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 |
|---|---|---|---|---|
| Cath uret open tp 6fx70cm HCPCS C1758 | $193.38 | $293.00 | $19.25 – $19.25 | 1 |
| Cauterization chemical granulation tissue CPT 17250 | $405.24 | $614.00 | $95.40 – $284.11 | 9 |
| Ccnd1/igh translocation alys CPT 81168 | $478.50 | $725.00 | $165.85 – $269.50 | 11 |
| Cdna analysis for variants CPT 81403 | $396.66 | $601.00 | $148.16 – $240.76 | 11 |
| Cebpa gene full sequence CPT 81218 | $415.14 | $629.00 | $195.07 – $314.47 | 11 |
| Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr HCPCS J0690 | $16.17 | $24.50 | $1.37 – $1.49 | 4 |
| Cefepime 1 gram solution for injection HCPCS J0692 | $16.17 | $24.50 | $1.44 – $1.56 | 4 |
| Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr HCPCS J0713 | $13.40 | $20.30 | $2.43 – $2.63 | 4 |
| Ceftazidime and avibactam HCPCS J0714 | $324.86 | $492.21 | $104.71 – $323.97 | 11 |
| Ceftriaxone 1 gram solution for injection HCPCS J0696 | $46.63 | $70.65 | $0.76 – $0.82 | 4 |
| #celiac hla-dq8 CPT 81383 | $629.64 | $954.00 | $109.13 – $141.87 | 11 |
| Cell count w differential body fluid CPT 89051 | $79.86 | $121.00 | $5.60 – $7.28 | 11 |
| Cell cryopreserve/storage CPT 88240 | $39.60 | $60.00 | $9.83 – $16.99 | 11 |
| Cell marker study CPT 88182 | $133.98 | $203.00 | $43.20 – $121.80 | 11 |
| Cerebrospinal fld flw imag CPT 78645 | $951.06 | $1,441.00 | $554.73 – $1,514.75 | 11 |
| Cervical or vaginal cancer screening g0101 HCPCS G0101 | $106.92 | $162.00 | $26.20 – $103.79 | 8 |
| #cf-97variants CPT 81220 | $1,009.14 | $1,529.00 | $210.00 – $723.58 | 11 |
| Change cystostomy tube; complex 51710 CPT 51710 | $1,779.36 | $2,696.00 | $655.12 – $712.40 | 8 |
| Change cystostomy tube simple CPT 51705 | $543.84 | $824.00 | $139.82 – $255.26 | 8 |
| Change of windpipe airway 31502 CPT 31502 | $444.84 | $674.00 | $90.89 – $291.52 | 11 |
| Chemo adm cns w/lmbr punct CPT 96450 | $885.06 | $1,341.00 | $337.46 – $1,341.00 | 11 |
| Chest 2 vws w oblique CPT 71048 | $355.08 | $538.00 | $91.15 – $495.60 | 11 |
| Chest apical lordotic proj CPT 71047 | $275.88 | $418.00 | $88.91 – $418.00 | 11 |
| Chest CT scan (with and without contrast) CPT 71270 | $1,818.96 | $2,756.00 | $179.20 – $1,247.60 | 11 |
| Chest CT scan (with contrast) CPT 71260 | $1,539.12 | $2,332.00 | $179.20 – $1,247.60 | 11 |
| Chest CT scan (without contrast) CPT 71250 | $1,264.56 | $1,916.00 | $106.81 – $1,247.60 | 11 |
| Chest X-ray CPT 71046 | $275.88 | $418.00 | $88.91 – $418.00 | 11 |
| Chest X-ray (single view) CPT 71045 | $259.38 | $393.00 | $69.71 – $393.00 | 11 |
| Chg pr pul rehab for copd patients CPT 94626 | $137.94 | $209.00 | $55.43 – $60.27 | 8 |
| Chimerism anal no cell selec CPT 81267 | $450.12 | $682.00 | $207.46 – $269.70 | 11 |
| Chlamydia type CPT 87140 | $49.50 | $75.00 | $5.57 – $7.24 | 11 |
| Chlnggrphy intraop addl s&i CPT 74301 | $378.84 | $574.00 | $74.74 – $495.60 | 10 |
| Chloride CPT 82435 | $54.12 | $82.00 | $4.60 – $5.98 | 11 |
| Chloride 24 hour urine CPT 82436 | $38.94 | $59.00 | $5.75 – $7.48 | 11 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $691.02 | $1,047.00 | $95.95 – $495.60 | 10 |
| Cholesterol CPT 82465 | $51.48 | $78.00 | $4.35 – $5.66 | 11 |
| Cholesterol body fluid CPT 84999 | $103.62 | $157.00 | $15.79 – $94.20 | 9 |
| Cholesterol (Lipid) Test CPT 80061 | $149.82 | $227.00 | $13.39 – $17.41 | 11 |
| Chrom analysis CPT 88273 | $398.64 | $604.00 | $34.81 – $45.25 | 11 |
| Chromatography CPT 83021 | $152.46 | $231.00 | $18.06 – $23.48 | 11 |
| Chromogenic substrate assay CPT 85130 | $444.84 | $674.00 | $11.89 – $15.46 | 11 |
| Chromo high res and frag x - sendout CPT 81243 | $237.60 | $360.00 | $54.46 – $74.15 | 11 |
| Chromosome analys amniotic CPT 88269 | $737.22 | $1,117.00 | $173.66 – $225.76 | 11 |
| Chromosome analysis 100 CPT 88249 | $339.24 | $514.00 | $173.17 – $225.12 | 11 |
| Chromosome analysis 15-20 cell count CPT 88262 | $390.72 | $592.00 | $125.49 – $163.14 | 11 |
| Chromosome count additional CPT 88285 | $46.86 | $71.00 | $26.72 – $34.98 | 11 |
| Chromosome karyotype study CPT 88280 | $217.14 | $329.00 | $33.47 – $43.51 | 11 |
| Chromosome study additional CPT 88289 | $240.24 | $364.00 | $34.43 – $44.76 | 11 |
| Chylomicron screen, bf - sendout CPT 82664 | $180.18 | $273.00 | $48.31 – $79.95 | 11 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $27.26 | $41.30 | $3.30 – $3.58 | 4 |
| Circum 28 days or older CPT 54161 | not published | not published | not published | 0 |
| C-kit mutation liquid tumor - sendout CPT 81272 | $495.00 | $750.00 | $195.07 – $428.36 | 11 |
| Clearance of airways CPT 31720 | $234.96 | $356.00 | $93.60 – $223.72 | 8 |
| Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 | $40.35 | $61.13 | $3.15 – $3.42 | 4 |
| Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 | $204.60 | $310.00 | $28.43 – $30.84 | 4 |
| Closed carpo/metacarpal disl thumb w/manip CPT 26641 | $638.88 | $968.00 | $252.01 – $791.66 | 8 |
| Closed tx humerus fx with manip 23605 CPT 23605 | $3,575.88 | $5,418.00 | $746.85 – $1,642.82 | 8 |
| Closed tx humerus fx w/manip 24505 CPT 24505 | $1,848.66 | $2,801.00 | $746.85 – $1,642.82 | 8 |
| Closed tx metatarsophalangeal jnt disl without anes CPT 28630 | $593.34 | $899.00 | $252.01 – $791.66 | 8 |
| Closed tx post hip arthroplasty disloc w/anes 27266 CPT 27266 | $1,848.66 | $2,801.00 | $1,567.01 – $1,661.03 | 8 |
| Close lac/mouth vest/2.5 cm or < 40830 CPT 40830 | $583.44 | $884.00 | $241.98 – $291.52 | 8 |
| Closure laceration vestibule mouth > 2.5 cm cmplx CPT 40831 | $1,121.34 | $1,699.00 | $551.01 – $1,800.94 | 8 |
| Clot factor xii hageman CPT 85280 | $108.90 | $165.00 | $19.35 – $25.16 | 11 |
| Clot factor xiii fibrin scrn CPT 85291 | $49.50 | $75.00 | $9.11 – $11.84 | 11 |
| Clot factor xiii fibrin stab CPT 85290 | $106.26 | $161.00 | $16.34 – $21.24 | 11 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | $819.72 | $1,242.00 | $252.01 – $791.66 | 8 |
| Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 | $510.18 | $773.00 | $252.01 – $791.66 | 8 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | $638.88 | $968.00 | $252.01 – $791.66 | 8 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | $503.58 | $763.00 | $252.01 – $791.66 | 8 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | $483.78 | $733.00 | $252.01 – $776.98 | 8 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $568.26 | $861.00 | $252.01 – $791.66 | 8 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | $551.10 | $835.00 | $252.01 – $791.66 | 8 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $1,607.10 | $2,435.00 | $746.85 – $1,642.82 | 8 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | $613.80 | $930.00 | $252.01 – $791.66 | 8 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $1,607.10 | $2,435.00 | $373.42 – $821.41 | 8 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $780.78 | $1,183.00 | $252.01 – $791.66 | 8 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $450.12 | $682.00 | $252.01 – $722.92 | 8 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $613.14 | $929.00 | $252.01 – $791.66 | 8 |
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | $549.78 | $833.00 | $252.01 – $791.66 | 8 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | $3,711.84 | $5,624.00 | $746.85 – $1,642.82 | 8 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $662.64 | $1,004.00 | $252.01 – $791.66 | 8 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $4,019.40 | $6,090.00 | $746.85 – $1,642.82 | 8 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | $1,848.66 | $2,801.00 | $1,567.01 – $1,661.03 | 8 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $614.46 | $931.00 | $252.01 – $791.66 | 8 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $1,848.66 | $2,801.00 | $746.85 – $1,642.82 | 8 |
| Clsd/ulnar fx/prox end without manip 24670 CPT 24670 | $512.16 | $776.00 | $252.01 – $791.66 | 8 |
| Cltx lunate dislc w/mnpj CPT 25690 | $3,837.90 | $5,815.00 | $746.85 – $1,642.82 | 8 |
| #cmvcul-virus inoculation shell CPT 87254 | $129.36 | $196.00 | $7.06 – $25.43 | 11 |
| Cmv pcr-sendout CPT 87496 | $256.74 | $389.00 | $35.09 – $45.62 | 11 |
| Cnbp gene detc abnor allele CPT 81187 | $368.94 | $559.00 | $109.60 – $178.10 | 11 |
| Co2 monitor per day CPT 94681 | $677.16 | $1,026.00 | $167.54 – $687.30 | 11 |
| Coagulation time activated teg CPT 85347 | $59.40 | $90.00 | $4.28 – $5.56 | 11 |
| Cold agglutinin screen (arc) CPT 86156 | $122.10 | $185.00 | $8.07 – $10.49 | 11 |
| Cold agglutinin titer CPT 86157 | $9.24 | $14.00 | $8.06 – $10.48 | 11 |
| Collar cerv 18.25x3.5in serp firm density sm HCPCS L0120 | $48.18 | $73.00 | $40.61 – $40.61 | 1 |
| Collar cerv adlt perfit ace extric HCPCS L0140 | $145.20 | $220.00 | $102.85 – $102.85 | 1 |
| Collar cerv ascend 172 reg HCPCS L0172 | $213.84 | $324.00 | $204.04 – $204.04 | 1 |
| Collar cerv patriot adlt HCPCS L0150 | $93.06 | $141.00 | $133.43 – $133.43 | 1 |
| Collection blood specimen from completely implantable venous access device CPT 36591 | $129.36 | $196.00 | $117.60 – $135.93 | 10 |
| Collection blood specimen using established central/peripheral catheter venous nos CPT 36592 | $129.36 | $196.00 | $117.60 – $135.93 | 10 |
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.