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 |
|---|---|---|---|---|
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $602.25 | $1,095.00 | $63.40 – $277.72 | 3 |
| X-ray thoracic spine 2 views CPT 72070 | $403.70 | $734.00 | $76.16 – $181.84 | 3 |
| X-ray thoracic spine 3 views CPT 72072 | $414.15 | $753.00 | $76.16 – $190.57 | 3 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $297.55 | $541.00 | $63.40 – $158.61 | 3 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $793.65 | $1,443.00 | $63.40 – $205.09 | 3 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $1,119.80 | $2,036.00 | $76.16 – $373.59 | 3 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $371.25 | $675.00 | $63.40 – $161.51 | 3 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $229.35 | $417.00 | $63.40 – $173.14 | 3 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $652.85 | $1,187.00 | $127.78 – $748.37 | 3 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $528.55 | $961.00 | $127.78 – $635.07 | 3 |
| X-ray wrist 2 views (both sides) CPT 73100 | $266.20 | $484.00 | $63.40 – $167.32 | 3 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | not published | not published | $127.78 – $483.97 | 3 |
| Xwrap 1 sq cm HCPCS Q4204 | not published | not published | $90.66 – $7,172.07 | 4 |
| Xylose absorption test blood &/or urine CPT 84620 | not published | not published | $9.68 – $96.37 | 5 |
| Xyntha inj HCPCS J7185 | not published | not published | $1.03 – $2.93 | 5 |
| Yersinia antibody CPT 86793 | not published | not published | $9.89 – $47.30 | 5 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | $51,605.95 | $93,829.00 | not published | 0 |
| Zenith amniotic membrane psc HCPCS Q4253 | not published | not published | $90.66 – $220.95 | 5 |
| Ziconotide injection HCPCS J2278 | not published | not published | $8.09 – $19.25 | 5 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | not published | not published | $1.13 – $2.88 | 5 |
| Zika virus dna/rna amp probe CPT 87662 | not published | not published | $38.48 – $363.69 | 5 |
| Zika virus igm antibody CPT 86794 | not published | not published | $12.64 – $119.40 | 5 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | not published | not published | $5.96 – $13.30 | 3 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | not published | not published | $6.51 – $15.16 | 5 |
| Zolbetuximab-clzb 100 mg intravenous solution HCPCS J1326 | not published | not published | $25.44 – $63.76 | 3 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | not published | not published | $8.30 – $10.36 | 3 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $144.94 – $1,153.74 | 5 |
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.