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 |
|---|---|---|---|---|
| Tissue transglutaminase iga CPT 86364 | $62.70 | $114.00 | $8.65 – $67.26 | 5 |
| Tl-201 thallium diag per mci HCPCS A9505 | $57.20 | $104.00 | not published | 0 |
| Tlh uterus 250 g or less CPT 58570 | not published | not published | $8,030.21 – $16,582.00 | 4 |
| Tlh uterus over 250 g CPT 58572 | not published | not published | $8,030.21 – $16,582.00 | 4 |
| Tlh w/t/o 250 g or less CPT 58571 | not published | not published | $8,030.21 – $16,582.00 | 4 |
| Tlh w/t/o uterus over 250 g CPT 58573 | not published | not published | $8,030.21 – $16,582.00 | 4 |
| Tmvr w/prosthetic ring 33426 CPT 33426 | not published | not published | $16,352.00 – $16,352.00 | 1 |
| Tmvr w/rad reconst w or without ring 33427 CPT 33427 | not published | not published | $16,352.00 – $16,352.00 | 1 |
| Tnot opn elbw to sho ea tdn CPT 24310 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 | not published | not published | $2.32 – $4.67 | 3 |
| Tobramycin non-comp unit HCPCS J7682 | not published | not published | $21.46 – $29.60 | 3 |
| Tobramycin peak therapeutic drug level CPT 80200 | $158.95 | $289.00 | $12.10 – $128.18 | 5 |
| Tocilizumab 162 mg/0.9 ml subcutaneous pen injector HCPCS J3262 | not published | not published | $4.06 – $11.04 | 5 |
| Tocilizumab for covid-19 HCPCS Q0249 | not published | not published | $10.98 – $14.38 | 3 |
| Toe joint transfer CPT 26556 | not published | not published | $5,481.64 – $16,582.00 | 4 |
| Tomosynthesis breast diagnostic left HCPCS G0279 | not published | not published | $9.12 – $196.61 | 3 |
| Tomosynthesis breast screen bilateral CPT 77063 | not published | not published | $16.80 – $198.24 | 3 |
| Tone decay hearing test CPT 92563 | not published | not published | $28.22 – $37.62 | 2 |
| Tongue and neck surgery CPT 41135 | not published | not published | $6,798.00 – $9,811.00 | 2 |
| Tongue base vol reduction CPT 41530 | not published | not published | $2,504.63 – $6,798.00 | 4 |
| Tongue biopsy; posterior one-third 41105 CPT 41105 | not published | not published | $2,504.63 – $4,321.00 | 4 |
| Tongue jaw & neck surgery CPT 41155 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Tongue mouth jaw surgery CPT 41150 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Tongue mouth neck surgery CPT 41153 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Tongue removal neck surgery CPT 41145 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Tongue suspension CPT 41512 | not published | not published | $4,472.08 – $14,543.00 | 4 |
| Tongue to lip surgery CPT 41510 | not published | not published | $2,504.63 – $4,321.00 | 4 |
| Tonsillectomy (age 12+) CPT 42826 | not published | not published | $2,504.63 – $6,798.00 | 4 |
| Tonsillectomy (child under 12) CPT 42825 | not published | not published | $4,472.08 – $9,811.00 | 4 |
| Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution HCPCS J9351 | not published | not published | $1.84 – $3.29 | 3 |
| Topotecan oral HCPCS J8705 | not published | not published | $94.00 – $237.31 | 5 |
| Toripalimab-tpzi 240 mg/6 ml (40 mg/ml) intravenous solution HCPCS J3263 | not published | not published | $30.67 – $75.05 | 5 |
| Tot abd hyst/par vag/pelv node sam 58200 CPT 58200 | not published | not published | $14,906.00 – $14,906.00 | 1 |
| Total hip arthroplasty CPT 27132 | not published | not published | $9,698.86 – $24,224.00 | 4 |
| Total Hip Replacement CPT 27130 | not published | not published | $9,698.86 – $24,224.00 | 4 |
| Total hysterectomy CPT 58150 | not published | not published | $7,919.00 – $14,906.00 | 2 |
| Total Knee Replacement CPT 27447 | not published | not published | $9,698.86 – $24,224.00 | 4 |
| Total lung lavage CPT 32997 | not published | not published | $3,232.00 – $10,498.00 | 2 |
| Total ob care failed vbac 59618 CPT 59618 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Total tau CPT 84394 | $275.00 | $500.00 | $96.69 – $128.92 | 2 |
| Tot disc arthrp 1ntrspc crv CPT 22856 | not published | not published | $13,245.76 – $17,661.01 | 4 |
| Tot disc arthrp 1ntrspc lmbr CPT 22857 | not published | not published | $13,245.76 – $24,224.00 | 4 |
| Tot disc arthrp 2ntrspc lmbr CPT 22860 | not published | not published | $13,711.00 – $13,711.00 | 1 |
| Tot disc arthrp ant appr disc 2nd level cervi 22858 CPT 22858 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Tot esophagectomy without thoracotomy 43107 CPT 43107 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Tot estradiol response panel CPT 80415 | not published | not published | $41.92 – $444.41 | 5 |
| Toxoplasma antibody igg CPT 86777 | $16.50 | $30.00 | $10.79 – $114.45 | 5 |
| Toxoplasma antibody igm CPT 86778 | $16.50 | $30.00 | $10.81 – $101.62 | 5 |
| Tp53 gene full gene sequence CPT 81351 | $2,544.30 | $4,626.00 | $481.39 – $3,746.79 | 5 |
| Tp53 gene known famil vrnt CPT 81353 | not published | not published | $231.00 – $1,797.95 | 5 |
| Tp53 gene trgt sequence alys CPT 81352 | $1,082.40 | $1,968.00 | $247.13 – $1,923.50 | 5 |
| Tpmt gene com vrnts CPT 81335 | $218.35 | $397.00 | $131.11 – $981.20 | 5 |
| Tprnl balo cntnc dev adjmt CPT 53454 | not published | not published | $188.75 – $4,074.00 | 4 |
| Tprnl balo cntnc dev bi CPT 53451 | not published | not published | $9,966.87 – $24,224.00 | 4 |
| Tprnl balo cntnc dev rmvl ea CPT 53453 | not published | not published | $2,662.91 – $10,498.00 | 4 |
| Tprnl balo cntnc dev uni CPT 53452 | not published | not published | $6,798.00 – $9,811.00 | 4 |
| Tprnl plmt biodegrdabl matrl CPT 55874 | not published | not published | $4,050.52 – $16,582.00 | 4 |
| Trabectedin 1 mg intravenous solution HCPCS J9352 | not published | not published | $307.86 – $727.83 | 5 |
| Trabeculoplasty laser surg CPT 65855 | not published | not published | $415.49 – $4,074.00 | 4 |
| Trachelectomy (cervicectomy) 57530 CPT 57530 | not published | not published | $3,779.05 – $6,798.00 | 4 |
| Tracheobrnchsc thru est trachs incisn CPT 31615 | not published | not published | $407.43 – $4,074.00 | 4 |
| Tracheo-esophagoplasty cong CPT 43314 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Tracheoplasty intrathoracic CPT 31760 | not published | not published | $9,811.00 – $9,811.00 | 1 |
| Tracheostoma revision; simple, without flap rotation CPT 31613 | not published | not published | $2,504.63 – $6,798.00 | 4 |
| Train for caregiver add 15 HCPCS G0540 | not published | not published | $15.69 – $20.92 | 2 |
| Transabdom amnioinfus w/us CPT 59070 | not published | not published | $230.21 – $4,074.00 | 4 |
| Transab esoph hiat hern repair 43332 CPT 43332 | not published | not published | $14,906.00 – $14,906.00 | 1 |
| Transab esoph hiat hern rpr CPT 43333 | not published | not published | $14,906.00 – $14,906.00 | 1 |
| Transcath biopsy CPT 37200 | $2,488.20 | $4,524.00 | $4,203.64 – $16,582.00 | 4 |
| Transcath closure of asd CPT 93580 | not published | not published | $13,711.00 – $38,635.00 | 4 |
| Transcath closure of vsd CPT 93581 | not published | not published | $13,711.00 – $38,635.00 | 4 |
| Transcatheter bx s&i CPT 75970 | $1,205.60 | $2,192.00 | $3,127.28 – $3,127.28 | 1 |
| Transcath mv repair addl prosthesis CPT 33419 | not published | not published | $1,704.00 – $1,704.00 | 1 |
| Transcath mv repair init prosthesis CPT 33418 | not published | not published | $10,498.00 – $10,498.00 | 1 |
| Transcath occlusion cns CPT 61624 | not published | not published | $13,848.46 – $24,224.00 | 4 |
| Transcath occlusion non-cns CPT 61626 | not published | not published | $8,720.95 – $24,224.00 | 4 |
| Trans cath replace aortic valve 33366 CPT 33366 | not published | not published | $16,352.00 – $16,352.00 | 1 |
| Transcath rmvl perm ldss pmkr rv CPT 33275 | not published | not published | $2,385.29 – $10,498.00 | 4 |
| Transcochlear approach/skull CPT 61596 | not published | not published | $18,190.00 – $18,190.00 | 1 |
| Transcondylar approach/skull CPT 61597 | not published | not published | $18,190.00 – $18,190.00 | 1 |
| Transcrv abltj utrn fibrd rf CPT 58580 | not published | not published | $5,601.92 – $16,352.00 | 3 |
| Transcutaneous carboxyhb CPT 88740 | not published | not published | $7.03 – $39.86 | 5 |
| Transcutaneous hgb 88738 CPT 88738 | not published | not published | $3.76 – $39.86 | 5 |
| Transcutaneous methb CPT 88741 | not published | not published | $7.03 – $39.86 | 5 |
| Transect artery sinus CPT 61611 | not published | not published | $4,321.00 – $4,321.00 | 1 |
| Transect pulmonary artery CPT 33922 | not published | not published | $15,466.00 – $15,466.00 | 1 |
| Transfer of abdominal muscle CPT 27100 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Transfer of embryo CPT 58976 | not published | not published | $230.21 – $4,074.00 | 4 |
| Transfer of iliopsoas muscle CPT 27110 | not published | not published | $5,481.64 – $18,190.00 | 4 |
| Transfer of iliopsoas muscle CPT 27111 | not published | not published | $2,471.80 – $14,543.00 | 4 |
| Transfer of spinal muscle CPT 27105 | not published | not published | $2,471.80 – $14,543.00 | 4 |
| Transferrin CPT 84466 | $18.70 | $34.00 | $9.57 – $101.52 | 5 |
| Transfer skin pedicle flap CPT 15650 | not published | not published | $1,558.69 – $4,321.00 | 4 |
| Transfer tendon to pelvis CPT 27098 | not published | not published | $2,471.80 – $10,498.00 | 4 |
| Transfusion blood/blood component(s) CPT 36430 | $1,373.35 | $2,497.00 | $333.28 – $4,074.00 | 4 |
| Transorl lwr esophgl myotomy CPT 43497 | not published | not published | $4,586.20 – $10,498.00 | 4 |
| Transperi needle place pros CPT 55875 | not published | not published | $4,050.52 – $14,543.00 | 4 |
| Transpetrosal approach/skull CPT 61598 | not published | not published | $18,190.00 – $18,190.00 | 1 |
| Transpl allograft pancreas CPT 48554 | not published | not published | $13,711.00 – $13,711.00 | 1 |
| Transplantation heart/lung CPT 33935 | not published | not published | $13,711.00 – $13,711.00 | 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.