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 |
|---|---|---|---|---|
| Assay of urine urobilinogen CPT 84583 | not published | not published | $6.05 – $10.59 | 4 |
| Assay phosphatidylglycerol CPT 84081 | not published | not published | $16.52 – $28.91 | 4 |
| Assay phosphohexose enzymes CPT 84087 | not published | not published | $10.73 – $18.78 | 4 |
| Assay rbc glutathione CPT 82979 | not published | not published | $9.44 – $16.52 | 4 |
| Assay toxin or antitoxin CPT 87230 | $59.40 | $108.00 | $19.74 – $34.55 | 4 |
| Assess aphasia/interp/rpt/per hr 96105 CPT 96105 | $347.60 | $632.00 | $94.48 – $94.48 | 1 |
| Assess care plan pt w/cog impair 99483 CPT 99483 | not published | not published | $98.68 – $98.68 | 1 |
| Assess cyst contrast inject CPT 49424 | $400.40 | $728.00 | $2,181.00 – $9,837.00 | 2 |
| Assessment leukocyte fecal qualitative/semiquantitative CPT 89055 | $52.80 | $96.00 | $4.27 – $7.47 | 4 |
| Asses tinnit/pitch/loud/match/mask 92625 CPT 92625 | not published | not published | $124.98 – $124.98 | 1 |
| Assist-bilat spinal disk surgery add-on 63035 CPT 63035 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Assistive tech assessment, ot CPT 97755 | not published | not published | $36.81 – $36.81 | 1 |
| Assist oocyte fertilization CPT 89280 | not published | not published | $782.58 – $782.58 | 1 |
| Assist oocyte fertilization CPT 89281 | not published | not published | $165.49 – $165.49 | 1 |
| Ast/sgot CPT 84450 | $29.15 | $53.00 | $5.18 – $9.07 | 4 |
| Atezolizumab 60 mg/ml intravenous solution (wrapper) HCPCS J9022 | not published | not published | $89.39 – $243.36 | 6 |
| Athrectomy fem/pop/unilateral 37225 CPT 37225 | $9,421.50 | $17,130.00 | $16,164.00 – $25,004.00 | 2 |
| Athrectomy tib/pero/unilat/ini ves 37229 CPT 37229 | $12,183.60 | $22,152.00 | $13,352.00 – $25,004.00 | 2 |
| Atomic absorption CPT 82190 | not published | not published | $15.90 – $27.83 | 4 |
| Atropine 0.1 mg/ml injection syringe HCPCS J0461 | not published | not published | $0.11 – $0.33 | 6 |
| Attach bladder/urethra comp 51841 CPT 51841 | not published | not published | $8,433.00 – $8,701.00 | 2 |
| Attach bladder/urethra simple 51840 CPT 51840 | not published | not published | $4,859.04 – $8,701.00 | 3 |
| Attach ocular implant CPT 65140 | not published | not published | $3,818.69 – $10,137.00 | 3 |
| Aud brainstem implt programg CPT 92640 | not published | not published | $124.98 – $124.98 | 1 |
| Audiometry air + bone CPT 92553 | not published | not published | $124.98 – $124.98 | 1 |
| Auditory function 60 min CPT 92620 | not published | not published | $124.98 – $124.98 | 1 |
| Augmentation cheek bone CPT 21270 | not published | not published | $5,750.12 – $15,012.00 | 3 |
| Augmentation lower jaw bone CPT 21125 | not published | not published | $5,750.12 – $8,960.00 | 3 |
| Augmentation lower jaw bone CPT 21127 | not published | not published | $5,750.12 – $15,012.00 | 3 |
| Augmentation of facial bones CPT 21208 | not published | not published | $5,750.12 – $15,012.00 | 3 |
| Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body CPT 22515 | $2,381.50 | $4,330.00 | $2,181.00 – $9,837.00 | 2 |
| Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic CPT 22513 | $6,619.80 | $12,036.00 | $7,048.20 – $17,116.00 | 3 |
| Autgrft implnt knee w/scope CPT 29866 | not published | not published | $7,048.20 – $17,116.00 | 3 |
| Autochondrocyte implant knee CPT 27412 | not published | not published | $7,048.20 – $17,116.00 | 3 |
| Autoimmune rheumatoid arthr anl 12 mrk ia CPT 81490 | not published | not published | $840.65 – $1,471.14 | 4 |
| Autologous blood op salvage CPT 86891 | not published | not published | $158.71 – $782.58 | 2 |
| Autologous blood process CPT 86890 | $239.80 | $436.00 | $112.54 – $165.49 | 2 |
| Autolog prp not diab ulcer HCPCS G0460 | not published | not published | $2,004.13 – $2,004.13 | 1 |
| Automated diff wbc count CPT 85004 | not published | not published | $6.47 – $11.32 | 4 |
| Autonomic nrv adrenrg inervj CPT 95922 | not published | not published | $129.23 – $129.23 | 1 |
| Autonomic nrv parasym inervj CPT 95921 | not published | not published | $124.98 – $124.98 | 1 |
| Autonomic nrv syst funj test CPT 95923 | not published | not published | $129.23 – $129.23 | 1 |
| Avelumab 20 mg/ml intravenous solution HCPCS J9023 | not published | not published | $97.14 – $264.46 | 6 |
| Av fistula revision CPT 36833 | not published | not published | $5,404.97 – $17,116.00 | 3 |
| Av fuse uppr arm basilic CPT 36819 | not published | not published | $5,404.97 – $17,116.00 | 3 |
| Av fuse uppr arm cephalic CPT 36818 | not published | not published | $5,404.97 – $17,116.00 | 3 |
| Av fusion direct any site CPT 36821 | not published | not published | $3,066.96 – $10,137.00 | 3 |
| Av fusion/forearm vein 36820 CPT 36820 | not published | not published | $5,404.97 – $17,116.00 | 3 |
| Avul nail plate addl CPT 11732 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Avulsion nail plate partial/complete simple single nail plate CPT 11730 | $252.45 | $459.00 | $194.88 – $4,217.00 | 3 |
| Axatilimab-csfr 22 mg/0.44ml soln 0.44 ml vial HCPCS J9038 | not published | not published | $56.46 – $171.52 | 2 |
| Axicabtagene ciloleucel car+ HCPCS Q2041 | not published | not published | $502,840.73 – $1,368,983.88 | 6 |
| Axillary lymphadenect/superficial 38740 CPT 38740 | not published | not published | $5,872.22 – $17,116.00 | 3 |
| Azacitidine injection HCPCS J9025 | not published | not published | $0.32 – $0.95 | 6 |
| Azathioprine 50 mg tablet HCPCS J7500 | not published | not published | $1.01 – $3.04 | 6 |
| Azathioprine parenteral HCPCS J7501 | not published | not published | $254.76 – $816.75 | 2 |
| Azithromycin 500 mg intravenous solution HCPCS J0456 | not published | not published | $2.22 – $6.66 | 6 |
| Aztreonam 1 gram solution for injection HCPCS J0457 | not published | not published | $2.48 – $7.43 | 6 |
| Baclofen 2,000 mcg/ml intrathecal solution (wrapper) HCPCS J0475 | not published | not published | $174.80 – $475.89 | 6 |
| Baclofen 50 mcg/ml intrathecal solution (wrapper) HCPCS J0476 | not published | not published | $52.95 – $161.46 | 6 |
| Baclofen eval charges CPT 97750 | $58.30 | $106.00 | $32.73 – $32.73 | 1 |
| Bacterial meningitis antigen CPT 86403 | $84.70 | $154.00 | $11.54 – $20.20 | 4 |
| Bacterial vaginosis pcr CPT 87801 | $233.75 | $425.00 | $70.20 – $122.85 | 4 |
| Bactericidal level serum CPT 87197 | not published | not published | $15.02 – $26.29 | 4 |
| #bac vag cand-c. albicans naa CPT 87481 | $182.60 | $332.00 | $35.09 – $61.41 | 4 |
| Balloon dilate urtrl strix CPT 50706 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Bartholin gland cyst/marsupializat 56440 CPT 56440 | not published | not published | $3,144.33 – $8,701.00 | 3 |
| Bartonella dna pcr-sendout CPT 87471 | $195.25 | $355.00 | $35.09 – $61.41 | 4 |
| Basic vestibular evaluation CPT 92540 | not published | not published | $209.73 – $209.73 | 1 |
| Basiliximab HCPCS J0480 | not published | not published | $4,687.66 – $12,762.16 | 6 |
| Bausch health Ultrasound surg HCPCS V2788 | $777.28 | $1,413.24 | not published | 0 |
| B cells total count CPT 86355 | $104.50 | $190.00 | $37.73 – $66.03 | 4 |
| Bcg live 50 mg intravesical suspension HCPCS J9030 | not published | not published | $3.14 – $8.55 | 6 |
| Bckdhb gene CPT 81205 | not published | not published | $94.99 – $166.23 | 4 |
| Becaplermin 0.01% gel 15 gm HCPCS S0157 | not published | not published | $141.03 – $141.03 | 1 |
| Behavior counsel obesity 15min medicare g0447 HCPCS G0447 | not published | not published | $98.68 – $98.68 | 1 |
| Belatacept 250 mg intravenous solution HCPCS J0485 | not published | not published | $3.88 – $10.59 | 6 |
| Belimumab 120 mg intravenous solution HCPCS J0490 | not published | not published | $54.97 – $149.66 | 6 |
| Bendamustine 100 mg intravenous powder for solution HCPCS J9033 | not published | not published | $1.24 – $3.38 | 6 |
| Bendamustine 25 mg/ml intravenous solution (belrapzo) HCPCS J9036 | not published | not published | $11.60 – $38.66 | 6 |
| Bendamustine 25 mg/ml intravenous solution (bendeka) HCPCS J9034 | not published | not published | $12.53 – $36.98 | 6 |
| Bendamustine 25 mg/ml intravenous solution (vivimusta) HCPCS J9056 | not published | not published | $27.24 – $74.17 | 6 |
| Benign lesion paring 2-4 CPT 11056 | not published | not published | $194.88 – $4,217.00 | 3 |
| Benign lesion paring 4+ CPT 11057 | not published | not published | $194.88 – $4,217.00 | 3 |
| #_benzodiazconfur CPT 80346 | $117.15 | $213.00 | $27.15 – $27.15 | 1 |
| Benztropine 1 mg/ml injection solution HCPCS J0515 | not published | not published | $16.77 – $50.30 | 6 |
| Beta 2 glycoprotein 1 antibody iga CPT 86146 | $174.35 | $317.00 | $25.45 – $44.54 | 4 |
| Beta-2 microglobulin CPT 82232 | $135.30 | $246.00 | $16.18 – $28.32 | 4 |
| Beta-amyloid 1-40 CPT 82233 | not published | not published | $128.92 – $128.92 | 1 |
| Beta-amyloid 1-42 CPT 82234 | $275.00 | $500.00 | $128.92 – $128.92 | 1 |
| Betamethasone acetate and sodium phos 6 mg/ml suspension for injection HCPCS J0702 | not published | not published | $6.85 – $20.54 | 6 |
| Bevacizumab 25 mg/ml intravenous solution HCPCS J9035 | not published | not published | $72.73 – $198.00 | 6 |
| Bevacizumab-awwb 25 mg/ml intravenous solution HCPCS Q5107 | not published | not published | $24.53 – $81.18 | 6 |
| Bevacizumab-bvzr 25 mg/ml intravenous solution HCPCS Q5118 | not published | not published | $25.89 – $73.34 | 6 |
| Bevacizumab injection HCPCS C9257 | not published | not published | $1.87 – $4.95 | 2 |
| Bfb train 1st 15min cntct 90912 CPT 90912 | $320.10 | $582.00 | $36.01 – $36.01 | 1 |
| Bfb train ea addl 15 min 90913 CPT 90913 | $130.35 | $237.00 | $20.21 – $20.21 | 1 |
| B-hexosaminidase ea assay CPT 83080 | not published | not published | $16.87 – $29.52 | 4 |
| Bilateral laminotomy addl lumbar 63044 CPT 63044 | not published | not published | $9,837.00 – $10,137.00 | 2 |
| Bilateral n blobk inj pudendal 64430 CPT 64430 | $1,351.35 | $2,457.00 | $859.12 – $4,217.00 | 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.