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 |
|---|---|---|---|---|
| Suspension of uterus CPT 58410 | not published | not published | $8,960.00 – $8,960.00 | 1 |
| Suspension of uterus 58400 CPT 58400 | not published | not published | $8,960.00 – $10,137.00 | 2 |
| Sutr lg intestine 1/mult perf without colostomy 44604 CPT 44604 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Suture bile duct injury 47900 CPT 47900 | not published | not published | $8,433.00 – $8,433.00 | 1 |
| Svc venogram s&i CPT 75827 | $3,434.75 | $6,245.00 | $218.47 – $1,529.03 | 2 |
| Sweat collection by iontophoresis CPT 89230 | not published | not published | $2.45 – $50.62 | 2 |
| Sympathectomy cervical CPT 64802 | not published | not published | $1,896.75 – $4,743.00 | 3 |
| Sympathectomy digital artery CPT 64820 | not published | not published | $1,896.75 – $8,701.00 | 3 |
| Sympathectomy lumbar CPT 64818 | not published | not published | $8,960.00 – $8,960.00 | 1 |
| Sympathectomy supfc palmar CPT 64823 | not published | not published | $3,178.20 – $10,137.00 | 3 |
| Sympathectomy thoracolumbar CPT 64809 | not published | not published | $8,960.00 – $8,960.00 | 1 |
| Synojoynt, inj., 1 mg HCPCS J7331 | not published | not published | $8.43 – $25.29 | 6 |
| Synthetic sentence id test CPT 92576 | not published | not published | $36.28 – $36.28 | 1 |
| Synvisc or synvisc-one HCPCS J7325 | not published | not published | $6.02 – $25.18 | 6 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $36.30 | $66.00 | $4.40 – $7.70 | 4 |
| System pacing micra av HCPCS C1786 | $7,106.13 | $12,920.24 | not published | 0 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $1,733.54 | $3,151.90 | not published | 0 |
| System sealant biosentry tract HCPCS C2613 | $435.24 | $791.34 | not published | 0 |
| T3 (triiodothyronine) free CPT 84481 | $136.95 | $249.00 | $16.94 – $29.65 | 4 |
| T3 (triiodothyronine) total CPT 84480 | $107.80 | $196.00 | $14.18 – $24.82 | 4 |
| T4 (thyroxine) free CPT 84439 | $76.45 | $139.00 | $9.02 – $15.79 | 4 |
| T4 (thyroxine) total CPT 84436 | $42.90 | $78.00 | $6.87 – $12.02 | 4 |
| Tacrol astagraf ex rel oral HCPCS J7508 | not published | not published | $0.57 – $1.71 | 6 |
| Tacrol envarsus ex rel oral HCPCS J7503 | not published | not published | $1.81 – $5.42 | 6 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | not published | not published | $0.19 – $0.58 | 6 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | not published | not published | $255.06 – $694.40 | 6 |
| Tacrolimus therapeutic drug level CPT 80197 | $185.90 | $338.00 | $13.73 – $24.03 | 4 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | not published | not published | $13.93 – $37.92 | 6 |
| Tah rad debulk/lymph remove 58954 CPT 58954 | not published | not published | $8,960.00 – $8,960.00 | 1 |
| Tah rad dissect for debulk 58953 CPT 58953 | not published | not published | $8,960.00 – $8,960.00 | 1 |
| Tah w/mmk 58152 CPT 58152 | not published | not published | $13,176.00 – $13,176.00 | 1 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | not published | not published | $70.38 – $191.61 | 6 |
| Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 | not published | not published | $70.00 – $190.58 | 6 |
| Talymed HCPCS Q4127 | not published | not published | $68.49 – $186.47 | 6 |
| Tamoxifen 10 mg tabs 60 each bottle HCPCS S0187 | not published | not published | $8.84 – $8.84 | 1 |
| Tap block bilat cont infusion 64489 CPT 64489 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Tap block uni by cont infusion 64487 CPT 64487 | not published | not published | $2,181.00 – $9,837.00 | 2 |
| Target gsa panel hmtlmph neop CPT 81450 | $4,565.55 | $8,301.00 | $759.53 – $1,329.18 | 4 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $4,131.05 | $7,511.00 | $2,919.60 – $5,109.30 | 4 |
| Target gsa panel organ neop CPT 81445 | $4,378.00 | $7,960.00 | $597.91 – $1,046.34 | 4 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | not published | not published | $1,570.77 – $4,276.42 | 5 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | not published | not published | $717.88 – $4,217.00 | 3 |
| Tavr perq femoral CPT 33361 | not published | not published | $16,164.00 – $16,164.00 | 1 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | not published | not published | $0.24 – $1.01 | 6 |
| Tbp gene detc abnor alleles CPT 81344 | not published | not published | $137.00 – $239.75 | 4 |
| Tbs dxa cal w/i&r fx risk CPT 77089 | not published | not published | $111.85 – $111.85 | 1 |
| Tbs i&r fx rsk qhp CPT 77092 | not published | not published | $28.67 – $28.67 | 1 |
| Tbs techl calculation only CPT 77091 | $139.15 | $253.00 | $77.26 – $84.53 | 2 |
| Tbs techl prep&transmis data CPT 77090 | $63.25 | $115.00 | $5.93 – $84.53 | 2 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | not published | not published | $100.00 – $175.00 | 4 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $73.70 | $134.00 | $61.98 – $108.47 | 4 |
| Tc-99m apcitide diag HCPCS A9504 | not published | not published | $1,386.10 – $1,386.10 | 1 |
| Tc-99m arcitumomab HCPCS A9568 | not published | not published | $2,203.89 – $2,203.89 | 1 |
| Tc-99m bicisate HCPCS A9557 | not published | not published | $775.52 – $1,861.65 | 2 |
| Tc-99m depreotide HCPCS A9536 | not published | not published | $2,110.89 – $2,110.89 | 1 |
| Tc-99m disofenin HCPCS A9510 | not published | not published | $162.92 – $162.92 | 1 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | not published | not published | $934.13 – $2,832.27 | 2 |
| Tc-99m exametazime diag HCPCS A9521 | not published | not published | $2,184.37 – $2,184.37 | 1 |
| Tc-99m graphite crucible HCPCS A9506 | not published | not published | $328.60 – $894.61 | 2 |
| Tc-99m labeled rbc HCPCS A9560 | $309.20 | $562.18 | $287.08 – $287.08 | 1 |
| Tc-99m maa HCPCS A9540 | $212.99 | $387.25 | $80.16 – $80.16 | 1 |
| Tc-99m mebrofenin HCPCS A9537 | $261.39 | $475.25 | $308.90 – $308.90 | 1 |
| Tc-99m medronate HCPCS A9503 | $66.55 | $121.00 | $161.14 – $161.14 | 1 |
| Tc-99m mertiatide HCPCS A9562 | $494.67 | $899.40 | $2,091.51 – $2,091.51 | 1 |
| Tc-99m non-heu per study dose HCPCS Q9969 | not published | not published | $16.34 – $16.34 | 1 |
| Tc-99m oxidronate HCPCS A9561 | $91.90 | $167.10 | $137.38 – $137.38 | 1 |
| Tc-99m pentetate dtpa HCPCS A9539 | not published | not published | $75.74 – $75.74 | 1 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $130.50 | $237.28 | $55.49 – $55.49 | 1 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $40.32 | $73.30 | $29.06 – $29.06 | 1 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $121.00 | $220.00 | $110.96 – $110.96 | 1 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $964.10 | $1,752.90 | $1,226.71 – $1,226.71 | 1 |
| Tc-99m succimer (dmsa) HCPCS A9551 | not published | not published | $659.93 – $1,812.34 | 2 |
| Tc-99m sulfur colloid HCPCS A9541 | $36.71 | $66.75 | $2,045.69 – $2,045.69 | 1 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | not published | not published | $429.74 – $429.74 | 1 |
| Tca peel dermal 15789 CPT 15789 | not published | not published | $717.88 – $4,217.00 | 3 |
| Tcd emboli detect w/inj CPT 93893 | not published | not published | $101.55 – $101.55 | 1 |
| Tcd emboli detect without inj CPT 93892 | not published | not published | $101.55 – $101.55 | 1 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $428.53 – $4,217.00 | 3 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $52.25 | $95.00 | $46.98 – $82.22 | 4 |
| T cells absolute cd 4 count CPT 86361 | $181.50 | $330.00 | $26.78 – $46.87 | 4 |
| T cells total count CPT 86359 | $52.25 | $95.00 | $37.73 – $66.03 | 4 |
| Tcranial magn stim tx deli CPT 90868 | not published | not published | $209.73 – $209.73 | 1 |
| Tcranial magn stim tx plan CPT 90867 | not published | not published | $209.73 – $209.73 | 1 |
| Tcran magn stim redetemine CPT 90869 | not published | not published | $209.73 – $209.73 | 1 |
| Tdh sdrl/ventr pnxr CPT 61105 | not published | not published | $4,743.00 – $4,743.00 | 1 |
| Teaec w/wo patch graft iliofemoral CPT 35355 | not published | not published | $8,960.00 – $8,960.00 | 1 |
| Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution HCPCS J9274 | not published | not published | $214.76 – $584.68 | 6 |
| Tee w or without fol w/cont,cong HCPCS C8926 | not published | not published | $761.45 – $761.45 | 1 |
| Tee w or without fol w/cont, mon HCPCS C8927 | not published | not published | $761.45 – $761.45 | 1 |
| Telavancin injection HCPCS J3095 | not published | not published | $7.09 – $19.31 | 6 |
| Telethx isodose plan cplx CPT 77307 | not published | not published | $356.65 – $363.70 | 2 |
| Telethx isodose plan simple CPT 77306 | not published | not published | $194.68 – $363.70 | 2 |
| Temozolomide HCPCS J8700 | not published | not published | $0.34 – $1.15 | 6 |
| Temozolomide 100 mg intravenous solution HCPCS J9328 | not published | not published | $10.41 – $28.35 | 6 |
| Temperature gradient studies CPT 93740 | not published | not published | $124.98 – $124.98 | 1 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | not published | not published | $30.32 – $82.55 | 6 |
| Tendon lengthening CPT 26476 | not published | not published | $3,178.20 – $8,433.00 | 3 |
| Tendon lngth upr a/e ea tdn CPT 24305 | not published | not published | $3,178.20 – $10,137.00 | 3 |
| Tendon shortening CPT 26477 | not published | not published | $3,178.20 – $8,433.00 | 3 |
| Tendon transfer with graft CPT 26492 | not published | not published | $3,178.20 – $10,137.00 | 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.