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 |
|---|---|---|---|---|
| Antigen therapy services CPT 95145 | not published | not published | $45.48 – $45.48 | 1 |
| Antigen therapy services CPT 95146 | not published | not published | $45.48 – $45.48 | 1 |
| Antigen therapy services CPT 95147 | not published | not published | $69.94 – $69.94 | 1 |
| Antigen therapy services CPT 95148 | not published | not published | $69.94 – $69.94 | 1 |
| Antigen therapy services CPT 95149 | not published | not published | $69.94 – $69.94 | 1 |
| Antigen therapy services CPT 95165 | $18.70 | $34.00 | $45.48 – $45.48 | 1 |
| Antigen therapy services CPT 95170 | not published | not published | $45.48 – $45.48 | 1 |
| Antihemophilic factor-vwf 250 unit-600 unit intravenous solution HCPCS J7187 | not published | not published | $1.45 – $3.94 | 6 |
| Antihemophilic viii/vwf comp HCPCS J7186 | not published | not published | $1.20 – $3.27 | 6 |
| Anti-inhibitor HCPCS J7198 | not published | not published | $2.40 – $6.53 | 6 |
| Anti mog serum - sendout CPT 86362 | $339.90 | $618.00 | $12.05 – $21.09 | 4 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $59.95 | $109.00 | $12.05 – $21.09 | 4 |
| Antineutrophil cytoplasmic antibody titer each antibody CPT 86037 | not published | not published | $12.05 – $21.09 | 4 |
| Ant instr 2-3 vert segm 22845 CPT 22845 | not published | not published | $9,837.00 – $17,116.00 | 2 |
| Ant instrumentation/4-7 vert seg 22846 CPT 22846 | not published | not published | $4,743.00 – $17,116.00 | 2 |
| Antinuclear antibodies CPT 86038 | $150.70 | $274.00 | $12.09 – $21.16 | 4 |
| Antinuclear antibodies titer CPT 86039 | $150.15 | $273.00 | $11.16 – $19.53 | 4 |
| Antiphosphatidylserine antibody CPT 86148 | $125.95 | $229.00 | $16.07 – $28.12 | 4 |
| Antistreptolysin o screen CPT 86063 | not published | not published | $5.77 – $10.10 | 4 |
| Antistreptolysin o titer CPT 86060 | $97.90 | $178.00 | $7.30 – $12.78 | 4 |
| Antithrombin iii activity CPT 85300 | $113.85 | $207.00 | $11.85 – $20.74 | 4 |
| Antithrombin iii injection HCPCS J7197 | not published | not published | $3.94 – $10.73 | 6 |
| Anti-thymocyte glob (equine)(1:1000) intradermal test dose HCPCS J7504 | not published | not published | $4,376.29 – $11,914.45 | 6 |
| Antithymocyte globuln rabbit HCPCS J7511 | not published | not published | $939.35 – $2,557.38 | 6 |
| Ant/post colporrhap/enterocele rpr 57265 CPT 57265 | not published | not published | $4,859.04 – $15,012.00 | 3 |
| Ant sgm img ir flrscn angrph CPT 92287 | not published | not published | $129.23 – $129.23 | 1 |
| Ant sgm img i&r speclr mic CPT 92286 | not published | not published | $129.23 – $129.23 | 1 |
| Aortic circulation assist 33971 CPT 33971 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Aortic dysfunction/dilation CPT 81410 | not published | not published | $504.00 – $882.00 | 4 |
| Aortic dysfunction/dilation CPT 81411 | not published | not published | $1,350.19 – $2,362.83 | 4 |
| Aortic hemiarch graft 33866 CPT 33866 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Apc gene dup/delet variants CPT 81203 | not published | not published | $200.00 – $350.00 | 4 |
| Apc gene full sequence CPT 81201 | not published | not published | $780.00 – $1,365.00 | 4 |
| Apc gene known fam variants CPT 81202 | not published | not published | $280.00 – $490.00 | 4 |
| Aphakia prosth service temp CPT 92358 | not published | not published | $57.30 – $57.30 | 1 |
| Apheresis immunoads slctv CPT 36516 | not published | not published | $4,230.64 – $15,012.00 | 3 |
| Apheresis plasma CPT 36514 | not published | not published | $1,512.78 – $4,743.00 | 3 |
| Apheresis platelets CPT 36513 | not published | not published | $428.53 – $4,217.00 | 3 |
| Apheresis rbc CPT 36512 | not published | not published | $1,512.78 – $4,743.00 | 3 |
| Apheresis wbc CPT 36511 | not published | not published | $1,512.78 – $4,743.00 | 3 |
| Apl(pml-rara) quant - sendout CPT 81315 | not published | not published | $207.31 – $362.79 | 4 |
| Appendectomy CPT 44950 | not published | not published | $6,288.23 – $10,137.00 | 3 |
| Appendectomy add-on 44955 CPT 44955 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Appendectomy/open/rup/w/absc/peri 44960 CPT 44960 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Appendix Removal (Laparoscopic) CPT 44970 | not published | not published | $5,872.22 – $17,116.00 | 3 |
| App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm CPT 15277 | not published | not published | $2,004.13 – $4,743.00 | 3 |
| App high cost ss f/n/g/h/f >100sq cm addl 100sq cm CPT 15278 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| App high cost ss f/n/g/h/f <100sq cm addl <25sq cm CPT 15276 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| App high cost ss t/a/l >100sq cm 1st 100sq cm CPT 15273 | not published | not published | $2,004.13 – $10,137.00 | 3 |
| App high cost ss t/a/l >100sq cm addl 100sq cm CPT 15274 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| App high cost ss t/a/l <100sq cm addl <25sq cm CPT 15272 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Appl bdy cst sho to hip 1thi CPT 29044 | not published | not published | $157.84 – $4,217.00 | 3 |
| Appl bdy cst sho to hip b th CPT 29046 | not published | not published | $271.67 – $4,217.00 | 3 |
| Appl bdy cst sho to hip head CPT 29040 | not published | not published | $271.67 – $4,217.00 | 3 |
| Appl body cast sho to hips CPT 29035 | not published | not published | $271.67 – $4,217.00 | 3 |
| Appl cast figure-of-eight CPT 29049 | not published | not published | $271.67 – $4,217.00 | 3 |
| Appl cast plaster velpeau CPT 29058 | not published | not published | $271.67 – $4,217.00 | 3 |
| Appl cast shoulder spica CPT 29055 | not published | not published | $271.67 – $4,217.00 | 3 |
| Appl halo type body cast CPT 29000 | not published | not published | $271.67 – $4,217.00 | 3 |
| Appl hip spica cast1&1/2 CPT 29325 | not published | not published | $271.67 – $4,217.00 | 3 |
| Appl hip spica cast 1 leg CPT 29305 | not published | not published | $271.67 – $4,217.00 | 3 |
| Application clubfoot cast CPT 29450 | not published | not published | $157.84 – $4,217.00 | 3 |
| Application finger splntstatic 29130 CPT 29130 | $113.30 | $206.00 | $129.23 – $4,217.00 | 3 |
| Application halo femoral CPT 20663 | not published | not published | $3,178.20 – $10,137.00 | 3 |
| Application halo pelvic CPT 20662 | not published | not published | $1,561.89 – $8,701.00 | 3 |
| Application long leg splint 29505 CPT 29505 | $114.40 | $208.00 | $157.84 – $4,217.00 | 3 |
| Application lower leg splint 29515 CPT 29515 | $114.40 | $208.00 | $157.84 – $4,217.00 | 3 |
| Application multi layer compression below knee (both sides) CPT 29581 | $172.33 | $313.33 | $157.84 – $4,217.00 | 3 |
| Application of body cast CPT 29010 | not published | not published | $271.67 – $4,217.00 | 3 |
| Application of body cast CPT 29015 | not published | not published | $271.67 – $4,217.00 | 3 |
| Application of cylinder cast 29365 CPT 29365 | not published | not published | $271.67 – $4,217.00 | 3 |
| Application of forearm cast 29075 CPT 29075 | not published | not published | $271.67 – $4,217.00 | 3 |
| Application of long arm cast 29065 CPT 29065 | $395.45 | $719.00 | $271.67 – $4,217.00 | 3 |
| Application of long leg cast CPT 29355 | not published | not published | $271.67 – $4,217.00 | 3 |
| Application of long leg cast 29345 CPT 29345 | $505.45 | $919.00 | $271.67 – $4,217.00 | 3 |
| Application of paste boot 29580 CPT 29580 | $147.40 | $268.00 | $157.84 – $4,217.00 | 3 |
| Application short leg cast 29405 CPT 29405 | $454.85 | $827.00 | $271.67 – $4,217.00 | 3 |
| Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm CPT 15275 | not published | not published | $717.88 – $4,743.00 | 3 |
| Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm CPT 15271 | not published | not published | $717.88 – $4,743.00 | 3 |
| Appl long leg cast brace CPT 29358 | not published | not published | $271.67 – $4,217.00 | 3 |
| Appl mltpln uni ext fixj sys CPT 20692 | not published | not published | $10,137.00 – $16,164.00 | 3 |
| Appl modality 1/> areas paraffin bath 97018 CPT 97018 | $75.35 | $137.00 | $5.63 – $5.63 | 1 |
| Appl modality 1/> areas vasopneumatic devices 97016 CPT 97016 | $85.25 | $155.00 | $11.55 – $11.55 | 1 |
| Appl modality 1+lllt po pain CPT 97037 | not published | not published | $36.28 – $36.28 | 1 |
| Appl multlay comprs arm/hand CPT 29584 | not published | not published | $157.84 – $4,217.00 | 3 |
| Appl patllr tdn bearing cast CPT 29435 | not published | not published | $271.67 – $4,217.00 | 3 |
| Appl unipln uni ext fixj sys CPT 20690 | not published | not published | $7,048.20 – $14,758.00 | 3 |
| Apply finger cast 29086 CPT 29086 | not published | not published | $157.84 – $4,217.00 | 3 |
| Apply forearm splintdynamic 29126 CPT 29126 | not published | not published | $129.23 – $4,217.00 | 3 |
| Apply halo w/removal cranial CPT 20661 | not published | not published | $1,561.89 – $4,743.00 | 3 |
| Apply hand/wrist cast 29085 CPT 29085 | not published | not published | $157.84 – $4,217.00 | 3 |
| Apply interstit radiat compl CPT 77778 | not published | not published | $676.51 – $766.36 | 2 |
| Apply intrcav radiat compl CPT 77763 | not published | not published | $676.51 – $753.98 | 2 |
| Apply intrcav radiat interm CPT 77762 | not published | not published | $536.70 – $583.86 | 2 |
| Apply intrcav radiat simple CPT 77761 | not published | not published | $507.17 – $536.70 | 2 |
| Apply of finger splint 29131 CPT 29131 | not published | not published | $57.30 – $4,217.00 | 3 |
| Apply rem fixation device CPT 20660 | not published | not published | $1,561.89 – $4,743.00 | 3 |
| Apply rigid leg cast 29445 CPT 29445 | not published | not published | $271.67 – $4,217.00 | 3 |
| Apply short leg castambul type 29425 CPT 29425 | not published | not published | $271.67 – $4,217.00 | 3 |
| Apply surf ldr radionuclide CPT 77789 | not published | not published | $99.11 – $159.48 | 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.