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 |
|---|---|---|---|---|
| Ft insert ucb berkeley shell HCPCS L3000 | $54.44 | $98.98 | not published | 0 |
| Ftl cgen abnor 3 proteins CPT 81509 | not published | not published | $1,487.37 – $2,602.90 | 4 |
| Ftl cgen abnor five anal CPT 81512 | not published | not published | $69.52 – $121.66 | 4 |
| Ftl cgen abnor four anal CPT 81511 | $46.20 | $84.00 | $153.50 – $268.63 | 4 |
| Ftl cgen abnor three anal CPT 81510 | not published | not published | $55.54 – $97.20 | 4 |
| Ftl cgen abnor two proteins CPT 81508 | not published | not published | $54.30 – $95.03 | 4 |
| Full field erg w/i&r CPT 92273 | not published | not published | $209.73 – $209.73 | 1 |
| Full mouth x-ray of teeth CPT 70320 | not published | not published | $108.09 – $231.76 | 2 |
| Full thick gft/nose/ear/lid/lip/20sqcm or< 15260 CPT 15260 | not published | not published | $2,004.13 – $4,743.00 | 3 |
| Full thick gft/scalp/arm/leg/20sqcm or< 15220 CPT 15220 | not published | not published | $2,004.13 – $4,743.00 | 3 |
| Full thick gft/scalp/arm/leg/add 20sqcm 15221 CPT 15221 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | not published | not published | $2,004.13 – $4,743.00 | 3 |
| Fundus photography with i&r 92250 CPT 92250 | not published | not published | $129.23 – $129.23 | 1 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | not published | not published | $0.02 – $0.06 | 5 |
| Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr HCPCS J1940 | not published | not published | $0.50 – $0.50 | 1 |
| Fuse bile ducts and bowel 47785 CPT 47785 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Fuse esophagus & intestine CPT 43340 | not published | not published | $8,960.00 – $8,960.00 | 1 |
| Fuse esophagus & intestine CPT 43341 | not published | not published | $8,960.00 – $8,960.00 | 1 |
| Fuse esophagus & stomach CPT 43320 | not published | not published | $8,960.00 – $8,960.00 | 1 |
| Fuse gallbladder & bowel CPT 47740 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Fuse gallbladder & bowel CPT 47741 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Fuse/graft added joint CPT 26863 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Fuse liver ducts & bowel CPT 47765 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Fuse pancreas and bowel CPT 48548 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Fuse pancreas cyst and bowel CPT 48540 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Fuse pancreas cyst and bowel 48520 CPT 48520 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Fuse upper gi structures CPT 47721 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Fusion/graft of finger joint CPT 26862 | not published | not published | $3,178.20 – $10,137.00 | 3 |
| Fusion/graft of hand joint CPT 26844 | not published | not published | $7,048.20 – $14,758.00 | 3 |
| Fusion of ankle joint open CPT 27870 | not published | not published | $12,470.63 – $17,116.00 | 3 |
| Fusion of big toe joint CPT 28750 | not published | not published | $7,048.20 – $17,116.00 | 3 |
| Fusion of big toe joint CPT 28755 | not published | not published | $7,048.20 – $14,758.00 | 3 |
| Fusion of facial/other nerve CPT 64866 | not published | not published | $8,960.00 – $8,960.00 | 1 |
| Fusion of finger jnt add-on CPT 26861 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Fusion of finger joint CPT 26860 | not published | not published | $3,178.20 – $10,137.00 | 3 |
| Fusion of finger tendons CPT 26471 | not published | not published | $3,178.20 – $8,433.00 | 3 |
| Fusion of finger tendons CPT 26474 | not published | not published | $1,561.89 – $4,743.00 | 3 |
| Fusion of foot bones CPT 28730 | not published | not published | $12,470.63 – $17,116.00 | 3 |
| Fusion of foot bones CPT 28735 | not published | not published | $12,470.63 – $17,116.00 | 3 |
| Fusion of foot bones CPT 28740 | not published | not published | $7,048.20 – $17,116.00 | 3 |
| Fusion of hand joint CPT 26843 | not published | not published | $7,048.20 – $14,758.00 | 3 |
| Fusion of knee CPT 27580 | not published | not published | $8,433.00 – $17,116.00 | 3 |
| Fusion of knuckle CPT 26850 | not published | not published | $7,048.20 – $14,758.00 | 3 |
| Fusion of knuckle joint CPT 26516 | not published | not published | $3,178.20 – $10,137.00 | 3 |
| Fusion of knuckle joints CPT 26517 | not published | not published | $3,178.20 – $10,137.00 | 3 |
| Fusion of knuckle joints CPT 26518 | not published | not published | $7,048.20 – $10,137.00 | 3 |
| Fusion of knuckle with graft CPT 26852 | not published | not published | $7,048.20 – $14,758.00 | 3 |
| Fusion of skull arteries CPT 61711 | not published | not published | $14,758.00 – $14,758.00 | 1 |
| Fusion of spermatic ducts CPT 54900 | not published | not published | $2,030.46 – $8,701.00 | 3 |
| Fusion of spermatic ducts CPT 54901 | not published | not published | $3,423.93 – $8,701.00 | 3 |
| Fusion of tendons at wrist CPT 25300 | not published | not published | $3,178.20 – $10,137.00 | 3 |
| Fusion of tendons at wrist CPT 25301 | not published | not published | $3,178.20 – $10,137.00 | 3 |
| Fusion of thumb CPT 26841 | not published | not published | $7,048.20 – $14,758.00 | 3 |
| Fusion of tibiofibular joint CPT 27871 | not published | not published | $12,470.63 – $17,116.00 | 3 |
| Fusion of toes CPT 28280 | not published | not published | $3,178.20 – $8,701.00 | 3 |
| Fusion of ureter & bowel CPT 50810 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Fusion of ureter & kidney CPT 50740 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Fusion of ureter & kidney CPT 50750 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Fxn gene charac alleles CPT 81285 | not published | not published | $274.83 – $480.95 | 4 |
| Fxn gene detc abnor alleles CPT 81284 | not published | not published | $137.00 – $239.75 | 4 |
| Fxn gene full gene sequence CPT 81286 | not published | not published | $274.83 – $480.95 | 4 |
| Fxn gene known famil variant CPT 81289 | not published | not published | $185.20 – $324.10 | 4 |
| G6pc gene CPT 81250 | not published | not published | $58.49 – $102.36 | 4 |
| G6pd full gene sequence CPT 81249 | $1,320.00 | $2,400.00 | $600.00 – $1,050.00 | 4 |
| G6pd gene alys cmn variant CPT 81247 | not published | not published | $174.81 – $305.92 | 4 |
| G6pd known familial variant CPT 81248 | not published | not published | $375.25 – $656.69 | 4 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | not published | not published | $59.90 – $59.90 | 1 |
| Ga-68 gallium 68 dotatate HCPCS A9587 | not published | not published | $49.63 – $139.10 | 2 |
| Gabapentin non-blood CPT 80355 | $146.85 | $267.00 | $27.15 – $27.15 | 1 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | not published | not published | $0.26 – $0.79 | 6 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | not published | not published | $1.49 – $4.47 | 6 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | not published | not published | $0.12 – $0.36 | 6 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | not published | not published | $14.71 – $44.14 | 6 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | $82.50 | $150.00 | $21.07 – $36.87 | 4 |
| Galactokinase - sendout CPT 82759 | not published | not published | $21.48 – $37.59 | 4 |
| Galactose transferase test CPT 82776 | not published | not published | $11.74 – $20.55 | 4 |
| Galectin-3 CPT 82777 | not published | not published | $44.25 – $77.44 | 4 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $5,872.22 – $17,116.00 | 3 |
| Gallium ga-68 dotatoc HCPCS C9067 | not published | not published | $3.61 – $11.02 | 2 |
| Gallium ga-68 psma-11, ucla HCPCS A9594 | not published | not published | $363.50 – $1,013.23 | 2 |
| Gallium ga-68 psma-11 ucsf HCPCS A9593 | not published | not published | $550.13 – $1,456.29 | 2 |
| Gallium illuccix 1 millicure HCPCS A9596 | not published | not published | $478.52 – $2,806.90 | 2 |
| Gallium locametz 1 millicuri HCPCS A9800 | $2,066.13 | $3,756.60 | $362.50 – $2,372.01 | 2 |
| Gallium nitrate injection HCPCS J1457 | not published | not published | $3.51 – $3.51 | 1 |
| Galsulfase injection HCPCS J1458 | not published | not published | $484.88 – $1,320.08 | 6 |
| Gamma globulin > 10 cc inj HCPCS J1560 | not published | not published | $162.52 – $1,330.89 | 6 |
| Gamma globulin 1 cc inj HCPCS J1460 | not published | not published | $48.87 – $133.11 | 6 |
| Gammaglobulin iga CPT 82784 | $68.75 | $125.00 | $9.30 – $16.28 | 4 |
| Gammaglobulin ige CPT 82785 | $88.00 | $160.00 | $16.46 – $28.81 | 4 |
| Gamma glutamyltransferase CPT 82977 | $27.50 | $50.00 | $7.20 – $12.60 | 4 |
| Gammagraft HCPCS Q4111 | not published | not published | $7.60 – $22.80 | 6 |
| Gammaplex injection HCPCS J1557 | not published | not published | $57.48 – $156.49 | 6 |
| Gamunex-c/gammaked HCPCS J1561 | not published | not published | $48.35 – $131.64 | 6 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | not published | not published | $32.09 – $96.26 | 6 |
| Ganciclovir long act implant HCPCS J7310 | not published | not published | $11,175.24 – $11,175.24 | 1 |
| Gardner vag dna amp probe CPT 87511 | not published | not published | $35.09 – $61.41 | 4 |
| Gardner vag dna quant CPT 87512 | not published | not published | $41.76 – $73.08 | 4 |
| Gastric analy w/ph ea spec CPT 82930 | not published | not published | $6.71 – $11.74 | 4 |
| Gastric emptying imag study CPT 78265 | $517.55 | $941.00 | $388.31 – $971.56 | 2 |
| Gastric emptying imag study CPT 78266 | $996.60 | $1,812.00 | $527.40 – $1,162.84 | 2 |
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.