SSM Health Ripon Community Hospital
845 Parkside St, Ripon, WI · SSM Health · · NPI 1053362624
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 |
|---|---|---|---|---|
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Destruction les conjunctiva CPT 68135 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Destruction premal lesions 15/> 17004 CPT 17004 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Destruction vag lesions simple 57061 CPT 57061 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $30.03 – $52.55 | 4 |
| Detect agnt mult dna direc CPT 87800 | $316.25 | $575.00 | $43.67 – $81.17 | 4 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $2,870.52 | $5,219.12 | not published | 0 |
| Device intraute mirena HCPCS J7298 | not published | not published | $3,779.24 – $3,779.24 | 1 |
| Device sut capio slim opn HCPCS C2631 | $719.28 | $1,307.79 | not published | 0 |
| Device tiss remov myosure reach HCPCS C1782 | $1,266.58 | $2,302.88 | not published | 0 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $304.15 | $553.00 | $56.56 – $56.56 | 1 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | not published | not published | $121.75 – $307.51 | 5 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | not published | not published | $7.38 – $7.38 | 1 |
| Dexamethasone 4 mg tablet HCPCS J8540 | not published | not published | $0.03 – $0.17 | 5 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | not published | not published | $0.10 – $0.30 | 5 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $222.56 – $559.63 | 5 |
| Dexmedetomidine film, 1 mcg HCPCS J1105 | not published | not published | $1.77 – $1.77 | 1 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | not published | not published | $60.96 – $220.19 | 5 |
| Dextran 40 infusion HCPCS J7100 | not published | not published | $140.28 – $140.28 | 1 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | not published | not published | $1.27 – $3.22 | 5 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | not published | not published | $16.47 – $16.47 | 1 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | not published | not published | $1.95 – $4.90 | 5 |
| Dextrose 5 % IV bolus HCPCS J7070 | not published | not published | $3.90 – $9.80 | 5 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $173.80 | $316.00 | $22.23 – $45.00 | 4 |
| Diabetes (HbA1c) Test CPT 83036 | $86.35 | $157.00 | $9.71 – $19.64 | 4 |
| Diab manage trn ind/group HCPCS G0109 | $59.95 | $109.00 | not published | 0 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $5,257.00 – $16,106.00 | 3 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $172.70 | $314.00 | $1,887.00 – $2,654.00 | 3 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $19.25 | $35.00 | $406.43 – $406.43 | 1 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $19.25 | $35.00 | $318.64 – $318.64 | 1 |
| Diagnostic laryngoscopy 31505 CPT 31505 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $235.40 | $428.00 | $1,887.00 – $2,654.00 | 3 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $399.30 | $726.00 | $146.40 – $146.40 | 1 |
| Diagnostic Mammogram (one breast) CPT 77065 | $199.65 | $363.00 | $114.41 – $114.41 | 1 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $183.45 – $183.45 | 1 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $796.40 | $1,448.00 | $1,887.00 – $2,334.00 | 2 |
| Dialysis one evaluation CPT 90945 | $74.80 | $136.00 | not published | 0 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | not published | not published | $0.09 – $0.20 | 4 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | not published | not published | $6.37 – $23.28 | 5 |
| Dicyclomine injection HCPCS J0500 | not published | not published | $14.15 – $40.57 | 5 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.35 – $0.35 | 1 |
| Diffusing capacity CPT 94729 | $393.80 | $716.00 | not published | 0 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | not published | not published | $5.37 – $24.01 | 5 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | not published | not published | $5,465.44 – $13,803.03 | 5 |
| Digoxin total therapeutic drug level CPT 80162 | $98.45 | $179.00 | $13.28 – $26.87 | 4 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | not published | not published | $44.43 – $184.44 | 5 |
| Dilate biliary duct/ampulla CPT 47542 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Dilate esophagus CPT 43453 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Dilate esophagus 1/mult pass CPT 43450 | $2,283.60 | $4,152.00 | $2,654.00 – $4,761.00 | 3 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Dilate ic vasospasm init CPT 61640 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Dilate tear duct opening CPT 68801 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Dilate urethra stricture CPT 53600 | $634.15 | $1,153.00 | $1,887.00 – $2,654.00 | 3 |
| Dilate urethra stricture CPT 53601 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Dilate urethra stricture CPT 53605 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Dilate urethra stricture CPT 53621 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Dilation of salivary duct CPT 42660 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Dilation of urethra CPT 53661 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Dilation of urethra CPT 53665 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Dilation of vagina CPT 57400 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $2,654.00 – $3,030.00 | 3 |
| Dilat xst trc ndurlgc px CPT 50436 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Dilat xst trc new access rcs CPT 50437 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | not published | not published | $0.07 – $0.07 | 1 |
| Dimecaprol injection HCPCS J0470 | not published | not published | $174.74 – $174.74 | 1 |
| Dimenhydrinate injection HCPCS J1240 | not published | not published | $9.19 – $23.61 | 5 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | not published | not published | $774.57 – $1,947.64 | 5 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | not published | not published | $3.55 – $3.55 | 1 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | not published | not published | $0.73 – $1.98 | 5 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | not published | not published | $45.79 – $45.79 | 1 |
| Disability dlco CPT 94727 | $531.85 | $967.00 | not published | 0 |
| Disaccharidases CPT 82657 | $165.55 | $301.00 | $22.17 – $38.80 | 4 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $3,388.00 – $3,388.00 | 1 |
| Discography cerv/thor spine CPT 72285 | $3,359.40 | $6,108.00 | $176.56 – $176.56 | 1 |
| Dise eval slp do brth flx dx CPT 42975 | not published | not published | $1,887.00 – $3,388.00 | 3 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $4,428.00 – $18,364.00 | 3 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Division of fallopian tube 58605 CPT 58605 | not published | not published | $3,579.00 – $4,761.00 | 3 |
| #d/lmeth-l-methamphetamine CPT 80374 | not published | not published | $35.06 – $35.06 | 1 |
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.