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 |
|---|---|---|---|---|
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | $4,743.00 – $4,743.00 | 1 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | not published | not published | $176.19 – $308.33 | 4 |
| Liver elastography 91200 CPT 91200 | not published | not published | $56.71 – $124.98 | 2 |
| Liver Function Test CPT 80076 | $75.35 | $137.00 | $8.17 – $14.30 | 4 |
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Liver imaging CPT 78201 | not published | not published | $460.37 – $527.40 | 2 |
| Liver imag w/vasclr flow CPT 78202 | not published | not published | $488.92 – $527.40 | 2 |
| Liver/spleen imag static only CPT 78215 | $1,032.35 | $1,877.00 | $388.31 – $469.87 | 2 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $270.04 – $388.31 | 2 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $2,309.33 – $8,701.00 | 2 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $3,178.20 – $10,137.00 | 3 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | not published | not published | $0.93 – $2.80 | 6 |
| Lomustine 10 mg HCPCS S0178 | not published | not published | $376.63 – $376.63 | 1 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | not published | not published | $212.00 – $577.17 | 6 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | not published | not published | $1.57 – $4.70 | 6 |
| Loudness balance test CPT 92562 | not published | not published | $209.73 – $209.73 | 1 |
| Low back disk surgery CPT 63030 | not published | not published | $7,048.20 – $17,116.00 | 3 |
| Low cost skin substitute app HCPCS C5271 | not published | not published | $2,181.00 – $2,181.00 | 1 |
| Low cost skin substitute app HCPCS C5273 | not published | not published | $4,137.00 – $4,137.00 | 1 |
| Low cost skin substitute app HCPCS C5275 | not published | not published | $2,181.00 – $2,181.00 | 1 |
| Low cost skin substitute app HCPCS C5277 | not published | not published | $2,181.00 – $2,181.00 | 1 |
| Low cost skin substitute app HCPCS C5272 | not published | not published | $2,181.00 – $2,181.00 | 1 |
| Low cost skin substitute app HCPCS C5274 | not published | not published | $2,181.00 – $2,181.00 | 1 |
| Low cost skin substitute app HCPCS C5276 | not published | not published | $2,181.00 – $2,181.00 | 1 |
| Low cost skin substitute app HCPCS C5278 | not published | not published | $2,181.00 – $2,181.00 | 1 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,919.40 | $5,308.00 | $170.37 – $548.67 | 2 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,601.50 | $4,730.00 | $338.87 – $443.07 | 2 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $2,190.10 | $3,982.00 | $101.55 – $341.23 | 2 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $3,555.20 | $6,464.00 | $338.87 – $696.75 | 2 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $3,281.30 | $5,966.00 | $338.87 – $609.58 | 2 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,704.90 | $4,918.00 | $231.76 – $390.72 | 2 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $232.10 | $422.00 | $61.48 – $101.55 | 2 |
| Lower jaw bone graft CPT 21215 | not published | not published | $5,750.12 – $15,012.00 | 3 |
| Low frequency non-thermal Ultrasound CPT 97610 | not published | not published | $194.88 – $194.88 | 1 |
| Loxapine for inhalation 1 mg HCPCS J2062 | not published | not published | $49.01 – $49.01 | 1 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $10,325.10 – $17,116.00 | 3 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $10,325.10 – $17,116.00 | 3 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $10,325.10 – $17,116.00 | 3 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $10,325.10 – $17,116.00 | 3 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $21.99 – $38.48 | 4 |
| Lumbar diskogram s&i CPT 72295 | $2,878.15 | $5,233.00 | $145.20 – $1,896.75 | 2 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $16,164.00 – $17,116.00 | 3 |
| Lumizyme injection HCPCS J0221 | not published | not published | $201.57 – $548.77 | 6 |
| Lung function test (mbc/mvv) CPT 94200 | $73.70 | $134.00 | $57.30 – $57.30 | 1 |
| Lung Function Test (Spirometry) CPT 94010 | $84.70 | $154.00 | $209.73 – $209.73 | 1 |
| Lung perfusion imaging CPT 78580 | $1,301.30 | $2,366.00 | $388.31 – $559.72 | 2 |
| Lung transplant double CPT 32853 | not published | not published | $13,352.00 – $13,352.00 | 1 |
| Lung transplant single CPT 32851 | not published | not published | $13,352.00 – $13,352.00 | 1 |
| Lung transplant with bypass CPT 32852 | not published | not published | $13,352.00 – $13,352.00 | 1 |
| Lung transplant with bypass CPT 32854 | not published | not published | $13,352.00 – $13,352.00 | 1 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $16,164.00 – $16,164.00 | 1 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | not published | not published | $205.04 – $558.23 | 6 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | not published | not published | $41.24 – $112.28 | 6 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | not published | not published | $350.21 – $806.54 | 2 |
| Lutetium lu 177 vipivotide HCPCS A9607 | not published | not published | $267.32 – $653.94 | 2 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $28.09 – $4,217.00 | 3 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $20.05 – $35.09 | 4 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $7,939.08 – $17,116.00 | 3 |
| Lymphatics/lymph node imaging CPT 78195 | $1,432.75 | $2,605.00 | $527.40 – $822.53 | 2 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $36.56 – $63.98 | 4 |
| Lymphocyte transformation mitogen CPT 86353 | $373.45 | $679.00 | $49.03 – $85.80 | 4 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $189.51 – $331.64 | 4 |
| Lymphocytotoxicity assay CPT 86806 | not published | not published | $47.59 – $83.28 | 4 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $548.55 – $609.32 | 2 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $526.65 – $1,529.03 | 2 |
| Lymph vessel x-ray trunk CPT 75805 | not published | not published | $585.74 – $3,066.96 | 2 |
| Lymph vessel x-ray trunk CPT 75807 | not published | not published | $565.73 – $3,066.96 | 2 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $523.87 – $4,217.00 | 3 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $3,144.33 – $8,701.00 | 3 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $2,030.46 – $8,701.00 | 3 |
| Lyumjev for insulin pump use HCPCS J1813 | not published | not published | $15.33 – $45.98 | 6 |
| Macro exam dissect molec study ea CPT 88387 | not published | not published | $8.67 – $8.67 | 1 |
| Macroscopic exam arthropod CPT 87168 | $117.15 | $213.00 | $4.27 – $7.47 | 4 |
| Macroscopic exam parasite CPT 87169 | $36.30 | $66.00 | $4.31 – $7.54 | 4 |
| Magnesium CPT 83735 | $39.05 | $71.00 | $6.70 – $11.73 | 4 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | not published | not published | $0.49 – $1.48 | 6 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $231.76 – $823.31 | 2 |
| Makena, 10 mg HCPCS J1726 | not published | not published | $79.91 – $79.91 | 1 |
| Malaria antibody CPT 86750 | $114.40 | $208.00 | $13.19 – $23.08 | 4 |
| Male sling procedure CPT 53440 | not published | not published | $12,815.23 – $25,004.00 | 3 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $1,561.89 – $4,743.00 | 3 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $1,561.89 – $4,743.00 | 3 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $99.55 | $181.00 | $129.23 – $129.23 | 1 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $144.10 | $262.00 | $129.23 – $129.23 | 1 |
| Manipulation of hip joint CPT 27275 | not published | not published | $1,561.89 – $4,743.00 | 3 |
| Manipulation of spine CPT 22505 | not published | not published | $1,561.89 – $4,743.00 | 3 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $239.60 – $4,217.00 | 3 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | not published | not published | $2.26 – $6.79 | 6 |
| Mannitol for inhaler HCPCS J7665 | not published | not published | $3.22 – $3.22 | 1 |
| Manual diff wbc count b-coat CPT 85009 | not published | not published | $5.07 – $8.87 | 4 |
| Mapping io sentinel lymph node CPT 38900 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Map tachycard site(s) CPT 93609 | $1,519.65 | $2,763.00 | $2,181.00 – $2,181.00 | 1 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | not published | not published | $48.53 – $132.12 | 6 |
| Marker biop eviva buckle ss HCPCS A4648 | $193.15 | $351.18 | not published | 0 |
| Marker lymphatic sentimag magtrace 10 vial HCPCS A9697 | not published | not published | $1,254.00 – $3,098.09 | 2 |
| Marsupialization liver lesion 47300 CPT 47300 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Mastectomy partial CPT 19301 | not published | not published | $3,803.19 – $8,701.00 | 3 |
| Mast mod rad CPT 19307 | not published | not published | $6,449.81 – $15,012.00 | 3 |
| Mastoidectomy CPT 69501 | not published | not published | $5,750.12 – $15,012.00 | 3 |
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.