HSHS St. Clare Memorial Hospital
855 S MAIN STREET, OCONTO FALLS, WI · Hshs · · NPI 1851477913
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 |
|---|---|---|---|---|
| Unlisted CT procedure CPT 76497 | $331.98 | $503.00 | $88.91 – $503.00 | 11 |
| Unlisted cytogenetic study CPT 88299 | $372.90 | $565.00 | $53.24 – $339.00 | 11 |
| Unlisted px arthroscopy CPT 29999 | not published | not published | not published | 0 |
| Unlisted px casting/strpg CPT 29799 | $285.78 | $433.00 | $95.40 – $166.02 | 9 |
| Unlisted px foot/toes CPT 28899 | $545.82 | $827.00 | $252.01 – $791.66 | 8 |
| Unlisted px leg/ankle CPT 27899 | not published | not published | not published | 0 |
| Unlisted surgical path px CPT 88399 | $1,824.24 | $2,764.00 | $43.20 – $1,658.40 | 11 |
| Unlisted ultrasound procedure CPT 76999 | $293.70 | $445.00 | $88.91 – $445.00 | 11 |
| Unlisted urinalysis px CPT 81099 | $584.76 | $886.00 | $3.91 – $531.60 | 9 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $2,651.88 | $4,018.00 | $356.43 – $1,513.40 | 11 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $2,410.98 | $3,653.00 | $356.43 – $1,513.40 | 11 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $2,295.48 | $3,478.00 | $121.89 – $1,513.40 | 11 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | $1,083.06 | $1,641.00 | $119.09 – $1,641.00 | 13 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | $1,147.74 | $1,739.00 | $133.17 – $1,659.80 | 13 |
| Urea nitrogen CPT 84520 | $25.74 | $39.00 | $3.95 – $5.14 | 11 |
| Urea nitrogen 24 hour urine CPT 84540 | $54.12 | $82.00 | $5.56 – $7.23 | 11 |
| Urea nitrogen clearance CPT 84545 | $217.14 | $329.00 | $7.20 – $9.36 | 11 |
| Urethrocystography void s&i CPT 74455 | $747.78 | $1,133.00 | $192.14 – $495.60 | 11 |
| Uric acid blood CPT 84550 | $67.32 | $102.00 | $4.52 – $5.88 | 11 |
| Uric acid urine CPT 84560 | $31.02 | $47.00 | $5.08 – $6.60 | 11 |
| Urinalysis microscopic only CPT 81015 | $21.78 | $33.00 | $3.05 – $3.97 | 11 |
| Urinalysis (with microscopy) CPT 81001 | $84.48 | $128.00 | $3.17 – $4.12 | 11 |
| Urinalysis (without microscopy) CPT 81003 | $33.00 | $50.00 | $2.25 – $2.93 | 11 |
| Urine Culture Test CPT 87086 | $91.08 | $138.00 | $8.07 – $10.49 | 11 |
| Urine pregnancy test CPT 81025 | $73.26 | $111.00 | $8.61 – $11.19 | 11 |
| Urography, antegrade CPT 74425 | $616.44 | $934.00 | $192.14 – $495.60 | 11 |
| Urography inf drip &/or bolus CPT 74410 | $747.78 | $1,133.00 | $179.20 – $495.60 | 11 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $120.12 | $182.00 | $34.57 – $36.64 | 7 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $101.11 | $153.20 | $34.57 – $41.56 | 11 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $59.40 | $90.00 | $21.60 – $90.00 | 11 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | $706.27 | $1,070.10 | $256.82 – $560.09 | 11 |
| Vaccine rabies im CPT 90675 | $1,084.28 | $1,642.85 | $182.75 – $572.35 | 11 |
| Vaccine tdap >=7 years im CPT 90715 | $158.99 | $240.90 | $34.57 – $63.00 | 10 |
| Vaccine td preservative free >= 7 years im CPT 90714 | $138.04 | $209.15 | $34.57 – $69.76 | 10 |
| Valproic acid total therapeutic drug level CPT 80164 | $77.88 | $118.00 | $13.54 – $17.60 | 11 |
| Vancomycin 1,000 mg intravenous injection HCPCS J3373 | $0.79 | $1.20 | $0.05 – $0.05 | 4 |
| Vancomycin 750 mg intravenous solution HCPCS J3374 | $0.79 | $1.19 | $0.17 – $0.18 | 4 |
| Vancomycin hcl injection HCPCS J3370 | $50.16 | $76.00 | $3.22 – $3.49 | 4 |
| Vancomycin peak therapeutic drug level CPT 80202 | $95.70 | $145.00 | $13.54 – $17.60 | 11 |
| Varicella zoster antibody igg CPT 86787 | $68.64 | $104.00 | $8.17 – $16.74 | 11 |
| Vasopressin 20 unit/ml intravenous solution HCPCS J2598 | $17.27 | $26.17 | $0.87 – $0.95 | 4 |
| Veeg cont 2-12 hrs CPT 95713 | $3,153.48 | $4,778.00 | $381.24 – $570.31 | 11 |
| Veeg ea 12-26hr cont mntr CPT 95716 | $4,224.00 | $6,400.00 | $455.52 – $877.34 | 11 |
| Veeg intrmnt 2-12 hrs CPT 95712 | $2,702.70 | $4,095.00 | $381.24 – $570.31 | 11 |
| Veeg unmon 12-26 hrs CPT 95714 | $4,505.16 | $6,826.00 | $381.24 – $771.23 | 11 |
| Veeg unmon 2-12 hrs CPT 95711 | $2,432.76 | $3,686.00 | $220.60 – $570.31 | 11 |
| Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture) CPT 36410 | $114.84 | $174.00 | $121.98 – $129.30 | 7 |
| Venipuncture <3 yrs other vein CPT 36406 | $27.72 | $42.00 | $4.36 – $4.62 | 7 |
| Very long chain fatty acids CPT 82726 | $225.06 | $341.00 | $19.75 – $25.68 | 11 |
| Vitamin b-12 CPT 82607 | $188.10 | $285.00 | $15.08 – $19.60 | 11 |
| Vitamin D Test CPT 82306 | $180.18 | $273.00 | $29.60 – $38.48 | 11 |
| Warde 1003990 aldosterone CPT 82088 | $252.12 | $382.00 | $40.75 – $52.98 | 11 |
| Warde 1005020 citrate 24 hour urine CPT 82507 | $162.36 | $246.00 | $27.80 – $36.14 | 11 |
| Warde 1005055 5-hiaa 24 hour urine CPT 83497 | $81.18 | $123.00 | $12.90 – $16.77 | 11 |
| Warde 1006955 catecholamines fractionated 24 hour urine CPT 82384 | $152.46 | $231.00 | $25.25 – $32.83 | 11 |
| Warde 1007138 vanillymandelic acid 24 hour urine CPT 84585 | $89.76 | $136.00 | $15.50 – $20.15 | 11 |
| Warde 1015200 kappa light chain free CPT 83521 | $81.18 | $123.00 | $17.27 – $22.45 | 11 |
| Warde 3004000 immunoglobulin subclass 1 CPT 82787 | $33.00 | $50.00 | $5.90 – $10.43 | 11 |
| Warde 3008005 oligoclonal bands CPT 83916 | $117.48 | $178.00 | $27.39 – $35.61 | 11 |
| Warde 3016000 west nile virus antibody CPT 86788 | $68.64 | $104.00 | $8.17 – $21.91 | 11 |
| Warde 3016000 west nile virus antibody igg CPT 86789 | $79.86 | $121.00 | $14.39 – $18.71 | 11 |
| Warde 3016300 saccharomyces cerevisiae iga antibody CPT 86671 | $130.02 | $197.00 | $7.15 – $15.93 | 11 |
| Warde 3400652 ova & parasites direct smear concentration and id CPT 87177 | $59.40 | $90.00 | $8.90 – $11.57 | 11 |
| Warde 3400652 smear complex special stain ova/parasites CPT 87209 | $79.86 | $121.00 | $17.98 – $23.37 | 11 |
| Warde 3400852 arsenic CPT 82175 | $72.60 | $110.00 | $18.97 – $24.66 | 11 |
| Warde 3708165 mercury urine CPT 83825 | $81.18 | $123.00 | $16.26 – $21.14 | 11 |
| Warde acetylcholine receptor blocking antibody CPT 86042 | $89.10 | $135.00 | $14.72 – $23.92 | 11 |
| Warde actin (smooth muscle) antibody each CPT 86015 | $67.32 | $102.00 | $11.53 – $15.67 | 11 |
| Warde adenosine deaminase pleural fluid CPT 84311 | $170.94 | $259.00 | $8.10 – $10.53 | 11 |
| Warde adrenocorticotropic hormone (acth) CPT 82024 | $233.64 | $354.00 | $38.62 – $50.21 | 11 |
| Warde aldolase CPT 82085 | $54.12 | $82.00 | $9.71 – $12.62 | 11 |
| Warde amino acids 6 or more quantitative each specimen CPT 82139 | $900.90 | $1,365.00 | $16.87 – $21.93 | 11 |
| Warde amiodarone therapeutic drug level CPT 80151 | $21.78 | $33.00 | $14.91 – $24.23 | 11 |
| Warde analysis gene hfe common variants CPT 81256 | $426.36 | $646.00 | $65.36 – $84.97 | 11 |
| Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative CPT 81206 | $753.06 | $1,141.00 | $163.96 – $213.15 | 11 |
| Warde anti-mullerian hormone CPT 82166 | $81.18 | $123.00 | $38.62 – $50.21 | 11 |
| Warde apolipoprotein b CPT 82172 | $96.36 | $146.00 | $21.09 – $27.42 | 11 |
| Warde bile acids CPT 82239 | $34.32 | $52.00 | $17.12 – $22.26 | 11 |
| Warde cadmium blood CPT 82300 | $72.60 | $110.00 | $23.64 – $30.73 | 11 |
| Warde calcitonin CPT 82308 | $126.06 | $191.00 | $26.79 – $34.83 | 11 |
| Warde calculus (stone) infrared CPT 82365 | $111.54 | $169.00 | $12.90 – $16.77 | 11 |
| Warde clozapine therapeutic drug level CPT 80159 | $69.96 | $106.00 | $20.15 – $26.20 | 11 |
| Warde cobalt heavy metal quantitative each nes CPT 83018 | $99.00 | $150.00 | $21.96 – $28.55 | 11 |
| Warde collagen cross links c-telopeptide CPT 82523 | $99.00 | $150.00 | $14.65 – $24.28 | 11 |
| Warde complement total hemolytic CPT 86162 | $129.36 | $196.00 | $20.32 – $26.42 | 11 |
| Warde copper CPT 82525 | $72.60 | $110.00 | $12.41 – $16.13 | 11 |
| Warde cryoglobulin CPT 82595 | $134.64 | $204.00 | $6.47 – $8.41 | 11 |
| Warde erythropoietin CPT 82668 | $89.76 | $136.00 | $18.79 – $24.43 | 11 |
| Warde estrogen fractionated CPT 82671 | $132.00 | $200.00 | $32.30 – $41.99 | 11 |
| Warde fluorescent antibody screen endomysial iga CPT 86231 | $29.70 | $45.00 | $12.05 – $15.72 | 11 |
| Warde folic acid rbc CPT 82747 | $73.26 | $111.00 | $16.37 – $22.95 | 11 |
| Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative CPT 82955 | $346.50 | $525.00 | $9.70 – $12.61 | 11 |
| Warde gastrin CPT 82941 | $81.18 | $123.00 | $17.63 – $22.92 | 11 |
| Warde growth hormone (hgh) CPT 83003 | $81.18 | $123.00 | $16.67 – $21.67 | 11 |
| Warde haloperidol therapeutic drug level CPT 80173 | $33.66 | $51.00 | $15.78 – $20.51 | 11 |
| Warde helminth antibody strongyloides igg CPT 86682 | $141.24 | $214.00 | $8.17 – $16.91 | 11 |
| Warde hemoglobin fractionation/quantitation electrophoresis CPT 83020 | $118.14 | $179.00 | $6.41 – $16.73 | 11 |
| Warde hepatitis a antibody CPT 86708 | $68.64 | $104.00 | $12.39 – $16.11 | 11 |
| Warde hepatitis be antibody CPT 86707 | $68.64 | $104.00 | $11.57 – $15.04 | 11 |
| Warde hepatitis delta agent antibody CPT 86692 | $116.82 | $177.00 | $17.16 – $22.31 | 11 |
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.