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 |
|---|---|---|---|---|
| T4 (thyroxine) total CPT 84436 | $67.10 | $122.00 | $6.87 – $13.87 | 4 |
| Tacrol astagraf ex rel oral HCPCS J7508 | not published | not published | $0.61 – $1.55 | 5 |
| Tacrol envarsus ex rel oral HCPCS J7503 | not published | not published | $1.95 – $4.90 | 5 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | not published | not published | $0.19 – $0.50 | 5 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | not published | not published | $275.74 – $693.35 | 5 |
| Tacrolimus therapeutic drug level CPT 80197 | $122.65 | $223.00 | $13.73 – $27.79 | 4 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | not published | not published | $15.12 – $38.03 | 5 |
| Tah rad debulk/lymph remove 58954 CPT 58954 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Tah rad dissect for debulk 58953 CPT 58953 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Tah w/mmk 58152 CPT 58152 | not published | not published | $5,257.00 – $5,257.00 | 1 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | not published | not published | $76.19 – $191.58 | 5 |
| Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 | not published | not published | $75.76 – $190.49 | 5 |
| Talymed HCPCS Q4127 | not published | not published | $75.34 – $186.47 | 4 |
| Tap block bilat cont infusion 64489 CPT 64489 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Tap block uni by cont infusion 64487 CPT 64487 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Target gsa panel hmtlmph neop CPT 81450 | $2,020.70 | $3,674.00 | $759.53 – $1,329.18 | 4 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $6,937.15 | $12,613.00 | $2,919.60 – $5,109.30 | 4 |
| Target gsa panel organ neop CPT 81445 | $1,037.30 | $1,886.00 | $597.91 – $1,046.34 | 4 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | not published | not published | $1,727.85 – $4,289.08 | 3 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Tavr perq femoral CPT 33361 | $16,500.00 | $30,000.00 | $7,609.00 – $7,609.00 | 1 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | not published | not published | $0.41 – $1.09 | 5 |
| Tbp gene detc abnor alleles CPT 81344 | not published | not published | $137.00 – $239.75 | 4 |
| Tbs dxa cal w/i&r fx risk CPT 77089 | not published | not published | $145.31 – $145.31 | 1 |
| Tbs i&r fx rsk qhp CPT 77092 | not published | not published | $37.25 – $37.25 | 1 |
| Tbs techl calculation only CPT 77091 | $144.65 | $263.00 | $100.37 – $100.37 | 1 |
| Tbs techl prep&transmis data CPT 77090 | $144.65 | $263.00 | $7.70 – $7.70 | 1 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | not published | not published | $100.00 – $175.00 | 4 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $202.40 | $368.00 | $61.98 – $125.42 | 4 |
| Tc-99m apcitide diag HCPCS A9504 | not published | not published | $1,386.10 – $1,386.10 | 1 |
| Tc-99m arcitumomab HCPCS A9568 | not published | not published | $2,203.89 – $2,203.89 | 1 |
| Tc-99m bicisate HCPCS A9557 | not published | not published | $1,861.65 – $1,861.65 | 1 |
| Tc-99m depreotide HCPCS A9536 | not published | not published | $2,110.89 – $2,110.89 | 1 |
| Tc-99m disofenin HCPCS A9510 | not published | not published | $162.92 – $162.92 | 1 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | $784.85 | $1,427.00 | $2,832.27 – $2,832.27 | 1 |
| Tc-99m exametazime diag HCPCS A9521 | $717.20 | $1,304.00 | $2,184.37 – $2,184.37 | 1 |
| Tc-99m graphite crucible HCPCS A9506 | not published | not published | $894.61 – $894.61 | 1 |
| Tc-99m labeled rbc HCPCS A9560 | $245.30 | $446.00 | $287.08 – $287.08 | 1 |
| Tc-99m maa HCPCS A9540 | $476.85 | $867.00 | $80.16 – $80.16 | 1 |
| Tc-99m mebrofenin HCPCS A9537 | $121.00 | $220.00 | $308.90 – $308.90 | 1 |
| Tc-99m medronate HCPCS A9503 | $99.55 | $181.00 | $161.14 – $161.14 | 1 |
| Tc-99m mertiatide HCPCS A9562 | $452.10 | $822.00 | $2,091.51 – $2,091.51 | 1 |
| Tc-99m non-heu per study dose HCPCS Q9969 | $12.65 | $23.00 | $27.23 – $27.23 | 1 |
| Tc-99m oxidronate HCPCS A9561 | not published | not published | $137.38 – $137.38 | 1 |
| Tc-99m pentetate dtpa HCPCS A9539 | $172.70 | $314.00 | $68.69 – $68.69 | 1 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $173.80 | $316.00 | $55.49 – $55.49 | 1 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $11.55 | $21.00 | $33.46 – $33.46 | 1 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | not published | not published | $104.79 – $104.79 | 1 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $190.85 | $347.00 | $1,226.71 – $1,226.71 | 1 |
| Tc-99m succimer (dmsa) HCPCS A9551 | not published | not published | $1,601.87 – $1,601.87 | 1 |
| Tc-99m sulfur colloid HCPCS A9541 | $118.25 | $215.00 | $2,045.69 – $2,045.69 | 1 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $177.65 | $323.00 | $429.74 – $429.74 | 1 |
| Tc-99m tilmanocept diag HCPCS A9520 | $306.90 | $558.00 | not published | 0 |
| Tca peel dermal 15789 CPT 15789 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $389.40 | $708.00 | $46.98 – $95.09 | 4 |
| T cells absolute cd 4 count CPT 86361 | $226.05 | $411.00 | $26.78 – $54.18 | 4 |
| T cells total count CPT 86359 | $312.95 | $569.00 | $37.73 – $76.34 | 4 |
| Tdh sdrl/ventr pnxr CPT 61105 | not published | not published | $3,388.00 – $3,388.00 | 1 |
| Teaec w/wo patch graft iliofemoral CPT 35355 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution HCPCS J9274 | not published | not published | $232.52 – $584.68 | 5 |
| Telavancin injection HCPCS J3095 | not published | not published | $7.80 – $20.15 | 5 |
| Telehealth original site facility fee HCPCS Q3014 | $43.45 | $79.00 | not published | 0 |
| Telethx isodose plan cplx CPT 77307 | $2,137.30 | $3,886.00 | $463.12 – $463.12 | 1 |
| Telethx isodose plan simple CPT 77306 | $1,590.05 | $2,891.00 | $256.86 – $256.86 | 1 |
| Temozolomide HCPCS J8700 | not published | not published | $0.28 – $0.74 | 5 |
| Temozolomide 100 mg intravenous solution HCPCS J9328 | not published | not published | $11.27 – $28.35 | 5 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | not published | not published | $31.96 – $80.37 | 5 |
| Tendon lengthening CPT 26476 | not published | not published | $3,579.00 – $4,761.00 | 3 |
| Tendon lngth upr a/e ea tdn CPT 24305 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Tendon shortening CPT 26477 | not published | not published | $3,579.00 – $4,761.00 | 3 |
| Tendon transfer with graft CPT 26492 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | not published | not published | $175.87 – $442.22 | 5 |
| Teniposide, 50 mg HCPCS Q2017 | not published | not published | $8,154.27 – $8,154.27 | 1 |
| Tenodesis biceps tdn at elbw CPT 24340 | not published | not published | $6,779.00 – $16,106.00 | 3 |
| Tenolysis extensor tendon hand/finger each CPT 26445 | not published | not published | $3,579.00 – $4,761.00 | 3 |
| Tenolysis triceps CPT 24332 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Tenoplasty elbow to sho 1 CPT 24320 | not published | not published | $6,779.00 – $8,770.00 | 3 |
| Tenosynovectomy radic 26145 CPT 26145 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Tenotomy hip flexor open CPT 27005 | $5,657.85 | $10,287.00 | $3,735.00 – $18,364.00 | 3 |
| Tenotomy length/rls abductor hallucis musc 28240 CPT 28240 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | not published | not published | $1.55 – $5.82 | 5 |
| Teriparatide injection HCPCS J3110 | not published | not published | $190.53 – $190.53 | 1 |
| Tert gene targeted seq alys CPT 81345 | not published | not published | $185.20 – $324.10 | 4 |
| Test for chlorohydrocarbons CPT 82441 | not published | not published | $6.01 – $12.16 | 4 |
| Test for porphobilinogen CPT 84106 | not published | not published | $5.82 – $10.19 | 4 |
| Test for urine cystines CPT 82615 | not published | not published | $9.55 – $16.71 | 4 |
| Testicular imaging w/vasc flow CPT 78761 | $1,936.00 | $3,520.00 | $598.58 – $598.58 | 1 |
| Testosterone response panel CPT 80414 | not published | not published | $51.64 – $102.01 | 4 |
| Testosterone undecanoate 1mg HCPCS J3145 | not published | not published | $2.08 – $5.23 | 5 |
| Test pathogen(s) for platelets reference HCPCS P9100 | not published | not published | $35.50 – $35.50 | 1 |
| Test stress cardiovascular tracing only CPT 93017 | $1,001.55 | $1,821.00 | not published | 0 |
| Test urine for lactose CPT 83633 | not published | not published | $11.12 – $19.69 | 4 |
| Test urine for porphyrins CPT 84119 | not published | not published | $13.36 – $23.38 | 4 |
| Test urine urobilinogen CPT 84578 | not published | not published | $4.47 – $7.82 | 4 |
| Tetanus ig im CPT 90389 | not published | not published | $2,120.83 – $2,120.83 | 1 |
| Tetanus immune globulin inj HCPCS J1670 | not published | not published | $619.39 – $1,557.47 | 5 |
| Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe HCPCS J2356 | not published | not published | $19.55 – $49.43 | 5 |
| Tgfbi gene common variants CPT 81333 | not published | not published | $137.00 – $239.75 | 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.