SSM Health St. Mary's Hospital - Madison
700 South Park St, Madison, WI · SSM Health · · NPI 1902290034
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 |
|---|---|---|---|---|
| Xpos opn fmrl eprst aor uni add-on CPT 34812 | $1,100.00 | $2,000.00 | $4,982.00 – $4,982.00 | 1 |
| X-ray abdomen 1 view CPT 74018 | $355.30 | $646.00 | $63.40 – $146.63 | 3 |
| X-ray abdomen 2 views CPT 74019 | $454.85 | $827.00 | $76.16 – $175.74 | 3 |
| X-ray abdomen >=3 views CPT 74021 | $568.15 | $1,033.00 | $76.16 – $204.84 | 3 |
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $620.95 | $1,129.00 | $76.16 – $228.31 | 3 |
| X-ray acromioclavicular joints without or w/weighted distraction bilateral CPT 73050 | $362.45 | $659.00 | $63.40 – $202.19 | 3 |
| X-ray ankle 2 views (both sides) CPT 73600 | $266.20 | $484.00 | $63.40 – $173.14 | 3 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | $625.35 | $1,137.00 | $254.15 – $588.58 | 3 |
| X-ray assay calculus CPT 82370 | not published | not published | $9.39 – $101.86 | 5 |
| X-ray bone age studies CPT 77072 | $194.15 | $353.00 | $76.16 – $109.21 | 3 |
| X-ray bone length studies CPT 77073 | $504.90 | $918.00 | $76.16 – $176.04 | 3 |
| X-ray bone survey complete CPT 77075 | $805.75 | $1,465.00 | $76.16 – $489.79 | 3 |
| X-ray bone survey infant CPT 77076 | $435.05 | $791.00 | $76.16 – $492.70 | 3 |
| X-ray cervical spine 2-3 views CPT 72040 | $426.80 | $776.00 | $63.40 – $176.04 | 3 |
| X-ray cervical spine 4-5 views CPT 72050 | $554.40 | $1,008.00 | $76.16 – $234.14 | 3 |
| X-ray cervical spine >= 6 views CPT 72052 | $663.30 | $1,206.00 | $76.16 – $306.78 | 3 |
| X-ray clavicle complete (both sides) CPT 73000 | $309.10 | $562.00 | $63.40 – $152.80 | 3 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $871.75 | $1,585.00 | $127.78 – $934.28 | 3 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $1,156.10 | $2,102.00 | $127.78 – $1,320.70 | 3 |
| X-ray elbow 2 views (both sides) CPT 73070 | $266.20 | $484.00 | $63.40 – $155.70 | 3 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $350.90 | $638.00 | $63.40 – $178.94 | 3 |
| Xray endovasc thor ao repr CPT 75956 | $6,463.60 | $11,752.00 | $2,678.07 – $2,678.07 | 1 |
| Xray endovasc thor ao repr CPT 75957 | $1,046.10 | $1,902.00 | $2,293.28 – $2,293.28 | 1 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $518.65 | $943.00 | $127.78 – $530.47 | 3 |
| X-ray exam entire spi 4/5 vw CPT 72083 | not published | not published | $76.16 – $405.55 | 3 |
| X-ray exam entire spi 6/> vw CPT 72084 | not published | not published | $76.16 – $486.88 | 3 |
| X-ray exam of arm infant CPT 73092 | $309.65 | $563.00 | $76.16 – $152.80 | 3 |
| X-ray exam of eye sockets CPT 70200 | not published | not published | $76.16 – $225.44 | 3 |
| X-ray exam of femur 1 CPT 73551 | $245.30 | $446.00 | $63.40 – $155.70 | 3 |
| X-ray exam of jaw joint CPT 70328 | not published | not published | $63.40 – $173.14 | 3 |
| X-ray exam of jaw joint CPT 70332 | $175.45 | $319.00 | $173.82 – $405.55 | 3 |
| X-ray exam of mastoids CPT 70120 | not published | not published | $76.16 – $199.27 | 3 |
| X-ray exam of middle ear CPT 70134 | not published | not published | $271.91 – $530.75 | 3 |
| X-ray exam of penis CPT 74445 | not published | not published | $76.16 – $326.36 | 3 |
| X-ray exam of perineum CPT 74775 | not published | not published | $173.82 – $431.32 | 3 |
| X-ray exam of salivary gland CPT 70380 | $394.90 | $718.00 | $63.40 – $216.68 | 3 |
| X-ray exam of sinuses CPT 70210 | $280.50 | $510.00 | $63.40 – $167.32 | 3 |
| X-ray exam of tear duct CPT 70170 | not published | not published | $173.82 – $285.32 | 3 |
| X-ray exam of teeth CPT 70300 | $80.30 | $146.00 | $63.40 – $84.53 | 3 |
| X-ray exam of teeth CPT 70310 | $231.00 | $420.00 | $173.82 – $231.76 | 3 |
| X-ray exam si joints CPT 72200 | not published | not published | $76.16 – $158.61 | 3 |
| X-ray exam thorac spine4/>vw CPT 72074 | not published | not published | $76.16 – $228.31 | 3 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $342.10 | $622.00 | $63.40 – $155.70 | 3 |
| X-ray facial bones complete > 3 views CPT 70150 | $458.70 | $834.00 | $76.16 – $225.44 | 3 |
| X-ray fallopian tube CPT 74742 | not published | not published | $443.74 – $443.74 | 1 |
| X-ray femur >=2 views (both sides) CPT 73552 | $371.25 | $675.00 | $63.40 – $184.76 | 3 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $220.55 | $401.00 | $63.40 – $196.36 | 3 |
| X-ray foot 2 views (both sides) CPT 73620 | $218.90 | $398.00 | $63.40 – $146.97 | 3 |
| X-ray forearm 2 views (both sides) CPT 73090 | $294.25 | $535.00 | $63.40 – $138.28 | 3 |
| X-ray hand 2 views (both sides) CPT 73120 | $266.20 | $484.00 | $76.16 – $141.17 | 3 |
| X-ray head for orthodontia CPT 70350 | not published | not published | $63.40 – $84.53 | 3 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $299.75 | $545.00 | $63.40 – $152.80 | 3 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $359.15 | $653.00 | $76.16 – $300.97 | 3 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $287.65 | $523.00 | $76.16 – $228.31 | 3 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $436.15 | $793.00 | $76.16 – $271.91 | 3 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $466.95 | $849.00 | $76.16 – $327.10 | 3 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $172.70 | $314.00 | $63.40 – $164.41 | 3 |
| X-ray humerus >= 2 views left CPT 73060 | $342.10 | $622.00 | $63.40 – $164.41 | 3 |
| X-ray joint survey 1 view CPT 77077 | $295.90 | $538.00 | $76.16 – $170.23 | 3 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $294.25 | $535.00 | $63.40 – $181.84 | 3 |
| X-ray knee 3 views (both sides) CPT 73562 | $359.15 | $653.00 | $63.40 – $210.90 | 3 |
| X-ray knee ap standing bilateral CPT 73565 | $261.80 | $476.00 | $63.40 – $219.62 | 3 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $255.75 | $465.00 | $63.40 – $158.61 | 3 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $282.15 | $513.00 | $76.16 – $234.14 | 3 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $523.60 | $952.00 | $76.16 – $266.08 | 3 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | not published | not published | $76.16 – $370.68 | 3 |
| X-ray male genital tract CPT 74440 | not published | not published | $173.82 – $510.13 | 3 |
| X-ray mandible complete > 4 views CPT 70110 | $615.45 | $1,119.00 | $76.16 – $202.19 | 3 |
| X-ray mandible ltd <4 views CPT 70100 | $442.75 | $805.00 | $63.40 – $190.57 | 3 |
| X-ray nasal bones complete > 3 views CPT 70160 | $336.60 | $612.00 | $63.40 – $190.57 | 3 |
| X-ray neck soft tissue CPT 70360 | $243.10 | $442.00 | $63.40 – $158.61 | 3 |
| X-ray nose to rectum for foreign body child CPT 76010 | $377.85 | $687.00 | $63.40 – $135.36 | 3 |
| X-ray of mammary ducts CPT 77054 | $569.25 | $1,035.00 | $173.82 – $437.50 | 3 |
| X-ray optic foramina CPT 70190 | not published | not published | $63.40 – $196.36 | 3 |
| X-ray pelvis 1-2 views CPT 72170 | $315.15 | $573.00 | $76.16 – $184.76 | 3 |
| X-ray pelvis complete > 3 views CPT 72190 | $473.55 | $861.00 | $76.16 – $219.62 | 3 |
| Xray place dist ext thor ao CPT 75959 | $915.75 | $1,665.00 | $1,334.23 – $1,334.23 | 1 |
| Xray place prox ext thor ao CPT 75958 | $1,046.10 | $1,902.00 | $1,521.80 – $1,521.80 | 1 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $801.35 | $1,457.00 | $254.15 – $2,843.03 | 3 |
| X-ray ribs 2 views left CPT 71100 | $398.20 | $724.00 | $63.40 – $173.14 | 3 |
| X-ray ribs 3 views bilateral CPT 71110 | $485.10 | $882.00 | $76.16 – $190.57 | 3 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $519.20 | $944.00 | $76.16 – $181.84 | 3 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $519.75 | $945.00 | $76.16 – $251.56 | 3 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $419.10 | $762.00 | $76.16 – $187.67 | 3 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $372.35 | $677.00 | $63.40 – $155.70 | 3 |
| X-ray scapula complete (both sides) CPT 73010 | $468.60 | $852.00 | $76.16 – $167.32 | 3 |
| X-ray sella turcica CPT 70240 | not published | not published | $63.40 – $161.51 | 3 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $211.75 | $385.00 | $63.40 – $120.85 | 3 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $491.70 | $894.00 | $63.40 – $199.27 | 3 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $521.40 | $948.00 | $231.21 – $530.75 | 3 |
| X-ray skull < 4 views CPT 70250 | $376.75 | $685.00 | $76.16 – $187.67 | 3 |
| X-ray skull > 4 views complete CPT 70260 | $551.10 | $1,002.00 | $76.16 – $225.44 | 3 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $943.25 | $1,715.00 | $76.16 – $492.70 | 3 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $746.90 | $1,358.00 | $127.78 – $649.57 | 3 |
| X-ray small intestine follow-through study CPT 74248 | $1,504.80 | $2,736.00 | $384.08 – $384.08 | 1 |
| X-ray spine single view CPT 72020 | $268.95 | $489.00 | $63.40 – $115.03 | 3 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $366.30 | $666.00 | $63.40 – $199.27 | 3 |
| X-ray sternum > 2 views CPT 71120 | $326.15 | $593.00 | $63.40 – $155.70 | 3 |
| X-ray surgical specimen CPT 76098 | $288.20 | $524.00 | $68.54 – $530.75 | 3 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $662.75 | $1,205.00 | $127.78 – $818.10 | 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.