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 |
|---|---|---|---|---|
| Pyruvate kinase CPT 84220 | $69.85 | $127.00 | $7.08 – $75.07 | 5 |
| Quan puplmtry phy/qhp uni/bi CPT 95919 | not published | not published | $100.51 – $134.01 | 2 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | not published | not published | $410.18 – $2,138.71 | 3 |
| Quant diff pulm perf w/imaging CPT 78597 | not published | not published | $302.00 – $1,342.37 | 3 |
| Quest t3 uptake CPT 84479 | $12.10 | $22.00 | $4.85 – $51.42 | 5 |
| Rabies ig ht&sol human im/sc CPT 90377 | not published | not published | $182.40 – $463.46 | 5 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | not published | not published | $210.89 – $518.68 | 5 |
| Radial keratotomy CPT 65771 | not published | not published | $6,798.00 – $10,498.00 | 2 |
| Radiation handling CPT 77790 | not published | not published | $115.17 – $115.17 | 1 |
| Radiation physics consult CPT 77336 | $542.85 | $987.00 | $101.54 – $612.35 | 3 |
| Radiation therapy dose plan CPT 77300 | $476.30 | $866.00 | $101.54 – $267.45 | 3 |
| Radiation therapy management CPT 77431 | not published | not published | $806.43 – $806.43 | 1 |
| Radiation treatment aid(s) CPT 77332 | $550.55 | $1,001.00 | $101.54 – $428.08 | 3 |
| Radiation treatment aid(s) CPT 77333 | $734.25 | $1,335.00 | $73.63 – $135.38 | 3 |
| Radiation treatment aid(s) CPT 77334 | $1,103.85 | $2,007.00 | $282.86 – $688.37 | 3 |
| Radiation treatment delivery CPT 77401 | not published | not published | $189.94 – $189.94 | 1 |
| Radiation treatment delivery CPT 77402 | $464.20 | $844.00 | $77.08 – $1,120.34 | 3 |
| Radiation treatment delivery CPT 77412 | $848.65 | $1,543.00 | $417.41 – $2,164.22 | 3 |
| Radiation tx management x5 CPT 77427 | not published | not published | $1,467.89 – $1,467.89 | 1 |
| Radical abdominal hysterectomy 58210 CPT 58210 | not published | not published | $14,906.00 – $14,906.00 | 1 |
| Radical rescj tumor clavicle CPT 23200 | not published | not published | $5,481.64 – $16,582.00 | 4 |
| Radical rescj tumor prox hum CPT 23220 | not published | not published | $5,481.64 – $16,582.00 | 4 |
| Radical rescj tumor scapula CPT 23210 | not published | not published | $5,481.64 – $16,582.00 | 4 |
| Radical resection of elbow CPT 24149 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Radical resection sternum 21630 CPT 21630 | not published | not published | $5,481.64 – $16,582.00 | 4 |
| Radic resect abd tumor<5cm 22904 CPT 22904 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Radic resect shoulder tumor 5cm/> 23078 CPT 23078 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Radiology port images(s) CPT 77417 | $267.85 | $487.00 | $84.70 – $84.70 | 1 |
| Radiotherapy dose plan imrt CPT 77301 | $5,672.15 | $10,313.00 | $1,045.63 – $12,000.45 | 3 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $1,412.95 | $2,569.00 | $410.18 – $2,282.71 | 3 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $1,570.25 | $2,855.00 | $410.18 – $4,148.42 | 3 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | $2,040.50 | $3,710.00 | $978.03 – $4,899.45 | 3 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $1,727.00 | $3,140.00 | $410.18 – $2,327.00 | 3 |
| Radphm lcl tumor plr sgl day CPT 78800 | not published | not published | $302.00 – $1,270.38 | 3 |
| Radphm quant measure sgl area add-on CPT 78835 | not published | not published | $633.99 – $633.99 | 1 |
| Rad rescj tum dstl/shft hum CPT 24150 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Rad rescj tum shoulder<5 cm CPT 23077 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Rad rescj tum tiss a/e 5 cm+ CPT 24079 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Rad rescj tum tiss a/e <5cm CPT 24077 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Rad resec soft tis tum/ft/toe/<3cm 28046 CPT 28046 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Rad resect abd tumor 5 cm/> CPT 22905 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Rad resect hand tumor < 3 cm CPT 26117 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Rad resect hand tumor 3 cm/> CPT 26118 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Rad resection tum radial h/n CPT 24152 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Rad resect tumor/neck/ant thor/<5cm21557 CPT 21557 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | not published | not published | $57.42 – $141.46 | 5 |
| Ranibizumab injection HCPCS J2778 | not published | not published | $38.32 – $229.36 | 5 |
| Rapid Strep Test CPT 87880 | $162.80 | $296.00 | $12.40 – $95.32 | 5 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | not published | not published | $290.59 – $715.31 | 5 |
| Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 | not published | not published | $170.19 – $427.87 | 5 |
| Rbc count only automated CPT 85041 | $47.30 | $86.00 | $2.26 – $23.98 | 5 |
| Rbc depletion of harvest CPT 38212 | not published | not published | $333.28 – $4,074.00 | 4 |
| Rbc mechanical fragility CPT 85547 | not published | not published | $6.45 – $68.40 | 5 |
| Rbc osmotic fragility CPT 85555 | $91.30 | $166.00 | $5.60 – $53.12 | 5 |
| Rbc serum pretx incubj drugs CPT 86975 | $145.75 | $265.00 | $169.78 – $449.96 | 3 |
| Rcnst bfrnt sp orb rm&lw fhd CPT 21175 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Rcnstj forehead w/autograft CPT 21180 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Rcnstj forehead with grafts CPT 21179 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Rcnstj mdfc lefort i 1 w/grf CPT 21145 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Rcnstj mdfc lefort i 2 w/grf CPT 21146 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Rcnstj mdfc lefort iii w/i CPT 21155 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Rcnstj mdfc lefort iii without i CPT 21154 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Rcnstj mdfc lefrtii w/b1 grf CPT 21151 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Rcnst mdfc lfrtiii advm w/i CPT 21160 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Rcnst mdfc lfrtiii advm wo i CPT 21159 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Rdctj forehead cntrg only CPT 21137 | not published | not published | $2,504.63 – $6,798.00 | 4 |
| Rdctj forehead cntrg&prostc CPT 21138 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Rdctj forehead cntrg&setback CPT 21139 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Realignment of knee CPT 27457 | not published | not published | $5,481.64 – $14,543.00 | 4 |
| Realignment of knee CPT 27455 | not published | not published | $5,481.64 – $16,582.00 | 4 |
| Realignment of tendons CPT 26437 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Realignment of thigh bone CPT 27454 | not published | not published | $5,481.64 – $16,582.00 | 4 |
| Rebuild eardrum structures CPT 69632 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Rebuild eardrum structures CPT 69633 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Rebuild eardrum structures CPT 69636 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Rebuild outer ear canal CPT 69310 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Rebuild outer ear canal CPT 69320 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Rechanneling of artery CPT 35361 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Rechanneling of artery CPT 35306 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Rechanneling of artery CPT 35311 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Rechanneling of artery CPT 35363 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Rechanneling of artery 35305 CPT 35305 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Rechanneling of artery 35341 CPT 35341 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Rechanneling w/graft tibioperoneal trunk artery 35304 CPT 35304 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Rechanneling w/wo patch graft abd aorta 35331 CPT 35331 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Rechanneling w/wo patch graft deep profunda fem art 35372 CPT 35372 | not published | not published | $4,203.64 – $16,582.00 | 4 |
| Rechanneling w/wo patch grf axillary-brachial 35321 CPT 35303 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Recipient nephrectomy CPT 50340 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Recon, cta for surg plan HCPCS G0288 | $2,123.00 | $3,860.00 | $275.08 – $275.08 | 1 |
| Reconst lwr jaw w/fixation CPT 21196 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Reconst lwr jaw w/graft CPT 21194 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Reconst lwr jaw without fixation CPT 21195 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Reconst lwr jaw without graft CPT 21193 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Reconst major injured chest 32820 CPT 32820 | not published | not published | $14,906.00 – $14,906.00 | 1 |
| Reconst pectus excavatum/carinatum opn 21740 CPT 21740 | not published | not published | $5,481.64 – $16,582.00 | 4 |
| Reconstr lwr jaw segment CPT 21198 | not published | not published | $4,472.08 – $9,811.00 | 4 |
| Reconstr lwr jaw w/advance CPT 21199 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Reconstruct ankle joint CPT 27702 | not published | not published | $10,498.00 – $27,330.85 | 4 |
| Reconstruct bronchus CPT 31775 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Reconstruct cleft foot CPT 28360 | not published | not published | $5,481.64 – $18,190.00 | 4 |
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.