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 |
|---|---|---|---|---|
| F-18 florbetapir less than or equal to 10 mci HCPCS A9586 | not published | not published | $1,825.64 – $5,974.85 | 2 |
| F-18 fluciclovine per mci HCPCS A9588 | not published | not published | $322.27 – $730.77 | 2 |
| F-18 sodium fluoride HCPCS A9580 | not published | not published | $713.33 – $713.33 | 1 |
| F9 full gene sequence CPT 81238 | not published | not published | $600.00 – $1,050.00 | 4 |
| Face bone graft CPT 21210 | not published | not published | $5,750.12 – $15,012.00 | 3 |
| Facial bones <3 CPT 70140 | $187.55 | $341.00 | $50.04 – $84.53 | 2 |
| Facial nerve function test CPT 92516 | not published | not published | $209.73 – $209.73 | 1 |
| Facility svs dental rehab HCPCS G0330 | not published | not published | $3,220.41 – $3,220.41 | 1 |
| Factor ix CPT 85250 | $139.15 | $253.00 | $19.04 – $33.32 | 4 |
| Factor ix alprolix recomb HCPCS J7201 | not published | not published | $3.55 – $9.67 | 6 |
| Factor ix complex HCPCS J7194 | not published | not published | $1.66 – $4.52 | 6 |
| Factor ix idelvion inj HCPCS J7202 | not published | not published | $5.18 – $14.11 | 6 |
| Factor ix non-recombinant HCPCS J7193 | not published | not published | $1.38 – $3.76 | 6 |
| Factor ix recomb gly rebinyn HCPCS J7203 | not published | not published | $4.32 – $11.76 | 6 |
| Factor ix recombinan rixubis HCPCS J7200 | not published | not published | $1.63 – $4.44 | 6 |
| Factor ix recombinant nos HCPCS J7195 | not published | not published | $1.85 – $5.03 | 6 |
| Factor viia recomb sevenfact HCPCS J7212 | not published | not published | $2.19 – $6.50 | 6 |
| Factor viii CPT 85240 | $138.60 | $252.00 | $17.90 – $31.33 | 4 |
| Factor viii HCPCS J7190 | not published | not published | $1.12 – $3.05 | 6 |
| Factor viii fc fusion recomb HCPCS J7205 | not published | not published | $2.32 – $6.32 | 6 |
| Factor viii nuwiq recomb 1iu HCPCS J7209 | not published | not published | $1.19 – $3.23 | 6 |
| Factor viii pegylated recomb HCPCS J7207 | not published | not published | $2.10 – $5.73 | 6 |
| Factor viii recombinant nos HCPCS J7192 | not published | not published | $1.56 – $4.24 | 6 |
| Factor viii recomb novoeight HCPCS J7182 | not published | not published | $1.40 – $3.81 | 6 |
| Factor viii recomb obizur HCPCS J7188 | not published | not published | $3.23 – $8.79 | 6 |
| Factor xiii anti-hem factor HCPCS J7180 | not published | not published | $10.48 – $28.53 | 6 |
| Factor xiii recomb a-subunit HCPCS J7181 | not published | not published | $17.34 – $47.21 | 6 |
| Fallopian tube recnl CPT 58345 | not published | not published | $3,144.33 – $8,701.00 | 3 |
| Family therapy without pt 50min 90846 CPT 90846 | not published | not published | $172.41 – $172.41 | 1 |
| Family therapy with patient 50 min 90847 CPT 90847 | not published | not published | $172.41 – $172.41 | 1 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | not published | not published | $0.01 – $0.03 | 5 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | not published | not published | $28.90 – $78.69 | 6 |
| Fancc gene CPT 81242 | not published | not published | $36.62 – $64.09 | 4 |
| Fasciotomy hip/thigh any typ CPT 27025 | not published | not published | $3,178.20 – $17,116.00 | 3 |
| Fat/lipids feces qualitative CPT 82705 | $12.65 | $23.00 | $5.10 – $8.93 | 4 |
| Fatty acids nonesterified CPT 82725 | $530.75 | $965.00 | $18.77 – $32.85 | 4 |
| Fecal bilirubin test CPT 82252 | not published | not published | $4.56 – $7.98 | 4 |
| Fecal microbiota, live-jslm 150 ml rectal suspension enema HCPCS J1440 | not published | not published | $63.93 – $174.04 | 6 |
| Fecal microbiota prep instil HCPCS G0455 | $124.30 | $226.00 | $903.30 – $903.30 | 1 |
| #fecal-sodium CPT 84302 | $38.50 | $70.00 | $4.86 – $8.51 | 4 |
| Feeding tube reposition CPT 74355 | not published | not published | $282.52 – $282.52 | 1 |
| Fees w/laryngeal sense test CPT 92616 | not published | not published | $77.52 – $77.52 | 1 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | not published | not published | $18.64 – $32.62 | 4 |
| Femoral endovas graft add-on 34813 CPT 34813 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Fem/popl revasc w/stent CPT 37226 | $7,893.05 | $14,351.00 | $16,164.00 – $25,004.00 | 2 |
| Feno poc CPT 95012 | not published | not published | $36.28 – $36.28 | 1 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | not published | not published | $0.84 – $2.52 | 6 |
| Fern test HCPCS Q0114 | not published | not published | $9.74 – $17.05 | 4 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | not published | not published | $1.13 – $3.07 | 6 |
| Ferritin CPT 82728 | $14.85 | $27.00 | $13.63 – $23.85 | 4 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | not published | not published | $0.33 – $0.89 | 6 |
| Ferumoxytol, esrd use HCPCS Q0139 | not published | not published | $0.33 – $0.89 | 6 |
| Fetal aneuploidy trisom risk CPT 81507 | $899.80 | $1,636.00 | $795.00 – $1,391.25 | 4 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $603.35 | $1,097.00 | $101.55 – $179.46 | 2 |
| Fetal chrmoml microdeltj CPT 81422 | not published | not published | $759.05 – $1,328.34 | 4 |
| Fetal chrom aneuploidy gsa panel CPT 81420 | $978.45 | $1,779.00 | $759.05 – $1,328.34 | 4 |
| Fetal contract stress test 59020 - 26 CPT 59020 | $460.90 | $838.00 | $196.38 – $9,837.00 | 3 |
| Fetal cord puncture prenatal CPT 59012 | not published | not published | $295.99 – $4,217.00 | 3 |
| Fetal fibronectin CPT 82731 | $155.65 | $283.00 | $64.41 – $112.72 | 4 |
| Fetal fluid drainage w/us CPT 59074 | not published | not published | $295.99 – $4,217.00 | 3 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $62.70 | $114.00 | $7.73 – $13.53 | 4 |
| Fetal hemoglobin rosette CPT 85461 | $33.55 | $61.00 | $9.36 – $16.38 | 4 |
| Fetal lung maturity assess lam body dnst CPT 83664 | $88.00 | $160.00 | $19.32 – $33.81 | 4 |
| Fetal monitor/interpret only CPT 59051 | not published | not published | $9,837.00 – $9,837.00 | 1 |
| Fetal monitor w/report CPT 59050 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Fetal non stress test CPT 59025 | $287.65 | $523.00 | $196.38 – $9,837.00 | 3 |
| Fetal scalp blood sampling 59030 CPT 59030 | not published | not published | $295.99 – $9,837.00 | 3 |
| Fetal shunt placement w/us CPT 59076 | not published | not published | $295.99 – $4,217.00 | 3 |
| #_fet/norfentcnfrmur CPT 80354 | $161.70 | $294.00 | $27.15 – $27.15 | 1 |
| Fiasp for insulin pump use HCPCS J1811 | not published | not published | $6.67 – $20.00 | 6 |
| Fibrin degradation d dimer quantitative CPT 85379 | $73.70 | $134.00 | $10.18 – $17.82 | 4 |
| Fibrin degradation products CPT 85362 | $58.85 | $107.00 | $6.89 – $12.06 | 4 |
| Fibrin degrade semiquant CPT 85378 | $68.75 | $125.00 | $9.72 – $17.01 | 4 |
| Fibrin degradj d-dimer CPT 85380 | not published | not published | $10.18 – $17.82 | 4 |
| Fibrinogen activity CPT 85384 | $56.10 | $102.00 | $9.72 – $17.01 | 4 |
| Fibrinogen test CPT 85370 | not published | not published | $12.43 – $21.75 | 4 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | not published | not published | $15.48 – $27.09 | 4 |
| Fibrinolytic antiplasmin CPT 85410 | not published | not published | $7.71 – $13.49 | 4 |
| Fibrinolytic plasmin CPT 85400 | not published | not published | $7.71 – $13.49 | 4 |
| Fibrinolytic plasminogen CPT 85415 | $109.45 | $199.00 | $17.19 – $30.08 | 4 |
| Fibrinolytic plasminogen CPT 85421 | not published | not published | $10.18 – $17.82 | 4 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | $124.85 | $227.00 | $6.53 – $11.43 | 4 |
| Fibula bone graft microvasc CPT 20955 | not published | not published | $7,048.20 – $15,012.00 | 3 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | not published | not published | $0.29 – $0.79 | 6 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | not published | not published | $0.98 – $2.67 | 6 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | not published | not published | $0.33 – $0.89 | 6 |
| Filleted finger/toe flap CPT 14350 | not published | not published | $2,004.13 – $4,743.00 | 3 |
| Filtered speech hearing test CPT 92571 | not published | not published | $36.28 – $36.28 | 1 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $871.35 | $1,584.28 | not published | 0 |
| Filter vena cava fem denali HCPCS C1880 | $1,038.31 | $1,887.83 | not published | 0 |
| Fimbrioplasty 58760 CPT 58760 | not published | not published | $8,960.00 – $10,137.00 | 2 |
| Finasteride, 5 mg HCPCS S0138 | not published | not published | $16.42 – $16.42 | 1 |
| Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 CPT 10007 | not published | not published | $687.83 – $4,217.00 | 3 |
| Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008 CPT 10008 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Fine needle aspiration biopsy without img gdn; ea addtl 10004 CPT 10004 | $457.60 | $832.00 | $2,181.00 – $9,837.00 | 2 |
| Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 | $457.60 | $832.00 | $2,181.00 – $9,837.00 | 2 |
| Fine needle asp without image guide 10021 CPT 10021 | $391.05 | $711.00 | $394.86 – $4,217.00 | 3 |
| Finger tendon transfer CPT 26497 | not published | not published | $3,178.20 – $10,137.00 | 3 |
| Finger tendon transfer CPT 26498 | not published | not published | $3,178.20 – $10,137.00 | 3 |
| Fistula repair & colostomy CPT 57307 | not published | not published | $8,960.00 – $8,960.00 | 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.