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 |
|---|---|---|---|---|
| Bone marrow;aspiration only 38220 CPT 38220 | $1,135.75 | $2,065.00 | $1,247.68 – $4,321.00 | 4 |
| Bone marrow biopsyneedle/trocar 38221 CPT 38221 | $1,171.50 | $2,130.00 | $1,247.68 – $4,321.00 | 4 |
| Bone marrow harvest allogen CPT 38230 | not published | not published | $1,176.54 – $4,321.00 | 4 |
| Bone marrow harvest autolog CPT 38232 | not published | not published | $3,290.32 – $14,543.00 | 4 |
| Bone marrow imaging body CPT 78104 | not published | not published | $302.00 – $1,666.34 | 3 |
| Bone marrow imaging ltd CPT 78102 | not published | not published | $302.00 – $1,151.30 | 3 |
| Bone marrow imaging mult CPT 78103 | not published | not published | $302.00 – $1,500.20 | 3 |
| Bone marrow interpretation CPT 85097 | $84.70 | $154.00 | $512.12 – $811.52 | 3 |
| Bone/skin graft great toe CPT 20973 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Bone/skin graft metatarsal CPT 20972 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Bone survey-lead poisoning CPT 77074 | $356.40 | $648.00 | $78.98 – $320.08 | 3 |
| Boot walker genesis full shell 3-strap s HCPCS L4360 | $177.38 | $322.50 | not published | 0 |
| Borrelia antibody CPT 86619 | not published | not published | $10.04 – $106.36 | 5 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | $111.65 | $203.00 | $12.77 – $135.43 | 5 |
| Borrelia miyamotoi amp prb CPT 87478 | not published | not published | $26.32 – $205.00 | 5 |
| Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection HCPCS J9041 | not published | not published | $3.02 – $4.11 | 3 |
| (both sides) smear without diff wbc count CPT 85008 | $30.25 | $55.00 | $2.57 – $27.33 | 5 |
| Bowel imaging CPT 78290 | $1,184.15 | $2,153.00 | $302.00 – $2,415.60 | 3 |
| Brace back pinnacle tlso 464 HCPCS L0464 | $2,223.92 | $4,043.49 | not published | 0 |
| Brace knee extender plus 22-30in HCPCS L1832 | $266.06 | $483.75 | not published | 0 |
| Brace ortho exos 28-50in sm HCPCS L0637 | $1,863.75 | $3,388.63 | not published | 0 |
| Brace ortho tlso 2xl 19in strnl y bar wst belt pd shldr HCPCS L0456 | $1,452.81 | $2,641.48 | not published | 0 |
| Brachioplasty 15836 CPT 15836 | not published | not published | $2,194.34 – $10,498.00 | 4 |
| Brach/thor cath 1st CPT 36215 | $1,178.65 | $2,143.00 | $1,704.00 – $1,704.00 | 1 |
| Brach/thor cath 2nd CPT 36216 | $1,749.00 | $3,180.00 | $1,704.00 – $1,704.00 | 1 |
| Brach/thor cath 3rd CPT 36217 | $1,934.90 | $3,518.00 | $1,704.00 – $1,704.00 | 1 |
| Brach/thor cath addl CPT 36218 | $418.55 | $761.00 | $1,704.00 – $1,704.00 | 1 |
| Brachytx isodose complex CPT 77318 | not published | not published | $282.86 – $1,590.97 | 3 |
| Brachytx isodose intermed CPT 77317 | not published | not published | $282.86 – $1,172.33 | 3 |
| Brachytx isodose plan simple CPT 77316 | not published | not published | $282.86 – $902.09 | 3 |
| Braf gene CPT 81210 | $1,689.05 | $3,071.00 | $131.55 – $1,044.79 | 5 |
| Brain biopsy w/ct/mr guide CPT 61751 | not published | not published | $18,190.00 – $18,190.00 | 1 |
| Brain cavity shunt w/scope CPT 62201 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Brain flow imaging only CPT 78610 | not published | not published | $410.18 – $1,284.22 | 3 |
| Brain image < 4 views CPT 78600 | not published | not published | $302.00 – $1,309.14 | 3 |
| Brain image 4+ views CPT 78605 | not published | not published | $410.18 – $1,389.44 | 3 |
| Brain image w/flow < 4 views CPT 78601 | not published | not published | $302.00 – $1,522.34 | 3 |
| Brain image w/flow 4 + views CPT 78606 | $1,147.30 | $2,086.00 | $410.18 – $2,412.86 | 3 |
| Brain MRA (blood vessel MRI, with and without contrast) CPT 70546 | $2,289.10 | $4,162.00 | $263.55 – $3,935.30 | 3 |
| Brain MRA (blood vessel MRI, with contrast) CPT 70545 | $2,160.95 | $3,929.00 | $263.55 – $2,531.42 | 3 |
| Brain MRA (blood vessel MRI, without contrast) CPT 70544 | $1,907.40 | $3,468.00 | $180.25 – $2,567.41 | 3 |
| Brain MRI (with and without contrast) CPT 70553 | $2,456.30 | $4,466.00 | $263.55 – $2,027.44 | 3 |
| Brain MRI (with contrast) CPT 70552 | $2,251.70 | $4,094.00 | $263.55 – $1,778.23 | 3 |
| Brain MRI (without contrast) CPT 70551 | $2,047.10 | $3,722.00 | $180.25 – $1,206.17 | 3 |
| Brca1&2 gene full seq alys CPT 81163 | not published | not published | $351.00 – $2,731.94 | 5 |
| Brca1&2 gen ful dup/del alys CPT 81164 | not published | not published | $438.17 – $3,410.44 | 5 |
| Brca1 dna gene analy known fam var CPT 81215 | not published | not published | $281.44 – $656.69 | 5 |
| Brca1 gene full dup/del alys CPT 81166 | not published | not published | $226.01 – $1,759.13 | 5 |
| Brca1 gene full seq alys CPT 81165 | not published | not published | $212.16 – $1,651.31 | 5 |
| Brca2 dna gene analy full seq analy CPT 81216 | not published | not published | $138.84 – $1,039.07 | 5 |
| Brca2 dna gene analy known fam var CPT 81217 | not published | not published | $281.44 – $656.69 | 5 |
| Brca2 gene full dup/del alys CPT 81167 | not published | not published | $212.16 – $1,651.31 | 5 |
| Brcassure ashkenazi panel-sendout CPT 81212 | not published | not published | $330.00 – $1,029.96 | 5 |
| Brcassure comprehensive panel-sendout CPT 81162 | $4,269.10 | $7,762.00 | $1,368.66 – $14,511.15 | 5 |
| Breast augmentation 19325 CPT 19325 | not published | not published | $6,174.51 – $16,582.00 | 4 |
| Breast Biopsy (ultrasound-guided, percutaneous) CPT 19083 | $2,301.20 | $4,184.00 | $1,247.68 – $4,321.00 | 4 |
| Breast punct aspir cyst, bil CPT 19000 | $1,496.55 | $2,721.00 | $534.95 – $4,074.00 | 4 |
| Breast reconstruction 19357 CPT 19357 | not published | not published | $10,410.69 – $16,582.00 | 4 |
| Breast reconstruction tram flap 19367 CPT 19367 | not published | not published | $14,543.00 – $15,466.00 | 2 |
| Breast reconstr w/lat flap 19361 CPT 19361 | not published | not published | $15,466.00 – $15,466.00 | 1 |
| Breast reduction CPT 19318 | not published | not published | $5,016.25 – $15,466.00 | 4 |
| Breath hydrogen test 91065 CPT 91065 | not published | not published | $163.12 – $1,704.00 | 3 |
| Breathing response hypoxia CPT 94450 | not published | not published | $97.20 – $129.61 | 2 |
| Breath recording infant CPT 94772 | not published | not published | $281.90 – $375.86 | 2 |
| Breath test analysis c-14 CPT 78268 | not published | not published | $70.81 – $535.60 | 5 |
| Breath tst attain/anal c-14 CPT 78267 | not published | not published | $8.30 – $62.51 | 5 |
| Brentuximab vedotin 50 mg intravenous solution HCPCS J9042 | not published | not published | $209.41 – $491.18 | 5 |
| Brexucabtagene car pos t HCPCS Q2053 | not published | not published | $382,577.94 – $930,468.00 | 5 |
| Bronch/asp/tracheobronch tree/subs 31646 CPT 31646 | not published | not published | $295.47 – $4,074.00 | 4 |
| Bronch ebus ivntj perph les 31654 CPT 31654 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Bronch ebus samplng 1/2 node CPT 31652 | not published | not published | $2,816.54 – $10,498.00 | 4 |
| Bronch ebus samplng 3/> node CPT 31653 | not published | not published | $2,816.54 – $10,498.00 | 4 |
| Bronchial allergy tests CPT 95070 | not published | not published | $281.90 – $375.86 | 2 |
| Bronchial brush biopsy CPT 31717 | not published | not published | $295.47 – $4,074.00 | 4 |
| Bronchial challenge CPT 94070 | not published | not published | $281.90 – $375.86 | 2 |
| Bronchial valve init insert CPT 31647 | not published | not published | $5,331.49 – $15,466.00 | 4 |
| Bronchial valve remov addl CPT 31649 | not published | not published | $1,344.61 – $4,321.00 | 4 |
| Bronchial valve remov init CPT 31648 | not published | not published | $2,816.54 – $10,498.00 | 4 |
| Bronchoscopy bronch stents CPT 31636 | not published | not published | $5,331.49 – $15,466.00 | 4 |
| Bronchoscopy clear airways 31645 CPT 31645 | not published | not published | $1,344.61 – $4,321.00 | 4 |
| Bronchoscopy dilate/fx repr CPT 31630 | not published | not published | $2,816.54 – $10,498.00 | 4 |
| Bronchoscopy dilate w/stent CPT 31631 | not published | not published | $5,331.49 – $15,466.00 | 4 |
| Bronchoscopy/lung bx addl 31632 CPT 31632 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Bronchoscopy/lung bx each 31628 CPT 31628 | not published | not published | $2,816.54 – $10,498.00 | 4 |
| Bronchoscopy/needle bx addl 31633 CPT 31633 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Bronchoscopy/needle bx each 31629 CPT 31629 | not published | not published | $2,816.54 – $10,498.00 | 4 |
| Bronchoscopy revise stent CPT 31638 | not published | not published | $5,331.49 – $15,466.00 | 4 |
| Bronchoscopy treat blockage CPT 31641 | not published | not published | $2,816.54 – $10,498.00 | 4 |
| Bronchoscopy w/biopsy(s) 31625 CPT 31625 | not published | not published | $1,344.61 – $4,321.00 | 4 |
| Bronchoscopy w/fb removal 31635 CPT 31635 | not published | not published | $1,344.61 – $4,321.00 | 4 |
| Bronchoscopy w/markers CPT 31626 | not published | not published | $5,331.49 – $15,466.00 | 4 |
| Bronchoscopy w/tumor excise CPT 31640 | not published | not published | $2,816.54 – $10,498.00 | 4 |
| Bronch thermoplsty 1 lobe CPT 31660 | not published | not published | $5,331.49 – $15,466.00 | 4 |
| Bronch thermoplsty 2/> lobes CPT 31661 | not published | not published | $5,331.49 – $15,466.00 | 4 |
| Bronch w/balloon occlusion CPT 31634 | not published | not published | $5,331.49 – $15,466.00 | 4 |
| Bronch w/debrdmt subgltc & uppr trach CPT 31899 | not published | not published | $150.79 – $13,711.00 | 4 |
| Br punct aspir ea add, l CPT 19001 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Bso omentectomy w/tah 58956 CPT 58956 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Budesonide non-comp unit HCPCS J7626 | not published | not published | $1.73 – $2.61 | 3 |
| Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr HCPCS J1939 | not published | not published | $0.83 – $1.16 | 3 |
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.