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 |
|---|---|---|---|---|
| Exc thrombosed hemorrhoid 46320 CPT 46320 | $2,175.36 | $3,296.00 | $635.82 – $2,633.08 | 14 |
| Exc tr-ext mal+marg tal >4 cm 11606 CPT 11606 | not published | not published | not published | 0 |
| Exercise tst brncspsm w/ecg CPT 94617 | $247.50 | $375.00 | $25.49 – $375.00 | 16 |
| Exercise w/hemodynamic meas CPT 93464 | $567.60 | $860.00 | $73.27 – $77.67 | 7 |
| Exome re-evaluation CPT 81417 | $1,395.90 | $2,115.00 | $59.04 – $720.00 | 16 |
| Exome sequence analysis CPT 81415 | $5,520.90 | $8,365.00 | $835.31 – $10,755.00 | 16 |
| Exome sequence analysis CPT 81416 | $1,796.52 | $2,722.00 | $835.31 – $6,124.50 | 16 |
| Exploration maxillary sinus CPT 31256 | not published | not published | not published | 0 |
| Exploration of knee joint CPT 27310 | not published | not published | not published | 0 |
| Explore parathyroid glands CPT 60500 | not published | not published | not published | 0 |
| Explore penetrating wnd/extremity 20103 CPT 20103 | $1,871.10 | $2,835.00 | $168.77 – $3,634.16 | 14 |
| Ex sq tumor/face or scalp 2 cm/> 21012 CPT 21012 | not published | not published | not published | 0 |
| Ext ecg>48hr<7d scan a/r CPT 93243 | $157.08 | $238.00 | $27.31 – $292.76 | 16 |
| Ext ecg>7d<15d scan a/r CPT 93247 | $316.80 | $480.00 | $27.31 – $480.00 | 16 |
| External chromosome analysis 20-25 cells CPT 88264 | $737.22 | $1,117.00 | $144.61 – $325.37 | 16 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $339.24 | $514.00 | $70.04 – $323.44 | 16 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $118.14 | $179.00 | $17.93 – $40.34 | 16 |
| Facial bones <3 CPT 70140 | $315.48 | $478.00 | $24.82 – $456.60 | 16 |
| Facility svs dental rehab HCPCS G0330 | not published | not published | not published | 0 |
| Factor ix CPT 85250 | $198.00 | $300.00 | $19.04 – $42.84 | 16 |
| Factor viii CPT 85240 | $195.36 | $296.00 | $9.84 – $40.28 | 16 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $0.40 | $0.61 | $0.02 – $0.02 | 4 |
| Fancc gene CPT 81242 | $122.10 | $185.00 | $36.62 – $82.40 | 16 |
| Fat/lipids feces qualitative CPT 82705 | $28.38 | $43.00 | $5.10 – $11.48 | 16 |
| Fatty acids nonesterified CPT 82725 | $126.06 | $191.00 | $18.72 – $42.23 | 16 |
| #fecal-sodium CPT 84302 | $29.70 | $45.00 | $4.86 – $10.94 | 16 |
| Fem/popl revasc w/stent CPT 37226 | $16,782.48 | $25,428.00 | $4,729.17 – $5,012.92 | 7 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $32.34 | $49.00 | $1.43 – $2.13 | 5 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | $6.73 | $10.19 | $1.12 – $10.19 | 16 |
| Ferritin CPT 82728 | $81.18 | $123.00 | $13.63 – $30.67 | 16 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | $8.65 | $13.10 | $0.36 – $13.10 | 16 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $489.72 | $742.00 | $44.52 – $521.52 | 16 |
| Fetal contract stress test 59020 - 26 CPT 59020 | $494.34 | $749.00 | $85.57 – $452.28 | 16 |
| Fetal fibronectin CPT 82731 | $396.00 | $600.00 | $64.41 – $144.92 | 16 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $147.84 | $224.00 | $7.73 – $17.39 | 16 |
| Fetal hemoglobin rosette CPT 85461 | $59.40 | $90.00 | $9.33 – $21.06 | 16 |
| Fetal lung maturity assess lam body dnst CPT 83664 | $131.34 | $199.00 | $6.82 – $43.47 | 16 |
| Fetal non stress test CPT 59025 | $413.82 | $627.00 | $85.57 – $452.28 | 16 |
| #_fet/norfentcnfrmur CPT 80354 | $126.06 | $191.00 | $4.99 – $114.60 | 10 |
| Fibrin degradation d dimer quantitative CPT 85379 | $68.64 | $104.00 | $10.18 – $22.91 | 16 |
| Fibrin degradation products CPT 85362 | $47.52 | $72.00 | $6.89 – $15.50 | 16 |
| Fibrinogen activity CPT 85384 | $68.64 | $104.00 | $9.72 – $21.87 | 16 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $294.36 | $446.00 | $7.27 – $34.83 | 16 |
| Fibrinolytic antiplasmin CPT 85410 | $178.86 | $271.00 | $7.71 – $17.35 | 16 |
| Fibrinolytic plasminogen CPT 85415 | $220.44 | $334.00 | $17.19 – $38.68 | 16 |
| Fibrinolytic plasminogen CPT 85421 | $126.06 | $191.00 | $10.18 – $22.91 | 16 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | $207.90 | $315.00 | $6.53 – $14.69 | 16 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $2,325.84 | $3,524.00 | $1,938.20 – $1,938.20 | 1 |
| Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 CPT 10007 | $1,087.02 | $1,647.00 | $301.92 – $1,558.17 | 14 |
| Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008 CPT 10008 | $543.84 | $824.00 | $301.92 – $320.04 | 7 |
| Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 | $543.84 | $824.00 | $301.92 – $320.04 | 7 |
| Fixation of knee joint CPT 27570 | not published | not published | not published | 0 |
| Fix g/colon tube w/device CPT 49460 | $1,083.06 | $1,641.00 | $94.57 – $1,995.72 | 16 |
| Flecainide (tambocor)-sendout CPT 80181 | $21.78 | $33.00 | $14.91 – $41.94 | 16 |
| Fl exam g/colon tube w contrast CPT 49465 | $499.62 | $757.00 | $52.32 – $525.02 | 16 |
| Flexible Sigmoidoscopy CPT 45330 | not published | not published | not published | 0 |
| Flow cytometry marker each additional CPT 88185 | $258.06 | $391.00 | $11.76 – $63.00 | 11 |
| Flow cytometry one marker technical component CPT 88184 | $416.46 | $631.00 | $65.34 – $788.72 | 16 |
| #flow interp 9 - 15 markers CPT 88188 | $263.34 | $399.00 | $11.76 – $239.40 | 11 |
| Flt3 gene CPT 81245 | $247.50 | $375.00 | $132.74 – $372.40 | 16 |
| Flt3 gene analysis CPT 81246 | $207.90 | $315.00 | $83.00 – $186.75 | 16 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | $64.25 | $97.35 | $4.17 – $8.02 | 5 |
| Fluidotherapy charges pt CPT 97022 | $77.22 | $117.00 | $14.19 – $117.00 | 16 |
| Fluid pressure muscle 20950 CPT 20950 | $1,430.22 | $2,167.00 | $81.33 – $1,558.17 | 14 |
| Fluorescent antibody titer dna CPT 86256 | $297.00 | $450.00 | $12.05 – $27.11 | 16 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $568.92 | $862.00 | $89.39 – $495.60 | 11 |
| Fluoroguide needle placement CPT 77002 | $517.44 | $784.00 | $89.39 – $495.60 | 11 |
| Fluoro polarize fetal lung CPT 83663 | $434.94 | $659.00 | $13.65 – $42.55 | 16 |
| Fluoroscopy up to 1 hour CPT 76000 | $517.44 | $784.00 | $52.32 – $525.02 | 16 |
| Fna bx w/ct gdn 1st les CPT 10009 | $1,087.02 | $1,647.00 | $301.92 – $1,558.17 | 14 |
| Fna bx w/ct gdn ea addl CPT 10010 | $543.84 | $824.00 | $301.92 – $320.04 | 7 |
| Folic acid CPT 82746 | $89.76 | $136.00 | $14.70 – $33.08 | 16 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | $3.23 | $4.90 | $0.08 – $0.09 | 4 |
| Follow-up angiography CPT 75898 | $3,161.40 | $4,790.00 | $86.90 – $6,947.70 | 16 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | $42.97 | $65.11 | $6.43 – $65.11 | 16 |
| Fo nontorsion joint cf HCPCS L3935 | $170.28 | $258.00 | $249.26 – $560.83 | 9 |
| Foot drp splt w/exp heel lg HCPCS L4398 | $118.80 | $180.00 | $111.94 – $251.86 | 9 |
| Foot X-ray CPT 73630 | $335.94 | $509.00 | $24.82 – $456.60 | 16 |
| Foreskn manip w/lss preputial ads+stretching 54450 CPT 54450 | $711.48 | $1,078.00 | $178.39 – $549.77 | 14 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $6.98 | $10.57 | $0.18 – $0.29 | 5 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $16.17 | $24.50 | $1.34 – $3.02 | 11 |
| Fragmenting of kidney stone CPT 50590 | not published | not published | not published | 0 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $1,226.28 | $1,858.00 | $55.39 – $165.98 | 14 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $188.76 | $286.00 | $38.65 – $193.46 | 14 |
| Fresh frozen plasma thawing ea un CPT 86927 | $198.00 | $300.00 | $30.87 – $374.88 | 16 |
| Fructosamine glycated protein CPT 82985 | $72.60 | $110.00 | $16.62 – $37.71 | 16 |
| Full thick gft/scalp/arm/leg/20sqcm or< 15220 CPT 15220 | not published | not published | not published | 0 |
| Full thick gft/scalp/arm/leg/add 20sqcm 15221 CPT 15221 | not published | not published | not published | 0 |
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | not published | not published | not published | 0 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $1.62 | $2.45 | $0.03 – $0.04 | 4 |
| Fusion of big toe joint CPT 28750 | not published | not published | not published | 0 |
| Fusion of big toe joint CPT 28755 | not published | not published | not published | 0 |
| Fusion of knuckle joint CPT 26516 | not published | not published | not published | 0 |
| Gabapentin non-blood CPT 80355 | $36.30 | $55.00 | $4.99 – $39.00 | 10 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $24.18 | $36.63 | $24.34 – $26.40 | 5 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | $224.40 | $340.00 | $21.07 – $47.41 | 16 |
| Galectin-3 CPT 82777 | $147.84 | $224.00 | $24.14 – $99.56 | 16 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | not published | 0 |
| Gammaglobulin iga CPT 82784 | $54.12 | $82.00 | $9.30 – $20.93 | 16 |
| Gammaglobulin ige CPT 82785 | $99.00 | $150.00 | $16.46 – $37.04 | 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.