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 |
|---|---|---|---|---|
| I131 iodide cap, rx HCPCS A9517 | $50.05 | $91.00 | $62.96 – $62.96 | 1 |
| I131 iodide sol, rx HCPCS A9530 | not published | not published | $56.84 – $56.84 | 1 |
| I131 max 100uci HCPCS A9531 | not published | not published | $11.47 – $11.47 | 1 |
| I131 serum albumin, dx HCPCS A9524 | not published | not published | $981.02 – $981.02 | 1 |
| Iaadi respiratory synctial virus CPT 87280 | $29.70 | $54.00 | $13.42 – $24.26 | 4 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | $205.70 | $374.00 | $35.09 – $71.00 | 4 |
| Ia infect ag ab qual/semiquant sgl step CPT 86318 | not published | not published | $18.09 – $31.66 | 4 |
| Ia nfct ab sarscov2 covid19 CPT 86328 | not published | not published | $45.28 – $79.24 | 4 |
| Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 | not published | not published | $24.44 – $69.04 | 5 |
| Ibmfs seq alys pnl 30 genes CPT 81441 | not published | not published | $2,448.56 – $4,284.98 | 4 |
| Ibuprofen injection HCPCS J1741 | not published | not published | $3.21 – $8.09 | 5 |
| Ibutilide fumarate 0.1 mg/ml intravenous solution HCPCS J1742 | not published | not published | $509.03 – $509.03 | 1 |
| Icatibant injection HCPCS J1744 | not published | not published | $137.85 – $367.70 | 2 |
| Icd cobalt xt dr MRI is1 df1 HCPCS C1721 | $16,159.13 | $29,380.24 | not published | 0 |
| Icd crtd cobalt hf MRI is1 df1 HCPCS C1882 | $21,728.44 | $39,506.25 | not published | 0 |
| Icd crtp serena MRI HCPCS C2621 | $9,933.00 | $18,060.00 | not published | 0 |
| I&d abscess posterior spine l/s/ls-22015 CPT 22015 | not published | not published | $3,388.00 – $18,364.00 | 3 |
| I&d abscss rtrphryngl/paraphryngl intraorl apprch CPT 42720 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Idarubicin hcl injection HCPCS J9211 | not published | not published | $47.86 – $127.41 | 5 |
| I&d/bursa/foot 28001 CPT 28001 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Idecabtagene vicleucel car HCPCS Q2055 | not published | not published | $580,384.71 – $1,438,330.59 | 4 |
| Identify sperm tissue CPT 89264 | not published | not published | $49.47 – $49.47 | 1 |
| Idet 1 or more levels CPT 22527 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Idet single level CPT 22526 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| I&d frarm&/wrst deep absc/hematoma CPT 25028 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Idh1 common variants CPT 81120 | $496.10 | $902.00 | $193.25 – $338.19 | 4 |
| Idh2 common variants CPT 81121 | $786.50 | $1,430.00 | $295.79 – $517.63 | 4 |
| I&d intramural/intramuscular/submuc abscess transanal anes CPT 46045 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| I&d lacrimal gland CPT 68400 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| I&d lacrimal sac CPT 68420 | not published | not published | $2,959.00 – $3,388.00 | 3 |
| I&d upper arm/elbow deep abscess/hematoma CPT 23930 | $2,014.65 | $3,663.00 | $3,388.00 – $7,791.00 | 3 |
| Idursulfase injection HCPCS J1743 | not published | not published | $587.07 – $1,476.19 | 5 |
| I & d vag hematoma non-ob 57023 CPT 57023 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| I&d vag hemtma obst/postpart CPT 57022 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Ifnl3 gene CPT 81283 | not published | not published | $73.37 – $128.40 | 4 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | not published | not published | $27.08 – $68.26 | 5 |
| Igh@/bcl2 translocation alys CPT 81278 | not published | not published | $207.31 – $362.79 | 4 |
| Igh gene rearrang dir probe CPT 81262 | not published | not published | $68.55 – $119.96 | 4 |
| Igh gene rearrange amp meth CPT 81261 | not published | not published | $197.99 – $400.63 | 4 |
| Igh@ var region somatic mutation analy CPT 81263 | not published | not published | $294.52 – $595.96 | 4 |
| Igk rearrangeabn clonal pop CPT 81264 | not published | not published | $172.73 – $302.28 | 4 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $259.60 | $472.00 | $64.60 – $88.96 | 2 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $410.85 | $747.00 | $188.36 – $283.41 | 2 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $343.20 | $624.00 | $99.41 – $143.50 | 2 |
| Iiv3 vacc no prsv 0.25 ml im CPT 90655 | not published | not published | $35.06 – $35.06 | 1 |
| Ikbkap gene CPT 81260 | not published | not published | $39.31 – $68.79 | 4 |
| Ileostomy/jejunostomy non-tube 44310 CPT 44310 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Iliac bone graft microvasc CPT 20956 | not published | not published | $6,779.00 – $18,364.00 | 3 |
| Iliac/fem angio cath insert HCPCS G0278 | $518.65 | $943.00 | not published | 0 |
| Iliac revasc add-on 37222 CPT 37222 | $6,013.15 | $10,933.00 | $5,512.00 – $18,364.00 | 3 |
| Iloprost non-comp unit dose HCPCS Q4074 | not published | not published | $163.64 – $403.59 | 4 |
| Imbrication/diaphragm/transthor/transabd 39545 CPT 39545 | not published | not published | $5,257.00 – $5,257.00 | 1 |
| Imetelstat 188 mg intravenous solution HCPCS J0870 | not published | not published | $61.06 – $151.02 | 3 |
| Immt breast prosthesis 19340 CPT 19340 | not published | not published | $6,019.00 – $16,106.00 | 3 |
| Immune complex assay CPT 86332 | not published | not published | $24.37 – $49.32 | 4 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | not published | not published | $49.64 – $126.49 | 5 |
| Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution HCPCS J1566 | not published | not published | $88.17 – $221.69 | 5 |
| Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution HCPCS J1568 | not published | not published | $52.87 – $134.23 | 5 |
| Immune globulin ig human im use 90281 CPT 90281 | not published | not published | $162.64 – $162.64 | 1 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $166.65 | $303.00 | $20.81 – $42.11 | 4 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $168.30 | $306.00 | $20.81 – $42.11 | 4 |
| Immunoassay tumor qual CPT 86294 | not published | not published | $25.57 – $44.75 | 4 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $12.87 | $23.40 | $11.98 – $24.25 | 4 |
| Immunodiffusion nes CPT 86329 | not published | not published | $14.05 – $28.42 | 4 |
| Immunoelectrophoresis assay CPT 86327 | not published | not published | $37.40 – $52.36 | 3 |
| Immunofixation electrophoresis serum CPT 86334 | $134.20 | $244.00 | $22.34 – $45.23 | 4 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $82.50 | $150.00 | $62.03 – $63.88 | 2 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $76.45 | $139.00 | $78.58 – $283.41 | 2 |
| Immunoglobulin assay CPT 86023 | $156.20 | $284.00 | $12.46 – $25.21 | 4 |
| Impact tooth remov part bony HCPCS D7230 | not published | not published | $5,512.00 – $5,512.00 | 1 |
| Imp extar knee shck absrb HCPCS C8003 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Impl absrb msh/prsth dly cls CPT 15778 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Implantation iris prosthesis CPT 66683 | not published | not published | $3,388.00 – $3,388.00 | 1 |
| Implant biventricular device 33976 CPT 33976 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Implant brain electrodes CPT 61531 | not published | not published | $3,579.00 – $6,779.00 | 3 |
| Implant brain electrodes CPT 61533 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Implant brain electrodes CPT 61760 | not published | not published | $3,579.00 – $6,779.00 | 3 |
| Implant cartilage 10mm synthetic HCPCS L8699 | $1,407.18 | $2,558.50 | not published | 0 |
| Implant cochlear device CPT 69930 | not published | not published | $8,923.00 – $54,996.00 | 3 |
| Implant eye drug system CPT 67027 | not published | not published | $8,923.00 – $16,106.00 | 3 |
| Implant hormone pellet(s) 11980 CPT 11980 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Implant nerve end CPT 64787 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Implant neuroelectrde addl CPT 61864 | not published | not published | $3,388.00 – $3,388.00 | 1 |
| Implant neuroelectrde addl CPT 61868 | not published | not published | $3,388.00 – $3,388.00 | 1 |
| Implant neuroelectrode CPT 61863 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Implant neuroelectrode CPT 61867 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Implant neuroelectrodes CPT 63655 | not published | not published | $8,923.00 – $27,583.00 | 3 |
| Implant neuroelectrodes CPT 64553 | not published | not published | $7,609.00 – $18,364.00 | 3 |
| Implant neuroelectrodes CPT 64555 | not published | not published | $7,609.00 – $18,364.00 | 3 |
| Implant neuroelectrodes CPT 64561 | $2,763.09 | $5,023.80 | $7,609.00 – $18,364.00 | 3 |
| Implant neuroelectrodes CPT 61850 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Implant neuroelectrodes CPT 61860 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Implant neurostim arrays CPT 61886 | not published | not published | $8,923.00 – $54,996.00 | 3 |
| Implant open hernia repair w/mesh 49568 CPT 49568 | not published | not published | $5,415.00 – $5,415.00 | 1 |
| Implant/replace hearing aid CPT 69710 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Implant single ventricular device 33975 CPT 33975 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Implant spinal canal cath CPT 62351 | not published | not published | $6,779.00 – $18,364.00 | 3 |
| Implant spine infusion pump CPT 62361 | not published | not published | $8,923.00 – $44,873.00 | 3 |
| Implant spine infusion pump CPT 62362 | not published | not published | $8,923.00 – $44,873.00 | 3 |
| Implant tcat pulm vlv perq CPT 33477 | $20,174.55 | $36,681.00 | $6,019.00 – $6,019.00 | 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.