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 |
|---|---|---|---|---|
| Hla i typing high res 1 allele grp ea CPT 81381 | $356.95 | $649.00 | $169.90 – $297.33 | 4 |
| Hla i typing low res one locus ea CPT 81373 | not published | not published | $127.43 – $223.00 | 4 |
| Hla typing a b or c CPT 86813 | not published | not published | $58.00 – $101.50 | 4 |
| Hla typing dr/dq CPT 86816 | $231.55 | $421.00 | $30.17 – $52.80 | 4 |
| Hla x-match noncytotoxc addl CPT 86826 | not published | not published | $36.53 – $63.93 | 4 |
| Hla x-math non-cytotoxic CPT 86825 | not published | not published | $109.49 – $191.61 | 4 |
| Hlth bhv assmt/reassessment CPT 96156 | not published | not published | $98.68 – $98.68 | 1 |
| Hlth bhv ivntj indiv 1st 30 CPT 96158 | not published | not published | $172.41 – $172.41 | 1 |
| Hocm 250-299mg/ml iodine,1ml HCPCS Q9961 | not published | not published | $0.29 – $0.86 | 6 |
| Hocm 350-399mg/ml iodine,1ml HCPCS Q9963 | not published | not published | $0.22 – $0.66 | 6 |
| Home sleep test/type 2 porta HCPCS G0398 | not published | not published | $209.73 – $209.73 | 1 |
| Home sleep test/type 3 porta HCPCS G0399 | not published | not published | $209.73 – $209.73 | 1 |
| Home sleep test/type 4 porta HCPCS G0400 | not published | not published | $209.73 – $209.73 | 1 |
| Homocysteine CPT 83090 | $87.45 | $159.00 | $17.92 – $31.36 | 4 |
| Homogenization tissue CPT 87176 | $32.45 | $59.00 | $5.88 – $10.29 | 4 |
| Homovanillic acid (hva) CPT 83150 | $393.25 | $715.00 | $22.41 – $39.22 | 4 |
| Hopd mntl hlt, 30-60 min HCPCS C7901 | not published | not published | $98.68 – $98.68 | 1 |
| Hpa-15 genotyping CPT 81112 | not published | not published | $122.22 – $213.89 | 4 |
| Hpa-1 genotyping CPT 81105 | not published | not published | $122.22 – $213.89 | 4 |
| Hpa-2 genotyping CPT 81106 | not published | not published | $122.22 – $213.89 | 4 |
| Hpa-3 genotyping CPT 81107 | not published | not published | $122.22 – $213.89 | 4 |
| Hpa-4 genotyping CPT 81108 | not published | not published | $122.22 – $213.89 | 4 |
| Hpa-5 genotyping CPT 81109 | not published | not published | $122.22 – $213.89 | 4 |
| Hpa-6 genotyping CPT 81110 | not published | not published | $122.22 – $213.89 | 4 |
| Hpa-9 genotyping CPT 81111 | not published | not published | $122.22 – $213.89 | 4 |
| Hpv combo assay ca screen HCPCS G0476 | not published | not published | $35.09 – $61.41 | 4 |
| Hpv low-risk types CPT 87623 | not published | not published | $35.09 – $61.41 | 4 |
| Hpv types 16 & 18 only CPT 87625 | $127.05 | $231.00 | $40.55 – $70.96 | 4 |
| H pylori ag ia CPT 87339 | not published | not published | $16.00 – $28.00 | 4 |
| H pylori (c-13) blood CPT 83009 | not published | not published | $67.36 – $117.88 | 4 |
| H pylori (c-13) breath CPT 83013 | $127.05 | $231.00 | $67.36 – $117.88 | 4 |
| H pylori drug admin CPT 83014 | not published | not published | $7.86 – $13.76 | 4 |
| Hrdtry brst ca-rlatd do 5+ CPT 81432 | not published | not published | $808.26 – $2,281.91 | 4 |
| Hrdtry brst ca-rlatd dsordrs CPT 81433 | not published | not published | $522.44 – $522.44 | 1 |
| Hrdtry cardmypy gene panel CPT 81439 | not published | not published | $584.90 – $1,023.58 | 4 |
| Hrdtry perph neurphy panel CPT 81448 | not published | not published | $584.90 – $1,023.58 | 4 |
| Hrv skn cll ssp agrft 1st 25 CPT 15011 | not published | not published | $2,004.13 – $4,743.00 | 2 |
| Hsv dna dir probe CPT 87528 | not published | not published | $20.05 – $35.09 | 4 |
| Htt gene charac alleles CPT 81274 | not published | not published | $274.83 – $480.95 | 4 |
| Htt gene detc abnor alleles CPT 81271 | not published | not published | $137.00 – $239.75 | 4 |
| Human epididymis protein 4 (he4) CPT 86305 | $239.25 | $435.00 | $20.81 – $36.42 | 4 |
| Human ig IV CPT 90283 | not published | not published | $252.38 – $252.38 | 1 |
| Human ig sc CPT 90284 | not published | not published | $63.03 – $63.03 | 1 |
| Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution HCPCS J7165 | not published | not published | $1.73 – $10.30 | 2 |
| Hyaluronidase 150 unit/ml injection solution HCPCS J3470 | not published | not published | $32.17 – $96.50 | 6 |
| Hyaluronidase 200 units/ml inj HCPCS J3471 | not published | not published | $0.50 – $1.50 | 5 |
| Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 | not published | not published | $0.36 – $1.09 | 6 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | not published | not published | $4.40 – $13.21 | 6 |
| Hydration IV infusion each additional hour CPT 96361 | $158.40 | $288.00 | $45.48 – $125.61 | 2 |
| Hydration IV infusion initial 31minutes - 1 hour CPT 96360 | $201.30 | $366.00 | $206.61 – $573.61 | 2 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | not published | not published | $20.58 – $61.74 | 6 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | not published | not published | $0.12 – $0.41 | 6 |
| Hydromorphone 250 mg HCPCS S0092 | not published | not published | $203.43 – $203.43 | 1 |
| Hydroxocobalamin im 10mcg HCPCS J3425 | not published | not published | $0.01 – $0.03 | 6 |
| Hydroxyurea 500 mg HCPCS S0176 | not published | not published | $12.47 – $12.47 | 1 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | not published | not published | $16.00 – $53.28 | 6 |
| Hydroxyzine pamoate 25 mg capsule HCPCS Q0177 | not published | not published | $5.28 – $5.28 | 1 |
| Hydrxycorticsterds 17- (17-ohcs) CPT 83491 | not published | not published | $17.90 – $31.33 | 4 |
| Hymenotomy CPT 56442 | not published | not published | $3,144.33 – $8,701.00 | 3 |
| Hymovis injection 1 mg HCPCS J7322 | not published | not published | $17.50 – $47.65 | 6 |
| Hyoid myotomy & suspension CPT 21685 | not published | not published | $5,750.12 – $8,960.00 | 3 |
| Hyoscyamine sulfate inj HCPCS J1980 | not published | not published | $24.67 – $24.67 | 1 |
| #hypersens-actinomyces ab CPT 86602 | not published | not published | $10.18 – $17.82 | 4 |
| Hyperthermia ext gen deep CPT 77605 | not published | not published | $676.51 – $1,747.49 | 2 |
| Hyperthermia ext gen supfc CPT 77600 | not published | not published | $374.64 – $858.69 | 2 |
| Hyperthermia gen intrcv prb CPT 77620 | not published | not published | $536.70 – $1,004.29 | 2 |
| Hyperthermia ntrstl prb 5/< CPT 77610 | not published | not published | $536.70 – $2,259.40 | 2 |
| Hyperthermia ntrstl prb>5 CPT 77615 | not published | not published | $536.70 – $2,405.96 | 2 |
| Hypnotherapy CPT 90880 | not published | not published | $98.68 – $98.68 | 1 |
| Hyqvia 100mg immuneglobulin HCPCS J1575 | not published | not published | $17.57 – $47.83 | 6 |
| Hysterectomy/bladder repair CPT 51925 | not published | not published | $13,176.00 – $13,176.00 | 1 |
| Hysterectomy/revise vagina 58275 CPT 58275 | not published | not published | $10,137.00 – $13,176.00 | 2 |
| Hysterectomy/revise vagina 58280 CPT 58280 | not published | not published | $10,137.00 – $13,176.00 | 2 |
| Hysteroplasty 58540 CPT 58540 | not published | not published | $8,960.00 – $8,960.00 | 1 |
| Hysterorrhaphy of ruptured uterus 59350 CPT 59350 | not published | not published | $8,960.00 – $8,960.00 | 1 |
| Hysterosalpingography s&i CPT 74740 | $380.05 | $691.00 | $148.08 – $231.76 | 2 |
| Hysteroscopy ablation CPT 58563 | not published | not published | $4,859.04 – $10,137.00 | 3 |
| Hysteroscopy biopsy CPT 58558 | not published | not published | $3,144.33 – $8,701.00 | 3 |
| Hysteroscopy dx sep proc CPT 58555 | not published | not published | $3,144.33 – $8,701.00 | 3 |
| Hysteroscopy lysis CPT 58559 | not published | not published | $4,859.04 – $8,960.00 | 3 |
| Hysteroscopy remove fb CPT 58562 | not published | not published | $3,144.33 – $8,701.00 | 3 |
| Hysteroscopy remove myoma CPT 58561 | not published | not published | $4,859.04 – $10,137.00 | 3 |
| Hysteroscopy resect septum CPT 58560 | not published | not published | $4,859.04 – $10,137.00 | 3 |
| Hysterotomy abdominal 59100 CPT 59100 | not published | not published | $4,743.00 – $8,701.00 | 3 |
| I-123 iobenguane diag HCPCS A9582 | not published | not published | $2,317.50 – $5,648.68 | 2 |
| I-123 ioflupane diag HCPCS A9584 | not published | not published | $1,387.74 – $3,778.88 | 2 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | $147.46 | $268.10 | $303.83 – $303.83 | 1 |
| I125 iothalamate, dx HCPCS A9554 | not published | not published | $105.68 – $649.64 | 2 |
| I125 serum albumin, dx HCPCS A9532 | not published | not published | $469.06 – $558.33 | 2 |
| I-131 iobenguane sulf diag mibg HCPCS A9508 | not published | not published | $953.01 – $2,805.69 | 2 |
| I131 iodide cap, rx HCPCS A9517 | $333.19 | $605.80 | $24.07 – $62.96 | 2 |
| I131 iodide sol, rx HCPCS A9530 | not published | not published | $20.77 – $56.84 | 2 |
| I131 max 100uci HCPCS A9531 | not published | not published | $11.47 – $11.47 | 1 |
| I131 serum albumin, dx HCPCS A9524 | not published | not published | $981.02 – $981.02 | 1 |
| Iaadi respiratory synctial virus CPT 87280 | not published | not published | $13.42 – $23.49 | 4 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | not published | not published | $35.09 – $61.41 | 4 |
| Ia infect ag ab qual/semiquant sgl step CPT 86318 | not published | not published | $18.09 – $31.66 | 4 |
| Ia nfct ab sarscov2 covid19 CPT 86328 | not published | not published | $45.28 – $79.24 | 4 |
| Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 | not published | not published | $22.22 – $66.66 | 6 |
| Ibmfs seq alys pnl 30 genes CPT 81441 | not published | not published | $2,448.56 – $4,284.98 | 4 |
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.