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 |
|---|---|---|---|---|
| Drng salivary gland simple 42300 CPT 42300 | not published | not published | $1,507.10 – $4,743.00 | 3 |
| Drng salivary gland submax/subling 42310 CPT 42310 | not published | not published | $523.87 – $4,217.00 | 3 |
| Dronabinol 2.5mg oral HCPCS Q0167 | not published | not published | $1.48 – $4.43 | 6 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | not published | not published | $8.57 – $25.70 | 5 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $251.25 | $456.81 | not published | 0 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | not published | not published | $12.53 – $37.59 | 6 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | not published | not published | $12.01 – $36.03 | 6 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | not published | not published | $9.09 – $27.28 | 6 |
| Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm HCPCS A2008 | not published | not published | $120.88 – $244.81 | 2 |
| Drsg wnd hyalomatrix 10x10cm -cost per sq cm HCPCS Q4117 | not published | not published | $81.48 – $120.88 | 2 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | not published | not published | $49.79 – $135.55 | 6 |
| Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm HCPCS A2007 | not published | not published | $120.88 – $219.27 | 2 |
| Drug admin & hemodynmic meas CPT 93463 | not published | not published | $2,181.00 – $2,181.00 | 1 |
| Drug assay caffeine CPT 80155 | not published | not published | $38.57 – $67.50 | 4 |
| Drug assay posaconazole CPT 80187 | not published | not published | $27.11 – $47.44 | 4 |
| Drug assay rufinamide CPT 80210 | not published | not published | $27.11 – $47.44 | 4 |
| Drug assay vedolizumab CPT 80280 | $312.95 | $569.00 | $38.57 – $67.50 | 4 |
| Drug assay voriconazole CPT 80285 | not published | not published | $27.11 – $47.44 | 4 |
| Drug asy hydroxychloroquine CPT 80220 | not published | not published | $18.64 – $32.62 | 4 |
| Drug of abuse screen urine CPT 80305 | $143.00 | $260.00 | $12.60 – $22.05 | 4 |
| Drug screen quant tiagabine CPT 80199 | $95.70 | $174.00 | $27.11 – $47.44 | 4 |
| Drug test def 15-21 classes HCPCS G0482 | not published | not published | $198.74 – $347.80 | 4 |
| Drug test def 1-7 classes HCPCS G0480 | $270.05 | $491.00 | $114.43 – $200.25 | 4 |
| Drug test def 22+ classes HCPCS G0483 | not published | not published | $246.92 – $432.11 | 4 |
| Drug test def 8-14 classes HCPCS G0481 | not published | not published | $156.59 – $274.03 | 4 |
| Drug test prsmv instrmnt CPT 80306 | $143.00 | $260.00 | $17.14 – $30.00 | 4 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $286.55 | $521.00 | $62.14 – $108.75 | 4 |
| Drvvt confirm - quest CPT 85597 | not published | not published | $17.98 – $31.47 | 4 |
| Dstrj extensive retinopathy CPT 67227 | not published | not published | $3,818.69 – $10,137.00 | 3 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | $2,572.90 | $4,678.00 | $1,896.75 – $8,701.00 | 3 |
| Dstr mal les s/n/h/f/g >4.0 CPT 17276 | not published | not published | $394.86 – $4,217.00 | 3 |
| Dstr mal ls f/e/e/n/l/m2.1-3 CPT 17283 | not published | not published | $394.86 – $4,217.00 | 3 |
| Dstr mal ls f/e/e/n/l/m3.1-4 CPT 17284 | not published | not published | $717.88 – $4,217.00 | 3 |
| Dstr mal ls f/e/e/n/l/m>4.0 CPT 17286 | not published | not published | $717.88 – $4,217.00 | 3 |
| Dstry eye lesn,fdr vssl tech HCPCS G0186 | not published | not published | $534.23 – $3,420.00 | 2 |
| Ductogram sgl duct CPT 77053 | $968.00 | $1,760.00 | $106.18 – $231.76 | 2 |
| Duodenal motility study CPT 91022 | not published | not published | $362.46 – $2,181.00 | 2 |
| Duplex scan bilateral study 93985 CPT 93985 | $785.40 | $1,428.00 | $231.76 – $231.76 | 1 |
| Duplex scan unilateral study 93986 CPT 93986 | $392.15 | $713.00 | $101.55 – $101.55 | 1 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $451.00 | $820.00 | $101.55 – $101.55 | 1 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $902.00 | $1,640.00 | $209.73 – $209.73 | 1 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | not published | not published | $231.76 – $231.76 | 1 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | not published | not published | $83.87 – $228.34 | 6 |
| Dxa bone density axl vrt fx CPT 77085 | $386.65 | $703.00 | $101.55 – $109.05 | 2 |
| Dx aly aud oi snd prcsr 1st CPT 92622 | not published | not published | $124.98 – $124.98 | 1 |
| Dx bronchoscope/brush 31623 CPT 31623 | not published | not published | $1,728.87 – $4,743.00 | 3 |
| Dx bronchoscope/lavage 31624 CPT 31624 | not published | not published | $1,728.87 – $4,743.00 | 3 |
| Dx bronchoscope/wash 31622 CPT 31622 | not published | not published | $1,728.87 – $4,743.00 | 3 |
| Dx dark adaptation exam i&r CPT 92284 | not published | not published | $433.92 – $433.92 | 1 |
| Dx duod intub w/asp spec 43756 CPT 43756 | not published | not published | $880.98 – $4,217.00 | 3 |
| Dx duod intub w/asp specs CPT 43757 | not published | not published | $880.98 – $4,217.00 | 3 |
| Dx gastr intub w/asp spec CPT 43754 | $333.85 | $607.00 | $209.73 – $4,217.00 | 3 |
| Dx gastr intub w/asp specs CPT 43755 | not published | not published | $124.98 – $4,217.00 | 3 |
| Dx laryngoscopy newborn CPT 31520 | not published | not published | $379.91 – $4,217.00 | 3 |
| Dx laryngoscopy w/oper scope CPT 31526 | not published | not published | $1,728.87 – $4,743.00 | 3 |
| Dynamic cavernosometry CPT 54231 | not published | not published | $242.69 – $4,217.00 | 3 |
| Dynamic surface emg CPT 96002 | not published | not published | $209.73 – $209.73 | 1 |
| Ear and throat examination CPT 92502 | not published | not published | $523.87 – $2,181.00 | 2 |
| Ear canal biopsy 69105 CPT 69105 | not published | not published | $1,507.10 – $4,743.00 | 3 |
| Ear cartilage graft CPT 21235 | not published | not published | $4,137.00 – $8,960.00 | 3 |
| Ear irrigation 69209 CPT 69209 | $72.60 | $132.00 | $57.30 – $4,217.00 | 3 |
| Ear protector evaluation CPT 92596 | not published | not published | $36.28 – $36.28 | 1 |
| Ecallantide injection HCPCS J1290 | not published | not published | $564.64 – $1,537.24 | 6 |
| Ecg 12 lead tracing only CPT 93005 | $224.40 | $408.00 | $57.30 – $57.30 | 1 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | not published | not published | $57.30 – $57.30 | 1 |
| Ecg external < 48 hours recording CPT 93225 | $389.61 | $708.38 | $129.23 – $129.23 | 1 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | not published | not published | $57.30 – $57.30 | 1 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | $46.20 | $84.00 | $36.28 – $36.28 | 1 |
| Ecg external >7 days up to 15 days recording CPT 93246 | $46.20 | $84.00 | $36.28 – $36.28 | 1 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $2,345.20 | $4,264.00 | $530.75 – $530.75 | 1 |
| Echocardiography doppler color flow mapping CPT 93325 | $365.75 | $665.00 | not published | 0 |
| Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 | $2,422.20 | $4,404.00 | $761.45 – $761.45 | 1 |
| Echocardiography transthoracic 2d followup/limited CPT 93308 | $367.95 | $669.00 | $231.76 – $231.76 | 1 |
| Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast HCPCS C8924 | $710.60 | $1,292.00 | $338.87 – $338.87 | 1 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $255.20 | $464.00 | not published | 0 |
| Echo exam of eye CPT 76516 | not published | not published | $101.55 – $127.14 | 2 |
| Echo exam of eye CPT 76519 | not published | not published | $101.55 – $142.34 | 2 |
| Echo exam of eye CPT 76529 | not published | not published | $84.53 – $126.18 | 2 |
| Echo exam of eye thickness CPT 76514 | not published | not published | $13.88 – $28.09 | 2 |
| Echo exam of fetal heart CPT 76825 | not published | not published | $514.99 – $530.75 | 2 |
| Echo exam of fetal heart CPT 76826 | not published | not published | $231.76 – $327.90 | 2 |
| Echo exam of fetal heart CPT 76827 | $398.20 | $724.00 | $101.55 – $126.18 | 2 |
| Echo exam of fetal heart CPT 76828 | $330.55 | $601.00 | $67.17 – $101.55 | 2 |
| Echo exam uterus 76831- CPT 76831 | not published | not published | $218.47 – $231.76 | 2 |
| Echograp trans r pros study CPT 76873 | not published | not published | $101.55 – $237.54 | 2 |
| Echo guidance radiotherapy CPT 76965 | not published | not published | $62.41 – $62.41 | 1 |
| Echo guide for amniocentesis CPT 76946 | not published | not published | $34.81 – $34.81 | 1 |
| Echo guide for artery repair CPT 76936 | $1,124.75 | $2,045.00 | $209.73 – $462.65 | 2 |
| Echo guide for heart biopsy CPT 76932 | not published | not published | $149.16 – $149.16 | 1 |
| Echo guide for transfusion CPT 76941 | not published | not published | $154.15 – $154.15 | 1 |
| Echo guide villus sampling CPT 76945 | not published | not published | $165.90 – $165.90 | 1 |
| Echo stress CPT 93350 | $703.45 | $1,279.00 | $530.75 – $530.75 | 1 |
| Echo tee cngntl wo ctrst probe plcmnt CPT 93316 | not published | not published | $530.75 – $530.75 | 1 |
| Echo tee guidance CPT 93355 | $2,151.60 | $3,912.00 | not published | 0 |
| Echo tee probe placement image acquisition interpretation & report CPT 93312 | $2,295.70 | $4,174.00 | $530.75 – $530.75 | 1 |
| Echo transesophageal CPT 93313 | not published | not published | $530.75 – $530.75 | 1 |
| Echo transesophageal CPT 93315 | $922.90 | $1,678.00 | $530.75 – $530.75 | 1 |
| Echo transesophageal intraop CPT 93318 | $922.90 | $1,678.00 | $530.75 – $530.75 | 1 |
| Echo transthoracic CPT 93303 | $1,822.15 | $3,313.00 | $530.75 – $530.75 | 1 |
| Echo transthoracic CPT 93304 | $1,245.75 | $2,265.00 | $530.75 – $530.75 | 1 |
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.