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 |
|---|---|---|---|---|
| Inj cefazolin (wg crit care) HCPCS J0687 | not published | not published | $0.97 – $2.92 | 6 |
| Inj. cefepime hcl (baxter) HCPCS J0701 | not published | not published | $5.80 – $17.41 | 6 |
| Inj, cefepime hcl (b braun) HCPCS J0703 | not published | not published | $5.04 – $15.13 | 6 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | not published | not published | $2.28 – $6.20 | 6 |
| Inj ceftolozane tazobactam HCPCS J0695 | not published | not published | $8.04 – $21.90 | 6 |
| Inj., cerliponase alfa 1 mg HCPCS J0567 | not published | not published | $123.38 – $374.70 | 2 |
| Inj. cetirizine hcl 0.5mg HCPCS J1201 | not published | not published | $15.62 – $42.52 | 6 |
| Inj, cimerli, 0.1 mg HCPCS Q5128 | not published | not published | $82.53 – $399.55 | 6 |
| Inj, cipaglucosidase, 5 mg HCPCS J1203 | not published | not published | $89.85 – $244.61 | 6 |
| Inj, clevidipine butyrate HCPCS C9248 | not published | not published | $7.49 – $7.49 | 1 |
| Inj, clindamycin (baxter) HCPCS J0737 | not published | not published | $2.53 – $7.58 | 6 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $303.05 | $551.00 | $2,181.00 – $9,837.00 | 2 |
| Inj., copanlisib, 1 mg HCPCS J9057 | not published | not published | $242.73 – $242.73 | 1 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | not published | not published | $1,043.55 – $3,130.64 | 6 |
| Inj, crovalimab-akkz, 10 mg HCPCS J1307 | not published | not published | $551.51 – $1,699.12 | 2 |
| Inj cutaquig 100 mg HCPCS J1551 | not published | not published | $14.03 – $39.04 | 6 |
| Inj cuvitru, 100 mg HCPCS J1555 | not published | not published | $16.68 – $45.41 | 6 |
| Inj, cyclophos (baxter) 5mg HCPCS J9076 | not published | not published | $4.39 – $15.82 | 2 |
| Inj cyclophos dr.reddy's 5mg HCPCS J9072 | not published | not published | $8.92 – $24.63 | 5 |
| Inj cyclophosphamd auromedic HCPCS J9071 | not published | not published | $0.49 – $2.38 | 6 |
| Inj cyclophosphamd (ingenus) HCPCS J9073 | not published | not published | $0.50 – $4.79 | 6 |
| Inj, cyclophosphamd, sandoz HCPCS J9074 | not published | not published | $3.44 – $11.81 | 6 |
| Inj, daptomycin (baxter) HCPCS J0874 | not published | not published | $0.07 – $0.20 | 6 |
| Inj, daptomycin (hospira) HCPCS J0877 | not published | not published | $0.05 – $0.17 | 6 |
| Inj daptomycin (xellia) HCPCS J0873 | not published | not published | $0.03 – $0.10 | 6 |
| Inj daxibotulinumtoxina-lanm HCPCS J0589 | not published | not published | $2.99 – $8.13 | 5 |
| Inj, decitabine (sun pharma) HCPCS J0893 | not published | not published | $0.78 – $2.33 | 5 |
| Inj delandistrogene mox rokl HCPCS J1413 | not published | not published | $3,316,897.12 – $10,454,400.00 | 2 |
| Inj disk cerv-thor ea lev CPT 62291 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Inj, donanemab-azbt, 2 mg HCPCS J0175 | not published | not published | $4.16 – $11.39 | 6 |
| Inj dupuytren cord w/enzyme CPT 20527 | not published | not published | $298.15 – $4,217.00 | 3 |
| Inj, durolane 1 mg HCPCS J7318 | not published | not published | $6.24 – $18.86 | 6 |
| Inj dx for sinogram CPT 20501 | $235.40 | $428.00 | $2,181.00 – $9,837.00 | 2 |
| Inject for sacroiliac joint HCPCS G0259 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | $930.60 | $1,692.00 | $685.65 – $4,217.00 | 3 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $507.10 | $922.00 | $2,181.00 – $9,837.00 | 2 |
| Injection, belinostat, 10mg HCPCS J9032 | not published | not published | $50.92 – $138.63 | 6 |
| Injection, burosumab-twza 1m HCPCS J0584 | not published | not published | $469.74 – $1,278.87 | 6 |
| Injection, cangrelor HCPCS C9460 | not published | not published | $20.28 – $50.94 | 2 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | not published | not published | $298.15 – $4,217.00 | 3 |
| Injection, casimersen, 10 mg HCPCS J1426 | not published | not published | $166.17 – $522.72 | 2 |
| Injection, cimetidine hydroc HCPCS S0023 | not published | not published | $5.28 – $5.28 | 1 |
| Injection, daratumumab 10 mg HCPCS J9145 | not published | not published | $67.63 – $184.12 | 6 |
| Injection, doxercalciferol HCPCS J1270 | not published | not published | $0.38 – $1.13 | 6 |
| Injection during cath supravalvular aortography CPT 93567 | $8,831.35 | $16,057.00 | $2,181.00 – $2,181.00 | 1 |
| Injection, edaravone, 1 mg HCPCS J1301 | not published | not published | $6.46 – $55.57 | 6 |
| Injection epidural blood patch or clot CPT 62273 | $960.30 | $1,746.00 | $685.65 – $4,217.00 | 3 |
| Injection estrone per 1 mg HCPCS J1435 | not published | not published | $0.87 – $0.87 | 1 |
| Injection eye drug CPT 67028 | $350.35 | $637.00 | $320.84 – $4,217.00 | 3 |
| Injection for arthrography wrist (both sides) CPT 25246 | $413.60 | $752.00 | $2,181.00 – $9,837.00 | 2 |
| Injection for bladder x-ray CPT 51600 | $820.60 | $1,492.00 | $2,181.00 – $9,837.00 | 2 |
| Injection for hip x-ray CPT 27095 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $331.65 | $603.00 | $2,181.00 – $9,837.00 | 2 |
| Injection for spleen x-ray CPT 38200 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Injection for tear sac x-ray CPT 68850 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Injection for ureter x-ray CPT 50684 | $410.85 | $747.00 | $2,181.00 – $9,837.00 | 2 |
| Injection for ureter x-ray CPT 50690 | $535.70 | $974.00 | $2,181.00 – $9,837.00 | 2 |
| Injection, fosphenytoin sodi HCPCS S0078 | not published | not published | $346.09 – $346.09 | 1 |
| Injection, fulvestrant HCPCS J9395 | not published | not published | $6.90 – $20.69 | 6 |
| Injection glatiramer acetate HCPCS J1595 | not published | not published | $724.98 – $724.98 | 1 |
| Injection, inclisiran, 1 mg HCPCS J1306 | not published | not published | $12.27 – $33.41 | 6 |
| Injection into brain canal CPT 61026 | not published | not published | $685.65 – $4,217.00 | 3 |
| Injection into brain canal CPT 61055 | not published | not published | $298.15 – $4,217.00 | 3 |
| Injection into hemorrhoid(s) CPT 46500 | not published | not published | $903.30 – $4,217.00 | 3 |
| Injection into spinal artery CPT 62294 | not published | not published | $859.12 – $4,217.00 | 3 |
| Injection into vocal cord CPT 31513 | not published | not published | $379.91 – $4,217.00 | 3 |
| Injection intraop add-on CPT 48400 | not published | not published | $4,217.00 – $4,217.00 | 1 |
| Injection, isavuconazonium HCPCS J1833 | not published | not published | $1.03 – $3.48 | 2 |
| Injection jaw joint x-ray CPT 21116 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Injection jugular CPT 36299 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Injection, khapzory, 0.5 mg HCPCS J0642 | not published | not published | $1.18 – $3.53 | 6 |
| Injection, necitumumab, 1 mg HCPCS J9295 | not published | not published | $5.73 – $15.59 | 6 |
| Injection of HIV prep drug HCPCS G0012 | not published | not published | $69.94 – $69.94 | 1 |
| Injection of sinus tract CPT 20500 | not published | not published | $1,507.10 – $4,743.00 | 3 |
| Injection,onabotulinumtoxina HCPCS J0585 | not published | not published | $6.48 – $17.64 | 6 |
| Injection, pentamidine iseth HCPCS S0080 | not published | not published | $405.31 – $405.31 | 1 |
| Injection, peramivir HCPCS J2547 | not published | not published | $1.68 – $5.18 | 2 |
| Injection, piperacillin sodi HCPCS S0081 | not published | not published | $3.51 – $3.51 | 1 |
| Injection px peyronie ds CPT 54200 | not published | not published | $242.69 – $4,217.00 | 3 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $316.80 | $576.00 | $388.31 – $4,217.00 | 3 |
| Injection, renflexis HCPCS Q5104 | not published | not published | $26.62 – $75.82 | 6 |
| Injection, ruconest HCPCS J0596 | not published | not published | $34.75 – $94.61 | 6 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | $1,773.20 | $3,224.00 | $685.65 – $4,217.00 | 3 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | not published | not published | $685.65 – $4,217.00 | 3 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $1,141.25 | $2,075.00 | $685.65 – $4,217.00 | 3 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $2,906.20 | $5,284.00 | $859.12 – $4,217.00 | 3 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $680.35 | $1,237.00 | $2,181.00 – $9,837.00 | 2 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $1,019.15 | $1,853.00 | $859.12 – $4,217.00 | 3 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $1,220.45 | $2,219.00 | $2,181.00 – $9,837.00 | 2 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $2,298.45 | $4,179.00 | $859.12 – $4,217.00 | 3 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $989.45 | $1,799.00 | $685.65 – $4,217.00 | 3 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $925.10 | $1,682.00 | $685.65 – $4,217.00 | 3 |
| Injection, siltuximab HCPCS J2860 | not published | not published | $163.37 – $444.77 | 6 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $88.00 | $160.00 | $298.15 – $4,217.00 | 3 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $222.20 | $404.00 | $298.15 – $4,217.00 | 3 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $232.10 | $422.00 | $298.15 – $4,217.00 | 3 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $143.55 | $261.00 | $45.48 – $45.48 | 1 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $58.85 | $107.00 | not published | 0 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $192.50 | $350.00 | $206.61 – $206.61 | 1 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $72.05 | $131.00 | $69.94 – $69.94 | 1 |
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.