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 |
|---|---|---|---|---|
| Target gsa panel hmtlmph neop CPT 81450 | $4,382.95 | $7,969.00 | $569.65 – $3,785.02 | 5 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $3,966.05 | $7,211.00 | $2,189.70 – $16,387.63 | 5 |
| Target gsa panel organ neop CPT 81445 | $6,824.40 | $12,408.00 | $448.43 – $3,490.28 | 5 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | not published | not published | $1,209.32 – $2,978.24 | 4 |
| Tas congenital car anomal CPT 33741 | not published | not published | $16,352.00 – $16,352.00 | 1 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | not published | not published | $558.33 – $4,074.00 | 4 |
| Tavr perq femoral CPT 33361 | not published | not published | $16,352.00 – $16,352.00 | 1 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | not published | not published | $0.18 – $0.74 | 5 |
| Tbp gene detc abnor alleles CPT 81344 | not published | not published | $102.75 – $799.73 | 5 |
| Tbs dxa cal w/i&r fx risk CPT 77089 | not published | not published | $325.49 – $325.49 | 1 |
| Tbs i&r fx rsk qhp CPT 77092 | not published | not published | $83.43 – $83.43 | 1 |
| Tbs techl calculation only CPT 77091 | not published | not published | $65.74 – $224.82 | 3 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $17.24 – $87.66 | 3 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $294.25 | $535.00 | $75.00 – $595.84 | 5 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $266.75 | $485.00 | $46.48 – $492.87 | 5 |
| Tc-99m bicisate HCPCS A9557 | $1,696.75 | $3,085.00 | not published | 0 |
| Tc-99m labeled rbc HCPCS A9560 | $267.30 | $486.00 | not published | 0 |
| Tc-99m maa HCPCS A9540 | $230.45 | $419.00 | not published | 0 |
| Tc-99m mebrofenin HCPCS A9537 | $225.50 | $410.00 | not published | 0 |
| Tc-99m medronate HCPCS A9503 | $209.55 | $381.00 | not published | 0 |
| Tc-99m mertiatide HCPCS A9562 | $799.15 | $1,453.00 | not published | 0 |
| Tc-99m non-heu per study dose HCPCS Q9969 | $12.65 | $23.00 | not published | 0 |
| Tc-99m pentetate dtpa HCPCS A9539 | $1.91 | $3.47 | not published | 0 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $175.45 | $319.00 | not published | 0 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $209.55 | $381.00 | not published | 0 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $209.55 | $381.00 | not published | 0 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $375.65 | $683.00 | not published | 0 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $371.25 | $675.00 | not published | 0 |
| Tc-99m sulfur colloid HCPCS A9541 | $76.45 | $139.00 | not published | 0 |
| Tc-99m tilmanocept diag HCPCS A9520 | $545.60 | $992.00 | not published | 0 |
| Tca peel dermal 15789 CPT 15789 | not published | not published | $558.33 – $4,074.00 | 4 |
| Tcd emboli detect w/inj CPT 93893 | not published | not published | $78.98 – $105.30 | 2 |
| Tcd emboli detect without inj CPT 93892 | not published | not published | $78.98 – $105.30 | 2 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $333.28 – $4,074.00 | 4 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $66.00 | $120.00 | $35.24 – $373.66 | 5 |
| T cells absolute cd 4 count CPT 86361 | not published | not published | $20.08 – $212.90 | 5 |
| T cells total count CPT 86359 | $66.00 | $120.00 | $28.30 – $300.00 | 5 |
| Tdh sdrl/ventr pnxr CPT 61105 | not published | not published | $4,321.00 – $4,321.00 | 1 |
| Teaec w/wo patch graft iliofemoral CPT 35355 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution HCPCS J9274 | not published | not published | $171.00 – $412.47 | 5 |
| Tee w or without fol w/cont,cong HCPCS C8926 | not published | not published | $592.21 – $789.61 | 2 |
| Tee w or without fol w/cont, mon HCPCS C8927 | not published | not published | $592.21 – $789.61 | 2 |
| Telavancin injection HCPCS J3095 | not published | not published | $5.61 – $14.19 | 5 |
| Telehealth original site facility fee HCPCS Q3014 | $52.25 | $95.00 | not published | 0 |
| Telethx isodose plan cplx CPT 77307 | $585.75 | $1,065.00 | $282.86 – $1,079.31 | 3 |
| Telethx isodose plan simple CPT 77306 | $319.55 | $581.00 | $282.86 – $598.61 | 3 |
| Temozolomide HCPCS J8700 | not published | not published | $0.50 – $0.69 | 3 |
| Temozolomide 100 mg intravenous solution HCPCS J9328 | not published | not published | $7.81 – $19.75 | 5 |
| Temperature gradient studies CPT 93740 | not published | not published | $97.20 – $129.61 | 2 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | not published | not published | $24.51 – $61.34 | 5 |
| Tendon lengthening CPT 26476 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Tendon lngth upr a/e ea tdn CPT 24305 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Tendon shortening CPT 26477 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Tendon transfer with graft CPT 26492 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | not published | not published | $163.07 – $326.68 | 5 |
| Tenodesis biceps tdn at elbw CPT 24340 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Tenolysis extensor tendon hand/finger each CPT 26445 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Tenolysis triceps CPT 24332 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Tenoplasty elbow to sho 1 CPT 24320 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Tenosynovectomy radic 26145 CPT 26145 | not published | not published | $1,214.74 – $4,321.00 | 4 |
| Tenotomy hip flexor open CPT 27005 | not published | not published | $2,471.80 – $16,582.00 | 4 |
| Tenotomy length/rls abductor hallucis musc 28240 CPT 28240 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | not published | not published | $1,214.74 – $6,798.00 | 4 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | not published | not published | $2.04 – $5.21 | 3 |
| Tert gene targeted seq alys CPT 81345 | not published | not published | $138.90 – $1,081.09 | 5 |
| Test for chlorohydrocarbons CPT 82441 | not published | not published | $4.51 – $47.76 | 5 |
| Test for porphobilinogen CPT 84106 | not published | not published | $4.36 – $34.03 | 5 |
| Test for urine cystines CPT 82615 | not published | not published | $7.16 – $64.91 | 5 |
| Testicular imaging w/vasc flow CPT 78761 | not published | not published | $302.00 – $1,394.97 | 3 |
| Testosterone response panel CPT 80414 | not published | not published | $38.73 – $400.86 | 5 |
| Testosterone undecanoate 1mg HCPCS J3145 | not published | not published | $1.61 – $3.79 | 5 |
| Test pathogen(s) for platelets reference HCPCS P9100 | not published | not published | $44.57 – $59.42 | 2 |
| Test stress cardiovascular tracing only CPT 93017 | $805.75 | $1,465.00 | not published | 0 |
| Test urine for lactose CPT 83633 | not published | not published | $8.44 – $43.73 | 5 |
| Test urine for porphyrins CPT 84119 | not published | not published | $10.02 – $68.54 | 5 |
| Test urine urobilinogen CPT 84578 | not published | not published | $3.35 – $25.86 | 5 |
| Tetanus immune globulin inj HCPCS J1670 | not published | not published | $446.26 – $1,096.39 | 5 |
| Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe HCPCS J2356 | not published | not published | $13.44 – $34.77 | 5 |
| Tgfbi gene common variants CPT 81333 | not published | not published | $102.75 – $799.73 | 5 |
| Tgsap hl neo 5-50 rna alys CPT 81451 | not published | not published | $569.65 – $4,437.33 | 5 |
| Tgsap so/hl 51/< rna alys CPT 81456 | not published | not published | $2,189.70 – $17,056.88 | 5 |
| Tgsap so neo 5-50 rna alys CPT 81449 | not published | not published | $448.43 – $3,493.11 | 5 |
| Thaw cryoprsvrd reprod tiss CPT 89354 | not published | not published | $128.70 – $171.61 | 2 |
| Thawing cryopresrved embryo CPT 89352 | not published | not published | $128.70 – $171.61 | 2 |
| Thawing cryopresrved oocyte CPT 89356 | not published | not published | $128.70 – $171.61 | 2 |
| Thawing cryopresrved sperm CPT 89353 | not published | not published | $39.37 – $52.49 | 2 |
| Thaw preserved stem cells CPT 38208 | not published | not published | $333.28 – $4,074.00 | 4 |
| Theophylline therapeutic drug level CPT 80198 | $190.85 | $347.00 | $10.60 – $112.50 | 5 |
| Therapeutic procd strg endur HCPCS G0237 | not published | not published | $21.85 – $29.13 | 2 |
| Therapy photodnmc lght dstr lsn skn by staff rx per day CPT 96567 | not published | not published | $151.57 – $1,704.00 | 3 |
| Ther fx nasal inf turbinate CPT 30930 | not published | not published | $2,504.63 – $6,798.00 | 4 |
| Ther nma rdctj intus/obstrcj CPT 74283 | $1,331.00 | $2,420.00 | $132.50 – $790.83 | 3 |
| Ther/proph/diag inj ia CPT 96373 | $215.60 | $392.00 | $160.68 – $214.25 | 2 |
| Ther radiology tx plng cplx CPT 77263 | not published | not published | $1,310.92 – $1,310.92 | 1 |
| Ther radiology tx plng intrm CPT 77262 | not published | not published | $896.71 – $896.71 | 1 |
| Ther radiology tx plng smpl CPT 77261 | not published | not published | $600.57 – $600.57 | 1 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | not published | not published | $2.55 – $3.40 | 3 |
| Thiotepa injection HCPCS J9340 | not published | not published | $355.32 – $410.24 | 2 |
| Thorabd diaphr hern repair CPT 43336 | not published | not published | $14,906.00 – $14,906.00 | 1 |
| Thorabd diaphr hern repair CPT 43337 | 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.