein-a CPT 84163 | $39.60 | $72.00 | $11.29 – $119.74 | 5 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $1,498.20 | $2,724.00 | $78.98 – $713.28 | 3 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $916.30 | $1,666.00 | $78.98 – $572.05 | 3 |
| Pre-op service lvrs 1-9 dos HCPCS G0304 | not published | not published | $281.90 – $375.86 | 2 |
| Pre-op service lvrs complete HCPCS G0302 | not published | not published | $281.90 – $375.86 | 2 |
| Preparation for bladder xray CPT 51605 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Preparation palate mold CPT 42280 | not published | not published | $407.43 – $4,074.00 | 4 |
| Prepare donor heart CPT 33944 | not published | not published | $14,906.00 – $14,906.00 | 1 |
| Prepare donor heart/lung CPT 33933 | not published | not published | $14,906.00 – $14,906.00 | 1 |
| Prepare donor intestine CPT 44715 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Prepare donor lung double CPT 32856 | not published | not published | $14,906.00 – $14,906.00 | 1 |
| Prepare donor lung single CPT 32855 | not published | not published | $14,906.00 – $14,906.00 | 1 |
| Prepare embryo for transfer CPT 89255 | not published | not published | $39.37 – $52.49 | 2 |
| Prepare fecal microbiota CPT 44705 | not published | not published | $4,074.00 – $4,074.00 | 1 |
| Prepare heart-aorta conduit CPT 33404 | not published | not published | $15,466.00 – $15,466.00 | 1 |
| Prepare penis study CPT 54230 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Prepare sperm duct x-ray CPT 55300 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Prep cadaver renal allograft CPT 50323 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Prep corneal endo allograft CPT 65757 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Prep donor intestine/artery CPT 44721 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Prep donor intestine/venous CPT 44720 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Prep donor liver 3-segment CPT 47144 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Prep donor liver/arterial CPT 47147 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Prep donor liver lobe split CPT 47145 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Prep donor liver/venous CPT 47146 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Prep donor liver whole CPT 47143 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Prep donor pancreas CPT 48551 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Prep donor pancreas/venous CPT 48552 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Prep donor renal graft CPT 50325 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Prepj skn cll ssp agrft 1st CPT 15013 | not published | not published | $4,074.00 – $7,148.27 | 3 |
| Prepj tum cav iort prtl mast CPT 19294 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Pre-plan 3d model w/ccta HCPCS C9793 | not published | not published | $648.73 – $864.97 | 2 |
| Prep renal graft/arterial CPT 50328 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Prep renal graft/ureteral CPT 50329 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Prep renal graft/venous CPT 50327 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Prep skin cell susp, automtd HCPCS C8002 | not published | not published | $5,361.20 – $18,190.00 | 3 |
| Prep skin to 100cm2 other CPT 15004 | not published | not published | $307.10 – $4,074.00 | 4 |
| Prep skin to 100cm2 trk/ext CPT 15002 | not published | not published | $558.33 – $4,321.00 | 4 |
| Prep skn trk/ext adl 100cm2 CPT 15003 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Pressure max expiratory/inspiratory CPT 94799 | $253.00 | $460.00 | $97.20 – $129.61 | 2 |
| Pressure treatment esophagus CPT 43460 | not published | not published | $4,321.00 – $4,321.00 | 1 |
| Pressure velocity wire add ves CPT 93572 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 | $84.70 | $154.00 | $128.70 – $189.75 | 3 |
| Pretreat rbc absorption reference CPT 86978 | $193.05 | $351.00 | $44.57 – $189.75 | 3 |
| Pretreat rbc density gradient separation reference CPT 86972 | $154.00 | $280.00 | $128.70 – $219.70 | 3 |
| Pretreat rbc w chem/drugs reference CPT 86970 | $69.30 | $126.00 | $44.57 – $157.78 | 3 |
| Pretreat rbc w enzyme reference CPT 86971 | $58.85 | $107.00 | $125.85 – $171.61 | 3 |
| Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm CPT 11420 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 | $814.55 | $1,481.00 | $307.10 – $4,074.00 | 4 |
| Pr gastrorrhaphy suture perforated duodenal or gastric ulcer/wound/ injury CPT 43840 | not published | not published | $2,912.58 – $10,498.00 | 4 |
| Prgr stim/pace a/iv drug CPT 93623 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Prim art mech thrmbc non-intracranial CPT 37184 | $3,748.25 | $6,815.00 | $13,848.46 – $18,464.62 | 4 |
| Prim art mech thrmbc non-intracranial add-on CPT 37185 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $541.75 | $985.00 | $307.10 – $4,074.00 | 4 |
| Pr incision & drainage abscess simple/single CPT 10060 | $515.90 | $938.00 | $151.57 – $4,074.00 | 4 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $668.25 | $1,215.00 | $230.21 – $4,074.00 | 4 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $444.95 | $809.00 | $307.10 – $4,074.00 | 4 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $253.55 | $461.00 | not published | 0 |
| Pr neuroplasty and/or transposition ulnar nerve at elbow CPT 64718 | not published | not published | $1,475.17 – $6,798.00 | 4 |
| Probe nasolacrimal duct CPT 68810 | not published | not published | $239.78 – $4,074.00 | 4 |
| Probe nasolacrimal duct CPT 68811 | not published | not published | $1,796.05 – $6,798.00 | 4 |
| Probe nasolacrimal duct CPT 68815 | not published | not published | $1,796.05 – $6,798.00 | 4 |
| Probe nl duct w/balloon CPT 68816 | not published | not published | $1,796.05 – $6,798.00 | 4 |
| Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 | not published | not published | $221.52 – $412.29 | 5 |
| Procalcitonin CPT 84145 | $82.50 | $150.00 | $20.42 – $213.00 | 5 |
| Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 | not published | not published | $4.23 – $5.46 | 3 |
| Proctectomy combined abd pull-thru px 45112 CPT 45112 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Proctectomy complete abd w/clst 45110 CPT 45110 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Proctosigmoidoscopy ablate CPT 45320 | not published | not published | $2,096.85 – $6,798.00 | 4 |
| Proctosigmoidoscopy control bleed 45317 CPT 45317 | not published | not published | $903.99 – $4,321.00 | 4 |
| Proctosigmoidoscopy dilate 45303 CPT 45303 | not published | not published | $903.99 – $4,321.00 | 4 |
| Proctosigmoidoscopy dx 45300 CPT 45300 | not published | not published | $702.53 – $4,074.00 | 4 |
| Proctosigmoidoscopy removal CPT 45308 | not published | not published | $2,096.85 – $4,321.00 | 4 |
| Proctosigmoidoscopy removal CPT 45309 | not published | not published | $903.99 – $4,321.00 | 4 |
| Proctosigmoidoscopy tumor removal 45315 CPT 45315 | not published | not published | $903.99 – $4,321.00 | 4 |
| Proctosigmoidoscopy volvul CPT 45321 | not published | not published | $2,096.85 – $6,798.00 | 4 |
| Proctosigmoidoscopy w/bx 45305 CPT 45305 | not published | not published | $903.99 – $4,321.00 | 4 |
| Proctosigmoidoscopy w/fb remove 45307 CPT 45307 | not published | not published | $2,096.85 – $6,798.00 | 4 |
| Proctosigmoidoscopy w/stent CPT 45327 | not published | not published | $4,586.20 – $9,811.00 | 4 |
| Progenamatrix, per sq cm HCPCS Q4222 | not published | not published | $94.01 – $242.34 | 5 |
| Progesterone CPT 84144 | $151.80 | $276.00 | $15.64 – $147.98 | 5 |
| Prolactin CPT 84146 | $209.00 | $380.00 | $14.54 – $154.12 | 5 |
| Prolonged IV inf, req pump HCPCS C8957 | not published | not published | $160.68 – $214.25 | 2 |
| Promethazine hcl injection HCPCS J2550 | not published | not published | $4.80 – $6.60 | 3 |
| Proph rta dtchmnt crtx dthrm CPT 67141 | not published | not published | $239.78 – $4,074.00 | 4 |
| Proph rta dtchmnt pc CPT 67145 | not published | not published | $415.49 – $4,074.00 | 4 |
| Proph tx w/wo mthylmthcrylt CPT 24498 | not published | not published | $9,698.86 – $16,582.00 | 4 |
| Prophylactic tx radius CPT 25490 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Prophylactic tx radius&ulna CPT 25492 | not published | not published | $2,471.80 – $14,543.00 | 4 |
| Prophylactic tx ulna CPT 25491 | not published | not published | $9,698.86 – $16,352.00 | 4 |
| Propofol infusion 10 mg/ml HCPCS J2704 | not published | not published | $0.13 – $0.17 | 3 |
| _propoxygc/msur CPT 80367 | $319.00 | $580.00 | $137.83 – $137.83 | 1 |
| Prostate biopsy, any mthd HCPCS G0416 | $389.95 | $709.00 | $270.78 – $361.05 | 2 |
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.