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 |
|---|---|---|---|---|
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | not published | not published | $0.39 – $1.16 | 6 |
| Adenovirus ag ia CPT 87301 | not published | not published | $11.98 – $20.97 | 4 |
| Adenovirus antibody,serum - quest CPT 86603 | $86.90 | $158.00 | $12.87 – $22.52 | 4 |
| Adenovirus assay w/optic CPT 87809 | not published | not published | $21.76 – $38.08 | 4 |
| Adhesiolysis tube ovary 58740 CPT 58740 | not published | not published | $8,701.00 – $8,960.00 | 2 |
| Adh-sendout CPT 84588 | $206.80 | $376.00 | $33.94 – $59.40 | 4 |
| Adj gastric band via subq port CPT 43999 | not published | not published | $880.98 – $13,723.00 | 3 |
| Adjmt/revj ext fixj sys anes CPT 20693 | not published | not published | $7,048.20 – $14,758.00 | 3 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | not published | not published | $2,004.13 – $4,743.00 | 3 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | not published | not published | $1.52 – $1.52 | 1 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $124.30 | $226.00 | $69.94 – $69.94 | 1 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $184.25 | $335.00 | $69.94 – $69.94 | 1 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $490.05 | $891.00 | $320.84 – $320.84 | 1 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | not published | not published | $320.84 – $320.84 | 1 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $88.00 | $160.00 | $69.94 – $69.94 | 1 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $152.90 | $278.00 | $69.94 – $69.94 | 1 |
| Administration immunization 1 vaccine CPT 90471 | $44.00 | $80.00 | $69.94 – $69.94 | 1 |
| Administration immunization each additional component CPT 90461 | $26.95 | $49.00 | not published | 0 |
| Administration immunization each additional vaccine CPT 90472 | $19.80 | $36.00 | not published | 0 |
| Administration immunization first component each vaccine CPT 90460 | $43.45 | $79.00 | not published | 0 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $48.40 | $88.00 | $69.94 – $69.94 | 1 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | $20.35 | $37.00 | not published | 0 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | $122.65 | $223.00 | not published | 0 |
| Administration vaccine hepatitis b HCPCS G0010 | $64.90 | $118.00 | $45.48 – $45.48 | 1 |
| Administration vaccine influenza virus HCPCS G0008 | $29.15 | $53.00 | $45.48 – $45.48 | 1 |
| Administration vaccine pneumococcal HCPCS G0009 | $39.05 | $71.00 | $45.48 – $45.48 | 1 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | $56.65 | $103.00 | not published | 0 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | not published | not published | $41.11 – $111.92 | 6 |
| Adrenal cortex & medulla img CPT 78075 | not published | not published | $1,146.64 – $1,257.53 | 2 |
| Adrenalectomy expl w/exc retro tumor 60545 CPT 60545 | not published | not published | $8,960.00 – $8,960.00 | 1 |
| Aep hearing status deter i&r CPT 92651 | $311.85 | $567.00 | $209.73 – $209.73 | 1 |
| Aep neurodiagnostic i&r CPT 92653 | not published | not published | $209.73 – $209.73 | 1 |
| Aep thrshld est mlt freq i&r CPT 92652 | $472.45 | $859.00 | $209.73 – $209.73 | 1 |
| Afamelanotide implant, 1 mg HCPCS J7352 | not published | not published | $2,943.42 – $7,822.63 | 2 |
| _afb id by dna probe rflx ast CPT 87149 | not published | not published | $20.05 – $35.09 | 4 |
| #afb mycobacteria suscep. #1 CPT 87190 | not published | not published | $7.31 – $12.79 | 4 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $564.85 | $1,027.00 | $115.36 – $201.88 | 4 |
| Aflibercept injection HCPCS J0178 | not published | not published | $743.60 – $2,166.73 | 6 |
| After cataract laser surgery CPT 66821 | not published | not published | $534.23 – $4,217.00 | 3 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | not published | not published | $222.84 – $606.69 | 6 |
| Air conduction bilat CPT 92552 | not published | not published | $129.23 – $129.23 | 1 |
| Air injection into abdomen 49400 CPT 49400 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | not published | not published | $124.98 – $124.98 | 1 |
| Albumin body fluid quantitative each specimen CPT 82042 | $39.05 | $71.00 | $7.78 – $13.62 | 4 |
| Albumin (human), 25%, 50ml HCPCS P9047 | not published | not published | $53.08 – $144.51 | 6 |
| Albumin, human 25 % intravenous solution HCPCS P9046 | not published | not published | $21.23 – $57.80 | 6 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | not published | not published | $53.08 – $144.51 | 6 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | not published | not published | $10.62 – $28.91 | 6 |
| Albumin ischemia modified CPT 82045 | not published | not published | $33.94 – $59.40 | 4 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $49.50 | $90.00 | $5.78 – $10.12 | 4 |
| Albumin serum plasma or whole blood CPT 82040 | $25.85 | $47.00 | $4.95 – $8.66 | 4 |
| Albuterol ipratrop non-comp HCPCS J7620 | not published | not published | $0.19 – $0.58 | 6 |
| Albuterol non-comp con HCPCS J7611 | not published | not published | $0.18 – $0.53 | 6 |
| Albuterol non-comp unit HCPCS J7613 | not published | not published | $0.08 – $0.23 | 6 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $80.30 | $146.00 | $17.27 – $30.22 | 4 |
| Alcohol/subs interv >30 min HCPCS G0397 | not published | not published | $172.41 – $172.41 | 1 |
| Aldesleukin injection HCPCS J9015 | not published | not published | $3,338.87 – $19,798.02 | 2 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | not published | not published | $2,441.49 – $6,646.96 | 6 |
| Alkaline phosphatase CPT 84075 | $28.05 | $51.00 | $5.18 – $9.07 | 4 |
| Allergen alpha lactalbumin ige CPT 86008 | $402.60 | $732.00 | $17.93 – $31.38 | 4 |
| Allergen egg white ige CPT 86003 | $47.30 | $86.00 | $5.22 – $9.14 | 4 |
| Allergen specific ige qual multi scrn ea CPT 86005 | $154.55 | $281.00 | $7.97 – $13.95 | 4 |
| Allergy injections; 2 or more 95117 CPT 95117 | not published | not published | $45.48 – $45.48 | 1 |
| Allergy injection; single 95115 CPT 95115 | $35.20 | $64.00 | $45.48 – $45.48 | 1 |
| Allergy Skin Testing CPT 95004 | not published | not published | $834.12 – $834.12 | 1 |
| Allg patch or app # of tests 95044 CPT 95044 | not published | not published | $834.12 – $834.12 | 1 |
| Allgrft implnt knee w/scope CPT 29867 | not published | not published | $12,470.63 – $17,116.00 | 3 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | not published | not published | $82.76 – $225.31 | 6 |
| Allograft amnioexcel plus 17mm disk HCPCS Q4137 | not published | not published | $102.18 – $278.19 | 6 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | not published | not published | $24.47 – $73.40 | 6 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | not published | not published | $120.88 – $431.05 | 6 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | not published | not published | $120.88 – $371.55 | 2 |
| Allograft membrn amnio 1x2cm hu ambriodry HCPCS V2790 | $963.74 | $1,752.25 | not published | 0 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | not published | not published | $120.88 – $349.65 | 6 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | not published | not published | $120.88 – $672.51 | 6 |
| Alloskin HCPCS Q4115 | not published | not published | $12.38 – $37.15 | 6 |
| All tstg perq&iq drugs/biol CPT 95018 | not published | not published | $36.28 – $36.28 | 1 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | not published | not published | $5.13 – $14.04 | 6 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | not published | not published | $64.41 – $112.72 | 4 |
| Alpha-fetoprotein amniotic CPT 82106 | $105.05 | $191.00 | $17.00 – $29.75 | 4 |
| Alpha-fetoprotein tumor marker CPT 82105 | $106.70 | $194.00 | $16.77 – $29.35 | 4 |
| Alprostadil for injection HCPCS J0270 | not published | not published | $1.29 – $1.29 | 1 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | not published | not published | $91.46 – $249.00 | 6 |
| Alt/sgpt CPT 84460 | $99.00 | $180.00 | $5.30 – $9.28 | 4 |
| Altuviiio per factor viii iu HCPCS J7214 | not published | not published | $4.60 – $12.52 | 6 |
| Aluminum - quest CPT 82108 | $124.30 | $226.00 | $25.48 – $44.59 | 4 |
| Alveoloplasty each quadrant CPT 41874 | not published | not published | $3,220.41 – $4,743.00 | 3 |
| Amantadine (symmetrel)-sendout CPT 80375 | $205.70 | $374.00 | $27.15 – $27.15 | 1 |
| Ambl bp mntr w/sw a/r CPT 93788 | not published | not published | $129.23 – $129.23 | 1 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | not published | not published | $0.60 – $1.80 | 6 |
| Amino acid screen, urine CPT 82128 | not published | not published | $13.87 – $24.27 | 4 |
| Amino acid single qual CPT 82127 | not published | not published | $14.18 – $24.82 | 4 |
| Amino acids quant 2-5 CPT 82136 | not published | not published | $19.61 – $34.32 | 4 |
| Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr HCPCS J0281 | not published | not published | $1.30 – $3.91 | 5 |
| Aminolevulinic acid, 10% gel HCPCS J7345 | not published | not published | $1.78 – $4.85 | 6 |
| Aminolevulinic acid delta CPT 82135 | not published | not published | $16.45 – $28.79 | 4 |
| Aminolevulinic acid hcl top HCPCS J7308 | not published | not published | $389.28 – $1,073.79 | 6 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | not published | not published | $6.72 – $33.15 | 6 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | not published | not published | $2.59 – $7.78 | 6 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | not published | not published | $0.33 – $0.98 | 6 |
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.