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 |
|---|---|---|---|---|
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $76.45 | $139.00 | $11.98 – $20.97 | 4 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $40.15 | $73.00 | $14.38 – $25.17 | 4 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $76.45 | $139.00 | $10.33 – $18.08 | 4 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $118.80 | $216.00 | $10.33 – $18.08 | 4 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $81.95 | $149.00 | $24.08 – $42.14 | 4 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $156.20 | $284.00 | $11.98 – $20.97 | 4 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $72.60 | $132.00 | $11.98 – $20.97 | 4 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | not published | not published | $11.98 – $20.97 | 4 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $487.85 | $887.00 | $35.09 – $61.41 | 4 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $185.35 | $337.00 | $35.09 – $61.41 | 4 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $156.20 | $284.00 | $37.27 – $65.22 | 4 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $572.00 | $1,040.00 | $416.78 – $729.37 | 4 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $261.80 | $476.00 | $35.09 – $61.41 | 4 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $185.35 | $337.00 | $35.09 – $61.41 | 4 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $185.35 | $337.00 | $41.68 – $72.94 | 4 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $179.85 | $327.00 | $35.09 – $61.41 | 4 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $130.35 | $237.00 | $51.31 – $89.79 | 4 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $229.35 | $417.00 | $142.63 – $249.60 | 4 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $264.00 | $480.00 | $142.63 – $249.60 | 4 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | not published | not published | $35.09 – $61.41 | 4 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $78.10 | $142.00 | $35.09 – $61.41 | 4 |
| Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae CPT 87494 | not published | not published | $70.18 – $70.18 | 1 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $200.20 | $364.00 | $76.77 – $134.35 | 4 |
| Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets CPT 87627 | not published | not published | $679.77 – $679.77 | 1 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $1,506.18 | $2,738.50 | $416.78 – $729.37 | 4 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $392.70 | $714.00 | $128.29 – $224.51 | 4 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $459.80 | $836.00 | $262.99 – $460.23 | 4 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $553.30 | $1,006.00 | $42.84 – $74.97 | 4 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $237.05 | $431.00 | $42.84 – $74.97 | 4 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $167.20 | $304.00 | $42.84 – $74.97 | 4 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $475.75 | $865.00 | $85.10 – $148.93 | 4 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $354.20 | $644.00 | $142.63 – $249.60 | 4 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | not published | not published | $30.52 – $83.09 | 6 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | not published | not published | $19.75 – $53.77 | 6 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | not published | not published | $15.02 – $43.31 | 6 |
| Influenza dna amp prob addl CPT 87503 | $62.15 | $113.00 | $29.22 – $51.14 | 4 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | not published | not published | $83.49 – $250.48 | 6 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $28.87 – $86.61 | 6 |
| Infratemporal approach/skull CPT 61591 | not published | not published | $14,758.00 – $14,758.00 | 1 |
| Infratemporal approach/skull CPT 61590 | not published | not published | $14,758.00 – $14,758.00 | 1 |
| Inf thrc fascial pln blk bi w/wo image CPT 64469 | not published | not published | $9,837.00 – $9,837.00 | 1 |
| Inf thrc fascial pln blk uni w/wo image CPT 64467 | not published | not published | $9,837.00 – $9,837.00 | 1 |
| Infuse radioactive materials CPT 77750 | not published | not published | $297.25 – $374.64 | 2 |
| Ingest challenge ini 120 min CPT 95076 | not published | not published | $362.46 – $362.46 | 1 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | not published | not published | $212.70 – $212.70 | 1 |
| Initial care training 30 m HCPCS G0539 | not published | not published | $39.26 – $39.26 | 1 |
| Initial foot exam pt lops HCPCS G0245 | not published | not published | $129.32 – $129.32 | 1 |
| Initiation & management bipap/cpap initial day CPT 94660 | $381.70 | $694.00 | $212.70 – $212.70 | 1 |
| Init/sub psych care m 1st 30 HCPCS G2214 | not published | not published | $98.68 – $98.68 | 1 |
| Inj, abilify asimtufii, 1 mg HCPCS J0402 | not published | not published | $5.87 – $15.99 | 6 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | not published | not published | $7.03 – $19.14 | 6 |
| Inj acetaminoph 10mg/ibu 3mg HCPCS J0138 | not published | not published | $0.09 – $0.59 | 5 |
| Inj, acetaminophen (b braun) HCPCS J0136 | not published | not published | $0.05 – $0.15 | 6 |
| Inj acetaminophen -fresenius HCPCS J0134 | not published | not published | $0.05 – $0.16 | 6 |
| Inj, acetaminophen (hikma) HCPCS J0137 | not published | not published | $0.03 – $0.08 | 6 |
| Inj. acthar gel to 40 units HCPCS J0801 | not published | not published | $3,893.43 – $10,599.86 | 6 |
| Inj, adalimumab, 1 mg HCPCS J0139 | not published | not published | $444.31 – $444.31 | 1 |
| Inj adalimumab-ryvk, 1 mg HCPCS Q5142 | not published | not published | $75.39 – $75.39 | 1 |
| Inj, adstiladrin, per tx dos HCPCS J9029 | not published | not published | $63,235.61 – $172,158.95 | 6 |
| Inj, aducanumab-avwa, 2 mg HCPCS J0172 | not published | not published | $5.98 – $17.93 | 6 |
| Inj, adzynma, 10 iu HCPCS J7171 | not published | not published | $34.52 – $93.98 | 6 |
| Inj, aflibercept-ayyh, 1 mg HCPCS Q5147 | not published | not published | $795.86 – $2,166.73 | 5 |
| Inj, aflibercept hd, 1 mg HCPCS J0177 | not published | not published | $298.68 – $874.42 | 6 |
| Inj, afstyla, 1 i.u HCPCS J7210 | not published | not published | $1.51 – $4.11 | 6 |
| Inj allopurinol sodium 1 mg HCPCS J0206 | not published | not published | $4.07 – $12.11 | 6 |
| Inj, alyglo, 500 mg HCPCS J1552 | not published | not published | $121.54 – $376.00 | 6 |
| Inj alymsys 10 mg HCPCS Q5126 | not published | not published | $46.05 – $125.37 | 6 |
| Inj, amisulpride, 1 mg HCPCS J0184 | not published | not published | $9.57 – $29.87 | 2 |
| Inj andexxa, 10 mg HCPCS J7169 | not published | not published | $131.16 – $408.38 | 2 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | not published | not published | $17.78 – $48.41 | 6 |
| Inj. (ani), up to 40 units HCPCS J0802 | not published | not published | $3,445.58 – $9,380.60 | 6 |
| Inj, aponvie, 1 mg HCPCS C9145 | not published | not published | $5.07 – $5.07 | 1 |
| Inj., aristada initio, 1 mg HCPCS J1943 | not published | not published | $3.14 – $8.55 | 6 |
| Inj, artesunate, 1mg HCPCS J0391 | not published | not published | $51.83 – $133.24 | 2 |
| Inj. asceniv HCPCS J1554 | not published | not published | $496.68 – $1,352.21 | 6 |
| Inj, aspara, rylaze, 0.1 mg HCPCS J9021 | not published | not published | $54.38 – $148.05 | 6 |
| Inj atezolizumb 5mg hya-tqjs HCPCS J9024 | not published | not published | $30.88 – $84.07 | 5 |
| Inj avacincaptad pegol 0.1mg HCPCS J2782 | not published | not published | $103.20 – $292.51 | 6 |
| Inj aval alfa-nqpt 4mg HCPCS J0219 | not published | not published | $77.82 – $211.86 | 6 |
| Inj., benralizumab, 1 mg HCPCS J0517 | not published | not published | $163.30 – $444.59 | 6 |
| Inj beta interferon sq 1 mcg HCPCS Q3028 | not published | not published | $127.58 – $127.58 | 1 |
| Inj, betibeglogene autotemce HCPCS J3393 | not published | not published | $2,930,260.34 – $9,147,600.00 | 2 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | not published | not published | $39.82 – $108.55 | 6 |
| Inj bimatoprost itc imp1mcg HCPCS J7351 | not published | not published | $209.91 – $571.48 | 6 |
| Inj, biorphen, 20 micrograms HCPCS J2372 | not published | not published | $0.18 – $0.53 | 6 |
| Inj bortezomib boruzu 0.1 mg HCPCS J9054 | not published | not published | $24.75 – $83.31 | 2 |
| Inj, bortezomib, dr. reddy's HCPCS J9046 | not published | not published | $3.46 – $149.77 | 2 |
| Inj, bortezomib freseniuskab HCPCS J9048 | not published | not published | $6.97 – $88.92 | 2 |
| Inj, bortezomib, hospira HCPCS J9049 | not published | not published | $1.43 – $4.30 | 6 |
| Inj, brixadi, 7 days or less HCPCS J0577 | not published | not published | $425.40 – $1,158.15 | 6 |
| Inj brixadi, more than 7 day HCPCS J0578 | not published | not published | $1,701.62 – $4,632.66 | 6 |
| Inj, brolucizumab-dbll, 1 mg HCPCS J0179 | not published | not published | $339.99 – $925.62 | 6 |
| Inj bulking agent anal canal HCPCS L8605 | not published | not published | $2,804.55 – $2,804.55 | 1 |
| Inj, bupivacaine liposome HCPCS J0666 | not published | not published | $1.42 – $3.86 | 6 |
| Inj, bupivacaine (posimir) HCPCS C9144 | not published | not published | $1.37 – $1.37 | 1 |
| Inj. byooviz, 0.1 mg HCPCS Q5124 | not published | not published | $85.57 – $240.97 | 6 |
| Inj calcitriol per 0.1 mcg HCPCS J0636 | not published | not published | $3.23 – $3.23 | 1 |
| Inj, carmustine (accord) HCPCS J9052 | not published | not published | $6,138.64 – $6,138.64 | 1 |
| Inj cefazolin sodium, baxter HCPCS J0689 | not published | not published | $1.25 – $3.74 | 6 |
| Inj cefazolin sodium, hikma HCPCS J0688 | not published | not published | $0.98 – $2.95 | 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.