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 |
|---|---|---|---|---|
| Auditory function 60 min CPT 92620 | not published | not published | $97.20 – $129.61 | 2 |
| Augmentation cheek bone CPT 21270 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Augmentation lower jaw bone CPT 21125 | not published | not published | $4,472.08 – $9,811.00 | 4 |
| Augmentation lower jaw bone CPT 21127 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Augmentation of facial bones CPT 21208 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body CPT 22515 | $3,194.40 | $5,808.00 | $1,704.00 – $1,704.00 | 1 |
| Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic CPT 22513 | $6,188.60 | $11,252.00 | $5,481.64 – $18,190.00 | 4 |
| Autgrft implnt knee w/scope CPT 29866 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Autochondrocyte implant knee CPT 27412 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Autoimmune rheumatoid arthr anl 12 mrk ia CPT 81490 | not published | not published | $630.49 – $3,447.68 | 5 |
| Autologous blood op salvage CPT 86891 | not published | not published | $608.64 – $811.52 | 3 |
| Autologous blood process CPT 86890 | $465.30 | $846.00 | $128.70 – $535.28 | 3 |
| Autolog prp not diab ulcer HCPCS G0460 | not published | not published | $1,558.69 – $2,078.25 | 2 |
| Automated diff wbc count CPT 85004 | $83.60 | $152.00 | $4.85 – $51.42 | 5 |
| Autonomic nrv adrenrg inervj CPT 95922 | not published | not published | $100.51 – $134.01 | 2 |
| Autonomic nrv parasym inervj CPT 95921 | not published | not published | $97.20 – $129.61 | 2 |
| Autonomic nrv syst funj test CPT 95923 | not published | not published | $100.51 – $134.01 | 2 |
| Avelumab 20 mg/ml intravenous solution HCPCS J9023 | not published | not published | $81.48 – $190.57 | 5 |
| Av fistula revision CPT 36833 | not published | not published | $4,203.64 – $16,582.00 | 4 |
| Av fuse uppr arm basilic CPT 36819 | not published | not published | $4,203.64 – $16,582.00 | 4 |
| Av fuse uppr arm cephalic CPT 36818 | not published | not published | $4,203.64 – $16,582.00 | 4 |
| Av fusion direct any site CPT 36821 | not published | not published | $2,385.29 – $10,498.00 | 4 |
| Av fusion/forearm vein 36820 CPT 36820 | not published | not published | $4,203.64 – $16,582.00 | 4 |
| Avul nail plate addl CPT 11732 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Avulsion nail plate partial/complete simple single nail plate CPT 11730 | $223.85 | $407.00 | $151.57 – $4,074.00 | 4 |
| Axicabtagene ciloleucel car+ HCPCS Q2041 | not published | not published | $421,875.67 – $1,012,845.30 | 5 |
| Axillary lymphadenect/superficial 38740 CPT 38740 | not published | not published | $4,567.04 – $16,582.00 | 4 |
| Azacitidine injection HCPCS J9025 | not published | not published | $0.40 – $0.54 | 3 |
| Azathioprine 50 mg tablet HCPCS J7500 | not published | not published | $1.46 – $4.07 | 3 |
| Azithromycin 500 mg intravenous solution HCPCS J0456 | not published | not published | $3.22 – $4.97 | 3 |
| Aztreonam 1 gram solution for injection HCPCS J0457 | not published | not published | $3.60 – $5.06 | 3 |
| Baclofen 2,000 mcg/ml intrathecal solution (wrapper) HCPCS J0475 | not published | not published | $139.58 – $334.06 | 5 |
| Baclofen 50 mcg/ml intrathecal solution (wrapper) HCPCS J0476 | not published | not published | $75.35 – $127.69 | 3 |
| Bacterial meningitis antigen CPT 86403 | $148.50 | $270.00 | $8.66 – $81.03 | 5 |
| Bacterial vaginosis pcr CPT 87801 | $1,228.70 | $2,234.00 | $52.65 – $558.19 | 5 |
| Bactericidal level serum CPT 87197 | not published | not published | $11.26 – $119.48 | 5 |
| #bac vag cand-c. albicans naa CPT 87481 | $231.00 | $420.00 | $26.32 – $279.04 | 5 |
| Balloon dilate urtrl strix CPT 50706 | $653.40 | $1,188.00 | $1,704.00 – $1,704.00 | 1 |
| Bartholin gland cyst/marsupializat 56440 CPT 56440 | not published | not published | $2,445.46 – $6,798.00 | 4 |
| Bartonella dna pcr-sendout CPT 87471 | not published | not published | $26.32 – $279.04 | 5 |
| Basiliximab HCPCS J0480 | not published | not published | $3,678.79 – $8,877.69 | 5 |
| B cells total count CPT 86355 | $135.30 | $246.00 | $28.30 – $300.00 | 5 |
| Bcg live 50 mg intravesical suspension HCPCS J9030 | not published | not published | $2.53 – $5.93 | 5 |
| Bckdhb gene CPT 81205 | not published | not published | $71.24 – $533.19 | 5 |
| Belatacept 250 mg intravenous solution HCPCS J0485 | not published | not published | $2.91 – $7.39 | 5 |
| Belimumab 120 mg intravenous solution HCPCS J0490 | not published | not published | $43.72 – $106.41 | 5 |
| Bendamustine 100 mg intravenous powder for solution HCPCS J9033 | not published | not published | $1.80 – $3.52 | 5 |
| Bendamustine 25 mg/ml intravenous solution (belrapzo) HCPCS J9036 | not published | not published | $8.70 – $31.69 | 5 |
| Bendamustine 25 mg/ml intravenous solution (bendeka) HCPCS J9034 | not published | not published | $9.40 – $24.93 | 5 |
| Bendamustine 25 mg/ml intravenous solution (vivimusta) HCPCS J9056 | not published | not published | $22.43 – $53.31 | 5 |
| Benign lesion paring 2-4 CPT 11056 | not published | not published | $151.57 – $4,074.00 | 4 |
| Benign lesion paring 4+ CPT 11057 | not published | not published | $151.57 – $4,074.00 | 4 |
| #_benzodiazconfur CPT 80346 | $268.95 | $489.00 | $137.83 – $137.83 | 1 |
| Benztropine 1 mg/ml injection solution HCPCS J0515 | not published | not published | $24.32 – $32.81 | 3 |
| Beta 2 glycoprotein 1 antibody iga CPT 86146 | $51.70 | $94.00 | $19.09 – $46.24 | 5 |
| Beta-2 microglobulin CPT 82232 | $19.25 | $35.00 | $12.14 – $128.66 | 5 |
| Beta-amyloid 1-40 CPT 82233 | not published | not published | $96.69 – $128.92 | 2 |
| Beta-amyloid 1-42 CPT 82234 | $275.00 | $500.00 | $96.69 – $128.92 | 2 |
| Betamethasone acetate and sodium phos 6 mg/ml suspension for injection HCPCS J0702 | not published | not published | $9.93 – $13.89 | 3 |
| Bevacizumab 25 mg/ml intravenous solution HCPCS J9035 | not published | not published | $56.12 – $138.79 | 5 |
| Bevacizumab-awwb 25 mg/ml intravenous solution HCPCS Q5107 | not published | not published | $18.40 – $54.81 | 5 |
| Bevacizumab-bvzr 25 mg/ml intravenous solution HCPCS Q5118 | not published | not published | $19.42 – $45.47 | 5 |
| B-hexosaminidase ea assay CPT 83080 | not published | not published | $12.65 – $114.58 | 5 |
| Bilateral laminotomy addl lumbar 63044 CPT 63044 | not published | not published | $7,919.00 – $7,919.00 | 1 |
| Bilateral n blobk inj pudendal 64430 CPT 64430 | not published | not published | $668.17 – $4,074.00 | 4 |
| Bilateral n block inj occipital 64405 CPT 64405 | $828.30 | $1,506.00 | $231.88 – $4,074.00 | 4 |
| Bilateral n block inj trigeminal 64400 CPT 64400 | $530.20 | $964.00 | $231.88 – $4,074.00 | 4 |
| Bile acids cholylglycine CPT 82240 | not published | not published | $19.94 – $211.37 | 5 |
| Bile duct endoscopy add-on 47550 CPT 47550 | not published | not published | $2,672.00 – $10,498.00 | 2 |
| Biliary endo perq dx w/speci CPT 47552 | not published | not published | $4,890.59 – $10,498.00 | 4 |
| Biliary endoscopy thru skin CPT 47553 | not published | not published | $4,890.59 – $16,582.00 | 4 |
| Biliary endoscopy thru skin CPT 47554 | not published | not published | $8,030.21 – $16,582.00 | 4 |
| Biliary endoscopy thru skin CPT 47555 | $1,579.05 | $2,871.00 | $4,890.59 – $10,498.00 | 4 |
| Biliary endoscopy thru skin CPT 47556 | $2,503.60 | $4,552.00 | $8,030.21 – $16,582.00 | 4 |
| Bilicheck CPT 88720 | not published | not published | $3.76 – $39.86 | 5 |
| Bilirubin direct CPT 82248 | $40.15 | $73.00 | $3.76 – $39.86 | 5 |
| Bilirubin total CPT 82247 | $75.90 | $138.00 | $3.76 – $39.86 | 5 |
| Bilobectomy 32482 CPT 32482 | not published | not published | $16,352.00 – $16,352.00 | 1 |
| Biofeedback, pt CPT 90901 | not published | not published | $12.03 – $16.04 | 2 |
| Biopsy abdominal mass CPT 49180 | $1,967.90 | $3,578.00 | $1,247.68 – $4,321.00 | 4 |
| Biopsy arm/elbow soft tissue CPT 24066 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Biopsy, bone open deep CPT 20245 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Biopsy bone trocar/needle superficial CPT 20220 | $1,369.50 | $2,490.00 | $1,247.68 – $4,321.00 | 4 |
| Biopsy cervixsingle/multiple 57500 CPT 57500 | not published | not published | $695.80 – $4,074.00 | 4 |
| Biopsy conjunctiva CPT 68100 | not published | not published | $1,796.05 – $4,321.00 | 4 |
| Biopsy/excision of lymph node(s); open deep 38530 CPT 38530 | not published | not published | $2,957.88 – $10,498.00 | 4 |
| Biopsy external ear 69100 CPT 69100 | not published | not published | $178.93 – $4,074.00 | 4 |
| Biopsy eyelid & lid margin CPT 67810 | not published | not published | $239.78 – $4,074.00 | 4 |
| Biopsy eye muscle CPT 67346 | not published | not published | $2,969.94 – $10,498.00 | 4 |
| Biopsy finger joint lining CPT 26105 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Biopsy finger joint lining CPT 26110 | not published | not published | $1,214.74 – $4,321.00 | 4 |
| Biopsy forearm soft tissues CPT 25066 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Biopsy hand joint lining CPT 26100 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides) CPT 38222 | $1,780.35 | $3,237.00 | $2,194.34 – $4,321.00 | 4 |
| Biopsy knee joint lining CPT 27330 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Biopsy lower leg soft tissue CPT 27613 | not published | not published | $1,247.68 – $4,321.00 | 4 |
| Biopsy lower leg soft tissue 27610 CPT 27610 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Biopsy muscle percutaneous needle CPT 20206 | $1,295.25 | $2,355.00 | $1,247.68 – $4,321.00 | 4 |
| Biopsy needle liver percutaneous CPT 47000 | $1,826.55 | $3,321.00 | $1,247.68 – $4,321.00 | 4 |
| Biopsy needle lymph node superficial CPT 38505 | $1,757.25 | $3,195.00 | $1,247.68 – $4,321.00 | 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.