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 |
|---|---|---|---|---|
| Ghs removal pharyngeal foreign body CPT 42809 | $383.35 | $697.00 | $433.92 – $4,217.00 | 3 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $1,201.20 | $2,184.00 | $1,561.89 – $4,743.00 | 3 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | not published | not published | $3,178.20 – $10,137.00 | 3 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | not published | not published | $15.89 – $27.81 | 4 |
| Ghs reticulocyte count CPT 85044 | not published | not published | $4.31 – $7.54 | 4 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $72.60 | $132.00 | $13.91 – $24.34 | 4 |
| Ghs sedimentation rate CPT 85651 | not published | not published | $4.27 – $7.47 | 4 |
| Ghs semen analysis fert CPT 89320 | not published | not published | $12.31 – $21.54 | 4 |
| Ghs semen analysis, post-vas CPT 89300 | not published | not published | $9.84 – $17.22 | 4 |
| Ghs sensitivity (per antimicro) CPT 87184 | $66.55 | $121.00 | $7.48 – $13.09 | 4 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $526.35 | $957.00 | $394.86 – $4,217.00 | 3 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $636.90 | $1,158.00 | $394.86 – $4,217.00 | 3 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $603.90 | $1,098.00 | $394.86 – $4,217.00 | 3 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | not published | not published | $394.86 – $4,217.00 | 3 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $526.35 | $957.00 | $194.88 – $4,217.00 | 3 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $447.70 | $814.00 | $194.88 – $4,217.00 | 3 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $579.70 | $1,054.00 | $194.88 – $4,217.00 | 3 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $663.30 | $1,206.00 | $194.88 – $4,217.00 | 3 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | not published | not published | $194.88 – $4,217.00 | 3 |
| Ghs sleep study unattended CPT 95800 | not published | not published | $209.73 – $209.73 | 1 |
| Ghs somatosensory testing lower extremit CPT 95926 | not published | not published | $209.73 – $209.73 | 1 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | not published | not published | $834.12 – $834.12 | 1 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | not published | not published | $46.74 – $46.74 | 1 |
| Ghs sphenopalatine ganglion block CPT 64505 | not published | not published | $298.15 – $4,217.00 | 3 |
| Ghs spont nystagmus CPT 92541 | not published | not published | $129.23 – $129.23 | 1 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $337.70 | $614.00 | $100.12 – $100.12 | 1 |
| Ghs st - eval for alt comm CPT 92567 | $94.60 | $172.00 | $36.28 – $36.28 | 1 |
| Ghs strapping shoulder - 29240 CPT 29240 | $113.30 | $206.00 | $129.23 – $4,217.00 | 3 |
| Ghs st - re-eval for alt comm CPT 92597 | $268.95 | $489.00 | $69.45 – $69.45 | 1 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | not published | not published | $45.48 – $45.48 | 1 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | not published | not published | $206.61 – $206.61 | 1 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $158.40 | $288.00 | $717.88 – $4,217.00 | 3 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | not published | not published | $394.86 – $4,217.00 | 3 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | not published | not published | $1,507.10 – $4,743.00 | 3 |
| Ghs trypsin (fecal) CPT 84488 | not published | not published | $7.30 – $12.78 | 4 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $209.55 | $381.00 | $239.60 – $4,217.00 | 3 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $239.60 – $4,217.00 | 3 |
| Ghs urine, hydroxproline total CPT 83505 | not published | not published | $24.30 – $42.53 | 4 |
| Ghs urine, porphyrins quant CPT 84120 | $124.30 | $226.00 | $14.71 – $25.74 | 4 |
| Ghs vaginal delivery only CPT 59409 | $1,416.80 | $2,576.00 | $3,144.33 – $8,701.00 | 3 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | not published | not published | $362.46 – $362.46 | 1 |
| Ghs windowing of cast CPT 29730 | $77.55 | $141.00 | $157.84 – $4,217.00 | 3 |
| Giardia ag if CPT 87269 | not published | not published | $13.61 – $23.82 | 4 |
| Giardia lamblia antibody CPT 86674 | not published | not published | $14.72 – $25.76 | 4 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $154.70 – $231.76 | 2 |
| Gi inhouse confirmation CPT 87045 | $65.45 | $119.00 | $9.44 – $16.52 | 4 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $3,220.41 – $15,012.00 | 3 |
| Gi protein loss CPT 78282 | not published | not published | $125.01 – $388.31 | 2 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | not published | not published | $880.98 – $4,137.00 | 2 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | $903.30 – $903.30 | 1 |
| Gi trc img intral esophagus CPT 91111 | not published | not published | $880.98 – $4,137.00 | 2 |
| Gi wireless capsule measure CPT 91112 | not published | not published | $880.98 – $4,137.00 | 2 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $101.12 – $176.96 | 4 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $61.52 – $107.66 | 4 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $35.00 – $61.25 | 4 |
| Glassia injection HCPCS J0257 | not published | not published | $5.45 – $14.83 | 6 |
| Glaucoma scrn hgh risk direc HCPCS G0118 | not published | not published | $36.28 – $36.28 | 1 |
| Glaucoma surgery CPT 66150 | not published | not published | $4,014.93 – $8,960.00 | 3 |
| Glaucoma surgery CPT 66155 | not published | not published | $4,014.93 – $8,960.00 | 3 |
| Glaucoma surgery CPT 66160 | not published | not published | $2,241.66 – $8,701.00 | 3 |
| Glaucoma surgery CPT 66170 | not published | not published | $2,241.66 – $8,701.00 | 3 |
| Glucagon 1 mg solution for injection HCPCS J1610 | not published | not published | $117.33 – $519.34 | 6 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | not published | not published | $129.28 – $409.58 | 6 |
| Glucagon plasma - sendout CPT 82943 | $121.00 | $220.00 | $14.29 – $25.01 | 4 |
| Glucagon tolerance panel CPT 80422 | not published | not published | $46.07 – $80.62 | 4 |
| Glucagon tolerance panel CPT 80424 | not published | not published | $50.50 – $88.38 | 4 |
| Glucagon tolerance test CPT 82946 | not published | not published | $17.77 – $31.10 | 4 |
| Glucose 1 hr post dose CPT 82950 | not published | not published | $4.75 – $8.31 | 4 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | not published | not published | $6.05 – $10.59 | 4 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $24.75 | $45.00 | $3.28 – $5.74 | 4 |
| Glucose blood quantitative CPT 82947 | $35.75 | $65.00 | $3.93 – $6.88 | 4 |
| Glucose body fluid CPT 82945 | $70.95 | $129.00 | $3.93 – $6.88 | 4 |
| Glucose monitoring continual min 72hr pt CPT 95249 | $183.70 | $334.00 | $57.30 – $57.30 | 1 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | not published | not published | $12.87 – $22.52 | 4 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | not published | not published | $3.92 – $6.86 | 4 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | not published | not published | $0.51 – $1.53 | 6 |
| Gold sodium thiomaleate inj HCPCS J1600 | not published | not published | $36.10 – $36.10 | 1 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | not published | not published | $10.77 – $29.32 | 6 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $105.60 | $192.00 | $18.58 – $32.52 | 4 |
| Gonadotropin hormone panel CPT 80426 | not published | not published | $148.41 – $259.72 | 4 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $105.60 | $192.00 | $18.52 – $32.41 | 4 |
| Gonioscopy CPT 92020 | not published | not published | $129.23 – $129.23 | 1 |
| Goniotomy CPT 65820 | not published | not published | $4,014.93 – $8,960.00 | 3 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | not published | not published | $705.14 – $2,115.42 | 6 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | not published | not published | $30.36 – $91.09 | 6 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | not published | not published | $120.88 – $2,874.88 | 6 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | not published | not published | $63.62 – $173.20 | 6 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $3,178.20 – $10,137.00 | 3 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | not published | not published | $5,438.20 – $5,438.20 | 1 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $622.67 | $1,132.13 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | not published | not published | $65.41 – $178.08 | 6 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | not published | not published | $105.46 – $287.12 | 6 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | not published | not published | $120.88 – $371.27 | 6 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | not published | not published | $51.79 – $140.99 | 6 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | not published | not published | $37.50 – $177.91 | 6 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $386.48 | $702.69 | not published | 0 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $668.29 | $1,215.07 | not published | 0 |
| Granisetron 1 mg tab HCPCS Q0166 | not published | not published | $140.48 – $140.48 | 1 |
| Granisetron hcl injection HCPCS J1626 | not published | not published | $0.26 – $0.78 | 6 |
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.