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 |
|---|---|---|---|---|
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | not published | not published | $761.22 – $1,914.08 | 5 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | not published | not published | $33.40 – $82.98 | 4 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | not published | not published | $1,161.57 – $3,157.04 | 4 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | not published | not published | $69.98 – $205.44 | 4 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $12,177.38 | $22,140.70 | not published | 0 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | not published | not published | $5,438.20 – $5,438.20 | 1 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $9,272.26 | $16,858.65 | not published | 0 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $2,150.95 | $3,910.81 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | not published | not published | $71.95 – $178.08 | 4 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | not published | not published | $116.01 – $287.74 | 4 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | not published | not published | $150.01 – $377.75 | 4 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | not published | not published | $56.97 – $131.90 | 4 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | not published | not published | $41.25 – $372.57 | 4 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $770.66 | $1,401.20 | not published | 0 |
| Granisetron 1 mg tab HCPCS Q0166 | not published | not published | $140.48 – $140.48 | 1 |
| Granisetron hcl injection HCPCS J1626 | not published | not published | $0.24 – $0.63 | 5 |
| Granulocyte pheresis ea unit HCPCS P9050 | $2,124.65 | $3,863.00 | not published | 0 |
| Great toe-hand transfer CPT 26551 | not published | not published | $3,735.00 – $16,106.00 | 3 |
| Great toe with reduction 28495 CPT 28495 | $495.00 | $900.00 | $1,887.00 – $2,654.00 | 3 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Grfg autol fat lipo ea addl CPT 15772 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Grfg autol soft tiss dir exc CPT 15769 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Group mnt 2 or more 30 mins HCPCS G0271 | $56.65 | $103.00 | not published | 0 |
| Growth hormone antibody CPT 86277 | not published | not published | $15.74 – $31.86 | 4 |
| Growth hormone panel CPT 80428 | not published | not published | $66.70 – $134.96 | 4 |
| Growth hormone panel CPT 80430 | not published | not published | $129.33 – $226.33 | 4 |
| Growth stimulation gene 2 CPT 83006 | not published | not published | $44.51 – $132.30 | 4 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Gstr rstcv oth/thn v-band CPT 43843 | not published | not published | $3,735.00 – $16,106.00 | 3 |
| Gstr rstcv px shrt roux-en-y CPT 43846 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Gstr rstcv px sm int rcnstj CPT 43847 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Gstr rstcv px v-banded gstp CPT 43842 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| G-tube reposition CPT 43761 | $575.85 | $1,047.00 | $1,887.00 – $2,654.00 | 3 |
| Gu dilat ureter/urethra s&i CPT 74485 | $254.10 | $462.00 | $219.33 – $219.33 | 1 |
| Guided cath fluid drainage 10030 CPT 10030 | $3,446.30 | $6,266.00 | $2,654.00 – $3,030.00 | 3 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $6,618.30 | $12,033.28 | not published | 0 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $770.57 | $1,401.03 | not published | 0 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $70.81 | $128.75 | not published | 0 |
| Guid loc target vol rad tx CPT 77387 | $433.40 | $788.00 | $215.16 – $215.16 | 1 |
| Gum graft CPT 41870 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Gw stiffened micro access kit HCPCS C1894 | $262.75 | $477.73 | not published | 0 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Hair analysis HCPCS P2031 | not published | not published | $4.95 – $9.07 | 4 |
| Hair removal by electrolysis 17380 CPT 17380 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | not published | not published | $5.07 – $15.11 | 5 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | not published | not published | $0.86 – $3.30 | 5 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | not published | not published | $5.77 – $5.77 | 1 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Hand tendon reconstruction CPT 26500 | not published | not published | $3,579.00 – $6,779.00 | 3 |
| Hand tendon reconstruction CPT 26502 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Hand X-ray CPT 73130 | $304.15 | $553.00 | $72.00 – $72.00 | 1 |
| Haptoglobin quantitative CPT 83010 | $98.45 | $179.00 | $12.58 – $25.45 | 4 |
| Harvest allogeneic stem cell CPT 38205 | not published | not published | $1,887.00 – $4,428.00 | 3 |
| Harvest auto stem cells CPT 38206 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Harvest cultured skin graft 15040 CPT 15040 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Harvest eye tissue alograft CPT 68371 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Harvest femoropopliteal vein 35572 CPT 35572 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Harvest stem cell concentrte CPT 38215 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Harvest vein for bypass 35500 CPT 35500 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Hba1/hba2 full gene sequence CPT 81259 | not published | not published | $600.00 – $1,050.00 | 4 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | not published | not published | $202.40 – $354.20 | 4 |
| Hba1/hba2 gene fam vrnt CPT 81258 | not published | not published | $375.25 – $656.69 | 4 |
| Hbb full gene sequence CPT 81364 | not published | not published | $324.58 – $568.02 | 4 |
| Hbb gene com variants CPT 81361 | not published | not published | $174.81 – $305.92 | 4 |
| Hbb gene dup/del variants CPT 81363 | not published | not published | $202.40 – $354.20 | 4 |
| Hbb gene known fam variant CPT 81362 | not published | not published | $375.25 – $656.69 | 4 |
| Hb glycosylated a1c home dev CPT 83037 | not published | not published | $9.71 – $19.64 | 4 |
| Hbot, full body chamber, 30m HCPCS G0277 | $365.75 | $665.00 | not published | 0 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | not published | not published | $1,276.81 – $1,276.81 | 1 |
| Hcg free betachain test CPT 84704 | $28.05 | $51.00 | $15.29 – $30.47 | 4 |
| Hcg qualitative CPT 84703 | $75.90 | $138.00 | $7.52 – $15.22 | 4 |
| Hcg quantitative CPT 84702 | $130.90 | $238.00 | $15.05 – $30.47 | 4 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | not published | not published | $257.14 – $257.14 | 1 |
| Hc metata joint dislocation anes CPT 28635 | $3,343.45 | $6,079.00 | $3,388.00 – $4,761.00 | 3 |
| Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks CPT 17311 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Hc mohs micrographic h/n/h/f/g each addl stage CPT 17312 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Hc mohs trunk/arm/leg 1st stage 5 blocks CPT 17313 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Hc mohs trunk/arm/leg ea addl block any stage CPT 17315 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Hc mohs trunk/arm/leg ea stage after 1st stage CPT 17314 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | not published | not published | $438.66 – $438.66 | 1 |
| Hc nm kidney imaging with flow CPT 78701 | not published | not published | $647.31 – $647.31 | 1 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | $2,256.65 | $4,103.00 | $629.45 – $629.45 | 1 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | $2,375.45 | $4,319.00 | $1,237.23 – $1,237.23 | 1 |
| Hc transcatheter placement and sbsq removal cepd perq CPT 33370 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | not published | not published | $735.94 – $735.94 | 1 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | not published | not published | $1,340.45 – $1,340.45 | 1 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | not published | not published | $2,115.11 – $2,115.11 | 1 |
| Hdr rdncl skn surf brachytx CPT 77767 | not published | not published | $568.88 – $568.88 | 1 |
| Hdr rdncl skn surf brachytx CPT 77768 | not published | not published | $935.04 – $935.04 | 1 |
| Head CT scan (with and without contrast) CPT 70470 | $1,515.80 | $2,756.00 | $422.52 – $422.52 | 1 |
| Head CT scan (with contrast) CPT 70460 | $1,443.75 | $2,625.00 | $347.65 – $347.65 | 1 |
| Head CT scan (without contrast) CPT 70450 | $1,375.00 | $2,500.00 | $241.91 – $241.91 | 1 |
| Hearing loss dup/del analys CPT 81431 | not published | not published | $679.57 – $1,189.25 | 4 |
| Hearing loss sequence analys CPT 81430 | not published | not published | $1,625.00 – $2,843.75 | 4 |
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.