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 |
|---|---|---|---|---|
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $15.95 | $29.00 | $7.24 – $78.57 | 5 |
| Ghs protein, misc fluid CPT 84160 | $18.70 | $34.00 | $4.21 – $32.58 | 5 |
| Ghs protoporphyrins fract CPT 84202 | $18.70 | $34.00 | $10.76 – $116.66 | 5 |
| Ghs pr without cont pulse ox CPT 94625 | $147.95 | $269.00 | $42.98 – $57.30 | 2 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | $14.30 | $26.00 | $9.19 – $99.58 | 5 |
| Ghs quinidine CPT 80194 | $23.65 | $43.00 | $10.95 – $118.77 | 5 |
| Ghs refill of implantable pump CPT 95990 | not published | not published | $240.63 – $2,036.00 | 3 |
| Ghs removal intranasal foreign body CPT 30300 | $402.60 | $732.00 | $96.93 – $4,198.00 | 4 |
| Ghs removal pharyngeal foreign body CPT 42809 | not published | not published | $325.44 – $4,198.00 | 4 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | not published | not published | $1,171.42 – $4,982.00 | 4 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | $4,177.25 | $7,595.00 | $2,383.65 – $9,052.00 | 4 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | $17.60 | $32.00 | $11.92 – $47.30 | 5 |
| Ghs reticulocyte count CPT 85044 | not published | not published | $3.23 – $34.99 | 5 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | not published | not published | $10.43 – $97.49 | 5 |
| Ghs sedimentation rate CPT 85651 | not published | not published | $3.20 – $28.85 | 5 |
| Ghs semen analysis fert CPT 89320 | not published | not published | $9.23 – $97.99 | 5 |
| Ghs semen analysis, post-vas CPT 89300 | not published | not published | $7.38 – $72.59 | 5 |
| Ghs sensitivity (per antimicro) CPT 87184 | $48.95 | $89.00 | $5.61 – $56.08 | 5 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $1,217.70 | $2,214.00 | $296.15 – $4,198.00 | 4 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $622.60 | $1,132.00 | $296.15 – $4,198.00 | 4 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $1,901.90 | $3,458.00 | $296.15 – $4,198.00 | 4 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $695.20 | $1,264.00 | $296.15 – $4,198.00 | 4 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $621.50 | $1,130.00 | $146.16 – $4,198.00 | 4 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $889.90 | $1,618.00 | $146.16 – $4,198.00 | 4 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $622.05 | $1,131.00 | $146.16 – $4,198.00 | 4 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $2,307.25 | $4,195.00 | $146.16 – $4,198.00 | 4 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $696.85 | $1,267.00 | $146.16 – $4,198.00 | 4 |
| Ghs sleep study unattended CPT 95800 | $940.50 | $1,710.00 | $157.30 – $209.73 | 2 |
| Ghs somatosensory testing lower extremit CPT 95926 | $608.85 | $1,107.00 | $157.30 – $209.73 | 2 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $1,143.45 | $2,079.00 | $625.59 – $834.12 | 2 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | not published | not published | $35.06 – $46.74 | 2 |
| Ghs sphenopalatine ganglion block CPT 64505 | not published | not published | $223.61 – $4,198.00 | 4 |
| Ghs spont nystagmus CPT 92541 | not published | not published | $96.93 – $129.23 | 2 |
| Ghs sp train/fitting sp device - kx CPT 92609 | not published | not published | $75.09 – $100.12 | 2 |
| Ghs st - eval for alt comm CPT 92567 | not published | not published | $27.21 – $36.28 | 2 |
| Ghs strapping shoulder - 29240 CPT 29240 | $447.70 | $814.00 | $96.93 – $4,198.00 | 4 |
| Ghs st - re-eval for alt comm CPT 92597 | $472.45 | $859.00 | $52.09 – $69.45 | 2 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | not published | not published | $34.11 – $45.48 | 2 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | not published | not published | $154.95 – $206.61 | 2 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $677.60 | $1,232.00 | $538.41 – $4,198.00 | 4 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | not published | not published | $296.15 – $4,198.00 | 4 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | not published | not published | $1,130.33 – $4,982.00 | 4 |
| Ghs trypsin (fecal) CPT 84488 | not published | not published | $5.48 – $59.39 | 5 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $1,107.70 | $2,014.00 | $179.70 – $4,198.00 | 4 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $179.70 – $4,198.00 | 4 |
| Ghs urine, hydroxproline total CPT 83505 | not published | not published | $18.22 – $197.72 | 5 |
| Ghs urine, porphyrins quant CPT 84120 | $38.50 | $70.00 | $11.03 – $119.65 | 5 |
| Ghs vaginal delivery only CPT 59409 | $3,038.20 | $5,524.00 | $2,358.24 – $8,124.00 | 4 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | not published | not published | $271.85 – $362.46 | 2 |
| Ghs windowing of cast CPT 29730 | not published | not published | $118.38 – $4,198.00 | 4 |
| Giardia ag if CPT 87269 | not published | not published | $10.21 – $97.49 | 5 |
| Giardia lamblia antibody CPT 86674 | $110.55 | $201.00 | $11.04 – $119.71 | 5 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $173.82 – $472.34 | 3 |
| Gi inhouse confirmation CPT 87045 | $96.80 | $176.00 | $7.08 – $76.75 | 5 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $2,415.31 – $16,624.00 | 4 |
| Gi protein loss CPT 78282 | not published | not published | $291.23 – $388.31 | 3 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | not published | not published | $660.74 – $3,863.00 | 3 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | $677.47 – $903.30 | 2 |
| Gi trc img intral esophagus CPT 91111 | not published | not published | $660.74 – $3,863.00 | 3 |
| Gi wireless capsule measure CPT 91112 | not published | not published | $660.74 – $3,863.00 | 3 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $75.84 – $580.49 | 5 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $46.14 – $353.15 | 5 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $26.25 – $200.92 | 5 |
| Glassia injection HCPCS J0257 | not published | not published | $4.19 – $10.85 | 5 |
| Glaucoma scrn hgh risk direc HCPCS G0117 | not published | not published | $21.07 – $28.09 | 2 |
| Glaucoma scrn hgh risk direc HCPCS G0118 | not published | not published | $27.21 – $36.28 | 2 |
| Glaucoma surgery CPT 66150 | not published | not published | $3,011.20 – $13,962.00 | 4 |
| Glaucoma surgery CPT 66155 | not published | not published | $3,011.20 – $13,962.00 | 4 |
| Glaucoma surgery CPT 66160 | not published | not published | $1,681.25 – $8,124.00 | 4 |
| Glaucoma surgery CPT 66170 | not published | not published | $1,681.25 – $8,124.00 | 4 |
| Glucagon 1 mg solution for injection HCPCS J1610 | not published | not published | $88.00 – $372.00 | 5 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | not published | not published | $96.96 – $275.28 | 5 |
| Glucagon plasma - sendout CPT 82943 | $22.00 | $40.00 | $10.72 – $80.24 | 5 |
| Glucagon tolerance panel CPT 80422 | not published | not published | $34.55 – $374.70 | 5 |
| Glucagon tolerance panel CPT 80424 | not published | not published | $37.88 – $410.69 | 5 |
| Glucagon tolerance test CPT 82946 | not published | not published | $13.33 – $60.41 | 5 |
| Glucose 1 hr post dose CPT 82950 | $52.25 | $95.00 | $3.56 – $38.64 | 5 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | not published | not published | $4.54 – $49.19 | 5 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $5.50 | $10.00 | $2.46 – $19.04 | 5 |
| Glucose blood quantitative CPT 82947 | $35.20 | $64.00 | $2.95 – $31.95 | 5 |
| Glucose body fluid CPT 82945 | $66.55 | $121.00 | $2.95 – $31.95 | 5 |
| Glucose monitoring continual min 72hr pt CPT 95249 | not published | not published | $42.98 – $57.30 | 2 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $106.70 | $194.00 | $9.65 – $104.66 | 5 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $57.75 | $105.00 | $2.94 – $31.88 | 5 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | not published | not published | $0.66 – $1.07 | 3 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | not published | not published | $8.28 – $20.96 | 5 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $89.10 | $162.00 | $13.94 – $151.12 | 5 |
| Gonadotropin hormone panel CPT 80426 | not published | not published | $111.31 – $1,206.92 | 5 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $88.55 | $161.00 | $13.89 – $150.55 | 5 |
| Gonioscopy CPT 92020 | not published | not published | $96.93 – $129.23 | 2 |
| Goniotomy CPT 65820 | not published | not published | $3,011.20 – $13,962.00 | 4 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | not published | not published | $956.32 – $1,394.89 | 3 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | not published | not published | $44.02 – $120.88 | 5 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | not published | not published | $90.66 – $2,261.83 | 5 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | not published | not published | $90.66 – $139.60 | 5 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $2,383.65 – $9,052.00 | 4 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $5,704.08 | $10,371.06 | not published | 0 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $4,436.09 | $8,065.61 | not published | 0 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $26,112.45 | $47,477.18 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | not published | not published | $64.03 – $124.27 | 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.