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 |
|---|---|---|---|---|
| CT lower extremity w/contrast (both sides) CPT 73701 | $2,030.05 | $3,691.00 | $170.37 – $444.00 | 2 |
| CT lower extremity without contrast (both sides) CPT 73700 | $1,883.20 | $3,424.00 | $101.55 – $341.23 | 2 |
| CT lwr extremity w/o&w/dye CPT 73702 | $2,515.70 | $4,574.00 | $170.37 – $564.86 | 2 |
| CT neck soft tissue w/contrast CPT 70491 | $1,697.30 | $3,086.00 | $170.37 – $440.20 | 2 |
| CT neck soft tissue without contrast CPT 70490 | $1,392.60 | $2,532.00 | $101.55 – $340.28 | 2 |
| CT neck soft tissue without & w/contrast CPT 70492 | $1,750.10 | $3,182.00 | $170.37 – $543.93 | 2 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $1,750.10 | $3,182.00 | $170.37 – $607.68 | 2 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $1,516.35 | $2,757.00 | $170.37 – $547.75 | 2 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $1,392.60 | $2,532.00 | $101.55 – $447.83 | 2 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | not published | not published | $230.06 – $4,217.00 | 3 |
| CT scan for therapy guide CPT 77014 | $253.00 | $460.00 | $194.68 – $194.68 | 1 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $4,869.15 | $8,853.00 | $338.87 – $667.63 | 2 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $3,467.75 | $6,305.00 | $338.87 – $582.94 | 2 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $2,693.35 | $4,897.00 | $231.76 – $297.46 | 2 |
| CT thoracic spine w/contrast CPT 72129 | $2,765.40 | $5,028.00 | $170.37 – $445.92 | 2 |
| CT thoracic spine without contrast CPT 72128 | $2,429.90 | $4,418.00 | $101.55 – $344.09 | 2 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $244.20 | $444.00 | $101.55 – $262.15 | 2 |
| CT t-spine w /wo contrast CPT 72130 | $2,919.40 | $5,308.00 | $170.37 – $549.64 | 2 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $1,536.15 | $2,793.00 | $338.87 – $435.46 | 2 |
| CT upper extremity without contrast (both sides) CPT 73200 | $1,447.05 | $2,631.00 | $101.55 – $341.23 | 2 |
| CT uppr extremity w/o&w/dye CPT 73202 | not published | not published | $170.37 – $575.34 | 2 |
| Cultr oocyte/embryo <4 days CPT 89250 | not published | not published | $165.49 – $1,188.25 | 2 |
| Cultr oocyte/embryo <4 days CPT 89251 | not published | not published | $165.49 – $1,235.98 | 2 |
| Cult skin graft fnhfg 15155 CPT 15155 | not published | not published | $3,442.14 – $10,137.00 | 3 |
| Cult skin grft t/arm/leg CPT 15150 | not published | not published | $2,004.13 – $4,743.00 | 3 |
| Culture aerobic additional method definitive id each CPT 87077 | $167.20 | $304.00 | $8.08 – $14.14 | 4 |
| Culture afb any source CPT 87116 | $92.40 | $168.00 | $10.80 – $18.90 | 4 |
| Culture anaerobic additional method definitive id each CPT 87076 | $70.40 | $128.00 | $8.08 – $14.14 | 4 |
| Culture anaerobic except blood CPT 87075 | $70.40 | $128.00 | $9.47 – $16.57 | 4 |
| Culture bact stool aero addl path ea CPT 87046 | $65.45 | $119.00 | $9.44 – $16.52 | 4 |
| Culture body fluid CPT 87070 | $62.70 | $114.00 | $8.62 – $15.09 | 4 |
| Culture fungi definitive id mold CPT 87107 | $139.15 | $253.00 | $10.32 – $18.06 | 4 |
| Culture fungi definitive id yeast CPT 87106 | $129.25 | $235.00 | $10.32 – $18.06 | 4 |
| Culture fungi other (except blood) CPT 87102 | $61.05 | $111.00 | $8.41 – $14.72 | 4 |
| Culture fungi skin/hair/nail CPT 87101 | $57.20 | $104.00 | $7.71 – $13.49 | 4 |
| Culture mycobacteria definitive id each isolate CPT 87118 | not published | not published | $14.61 – $25.57 | 4 |
| Culture mycoplasma any source CPT 87109 | $128.15 | $233.00 | $15.39 – $26.93 | 4 |
| Culture quantitative aerobic other source CPT 87071 | not published | not published | $9.89 – $17.31 | 4 |
| Culture screening strep group a CPT 87081 | $57.20 | $104.00 | $6.63 – $11.60 | 4 |
| Culture typing added method CPT 87158 | $103.40 | $188.00 | $7.74 – $13.55 | 4 |
| Culture typing immunologic CPT 87147 | $96.80 | $176.00 | $5.18 – $9.07 | 4 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | $388.85 | $707.00 | $218.06 – $381.61 | 4 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $92.40 | $168.00 | $35.09 – $61.41 | 4 |
| Culture urine each isolate CPT 87088 | $9.90 | $18.00 | $8.09 – $14.16 | 4 |
| Culture virus isolation CPT 87250 | not published | not published | $19.56 – $34.23 | 4 |
| Curette/treat cornea CPT 65435 | not published | not published | $968.30 – $4,743.00 | 3 |
| Curette/treat cornea CPT 65436 | not published | not published | $2,309.33 – $8,701.00 | 3 |
| Cutter lead HCPCS C1773 | $428.20 | $778.54 | not published | 0 |
| Cv line/pic reposition CPT 36597 | $1,604.90 | $2,918.00 | $1,529.03 – $4,743.00 | 3 |
| Cyanocobalamin unsat binding capacity CPT 82608 | not published | not published | $14.32 – $25.06 | 4 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | not published | not published | $0.67 – $2.00 | 6 |
| Cyclic citrullinated peptide antibody CPT 86200 | $182.60 | $332.00 | $12.95 – $22.66 | 4 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | not published | not published | $0.58 – $2.18 | 6 |
| Cyclophosphamide 25 mg capsule HCPCS J8530 | not published | not published | $1.09 – $3.42 | 6 |
| Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 | not published | not published | $71.40 – $214.20 | 6 |
| Cyclosporine 2 hour CPT 80158 | $103.95 | $189.00 | $18.05 – $31.59 | 4 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | not published | not published | $0.74 – $2.23 | 6 |
| Cyclosporine oral 100 mg HCPCS J7502 | not published | not published | $2.02 – $6.07 | 6 |
| Cylinder pump set 20cm titan zero angl HCPCS C1813 | $6,607.69 | $12,013.98 | not published | 0 |
| Cyp2c19 gene com variants CPT 81225 | $822.25 | $1,495.00 | $291.36 – $509.88 | 4 |
| Cyp2c9 gene com variants CPT 81227 | not published | not published | $174.81 – $305.92 | 4 |
| Cyp2d6 gene com variants CPT 81226 | not published | not published | $450.91 – $789.09 | 4 |
| Cyp3a4 gene common variants CPT 81230 | not published | not published | $174.81 – $305.92 | 4 |
| Cyp3a5 gene common variants CPT 81231 | not published | not published | $174.81 – $305.92 | 4 |
| Cystatin c CPT 82610 | $49.50 | $90.00 | $18.52 – $32.41 | 4 |
| Cystic fibrosis cftr CPT 81223 | not published | not published | $499.00 – $873.25 | 4 |
| Cystine urine quantitative CPT 82131 | $284.90 | $518.00 | $22.98 – $40.22 | 4 |
| Cysto cgen post urtl valves CPT 52400 | not published | not published | $3,423.93 – $8,701.00 | 3 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $543.40 | $988.00 | $55.75 – $338.87 | 2 |
| Cysto impl 4 or more HCPCS C9740 | not published | not published | $9,195.08 – $17,116.00 | 3 |
| Cysto insj dev ischmc rmdlg CPT 53865 | not published | not published | $8,433.00 – $9,195.08 | 2 |
| Cysto, litho, vacuum kidney HCPCS C9761 | not published | not published | $8,701.00 – $9,195.08 | 2 |
| Cystometrogram w/up 51727 CPT 51727 | not published | not published | $677.31 – $9,837.00 | 3 |
| Cystorrhaphy wound comp 51865 CPT 51865 | not published | not published | $8,433.00 – $10,137.00 | 2 |
| Cystorrhaphy wound simple 51860 CPT 51860 | not published | not published | $8,701.00 – $9,195.08 | 3 |
| Cysto rx balo cath urtl strx CPT 52284 | not published | not published | $5,208.09 – $8,960.00 | 2 |
| Cystoscopy and biopsy CPT 52007 | not published | not published | $3,423.93 – $8,701.00 | 3 |
| Cystoscopy and radiotracer CPT 52250 | not published | not published | $3,423.93 – $8,701.00 | 3 |
| Cystoscopy and treatment CPT 52214 | not published | not published | $3,423.93 – $8,701.00 | 3 |
| Cystoscopy and treatment CPT 52224 | not published | not published | $3,423.93 – $8,701.00 | 3 |
| Cystoscopy and treatment CPT 52234 | not published | not published | $3,423.93 – $8,701.00 | 3 |
| Cystoscopy and treatment CPT 52235 | not published | not published | $3,423.93 – $8,701.00 | 3 |
| Cystoscopy and treatment CPT 52240 | not published | not published | $5,208.09 – $8,960.00 | 3 |
| Cystoscopy and treatment CPT 52260 | not published | not published | $2,030.46 – $4,743.00 | 3 |
| Cystoscopy and treatment CPT 52265 | not published | not published | $2,030.46 – $4,743.00 | 3 |
| Cystoscopy and treatment CPT 52276 | not published | not published | $2,030.46 – $8,701.00 | 3 |
| Cystoscopy and treatment CPT 52277 | not published | not published | $3,423.93 – $8,701.00 | 3 |
| Cystoscopy and treatment CPT 52283 | not published | not published | $2,030.46 – $8,701.00 | 3 |
| Cystoscopy and treatment CPT 52285 | not published | not published | $677.31 – $4,217.00 | 3 |
| Cystoscopy and treatment CPT 52290 | not published | not published | $2,030.46 – $8,701.00 | 3 |
| Cystoscopy and treatment CPT 52300 | not published | not published | $3,423.93 – $8,701.00 | 3 |
| Cystoscopy and treatment CPT 52301 | not published | not published | $3,423.93 – $8,701.00 | 3 |
| Cystoscopy and treatment CPT 52305 | not published | not published | $5,208.09 – $8,960.00 | 3 |
| Cystoscopy and treatment CPT 52310 | $2,906.75 | $5,285.00 | $2,030.46 – $4,743.00 | 3 |
| Cystoscopy and treatment CPT 52315 | not published | not published | $2,030.46 – $8,701.00 | 3 |
| Cystoscopy and treatment CPT 52320 | not published | not published | $3,423.93 – $8,701.00 | 3 |
| Cystoscopy and treatment CPT 52330 | not published | not published | $3,423.93 – $8,701.00 | 3 |
| Cystoscopy (Bladder Scope) CPT 52000 | $234.85 | $427.00 | $677.31 – $4,217.00 | 3 |
| Cystoscopy chemodenervation CPT 52287 | $564.30 | $1,026.00 | $2,030.46 – $4,743.00 | 3 |
| Cystoscopy & duct catheter CPT 52010 | not published | not published | $677.31 – $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.