SSM Health Monroe Hospital
515 22Nd Ave, Monroe, WI · SSM Health · · NPI 1073653523
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 |
|---|---|---|---|---|
| Ureteral embolization/occl CPT 50705 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Ureteral reflux study CPT 78740 | $1,032.35 | $1,877.00 | $388.31 – $526.98 | 2 |
| Ureter endoscopy CPT 50970 | not published | not published | $3,420.00 – $4,743.00 | 3 |
| Ureter endoscopy & biopsy CPT 50955 | not published | not published | $5,208.09 – $8,960.00 | 3 |
| Ureter endoscopy & biopsy CPT 50974 | not published | not published | $4,137.00 – $8,960.00 | 3 |
| Ureter endoscopy & catheter CPT 50972 | not published | not published | $3,420.00 – $8,433.00 | 3 |
| Ureter endoscopy & treatment CPT 50957 | not published | not published | $5,208.09 – $8,960.00 | 3 |
| Ureter endoscopy & treatment CPT 50961 | not published | not published | $5,208.09 – $8,960.00 | 3 |
| Ureter endoscopy & treatment CPT 50976 | not published | not published | $4,137.00 – $8,960.00 | 3 |
| Ureter endoscopy & treatment CPT 50980 | not published | not published | $5,208.09 – $8,960.00 | 3 |
| Ureteroneocystostomy 50780 CPT 50780 | not published | not published | $8,433.00 – $8,701.00 | 2 |
| Ureteroureterostomy 50760 CPT 50760 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $383.35 | $697.00 | $139.39 – $231.76 | 2 |
| Urethrlys transvag with scope CPT 53500 | not published | not published | $3,423.93 – $10,137.00 | 3 |
| Urethrocystography void s&i CPT 74455 | $361.35 | $657.00 | $172.81 – $231.76 | 2 |
| Uric acid blood CPT 84550 | $29.15 | $53.00 | $4.52 – $7.91 | 4 |
| Uric acid urine CPT 84560 | $40.70 | $74.00 | $5.08 – $8.89 | 4 |
| Urinalysis glass test CPT 81020 | not published | not published | $4.70 – $8.23 | 4 |
| Urinalysis microscopic only CPT 81015 | $21.45 | $39.00 | $3.05 – $5.34 | 4 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | not published | not published | $2.17 – $3.80 | 4 |
| Urinalysis (with microscopy) CPT 81001 | $26.95 | $49.00 | $3.17 – $5.55 | 4 |
| Urinalysis (without microscopy) CPT 81003 | $51.70 | $94.00 | $2.25 – $3.94 | 4 |
| Urinary bldr retent nuc study CPT 78730 | not published | not published | $186.08 – $186.08 | 1 |
| Urinary reflex study CPT 51792 | not published | not published | $57.30 – $9,837.00 | 3 |
| Urine Culture Test CPT 87086 | $139.15 | $253.00 | $8.07 – $14.12 | 4 |
| Urine flow measurement 51736 CPT 51736 | not published | not published | $129.23 – $9,837.00 | 3 |
| Urine pregnancy test CPT 81025 | $39.05 | $71.00 | $8.61 – $15.07 | 4 |
| Urine screen for bacteria CPT 81007 | not published | not published | $29.98 – $52.47 | 4 |
| Urine shunt to intestine CPT 50815 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Urine specimen collect mult HCPCS P9615 | not published | not published | $3.57 – $25.00 | 4 |
| Urofollitropin, 75 iu HCPCS J3355 | not published | not published | $161.14 – $161.14 | 1 |
| Urography, antegrade CPT 74425 | $323.40 | $588.00 | $338.87 – $705.69 | 2 |
| Urography inf drip &/or bolus CPT 74410 | not published | not published | $170.37 – $219.44 | 2 |
| Use 1st target lesion CPT 76982 | not published | not published | $101.55 – $177.72 | 2 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | not published | not published | $11.36 – $34.88 | 6 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | not published | not published | $202.65 – $1,057.16 | 2 |
| U/s trtmt, not leiomyomata HCPCS C9734 | not published | not published | $8,701.00 – $12,470.63 | 2 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | not published | not published | $161.65 – $484.96 | 6 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | not published | not published | $147.06 – $441.18 | 6 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | not published | not published | $155.90 – $467.69 | 6 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | not published | not published | $87.78 – $263.34 | 6 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | not published | not published | $65.55 – $196.65 | 6 |
| Vaccine dtap < 7 years im CPT 90700 | not published | not published | $97.20 – $97.20 | 1 |
| Vaccine dtap-hep b-ipv im CPT 90723 | not published | not published | $336.47 – $336.47 | 1 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | not published | not published | $417.00 – $417.00 | 1 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | not published | not published | $1,018.73 – $1,018.73 | 1 |
| Vaccine dtap-ipv/hib im CPT 90698 | not published | not published | $367.50 – $367.50 | 1 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | not published | not published | $99.48 – $99.48 | 1 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | not published | not published | $42.98 – $42.98 | 1 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | not published | not published | $72.16 – $216.47 | 6 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | not published | not published | $362.29 – $362.29 | 1 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | not published | not published | $115.22 – $115.22 | 1 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | not published | not published | $79.25 – $79.25 | 1 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $75.15 – $225.44 | 6 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | not published | not published | $70.38 – $211.13 | 6 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | not published | not published | $177.56 – $532.67 | 6 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | not published | not published | $31.67 – $95.01 | 6 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | not published | not published | $1,004.55 – $1,004.55 | 1 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | not published | not published | $286.21 – $286.21 | 1 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | not published | not published | $83.49 – $250.48 | 6 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | not published | not published | $83.49 – $250.47 | 6 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | not published | not published | $21.86 – $65.57 | 6 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | not published | not published | $22.35 – $67.05 | 6 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | not published | not published | $82.73 – $82.73 | 1 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | not published | not published | $36.85 – $110.55 | 6 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | not published | not published | $10.93 – $32.79 | 6 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | not published | not published | $700.18 – $700.18 | 1 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | not published | not published | $676.90 – $676.90 | 1 |
| Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 | not published | not published | $561.41 – $561.41 | 1 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | not published | not published | $505.16 – $505.16 | 1 |
| Vaccine mmr live subcutaneous CPT 90707 | not published | not published | $309.79 – $309.79 | 1 |
| Vaccine mmrv live subcutaneous CPT 90710 | not published | not published | $907.10 – $907.10 | 1 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | not published | not published | $133.47 – $400.42 | 6 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | not published | not published | $257.99 – $773.97 | 6 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | not published | not published | $261.15 – $783.44 | 6 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | not published | not published | $312.90 – $938.71 | 6 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | not published | not published | $145.73 – $145.73 | 1 |
| Vaccine rabies im CPT 90675 | not published | not published | $317.67 – $864.86 | 6 |
| Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 | not published | not published | $1,002.31 – $1,002.31 | 1 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 | not published | not published | $3,633.78 – $3,633.78 | 1 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im CPT 90381 | not published | not published | $1,816.88 – $1,816.88 | 1 |
| Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im CPT 90679 | not published | not published | $960.50 – $960.50 | 1 |
| Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 | not published | not published | $319.95 – $319.95 | 1 |
| Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 | not published | not published | $322.43 – $322.43 | 1 |
| Vaccine tdap >=7 years im CPT 90715 | not published | not published | $39.07 – $117.21 | 6 |
| Vaccine td preservative free >= 7 years im CPT 90714 | not published | not published | $33.96 – $101.88 | 6 |
| Vaccine typhoid vicps im CPT 90691 | not published | not published | $321.67 – $321.67 | 1 |
| Vaccine varicella live subcutaneous CPT 90716 | not published | not published | $597.45 – $597.45 | 1 |
| Vaccine yellow fever live subcutaneous CPT 90717 | not published | not published | $480.74 – $480.74 | 1 |
| Vaccinia vrs vac 0.3 ml perq CPT 90622 | not published | not published | $0.01 – $0.03 | 3 |
| Vag hys/<250g/rmv tube/rpr entero 58263 CPT 58263 | not published | not published | $4,859.04 – $10,137.00 | 3 |
| Vag hyst incl t/o complex CPT 58291 | not published | not published | $4,859.04 – $15,012.00 | 3 |
| Vag hyst including t/o CPT 58262 | not published | not published | $4,859.04 – $10,137.00 | 3 |
| Vag hyst t/o & repair compl CPT 58292 | not published | not published | $7,202.85 – $16,164.00 | 3 |
| Vag hyst w/enterocele compl 58294 CPT 58294 | not published | not published | $4,859.04 – $15,012.00 | 3 |
| Vag hyst w/enterocele repair CPT 58270 | not published | not published | $4,859.04 – $10,137.00 | 3 |
| Vaginal bx CPT 58999 | not published | not published | $196.38 – $13,723.00 | 3 |
| Vaginal delivery after cesarean delivery 59612 CPT 59612 | not published | not published | $3,144.33 – $8,701.00 | 3 |
| Vaginal Delivery (full care) CPT 59400 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Vaginal hysterectomy CPT 58260 | not published | not published | $4,859.04 – $10,137.00 | 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.