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 |
|---|---|---|---|---|
| Epidrm agrft t/a/l 1st 100 CPT 15110 | $2,220.24 | $3,364.00 | $95.40 – $4,540.03 | 14 |
| Epidrm autogrft t/a/l add-on CPT 15111 | $180.18 | $273.00 | $95.40 – $289.38 | 9 |
| Epidural/lumbar/sacral/ea add level64484 CPT 64484 | $829.62 | $1,257.00 | $337.74 – $358.00 | 7 |
| Epidural lysis on single day 62264 CPT 62264 | $1,542.42 | $2,337.00 | $337.74 – $1,946.19 | 14 |
| Epinephrine 0.1 mg/ml injection syringe HCPCS J0168 | $6.70 | $10.15 | $4.95 – $5.37 | 4 |
| Epinephrine 1 mg/ml im kit - adult HCPCS J0169 | $7.29 | $11.05 | $2.28 – $2.47 | 4 |
| Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution HCPCS J0166 | $7.11 | $10.77 | $1.83 – $1.99 | 4 |
| Episiotomy/vag rpr oth/thn attending phys 59300 CPT 59300 | $6,502.98 | $9,853.00 | $748.81 – $7,122.95 | 14 |
| Epstein barr early antigen antibody CPT 86663 | $89.10 | $135.00 | $13.12 – $29.52 | 16 |
| Epstein barr nuclear antigen antibody CPT 86664 | $99.00 | $150.00 | $15.29 – $34.40 | 16 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $118.14 | $179.00 | $18.14 – $40.82 | 16 |
| Ercp biliary & pancreas CPT 74330 | $1,215.06 | $1,841.00 | $44.69 – $495.60 | 11 |
| Ercp bil/panc duct; each stent plcmt 43274 CPT 43274 | $6,875.22 | $10,417.00 | $422.00 – $13,358.37 | 16 |
| Ercp remove duct calculi 43264 CPT 43264 | not published | not published | not published | 0 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $228.12 | $345.63 | $15.11 – $18.26 | 5 |
| ER Visit (level 1, minor) CPT 99281 | $136.62 | $207.00 | $82.46 – $185.55 | 9 |
| ER Visit (level 2) CPT 99282 | $273.24 | $414.00 | $150.16 – $337.86 | 9 |
| ER Visit (level 3) CPT 99283 | $839.52 | $1,272.00 | $266.96 – $600.66 | 9 |
| ER Visit (level 4) CPT 99284 | $1,259.28 | $1,908.00 | $408.06 – $918.14 | 9 |
| ER Visit (level 5, high severity) CPT 99285 | $1,723.92 | $2,612.00 | $582.40 – $1,310.40 | 9 |
| Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1364 | $360.72 | $546.55 | $33.26 – $118.64 | 5 |
| Escharotomy ea addl incision CPT 16036 | $207.24 | $314.00 | $168.77 – $178.90 | 7 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) in sterile water intravenous soln HCPCS J1806 | $1.89 | $2.87 | $0.68 – $0.73 | 5 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only HCPCS J1805 | $5.39 | $8.17 | $0.35 – $0.44 | 5 |
| Esophagoscopy flex biopsy CPT 43202 | not published | not published | not published | 0 |
| Esoph egd dilation <30 mm CPT 43249 | not published | not published | not published | 0 |
| Establish access to aorta CPT 36160 | $374.22 | $567.00 | $302.34 – $320.48 | 7 |
| Establish access to artery CPT 36100 | $1,450.68 | $2,198.00 | $302.34 – $320.48 | 7 |
| Established Patient Office Visit (level 1) CPT 99211 | $321.42 | $487.00 | $95.40 – $154.00 | 3 |
| Established Patient Office Visit (level 2) CPT 99212 | $199.32 | $302.00 | $95.40 – $154.00 | 3 |
| Established Patient Office Visit (level 3) CPT 99213 | $243.54 | $369.00 | $95.40 – $154.00 | 3 |
| Established Patient Office Visit (level 4) CPT 99214 | $268.62 | $407.00 | $95.40 – $154.00 | 3 |
| Established Patient Office Visit (level 5) CPT 99215 | $339.24 | $514.00 | $95.40 – $154.00 | 3 |
| Estradiol total CPT 82670 | $170.94 | $259.00 | $27.94 – $62.87 | 16 |
| Estrogens total-sendout CPT 82672 | $134.64 | $204.00 | $21.70 – $48.83 | 16 |
| Ethylene glycol -sendout CPT 82693 | $321.42 | $487.00 | $7.95 – $33.53 | 16 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $396.00 | $600.00 | $90.57 – $220.75 | 16 |
| Evaluation heart device CPT 93640 | $2,523.84 | $3,824.00 | $1,209.00 – $2,985.70 | 10 |
| Evaluation of speech fluency 92521 CPT 92521 | $181.50 | $275.00 | $103.44 – $293.85 | 16 |
| Evasc prlng admn rx agnt 1st CPT 61650 | $1,701.48 | $2,578.00 | $2,578.00 – $2,732.68 | 7 |
| Evasc prlng admn rx agnt add CPT 61651 | $866.58 | $1,313.00 | $1,313.00 – $1,391.78 | 7 |
| Evasc rpr a-ao ndgft 34701 CPT 34701 | $17,216.76 | $26,086.00 | $7,257.52 – $7,692.97 | 7 |
| Evasc rpr a-ao ndgft rpt 34702 CPT 34702 | $23,954.04 | $36,294.00 | $7,257.52 – $7,692.97 | 7 |
| Evasc rpr a-biiliac ndgft rptr CPT 34706 | $23,954.04 | $36,294.00 | $7,257.52 – $7,692.97 | 7 |
| Evasc rpr a-unilac ndgft 34703 CPT 34703 | $17,216.76 | $26,086.00 | $7,257.52 – $7,692.97 | 7 |
| Evasc rpr a-unilac ndgft rpt CPT 34704 | $23,954.04 | $36,294.00 | $7,257.52 – $7,692.97 | 7 |
| Evasc rpr ilio-iliac ndgft CPT 34707 | $17,216.76 | $26,086.00 | $7,257.52 – $7,692.97 | 7 |
| Evasc rpr ilio-iliac rpt CPT 34708 | $23,954.04 | $36,294.00 | $7,257.52 – $7,692.97 | 7 |
| Event monitor CPT 93270 | $231.00 | $350.00 | $18.44 – $350.00 | 16 |
| Evoked oa emissions ltd CPT 92587 | $359.70 | $545.00 | $35.31 – $475.12 | 16 |
| Evoked potentials auditory screening automated analysis CPT 92650 | $174.90 | $265.00 | $13.51 – $86.80 | 10 |
| Evoked potentials upper limbs CPT 95925 | $906.18 | $1,373.00 | $58.61 – $885.08 | 16 |
| Evoked potential visual not glaucoma CPT 95930 | $1,431.54 | $2,169.00 | $58.61 – $885.08 | 16 |
| Evok oa screening qual CPT 92558 | $182.16 | $276.00 | $13.51 – $86.80 | 10 |
| Exam plvc w/anes othr thn lcl CPT 57410 | not published | not published | not published | 0 |
| Exc abd les sc 3 cm/> CPT 22903 | not published | not published | not published | 0 |
| Exc abdl tum deep < 5 cm CPT 22900 | not published | not published | not published | 0 |
| Exc arm/elbo les sc >=3cm 24071 CPT 24071 | not published | not published | not published | 0 |
| Exc back tum deep 5 cm/> CPT 21933 | not published | not published | not published | 0 |
| Exc bartholins gland/cyst CPT 56740 | not published | not published | not published | 0 |
| Exc ben+marg excep skin tag feenlm <0.5cm 11440 CPT 11440 | not published | not published | not published | 0 |
| Exc ben+marg excep skin tag feenlm 1.1-2cm 11442 CPT 11442 | not published | not published | not published | 0 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | not published | not published | not published | 0 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | not published | not published | not published | 0 |
| Exc/crtg b1 cst/b9 tum rds CPT 24120 | not published | not published | not published | 0 |
| Exc ext ear/partial/simple repair 69110 CPT 69110 | $6,035.70 | $9,145.00 | $1,120.18 – $6,391.52 | 14 |
| Exc foot/toe tum dep 1.5cm/> CPT 28041 | not published | not published | not published | 0 |
| Exc foot/toe tum subq < 1.5 cm 28043 CPT 28043 | not published | not published | not published | 0 |
| Exc hand les sc < 1.5 cm CPT 26115 | not published | not published | not published | 0 |
| Exchange biliary drg cath CPT 47536 | $3,544.20 | $5,370.00 | $246.25 – $7,878.29 | 16 |
| Exchange drainage catheter CPT 49423 | $2,191.20 | $3,320.00 | $131.98 – $4,222.35 | 16 |
| Exchange nephrostomy cath CPT 50435 | $2,955.48 | $4,478.00 | $187.92 – $4,599.67 | 16 |
| Exc im tumor/foot/toe < 1.5 cm 28045 CPT 28045 | not published | not published | not published | 0 |
| Excise anal ext tag/papilla CPT 46220 | not published | not published | not published | 0 |
| Excise/repair mouth lesion CPT 40812 | not published | not published | not published | 0 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | not published | not published | not published | 0 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | $1,683.00 | $2,550.00 | $185.89 – $1,558.17 | 14 |
| Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 | not published | not published | not published | 0 |
| Excision breast lesion CPT 19125 | not published | not published | not published | 0 |
| Excision of anal lesion(s) CPT 46922 | not published | not published | not published | 0 |
| Excision of tongue lesion CPT 41112 | not published | not published | not published | 0 |
| Excision tumor soft tissue back/flank subcutaneous >= 3 cm CPT 21931 | not published | not published | not published | 0 |
| Excis partial tal calc CPT 28120 | not published | not published | not published | 0 |
| Exc mal+marg tal 1.1-2 cm 11602 CPT 11602 | not published | not published | not published | 0 |
| Exc mal+marg tal 2.1-3 cm 11603 CPT 11603 | not published | not published | not published | 0 |
| Exc neck tum deep 5 cm/> CPT 21554 | not published | not published | not published | 0 |
| Exc prtl bn phlnx toe CPT 28124 | not published | not published | not published | 0 |
| Exc sac pr ulc prim str ostc CPT 15933 | not published | not published | not published | 0 |
| Exc shoulder tum deep < 5 cm CPT 23076 | not published | not published | not published | 0 |
| Exc skn hdrdnt ax smpl/ntrm CPT 11450 | not published | not published | not published | 0 |
| Exc snhfg mal+mrg >4 cm 11626 CPT 11626 | not published | not published | not published | 0 |
| Exc sq tum/leg or ankle area <3 cm 27618 CPT 27618 | not published | not published | not published | 0 |
| Exc sq tum/neck/ant thorax 3cm/> 21552 CPT 21552 | not published | not published | not published | 0 |
| Exc sq tum/neck or ant thorax <3cm 21555 CPT 21555 | not published | not published | not published | 0 |
| Exc sq tumor/foot or toe < 1.5 cm 28039 CPT 28039 | not published | not published | not published | 0 |
| Exc sq tumor/leg/ankle 3cm/> 27632 CPT 27632 | not published | not published | not published | 0 |
| Exc sq tumor/shoulder area 3cm/> 23071 CPT 23071 | not published | not published | not published | 0 |
| Exc sq tumor/thigh/knee area 3cm/> 27337 CPT 27337 | not published | not published | not published | 0 |
| Exc tendon sheath or cap lesion 26160 CPT 26160 | not published | not published | not published | 0 |
| Exc thigh/knee les sc<3cm 27327 CPT 27327 | not published | not published | not published | 0 |
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.