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 |
|---|---|---|---|---|
| Ibuprofen injection HCPCS J1741 | not published | not published | $2.98 – $8.12 | 6 |
| Ibutilide fumarate 0.1 mg/ml intravenous solution HCPCS J1742 | not published | not published | $175.89 – $1,285.53 | 2 |
| Icatibant injection HCPCS J1744 | not published | not published | $125.32 – $375.95 | 5 |
| Icd cobalt xt dr MRI is1 df1 HCPCS C1721 | $8,336.62 | $15,157.50 | not published | 0 |
| Icd crtd cobalt hf MRI is1 df1 HCPCS C1882 | $12,103.02 | $22,005.50 | not published | 0 |
| Icd crtp serena MRI HCPCS C2621 | $4,463.94 | $8,116.25 | not published | 0 |
| Icg angiography i&r uni/bi CPT 92240 | not published | not published | $209.73 – $209.73 | 1 |
| Icut allergy test-delayed CPT 95028 | not published | not published | $36.28 – $36.28 | 1 |
| Icut allergy test drug/bug CPT 95024 | $10.45 | $19.00 | $57.30 – $57.30 | 1 |
| I&d abscess posterior spine l/s/ls-22015 CPT 22015 | not published | not published | $4,743.00 – $17,116.00 | 3 |
| I&d abscss rtrphryngl/paraphryngl intraorl apprch CPT 42720 | not published | not published | $3,220.41 – $4,743.00 | 3 |
| Idarubicin hcl injection HCPCS J9211 | not published | not published | $43.51 – $130.52 | 6 |
| I&d/bursa/foot 28001 CPT 28001 | not published | not published | $1,604.25 – $4,743.00 | 3 |
| Idecabtagene vicleucel car HCPCS Q2055 | not published | not published | $527,622.46 – $1,436,452.15 | 6 |
| Identify sperm tissue CPT 89264 | not published | not published | $50.62 – $50.62 | 1 |
| Idet 1 or more levels CPT 22527 | not published | not published | $8,433.00 – $10,137.00 | 2 |
| Idet single level CPT 22526 | not published | not published | $8,433.00 – $10,137.00 | 2 |
| I&d frarm&/wrst deep absc/hematoma CPT 25028 | not published | not published | $3,178.20 – $8,701.00 | 3 |
| Idh1 common variants CPT 81120 | not published | not published | $193.25 – $338.19 | 4 |
| Idh2 common variants CPT 81121 | not published | not published | $295.79 – $517.63 | 4 |
| I&d intramural/intramuscular/submuc abscess transanal anes CPT 46045 | not published | not published | $2,696.09 – $8,701.00 | 3 |
| I&d lacrimal gland CPT 68400 | not published | not published | $968.30 – $4,743.00 | 3 |
| I&d lacrimal sac CPT 68420 | not published | not published | $2,309.33 – $4,743.00 | 3 |
| I&d upper arm/elbow deep abscess/hematoma CPT 23930 | not published | not published | $2,821.44 – $8,701.00 | 3 |
| Idursulfase injection HCPCS J1743 | not published | not published | $542.57 – $1,477.15 | 6 |
| I & d vag hematoma non-ob 57023 CPT 57023 | not published | not published | $2,821.44 – $8,701.00 | 3 |
| I&d vag hemtma obst/postpart CPT 57022 | not published | not published | $2,821.44 – $4,743.00 | 3 |
| Ifnl3 gene CPT 81283 | not published | not published | $73.37 – $128.40 | 4 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | not published | not published | $24.62 – $73.85 | 6 |
| Igh@/bcl2 translocation alys CPT 81278 | not published | not published | $207.31 – $362.79 | 4 |
| Igh gene rearrang dir probe CPT 81262 | not published | not published | $68.55 – $119.96 | 4 |
| Igh gene rearrange amp meth CPT 81261 | $437.80 | $796.00 | $197.99 – $346.48 | 4 |
| Igh@ var region somatic mutation analy CPT 81263 | not published | not published | $294.52 – $515.41 | 4 |
| Igk rearrangeabn clonal pop CPT 81264 | $489.50 | $890.00 | $172.73 – $302.28 | 4 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $184.40 | $335.27 | $69.07 – $69.07 | 1 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $63.80 | $116.00 | $151.08 – $348.17 | 2 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $382.25 | $695.00 | $75.80 – $165.49 | 2 |
| Iiv3 vacc no prsv 0.25 ml im CPT 90655 | not published | not published | $35.06 – $35.06 | 1 |
| Ikbkap gene CPT 81260 | not published | not published | $39.31 – $68.79 | 4 |
| Ileostomy/jejunostomy non-tube 44310 CPT 44310 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Iliac bone graft microvasc CPT 20956 | not published | not published | $7,048.20 – $17,116.00 | 3 |
| Iliac/fem angio cath insert HCPCS G0278 | $2,136.20 | $3,884.00 | not published | 0 |
| Iliac revasc add-on 37222 CPT 37222 | $4,214.10 | $7,662.00 | $9,837.00 – $17,116.00 | 2 |
| Iloprost non-comp unit dose HCPCS Q4074 | not published | not published | $148.76 – $446.29 | 6 |
| Imbrication/diaphragm/transthor/transabd 39545 CPT 39545 | not published | not published | $13,176.00 – $13,176.00 | 1 |
| Imetelstat 188 mg intravenous solution HCPCS J0870 | not published | not published | $55.51 – $151.12 | 5 |
| Img rta detcj/mntr ds staff CPT 92227 | not published | not published | $57.30 – $57.30 | 1 |
| Img rta detc/mntr ds phy/qhp CPT 92228 | not published | not published | $36.28 – $36.28 | 1 |
| Img rta detc/mntr ds poc aly CPT 92229 | not published | not published | $57.30 – $57.30 | 1 |
| Immt breast prosthesis 19340 CPT 19340 | not published | not published | $7,939.08 – $15,012.00 | 3 |
| Immune complex assay CPT 86332 | $204.60 | $372.00 | $24.37 – $42.65 | 4 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | not published | not published | $45.13 – $122.86 | 6 |
| Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution HCPCS J1566 | not published | not published | $80.96 – $220.56 | 6 |
| Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution HCPCS J1568 | not published | not published | $47.06 – $130.85 | 6 |
| Immune globulin ig human im use 90281 CPT 90281 | not published | not published | $162.64 – $162.64 | 1 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $150.70 | $274.00 | $20.81 – $36.42 | 4 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $118.80 | $216.00 | $20.81 – $36.42 | 4 |
| Immunoassay tumor qual CPT 86294 | not published | not published | $25.57 – $44.75 | 4 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $138.60 | $252.00 | $11.98 – $20.97 | 4 |
| Immunodiffusion nes CPT 86329 | not published | not published | $14.05 – $24.59 | 4 |
| Immunoelectrophoresis assay CPT 86327 | not published | not published | $35.61 – $35.61 | 1 |
| Immunofixation electrophoresis serum CPT 86334 | $215.60 | $392.00 | $22.34 – $39.10 | 4 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $422.95 | $769.00 | $101.80 – $101.80 | 1 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $248.60 | $452.00 | $134.00 – $165.49 | 2 |
| Immunoglobulin assay CPT 86023 | $101.20 | $184.00 | $12.46 – $21.81 | 4 |
| Impact tooth remov part bony HCPCS D7230 | not published | not published | $627.95 – $9,837.00 | 2 |
| Impedence cardiogram CPT 93701 | not published | not published | $129.23 – $129.23 | 1 |
| Imp extar knee shck absrb HCPCS C8003 | not published | not published | $16,164.00 – $17,031.17 | 2 |
| Impl absrb msh/prsth dly cls CPT 15778 | not published | not published | $16,164.00 – $16,164.00 | 1 |
| Implantation iris prosthesis CPT 66683 | not published | not published | $4,743.00 – $15,988.94 | 2 |
| Implant biventricular device 33976 CPT 33976 | not published | not published | $16,164.00 – $16,164.00 | 1 |
| Implant brain electrodes CPT 61531 | not published | not published | $4,137.00 – $14,758.00 | 2 |
| Implant brain electrodes CPT 61533 | not published | not published | $14,758.00 – $14,758.00 | 1 |
| Implant brain electrodes CPT 61760 | not published | not published | $4,137.00 – $14,758.00 | 2 |
| Implant cartilage 10mm synthetic HCPCS L8699 | $766.90 | $1,394.36 | not published | 0 |
| Implant cochlear device CPT 69930 | not published | not published | $13,352.00 – $51,258.00 | 3 |
| Implant eye drug system CPT 67027 | not published | not published | $13,352.00 – $15,012.00 | 3 |
| Implant hormone pellet(s) 11980 CPT 11980 | not published | not published | $433.92 – $4,217.00 | 3 |
| Implant nerve end CPT 64787 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Implant neuroelectrde addl CPT 61864 | not published | not published | $4,743.00 – $4,743.00 | 1 |
| Implant neuroelectrde addl CPT 61868 | not published | not published | $4,743.00 – $4,743.00 | 1 |
| Implant neuroelectrode CPT 61863 | not published | not published | $14,758.00 – $14,758.00 | 1 |
| Implant neuroelectrode CPT 61867 | not published | not published | $14,758.00 – $14,758.00 | 1 |
| Implant neuroelectrodes CPT 63655 | not published | not published | $13,352.00 – $25,004.00 | 3 |
| Implant neuroelectrodes CPT 64553 | not published | not published | $10,823.26 – $17,116.00 | 3 |
| Implant neuroelectrodes CPT 64555 | not published | not published | $6,190.30 – $17,116.00 | 3 |
| Implant neuroelectrodes CPT 64561 | $9,997.35 | $18,177.00 | $6,190.30 – $17,116.00 | 3 |
| Implant neuroelectrodes CPT 61850 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Implant neuroelectrodes CPT 61860 | not published | not published | $14,758.00 – $14,758.00 | 1 |
| Implant neurostim arrays CPT 61886 | not published | not published | $13,352.00 – $51,258.00 | 3 |
| Implant/replace hearing aid CPT 69710 | not published | not published | $8,960.00 – $15,012.00 | 2 |
| Implant single ventricular device 33975 CPT 33975 | not published | not published | $16,164.00 – $16,164.00 | 1 |
| Implant spinal canal cath CPT 62351 | not published | not published | $7,048.20 – $17,116.00 | 3 |
| Implant spine infusion pump CPT 62361 | not published | not published | $13,352.00 – $41,823.00 | 3 |
| Implant spine infusion pump CPT 62362 | not published | not published | $13,352.00 – $41,823.00 | 3 |
| Implant tcat pulm vlv perq CPT 33477 | not published | not published | $13,352.00 – $13,352.00 | 1 |
| Implant ureter in bowel CPT 50800 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Impl ear abutment ba300 9mm HCPCS L8693 | not published | not published | $1,867.13 – $1,867.13 | 1 |
| Impl neurostim electr perc CPT 63650 | not published | not published | $6,190.30 – $17,116.00 | 3 |
| Implnt bio implnt for soft tiss reinforcement 15777 CPT 15777 | not published | not published | $2,181.00 – $9,837.00 | 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.