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 |
|---|---|---|---|---|
| Chg pr pul rehab for copd patients CPT 94626 | $220.00 | $400.00 | $57.30 – $57.30 | 1 |
| Chg radiologic exam esophagus double contrast CPT 74221 | $548.90 | $998.00 | $170.37 – $195.18 | 2 |
| Chimerism anal no cell selec CPT 81267 | not published | not published | $207.46 – $363.06 | 4 |
| Chimerism anal w/cell select CPT 81268 | not published | not published | $260.79 – $456.38 | 4 |
| Chlamydia culture CPT 87110 | $97.35 | $177.00 | $19.60 – $34.30 | 4 |
| Chlamydia trachomatis ag if CPT 87270 | not published | not published | $11.98 – $20.97 | 4 |
| Chlamydia type CPT 87140 | $47.30 | $86.00 | $5.57 – $9.75 | 4 |
| Chlnggrphy intraop addl s&i CPT 74301 | not published | not published | $54.04 – $54.04 | 1 |
| Chloramphenicol sodium injec HCPCS J0720 | not published | not published | $158.94 – $158.94 | 1 |
| Chloride CPT 82435 | $27.50 | $50.00 | $4.60 – $8.05 | 4 |
| Chloride 24 hour urine CPT 82436 | $33.55 | $61.00 | $5.75 – $10.06 | 4 |
| Chloroprocaine hcl injection HCPCS J2401 | not published | not published | $0.04 – $0.12 | 6 |
| Chloroprocaine opht gel, 1mg HCPCS J2403 | not published | not published | $0.60 – $1.81 | 6 |
| Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 | not published | not published | $32.48 – $97.45 | 6 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | not published | not published | $29.04 – $87.11 | 6 |
| Chmotx admn plrl cav thrcnts CPT 96440 | not published | not published | $320.84 – $320.84 | 1 |
| Cholangiogram percutaneous compl CPT 47532 | $3,005.75 | $5,465.00 | $3,477.76 – $10,137.00 | 3 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $201.30 | $366.00 | $91.31 – $91.31 | 1 |
| Cholecystectomy expl duct 47612 CPT 47612 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Cholecystectomy w/cholangiography 47605 CPT 47605 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Cholecystoenterostomy direct 47720 CPT 47720 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Cholecystostomy complete w/supervision & interpretation CPT 47490 | $6,765.55 | $12,301.00 | $3,477.76 – $10,137.00 | 3 |
| Cholesterol CPT 82465 | $27.50 | $50.00 | $4.35 – $7.61 | 4 |
| Cholesterol body fluid CPT 84999 | $97.90 | $178.00 | not published | 0 |
| Cholesterol (Lipid) Test CPT 80061 | $95.15 | $173.00 | $13.39 – $23.43 | 4 |
| Choline c-11 HCPCS A9515 | not published | not published | $2,516.43 – $5,616.35 | 2 |
| Cholinesterase CPT 82480 | not published | not published | $7.87 – $13.77 | 4 |
| Cholinesterase challenge CPT 95857 | not published | not published | $209.73 – $209.73 | 1 |
| Chorion biopsy CPT 59015 | not published | not published | $894.65 – $4,217.00 | 3 |
| Chorionic gonadotropin/1000u HCPCS J0725 | not published | not published | $18.25 – $54.76 | 6 |
| Chrom analysis CPT 88273 | $339.90 | $618.00 | $34.81 – $60.92 | 4 |
| Chromatogram assay sugars CPT 84375 | not published | not published | $39.00 – $68.25 | 4 |
| Chromatography CPT 83021 | $74.25 | $135.00 | $18.06 – $31.61 | 4 |
| Chromogenic substrate assay CPT 85130 | not published | not published | $11.89 – $20.81 | 4 |
| Chromo high res and frag x - sendout CPT 81243 | $240.62 | $437.50 | $57.04 – $99.82 | 4 |
| Chromosome analys amniotic CPT 88269 | not published | not published | $173.66 – $303.91 | 4 |
| Chromosome analysis 100 CPT 88249 | not published | not published | $173.17 – $303.05 | 4 |
| Chromosome analysis 15-20 cell count CPT 88262 | $2,496.45 | $4,539.00 | $125.49 – $219.61 | 4 |
| Chromosome analysis 20-25 CPT 88245 | not published | not published | $173.17 – $303.05 | 4 |
| Chromosome analysis 45 CPT 88263 | $2,744.50 | $4,990.00 | $150.29 – $263.01 | 4 |
| Chromosome analysis 5 CPT 88261 | not published | not published | $264.34 – $462.60 | 4 |
| Chromosome analysis 50-100 CPT 88248 | not published | not published | $173.17 – $303.05 | 4 |
| Chromosome analys placenta CPT 88267 | not published | not published | $188.57 – $330.00 | 4 |
| Chromosome banding study CPT 88283 | not published | not published | $68.60 – $120.05 | 4 |
| Chromosome count additional CPT 88285 | not published | not published | $26.91 – $47.09 | 4 |
| Chromosome karyotype study CPT 88280 | not published | not published | $33.47 – $58.57 | 4 |
| Chromosome study additional CPT 88289 | not published | not published | $34.43 – $60.25 | 4 |
| Chronic urticaria - sendout CPT 86343 | not published | not published | $12.46 – $21.81 | 4 |
| Chylomicron screen, bf - sendout CPT 82664 | $240.62 | $437.50 | $61.50 – $107.63 | 4 |
| Cidofovir injection HCPCS J0740 | not published | not published | $391.43 – $1,420.68 | 6 |
| Cilastatin sodium injection HCPCS J0743 | not published | not published | $7.34 – $22.01 | 6 |
| Ciliary transsleral therapy CPT 66710 | not published | not published | $2,309.33 – $8,701.00 | 3 |
| Ciltacabtagene car-pos t HCPCS Q2056 | not published | not published | $553,169.30 – $1,506,003.43 | 6 |
| Cinacalcet 30 mg tablet HCPCS J0604 | not published | not published | $2.69 – $2.69 | 1 |
| Cine/video x-rays CPT 76120 | $374.00 | $680.00 | $101.55 – $185.08 | 2 |
| Cine/video x-rays add-on CPT 76125 | not published | not published | $86.57 – $86.57 | 1 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | not published | not published | $1.08 – $6.29 | 6 |
| Ciprofloxacin otic susp 6 mg HCPCS J7342 | not published | not published | $92.52 – $92.52 | 1 |
| Circum 28 days or older CPT 54161 | not published | not published | $2,030.46 – $8,701.00 | 3 |
| Circumcise/surg/28 days or < 54160 CPT 54160 | not published | not published | $677.31 – $8,701.00 | 3 |
| Circumcision (newborn) CPT 54150 | $136.40 | $248.00 | $2,030.46 – $8,701.00 | 3 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | not published | not published | $2.86 – $8.58 | 6 |
| C-kit mutation liquid tumor - sendout CPT 81272 | $917.40 | $1,668.00 | $329.51 – $576.64 | 4 |
| Cladribine 10 mg/10 ml intravenous solution HCPCS J9065 | not published | not published | $8.19 – $27.77 | 6 |
| Claviculectomy partial CPT 23120 | not published | not published | $3,178.20 – $10,137.00 | 3 |
| Claviculectomy total CPT 23125 | not published | not published | $3,178.20 – $10,137.00 | 3 |
| Clean out mastoid cavity CPT 69222 | not published | not published | $523.87 – $4,217.00 | 3 |
| Clearance of airways CPT 31720 | not published | not published | $212.70 – $4,217.00 | 3 |
| Clearance of tear duct CPT 68530 | not published | not published | $308.31 – $4,217.00 | 3 |
| C-lens fitg corneosclrl lens CPT 92313 | not published | not published | $129.23 – $129.23 | 1 |
| C-lens fitg tech aphakia 1 CPT 92315 | not published | not published | $129.23 – $129.23 | 1 |
| C-lens fitg tech aphakia ou CPT 92316 | not published | not published | $129.23 – $129.23 | 1 |
| C-lens fitg tech corneosclrl CPT 92317 | not published | not published | $36.28 – $36.28 | 1 |
| Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 | not published | not published | $1.61 – $4.84 | 6 |
| Clip ligating vesolock lg HCPCS C1760 | $296.72 | $539.50 | not published | 0 |
| Clitoroplasty intersex state CPT 56805 | not published | not published | $3,144.33 – $8,701.00 | 3 |
| Clofarabine 1 mg/ml intravenous solution HCPCS J9027 | not published | not published | $10.99 – $43.59 | 6 |
| Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 | not published | not published | $16.20 – $48.61 | 6 |
| Close bronchial fistula 32815 CPT 32815 | not published | not published | $13,176.00 – $13,176.00 | 1 |
| Closed carpo/metacarpal disl thumb w/manip CPT 26641 | $352.55 | $641.00 | $239.60 – $4,217.00 | 3 |
| Closed carpo/metacarpal fx disl thumb w/manip CPT 26645 | not published | not published | $1,561.89 – $4,743.00 | 3 |
| Closed treatment of femoral fracture proximal end neck; wi CPT 27232 | not published | not published | $1,561.89 – $4,217.00 | 3 |
| Closed tx/acetabululm without manip 27220 CPT 27220 | not published | not published | $239.60 – $4,217.00 | 3 |
| Closed tx humerus fx with manip 23605 CPT 23605 | $149.05 | $271.00 | $1,561.89 – $8,701.00 | 3 |
| Closed tx humerus fx without manip 23600 CPT 23600 | not published | not published | $239.60 – $4,217.00 | 3 |
| Closed tx humerus fx w/manip 24505 CPT 24505 | $2,013.55 | $3,661.00 | $1,561.89 – $4,743.00 | 3 |
| Closed tx metatarsophalangeal jnt disl without anes CPT 28630 | $174.90 | $318.00 | $239.60 – $4,217.00 | 3 |
| Closed tx nose/jaw fx CPT 21345 | not published | not published | $1,507.10 – $4,743.00 | 3 |
| Closed tx orbit without manipulj CPT 21400 | not published | not published | $523.87 – $4,217.00 | 3 |
| Closed tx orbit w/manipulj CPT 21401 | not published | not published | $1,507.10 – $4,743.00 | 3 |
| Closed tx post hip arthroplasty disloc w/anes 27266 CPT 27266 | $1,381.05 | $2,511.00 | $1,561.89 – $4,743.00 | 3 |
| Closed tx septal&nose fx CPT 21337 | not published | not published | $3,220.41 – $4,743.00 | 3 |
| Closed tx sesamoid fx 28530 CPT 28530 | not published | not published | $239.60 – $4,217.00 | 3 |
| Closed tx/talus fracture without manip 28430 CPT 28430 | not published | not published | $239.60 – $4,217.00 | 3 |
| Closed tx vert fx w/manj CPT 22315 | not published | not published | $3,178.20 – $8,433.00 | 3 |
| Close lac/mouth vest/2.5 cm or < 40830 CPT 40830 | not published | not published | $230.06 – $4,217.00 | 3 |
| Close mastoid fistula CPT 69700 | not published | not published | $1,507.10 – $4,743.00 | 3 |
| Close median sternotomy separation 21750 CPT 21750 | not published | not published | $7,048.20 – $17,116.00 | 3 |
| Close tear duct opening CPT 68760 | not published | not published | $308.31 – $4,217.00 | 3 |
| Close tear duct opening CPT 68761 | not published | not published | $308.31 – $4,217.00 | 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.