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 |
|---|---|---|---|---|
| Loudness balance test CPT 92562 | not published | not published | $157.30 – $209.73 | 2 |
| Low back disk surgery CPT 63030 | not published | not published | $5,286.15 – $19,855.00 | 4 |
| Low cost skin substitute app HCPCS C5271 | not published | not published | $2,036.00 – $4,198.00 | 2 |
| Low cost skin substitute app HCPCS C5273 | not published | not published | $3,863.00 – $4,982.00 | 2 |
| Low cost skin substitute app HCPCS C5275 | not published | not published | $2,036.00 – $4,198.00 | 2 |
| Low cost skin substitute app HCPCS C5277 | not published | not published | $2,036.00 – $4,198.00 | 2 |
| Low cost skin substitute app HCPCS C5272 | not published | not published | $2,036.00 – $2,036.00 | 1 |
| Low cost skin substitute app HCPCS C5274 | not published | not published | $2,036.00 – $2,036.00 | 1 |
| Low cost skin substitute app HCPCS C5276 | not published | not published | $2,036.00 – $2,036.00 | 1 |
| Low cost skin substitute app HCPCS C5278 | not published | not published | $2,036.00 – $2,036.00 | 1 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,717.55 | $4,941.00 | $127.78 – $1,678.03 | 3 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,491.50 | $4,530.00 | $254.15 – $1,355.57 | 3 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $2,265.45 | $4,119.00 | $76.16 – $1,047.60 | 3 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $3,009.05 | $5,471.00 | $254.15 – $2,132.97 | 3 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,757.70 | $5,014.00 | $254.15 – $1,871.50 | 3 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,506.90 | $4,558.00 | $173.82 – $1,198.66 | 3 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $454.85 | $827.00 | $76.16 – $190.57 | 3 |
| Lower jaw bone graft CPT 21215 | not published | not published | $4,312.59 – $16,624.00 | 4 |
| Low frequency non-thermal Ultrasound CPT 97610 | not published | not published | $146.16 – $194.88 | 2 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $7,743.83 – $21,366.00 | 4 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $7,743.83 – $20,778.00 | 4 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $7,743.83 – $20,778.00 | 4 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $7,743.83 – $20,778.00 | 4 |
| Lso r post pnl sj-t9 pre cst HCPCS L0630 | $734.30 | $1,335.10 | not published | 0 |
| Lso s/c shell/panel prefab HCPCS L0639 | $4,269.85 | $7,763.36 | not published | 0 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $16.49 – $178.81 | 5 |
| Lumbar diskogram s&i CPT 72295 | $1,260.05 | $2,291.00 | $449.12 – $1,896.75 | 3 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $12,773.37 – $20,778.00 | 4 |
| Lumizyme injection HCPCS J0221 | not published | not published | $158.35 – $392.57 | 5 |
| Lung function test (mbc/mvv) CPT 94200 | not published | not published | $42.98 – $57.30 | 2 |
| Lung Function Test (Spirometry) CPT 94010 | $162.80 | $296.00 | $157.30 – $209.73 | 2 |
| Lung perfusion imaging CPT 78580 | $1,065.35 | $1,937.00 | $291.23 – $1,716.36 | 3 |
| Lung transplant double CPT 32853 | not published | not published | $14,021.00 – $14,021.00 | 1 |
| Lung transplant single CPT 32851 | not published | not published | $14,021.00 – $14,021.00 | 1 |
| Lung transplant with bypass CPT 32852 | not published | not published | $14,021.00 – $14,021.00 | 1 |
| Lung transplant with bypass CPT 32854 | not published | not published | $14,021.00 – $14,021.00 | 1 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $20,778.00 – $20,778.00 | 1 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | not published | not published | $161.96 – $391.64 | 5 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | not published | not published | $32.64 – $79.73 | 5 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | $365.20 | $664.00 | not published | 0 |
| Lutetium lu 177 vipivotide HCPCS A9607 | $581.08 | $1,056.51 | not published | 0 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $21.07 – $4,198.00 | 4 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $15.04 – $163.11 | 5 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $5,954.31 – $21,366.00 | 4 |
| Lymphatics/lymph node imaging CPT 78195 | $1,414.60 | $2,572.00 | $395.55 – $2,514.09 | 3 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $27.42 – $459.16 | 5 |
| Lymphocyte transformation mitogen CPT 86353 | not published | not published | $36.77 – $398.75 | 5 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $142.13 – $425.25 | 5 |
| Lymphocytotoxicity assay CPT 86806 | not published | not published | $35.69 – $387.07 | 5 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $456.99 – $1,674.76 | 3 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $1,146.77 – $1,607.95 | 3 |
| Lymph vessel x-ray trunk CPT 75805 | not published | not published | $1,788.33 – $3,066.96 | 3 |
| Lymph vessel x-ray trunk CPT 75807 | not published | not published | $1,727.26 – $3,066.96 | 3 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $392.90 – $4,198.00 | 4 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $2,358.24 – $8,124.00 | 4 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $1,522.84 – $8,124.00 | 4 |
| Lyumjev for insulin pump use HCPCS J1813 | not published | not published | $22.23 – $29.02 | 3 |
| Macro exam dissect molec study ea CPT 88387 | not published | not published | $52.27 – $52.27 | 1 |
| Macroscopic exam arthropod CPT 87168 | $84.70 | $154.00 | $3.20 – $34.76 | 5 |
| Macroscopic exam parasite CPT 87169 | $89.10 | $162.00 | $3.23 – $34.76 | 5 |
| Magnesium CPT 83735 | $71.50 | $130.00 | $5.02 – $54.44 | 5 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | not published | not published | $0.71 – $0.95 | 3 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $173.82 – $2,516.46 | 3 |
| Malaria antibody CPT 86750 | not published | not published | $9.89 – $107.28 | 5 |
| Male sling procedure CPT 53440 | not published | not published | $9,611.43 – $27,690.00 | 4 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $6,044.00 – $6,044.00 | 1 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $1,171.42 – $4,982.00 | 4 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $1,171.42 – $4,982.00 | 4 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $168.30 | $306.00 | $96.93 – $129.23 | 2 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $266.20 | $484.00 | $96.93 – $129.23 | 2 |
| Manipulation of hip joint CPT 27275 | not published | not published | $1,171.42 – $4,982.00 | 4 |
| Manipulation of spine CPT 22505 | not published | not published | $1,171.42 – $4,982.00 | 4 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $179.70 – $4,198.00 | 4 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | not published | not published | $3.28 – $4.70 | 3 |
| Manual diff wbc count b-coat CPT 85009 | not published | not published | $3.80 – $30.27 | 5 |
| Mapping io sentinel lymph node CPT 38900 | not published | not published | $2,036.00 – $2,036.00 | 1 |
| Map tachycard site(s) CPT 93609 | $1,810.60 | $3,292.00 | $2,036.00 – $2,036.00 | 1 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | not published | not published | $42.33 – $95.86 | 5 |
| Marker biop eviva buckle ss HCPCS A4648 | $825.52 | $1,500.94 | not published | 0 |
| Marsupialization liver lesion 47300 CPT 47300 | not published | not published | $6,044.00 – $6,044.00 | 1 |
| Mastectomy partial CPT 19301 | not published | not published | $2,852.39 – $8,124.00 | 4 |
| Mast mod rad CPT 19307 | not published | not published | $4,837.36 – $17,504.00 | 4 |
| Mastoidectomy CPT 69501 | not published | not published | $4,312.59 – $16,624.00 | 4 |
| Mastoidectomy complete 69502 CPT 69502 | not published | not published | $4,312.59 – $13,962.00 | 4 |
| Mastoids complete CPT 70130 | not published | not published | $76.16 – $300.97 | 3 |
| Mastoid surgery revision CPT 69603 | not published | not published | $4,312.59 – $16,624.00 | 4 |
| Mastopexy CPT 19316 | not published | not published | $4,837.36 – $17,504.00 | 4 |
| Mast radical CPT 19305 | not published | not published | $17,504.00 – $17,504.00 | 1 |
| Mast rad urban type CPT 19306 | not published | not published | $17,504.00 – $17,504.00 | 1 |
| Mast simple complete CPT 19303 | not published | not published | $4,837.36 – $17,504.00 | 4 |
| Matrion 1 sq cm HCPCS Q4201 | not published | not published | $90.66 – $157.31 | 5 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | not published | not published | $27.52 – $120.88 | 5 |
| M.avium-intra dna amp prob CPT 87561 | not published | not published | $26.32 – $285.37 | 5 |
| M.avium-intra dna dir prob CPT 87560 | not published | not published | $20.47 – $163.11 | 5 |
| M.avium-intra dna quant CPT 87562 | not published | not published | $32.13 – $348.37 | 5 |
| Maxillofacial fixation CPT 21100 | not published | not published | $4,312.59 – $16,624.00 | 4 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $24.75 | $45.00 | $10.84 – $117.62 | 5 |
| Mayo aathr protein s free CPT 85306 | $86.35 | $157.00 | $11.49 – $116.18 | 5 |
| Mayo activated protein c resistance assay CPT 85307 | $86.35 | $157.00 | $11.49 – $116.18 | 5 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $317.90 | $578.00 | $28.93 – $230.27 | 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.