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 |
|---|---|---|---|---|
| Destruction premal lesions 15/> 17004 CPT 17004 | not published | not published | $394.86 – $4,217.00 | 3 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $2,696.09 – $8,701.00 | 3 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $3,144.33 – $8,701.00 | 3 |
| Destruction vag lesions simple 57061 CPT 57061 | not published | not published | $3,144.33 – $8,701.00 | 3 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $2,004.13 – $4,743.00 | 3 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $30.03 – $52.55 | 4 |
| Detect agnt mult dna direc CPT 87800 | not published | not published | $43.67 – $76.42 | 4 |
| Devel tst phys/qhp 1st hr CPT 96112 | not published | not published | $124.98 – $124.98 | 1 |
| Device intraute mirena HCPCS J7298 | not published | not published | $3,968.20 – $3,968.20 | 1 |
| Device tiss remov myosure reach HCPCS C1782 | $741.28 | $1,347.78 | not published | 0 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $162.52 | $295.50 | $45.28 – $84.53 | 2 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | not published | not published | $90.02 – $301.32 | 6 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | not published | not published | $7.38 – $7.38 | 1 |
| Dexamethasone 4 mg tablet HCPCS J8540 | not published | not published | $0.06 – $0.18 | 6 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | not published | not published | $0.09 – $0.28 | 6 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $203.66 – $558.77 | 6 |
| Dexmedetomidine film, 1 mcg HCPCS J1105 | not published | not published | $2.39 – $2.39 | 1 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | not published | not published | $41.44 – $220.41 | 6 |
| Dextran 40 infusion HCPCS J7100 | not published | not published | $140.28 – $140.28 | 1 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | not published | not published | $1.25 – $3.76 | 6 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | not published | not published | $16.47 – $16.47 | 1 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | not published | not published | $1.82 – $5.46 | 6 |
| Dextrose 5 % IV bolus HCPCS J7070 | not published | not published | $3.64 – $10.92 | 6 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $8.52 | $15.50 | $22.23 – $38.90 | 4 |
| Diabetes (HbA1c) Test CPT 83036 | $61.05 | $111.00 | $9.71 – $16.99 | 4 |
| Diab manage trn ind/group HCPCS G0109 | not published | not published | $15.49 – $15.49 | 1 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $1,728.87 – $4,743.00 | 3 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $5,872.22 – $15,012.00 | 3 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $433.92 – $4,217.00 | 3 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $1,162.34 – $4,743.00 | 3 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $50.60 | $92.00 | $129.23 – $4,217.00 | 3 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $323.40 | $588.00 | $312.83 – $312.83 | 1 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $123.75 | $225.00 | $245.27 – $245.27 | 1 |
| Diagnostic laryngoscopy 31505 CPT 31505 | not published | not published | $193.88 – $4,217.00 | 3 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $642.40 | $1,168.00 | $193.88 – $4,217.00 | 3 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $684.75 | $1,245.00 | $105.48 – $322.43 | 2 |
| Diagnostic Mammogram (one breast) CPT 77065 | $342.10 | $622.00 | $82.34 – $251.94 | 2 |
| Diagnostic radio unlisted proc CPT 76499 | $634.15 | $1,153.00 | $84.53 – $84.53 | 1 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $4,957.70 | $9,014.00 | $2,181.00 – $2,181.00 | 1 |
| Dialysis one evaluation CPT 90945 | not published | not published | $405.30 – $405.30 | 1 |
| Diathermy eg microwave CPT 97024 | not published | not published | $6.91 – $6.91 | 1 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | not published | not published | $0.08 – $0.23 | 6 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | not published | not published | $5.79 – $17.36 | 6 |
| Dicyclomine injection HCPCS J0500 | not published | not published | $12.86 – $38.57 | 6 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.76 – $0.76 | 1 |
| Diffusing capacity CPT 94729 | $326.15 | $593.00 | not published | 0 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | not published | not published | $4.88 – $14.64 | 6 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | not published | not published | $4,968.58 – $13,526.96 | 6 |
| Digoxin total therapeutic drug level CPT 80162 | $143.55 | $261.00 | $13.28 – $23.24 | 4 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | not published | not published | $53.35 – $257.24 | 6 |
| Dilate biliary duct/ampulla CPT 47542 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Dilate esophagus CPT 43453 | not published | not published | $1,863.90 – $4,743.00 | 3 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $880.98 – $4,217.00 | 3 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | not published | not published | $14,758.00 – $14,758.00 | 1 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | not published | not published | $14,758.00 – $14,758.00 | 1 |
| Dilate ic vasospasm init CPT 61640 | not published | not published | $14,758.00 – $14,758.00 | 1 |
| Dilate tear duct opening CPT 68801 | not published | not published | $433.92 – $4,217.00 | 3 |
| Dilate urethra stricture CPT 53600 | not published | not published | $242.69 – $4,217.00 | 3 |
| Dilate urethra stricture CPT 53601 | not published | not published | $129.23 – $4,217.00 | 3 |
| Dilate urethra stricture CPT 53605 | not published | not published | $3,423.93 – $4,743.00 | 3 |
| Dilate urethra stricture CPT 53621 | not published | not published | $242.69 – $4,217.00 | 3 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $124.98 – $4,217.00 | 3 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $1,162.34 – $4,743.00 | 3 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $3,144.33 – $8,701.00 | 3 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $1,162.34 – $4,743.00 | 3 |
| Dilation of salivary duct CPT 42660 | not published | not published | $523.87 – $4,217.00 | 3 |
| Dilation of urethra CPT 53661 | not published | not published | $129.23 – $4,217.00 | 3 |
| Dilation of urethra CPT 53665 | not published | not published | $2,030.46 – $8,701.00 | 3 |
| Dilation of vagina CPT 57400 | not published | not published | $3,144.33 – $8,701.00 | 3 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $1,507.10 – $4,743.00 | 3 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $677.31 – $4,217.00 | 3 |
| Dilator fascial 10fx20cm HCPCS C2627 | $290.93 | $528.96 | not published | 0 |
| Dilat xst trc ndurlgc px CPT 50436 | $2,719.20 | $4,944.00 | $3,423.93 – $8,701.00 | 3 |
| Dilat xst trc new access rcs CPT 50437 | $4,574.35 | $8,317.00 | $3,423.93 – $10,137.00 | 3 |
| Dimenhydrinate injection HCPCS J1240 | not published | not published | $8.35 – $25.04 | 6 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | not published | not published | $714.72 – $1,945.83 | 6 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | not published | not published | $3.55 – $3.55 | 1 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | not published | not published | $0.66 – $1.98 | 6 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | not published | not published | $45.79 – $45.79 | 1 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $36.28 – $36.28 | 1 |
| Disability dlco CPT 94727 | not published | not published | $209.73 – $209.73 | 1 |
| Disaccharidases CPT 82657 | $453.20 | $824.00 | $22.17 – $38.80 | 4 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $2,004.13 – $4,743.00 | 3 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | not published | not published | $14,758.00 – $14,758.00 | 1 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $4,743.00 – $4,743.00 | 1 |
| Discography cerv/thor spine CPT 72285 | not published | not published | $139.51 – $1,896.75 | 2 |
| Dise eval slp do brth flx dx CPT 42975 | not published | not published | $1,728.87 – $4,743.00 | 3 |
| Dissolve clot heart vessel CPT 92975 | $943.25 | $1,715.00 | not published | 0 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $5,404.97 – $17,116.00 | 3 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $5,750.12 – $15,012.00 | 3 |
| Division of fallopian tube 58605 CPT 58605 | not published | not published | $4,137.00 – $8,960.00 | 2 |
| #d/lmeth-l-methamphetamine CPT 80374 | not published | not published | $27.15 – $27.15 | 1 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | not published | not published | $13,352.00 – $13,352.00 | 1 |
| Dmd dup/delet analysis CPT 81161 | not published | not published | $279.00 – $488.25 | 4 |
| Dmpk gene detc abnor allele CPT 81234 | not published | not published | $137.00 – $239.75 | 4 |
| Dna antibody native/double stranded CPT 86225 | $264.00 | $480.00 | $13.74 – $24.05 | 4 |
| Dna gardnerella CPT 87510 | not published | not published | $20.05 – $35.09 | 4 |
| Dna probe chlamydia CPT 87490 | not published | not published | $22.75 – $39.81 | 4 |
| Dna probe gc CPT 87590 | not published | not published | $26.88 – $47.04 | 4 |
| Dna trichomonas CPT 87660 | not published | not published | $20.05 – $35.09 | 4 |
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.