HSHS St. Nicholas Hospital
3100 SUPERIOR AVE, SHEBOYGAN, WI · Hshs · · NPI 1730184342
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $40.92 | $62.00 | $29.28 – $65.88 | 16 |
| 17-hydroxypregnenolone CPT 84143 | $106.26 | $161.00 | $22.81 – $51.32 | 16 |
| 17-ketosteroids CPT 83586 | $73.92 | $112.00 | $12.80 – $28.80 | 16 |
| 2d tee w or without fol w/con,in HCPCS C8925 | $1,657.26 | $2,511.00 | $191.46 – $1,724.93 | 16 |
| 2nd order venous cath CPT 36012 | $823.02 | $1,247.00 | $302.34 – $320.48 | 7 |
| 3-d radiotherapy plan CPT 77295 | $5,101.14 | $7,729.00 | $470.57 – $3,045.63 | 16 |
| 3d recon without postprocess indpndt CPT 76376 | $641.52 | $972.00 | $972.00 – $972.00 | 5 |
| 5' nucleotidase - sendout CPT 83915 | $117.48 | $178.00 | $11.15 – $25.09 | 16 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $154.44 | $234.00 | $23.58 – $140.40 | 11 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $154.68 | $234.36 | $44.77 – $234.36 | 16 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $36.30 | $55.00 | $8.17 – $27.02 | 16 |
| Abd aorta w/runoff s&i CPT 75630 | $4,041.18 | $6,123.00 | $125.83 – $6,947.70 | 16 |
| Abd/low ext cath 1st CPT 36245 | $1,657.92 | $2,512.00 | $302.34 – $320.48 | 7 |
| Abd/low ext cath 2nd CPT 36246 | $1,588.62 | $2,407.00 | $302.34 – $320.48 | 7 |
| Abd/low ext cath 3rd CPT 36247 | $1,833.48 | $2,778.00 | $302.34 – $320.48 | 7 |
| Abd/low ext cath addl CPT 36248 | $1,344.42 | $2,037.00 | $302.34 – $320.48 | 7 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $2,091.54 | $3,169.00 | $134.40 – $1,215.09 | 16 |
| Abdominal CT scan (with contrast) CPT 74160 | $1,750.32 | $2,652.00 | $68.61 – $1,215.09 | 16 |
| Abdominal CT scan (without contrast) CPT 74150 | $1,259.28 | $1,908.00 | $47.18 – $1,215.09 | 16 |
| Abdominal MRI (with and without contrast) CPT 74183 | $3,375.24 | $5,114.00 | $136.47 – $1,444.47 | 16 |
| Abdominal MRI (with contrast) CPT 74182 | $2,789.16 | $4,226.00 | $179.97 – $1,444.47 | 16 |
| Abdominal MRI (without contrast) CPT 74181 | $2,656.50 | $4,025.00 | $93.34 – $1,444.47 | 16 |
| Abdominal paracentesis w/image guidance CPT 49083 | $1,721.94 | $2,609.00 | $318.99 – $1,995.72 | 14 |
| Abdominal Ultrasound (complete) CPT 76700 | $769.56 | $1,166.00 | $40.90 – $521.52 | 16 |
| Abdominal Ultrasound (limited) CPT 76705 | $578.16 | $876.00 | $40.90 – $521.52 | 16 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $1,083.06 | $1,641.00 | $318.99 – $1,995.72 | 14 |
| Abl1 gene CPT 81170 | $415.14 | $629.00 | $195.07 – $675.00 | 16 |
| Ablate arrhythmia add on CPT 93655 | $3,003.00 | $4,550.00 | $4,550.00 – $4,823.00 | 7 |
| Ablate bone tumor(s) cryo perq 20983 CPT 20983 | $8,251.32 | $12,502.00 | $791.17 – $15,966.53 | 14 |
| Ablate bone tumor(s) perq CPT 20982 | $14,861.22 | $22,517.00 | $791.17 – $38,581.30 | 16 |
| Ablate heart dysrhythm focus CPT 93650 | $8,764.14 | $13,279.00 | $7,627.70 – $17,162.33 | 14 |
| Ablate inf turbinate submuc 30802 CPT 30802 | not published | not published | not published | 0 |
| Ablation cryo abd perit om CPT 49999 | $2,220.24 | $3,364.00 | $318.99 – $1,995.72 | 16 |
| Ablation cryo retro lymph node CPT 38999 | $1,757.58 | $2,663.00 | $431.45 – $1,489.29 | 14 |
| Ablation of upper extremity nerves rf CPT 64999 | $1,230.24 | $1,864.00 | $176.37 – $675.41 | 14 |
| Abrasion lesion single CPT 15786 | $285.78 | $433.00 | $72.99 – $441.47 | 14 |
| Abscess drain retroperitoneal surg code CPT 49406 | $4,041.84 | $6,124.00 | $318.99 – $3,634.16 | 16 |
| Access & clsr pq fem art endogft dlvry w/img uni CPT 34713 | $329.34 | $499.00 | $499.00 – $528.94 | 7 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $1.83 | $2.77 | $0.08 – $0.11 | 5 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $159.85 | $242.20 | $40.87 – $45.81 | 5 |
| Acetone qualitative CPT 82009 | $40.92 | $62.00 | $4.52 – $10.17 | 16 |
| Acetylcholine receptor modulating antibody CPT 86043 | $89.10 | $135.00 | $9.64 – $27.11 | 16 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $8.93 | $13.53 | $0.61 – $0.97 | 5 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $64.02 | $97.00 | $13.98 – $97.00 | 16 |
| Acromp/acromionectomy prtl CPT 23130 | not published | not published | not published | 0 |
| Acute hepatitis panel CPT 80074 | $316.80 | $480.00 | $47.63 – $107.17 | 16 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $0.85 | $1.29 | $0.07 – $0.21 | 5 |
| #acylcarnitineprfl CPT 82017 | $387.42 | $587.00 | $16.87 – $37.96 | 16 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $8.90 | $13.48 | $0.71 – $0.95 | 5 |
| Adenovirus antibody,serum - quest CPT 86603 | $52.14 | $79.00 | $8.17 – $28.96 | 16 |
| Adh-sendout CPT 84588 | $207.24 | $314.00 | $33.94 – $76.37 | 16 |
| Adj gastric band via subq port CPT 43999 | not published | not published | not published | 0 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $32.34 | $49.00 | $1.52 – $6.13 | 3 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $203.28 | $308.00 | $28.17 – $308.00 | 16 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $279.18 | $423.00 | $28.17 – $423.00 | 16 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $772.20 | $1,170.00 | $129.21 – $1,170.00 | 16 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $502.26 | $761.00 | $20.47 – $761.00 | 16 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $194.70 | $295.00 | $20.47 – $295.00 | 16 |
| Administration immunization 1 vaccine CPT 90471 | $120.12 | $182.00 | $17.18 – $158.43 | 14 |
| Administration immunization each additional vaccine CPT 90472 | $42.90 | $65.00 | $17.18 – $18.21 | 7 |
| Administration vaccine hepatitis b HCPCS G0010 | $62.70 | $95.00 | $17.18 – $103.04 | 14 |
| Administration vaccine influenza virus HCPCS G0008 | $62.70 | $95.00 | $17.18 – $103.04 | 14 |
| Administration vaccine pneumococcal HCPCS G0009 | $72.60 | $110.00 | $17.18 – $103.04 | 14 |
| Aep hearing status deter i&r CPT 92651 | $359.70 | $545.00 | $35.31 – $475.12 | 16 |
| Aep neurodiagnostic i&r CPT 92653 | $539.88 | $818.00 | $35.31 – $475.12 | 16 |
| Aep thrshld est mlt freq i&r CPT 92652 | $537.24 | $814.00 | $35.31 – $475.12 | 16 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $594.66 | $901.00 | $115.36 – $259.56 | 16 |
| Air injection into abdomen 49400 CPT 49400 | $512.16 | $776.00 | $144.81 – $153.50 | 7 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | $209.22 | $317.00 | $45.62 – $317.00 | 16 |
| Albumin body fluid quantitative each specimen CPT 82042 | $54.12 | $82.00 | $7.27 – $17.51 | 16 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $279.68 | $423.75 | $53.08 – $119.42 | 16 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $43.56 | $66.00 | $5.78 – $13.01 | 16 |
| Albumin serum plasma or whole blood CPT 82040 | $31.02 | $47.00 | $4.95 – $11.14 | 16 |
| Alkaline phosphatase CPT 84075 | $25.74 | $39.00 | $5.18 – $11.66 | 16 |
| Allergen alpha lactalbumin ige CPT 86008 | $33.66 | $51.00 | $17.71 – $40.34 | 16 |
| Allergen egg white ige CPT 86003 | $22.44 | $34.00 | $4.57 – $11.75 | 16 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $1,874.73 | $2,840.50 | $121.70 – $273.83 | 11 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $269.28 | $408.00 | $118.07 – $273.83 | 11 |
| Alpha-fetoprotein tumor marker CPT 82105 | $152.46 | $231.00 | $16.77 – $37.73 | 16 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $304.31 | $461.08 | $42.87 – $211.12 | 16 |
| Alt/sgpt CPT 84460 | $32.34 | $49.00 | $5.30 – $11.93 | 16 |
| Aluminum - quest CPT 82108 | $126.06 | $191.00 | $25.48 – $57.33 | 16 |
| Ambl bp mntr w/sw a/r CPT 93788 | $267.30 | $405.00 | $27.31 – $405.00 | 16 |
| Aminolevulinic acid delta CPT 82135 | $137.28 | $208.00 | $16.45 – $37.01 | 16 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $97.38 | $147.55 | $17.18 – $22.41 | 5 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $37.85 | $57.35 | $4.11 – $4.53 | 5 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $3.23 | $4.90 | $0.65 – $0.73 | 5 |
| Amitriptyline (elavil) -sendout CPT 80335 | $62.70 | $95.00 | $4.99 – $39.00 | 10 |
| Ammonia CPT 82140 | $89.76 | $136.00 | $14.57 – $32.78 | 16 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | $6,562.38 | $9,943.00 | $951.18 – $7,199.69 | 14 |
| Amphetamine confirm urine -sendout CPT 80324 | $62.70 | $95.00 | $4.99 – $39.00 | 10 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $199.16 | $301.76 | $20.72 – $259.41 | 16 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $17.00 | $25.76 | $0.97 – $1.50 | 5 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $38.86 | $58.88 | $2.19 – $3.30 | 5 |
| Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 | $347.16 | $526.00 | $262.99 – $591.73 | 11 |
| Amputation thru metatarsal CPT 28805 | not published | not published | not published | 0 |
| Amputation toe interphalangeal joint CPT 28825 | not published | not published | not published | 0 |
| Amputation toe metatarsophalangeal joint CPT 28820 | not published | not published | not published | 0 |
| Amylase CPT 82150 | $54.12 | $82.00 | $6.48 – $14.58 | 16 |
| Ana ds-dna CPT 86226 | $101.64 | $154.00 | $12.11 – $27.25 | 16 |
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.