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 |
|---|---|---|---|---|
| Gamma glutamyltransferase CPT 82977 | $44.22 | $67.00 | $7.20 – $16.20 | 16 |
| Gastric mucosa imaging CPT 78261 | $731.28 | $1,108.00 | $162.47 – $1,108.00 | 16 |
| Gastroesophageal reflux test CPT 91034 | $790.68 | $1,198.00 | $171.97 – $821.09 | 14 |
| Gastro/jejuno tube, std HCPCS B4087 | $40.92 | $62.00 | $32.74 – $34.10 | 2 |
| Gated heart multiple CPT 78473 | $1,609.74 | $2,439.00 | $162.47 – $1,246.46 | 16 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $42.18 | $63.91 | $5.61 – $6.43 | 5 |
| General health panel CPT 80050 | $300.30 | $455.00 | $3.25 – $273.00 | 11 |
| Genetic tstg severe inh cond CPT 81443 | $3,915.78 | $5,933.00 | $2,448.56 – $5,509.26 | 16 |
| Genome sequence analysis CPT 81425 | $5,811.30 | $8,805.00 | $835.31 – $11,320.20 | 16 |
| Genome sequence analysis CPT 81426 | $3,129.72 | $4,742.00 | $835.31 – $6,097.39 | 16 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $32.34 | $49.00 | $3.52 – $3.88 | 5 |
| Gentamicin peak therapeutic drug level CPT 80170 | $138.60 | $210.00 | $16.38 – $36.86 | 16 |
| G-esoph reflx tst w/electrod CPT 91035 | $1,325.28 | $2,008.00 | $171.97 – $1,889.57 | 14 |
| Ghs abscess perianal iandd CPT 46050 | $1,087.02 | $1,647.00 | $635.82 – $2,046.27 | 14 |
| Ghs abscess postoperative iandd complex CPT 10180 | $6,540.60 | $9,910.00 | $95.40 – $6,391.52 | 14 |
| Ghs alpha thalasemia, 7 deletions CPT 81257 | $554.40 | $840.00 | $102.26 – $230.09 | 16 |
| Ghs antibodies (torch) igm CPT 86694 | $97.68 | $148.00 | $14.39 – $32.38 | 16 |
| Ghs aspiration bladder - needle CPT 51100 | $365.64 | $554.00 | $73.78 – $549.77 | 16 |
| Ghs bladder cath - complex-foley CPT 51703 | $335.94 | $509.00 | $38.07 – $283.13 | 14 |
| Ghs bleeding time (ivy) CPT 85002 | $114.18 | $173.00 | $4.77 – $10.85 | 16 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | $799.92 | $1,212.00 | $176.37 – $1,553.22 | 16 |
| Ghs central line insert < age 5, failed CPT 36555 | $3,635.28 | $5,508.00 | $485.09 – $6,947.70 | 14 |
| Ghs change cysto/gastrost CPT 43762 | $701.58 | $1,063.00 | $171.97 – $549.77 | 14 |
| Ghs chemo IV push, ea addtl CPT 96411 | $287.76 | $436.00 | $20.47 – $436.00 | 16 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $198.66 | $301.00 | $35.09 – $78.95 | 16 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $780.78 | $1,183.00 | $203.37 – $542.77 | 14 |
| Ghs closed reduction ankle dislocation CPT 27840 | $543.84 | $824.00 | $203.37 – $542.77 | 14 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | $1,607.10 | $2,435.00 | $203.37 – $3,538.22 | 14 |
| Ghs closed tx radiocarpal disloc w manip CPT 25660 | $593.34 | $899.00 | $203.37 – $542.77 | 14 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | $3,861.00 | $5,850.00 | $203.37 – $3,538.22 | 14 |
| Ghs clsd red med malleolus fx w manip CPT 27762 | $4,391.64 | $6,654.00 | $203.37 – $3,538.22 | 14 |
| Ghs clsd tx frac distal tibia w/manipulation CPT 27825 | not published | not published | not published | 0 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | $549.78 | $833.00 | $203.37 – $542.77 | 14 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | $701.58 | $1,063.00 | $203.37 – $542.77 | 14 |
| Ghs conjunctiva foreign body-embed bil CPT 65210 | $460.68 | $698.00 | $33.30 – $982.97 | 14 |
| Ghs conjunctiva foreign body-superf bil CPT 65205 | $352.44 | $534.00 | $16.65 – $146.38 | 14 |
| Ghs corneal fb without slit lamp bilat CPT 65220 | $460.68 | $698.00 | $33.30 – $982.97 | 14 |
| Ghs corneal fb with slit lamp bilat CPT 65222 | $372.90 | $565.00 | $33.30 – $292.76 | 14 |
| Ghs cricothyroidotomy CPT 31605 | $1,202.52 | $1,822.00 | $231.63 – $963.45 | 14 |
| Ghs diphtheria toxoid ab igg CPT 86648 | $79.86 | $121.00 | $8.17 – $34.22 | 16 |
| Ghs dislocation elbow closed treatment CPT 24600 | $529.32 | $802.00 | $101.68 – $271.38 | 14 |
| Ghs ed peritoneal lavage w guidance if performed CPT 49084 | $892.32 | $1,352.00 | $318.99 – $1,995.72 | 14 |
| Ghs ed rmvl or bivalving cast CPT 29700 | $217.14 | $329.00 | $79.49 – $615.43 | 14 |
| Ghs ed therapeutic lp, drain csf w fluoro CPT 62329 | $1,186.68 | $1,798.00 | $337.74 – $1,553.22 | 14 |
| Ghs eeg cont rec w/video by tec min 8 chnls CPT 95700 | $2,522.52 | $3,822.00 | $146.51 – $475.12 | 16 |
| Ghs excision ingrown nail CPT 11765 | $461.34 | $699.00 | $29.40 – $894.49 | 14 |
| Ghs eyelid foreign body-embedded - bil CPT 67938 | $486.42 | $737.00 | $127.74 – $698.42 | 14 |
| Ghs fb removal foot - deep - left CPT 28192 | not published | not published | not published | 0 |
| Ghs fb removal from muscle - complicated CPT 20525 | not published | not published | not published | 0 |
| Ghs fb removal - incisional CPT 10121 | $3,562.68 | $5,398.00 | $534.68 – $3,634.16 | 14 |
| Ghs fb removal - non-incisional CPT 20520 | $3,762.00 | $5,700.00 | $791.17 – $3,634.16 | 14 |
| Ghs febrile agglutinns(mayo) CPT 86000 | $38.28 | $58.00 | $6.98 – $15.71 | 16 |
| Ghs fish cytogen CPT 88271 | $607.20 | $920.00 | $20.36 – $48.20 | 16 |
| Ghs fish hybrid in situ 100-300 CPT 88275 | $477.84 | $724.00 | $51.19 – $115.18 | 16 |
| Ghs gastric intub aspiration lavage CPT 43753 | $583.44 | $884.00 | $211.16 – $475.12 | 9 |
| Ghs hepatitis c virus (hcv riba) CPT 86804 | $144.54 | $219.00 | $15.49 – $34.85 | 16 |
| Ghs hgb stability-thal CPT 83068 | $97.02 | $147.00 | $9.47 – $21.31 | 16 |
| Ghs histoplasma antigen CPT 87385 | $129.36 | $196.00 | $13.25 – $29.81 | 16 |
| Ghs HIV antibody CPT 86703 | $89.10 | $135.00 | $13.71 – $30.85 | 16 |
| Ghs i and d abscess/hematoma scrotum CPT 54700 | $2,366.10 | $3,585.00 | $1,046.14 – $4,599.67 | 14 |
| Ghs i and d perirectal abscess 46040 CPT 46040 | $2,471.04 | $3,744.00 | $635.82 – $2,633.08 | 14 |
| Ghs i and d pilonidal cyst complex CPT 10081 | $2,373.36 | $3,596.00 | $474.26 – $1,558.17 | 14 |
| Ghs i and d pilonidal cyst simple CPT 10080 | $706.86 | $1,071.00 | $72.99 – $1,558.17 | 14 |
| Ghs incision thrombosed ext hemorrhoid CPT 46083 | $434.28 | $658.00 | $244.34 – $658.00 | 14 |
| Ghs inf midline insertion CPT 36140 | $1,344.42 | $2,037.00 | $302.34 – $320.48 | 7 |
| Ghs inhibitor screen CPT 85335 | $441.54 | $669.00 | $12.87 – $28.96 | 16 |
| Ghs init tx 1st degree burn CPT 16000 | $229.68 | $348.00 | $80.58 – $441.47 | 14 |
| Ghs inj neurolytic other perph nerve CPT 64640 | $2,125.20 | $3,220.00 | $565.72 – $1,946.19 | 14 |
| Ghs inj tendon origin/insertion CPT 20551 | $395.34 | $599.00 | $73.45 – $675.41 | 16 |
| Ghs inj transforaminal cerv ea add bil CPT 64480 | $721.38 | $1,093.00 | $337.74 – $358.00 | 7 |
| Ghs inj transforaminal cerv single bil CPT 64479 | $1,413.72 | $2,142.00 | $337.74 – $1,946.19 | 14 |
| Ghs insertion of needle - bone CPT 36680 | $533.94 | $809.00 | $108.83 – $982.97 | 14 |
| Ghs intermed repair 12.6 - 20.0 cm-12035 CPT 12035 | $840.18 | $1,273.00 | $168.77 – $894.49 | 14 |
| Ghs intermed repair 20.1 - 30.0 cm-12036 CPT 12036 | $898.92 | $1,362.00 | $168.77 – $1,626.25 | 14 |
| Ghs intermed repair over 30 cm - 12037 CPT 12037 | $1,186.68 | $1,798.00 | $168.77 – $4,540.03 | 14 |
| Ghs intro needle/intracath vein - 36000 CPT 36000 | $97.02 | $147.00 | $17.30 – $147.00 | 11 |
| Ghs irrigate corpora cavernosa for priapism CPT 54220 | $413.82 | $627.00 | $38.07 – $549.77 | 14 |
| Ghs IV infusion bamlanivimab/etesevimab HCPCS M0245 | $606.54 | $919.00 | $450.00 – $477.00 | 7 |
| Ghs IV infusion casirivimab/imdevimab HCPCS M0243 | $651.42 | $987.00 | $450.00 – $477.00 | 7 |
| Ghs IV infusion sotrovimab HCPCS M0247 | $904.86 | $1,371.00 | $130.24 – $138.05 | 7 |
| Ghs IV thrombolytics - cerebral CPT 37195 | $528.00 | $800.00 | $130.24 – $726.80 | 14 |
| Ghs lac repair mouth.ant tong 2.5cm/less CPT 41250 | $513.48 | $778.00 | $74.89 – $982.97 | 14 |
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | $642.18 | $973.00 | $168.77 – $894.49 | 14 |
| Ghs layer closure 2.5 cm or less - 12041 CPT 12041 | $583.44 | $884.00 | $168.77 – $894.49 | 14 |
| Ghs layer closure 2.5cm or less - 12051 CPT 12051 | $715.44 | $1,084.00 | $168.77 – $894.49 | 14 |
| Ghs layer closure 2.6 - 5.0 cm - 12052 CPT 12052 | $783.42 | $1,187.00 | $168.77 – $894.49 | 14 |
| Ghs layer closure 2.6 - 7.5 cm - 12042 CPT 12042 | $642.18 | $973.00 | $168.77 – $894.49 | 14 |
| Ghs layer closure 5.1 - 7.5 cm - 12053 CPT 12053 | $792.66 | $1,201.00 | $168.77 – $894.49 | 14 |
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | $770.22 | $1,167.00 | $168.77 – $894.49 | 14 |
| Ghs layer closure 7.6 - 12.5 cm - 12044 CPT 12044 | $711.48 | $1,078.00 | $168.77 – $1,626.25 | 14 |
| Ghs layer closure 7.6 - 12.5 cm - 12054 CPT 12054 | $809.82 | $1,227.00 | $168.77 – $894.49 | 14 |
| Ghs layered repair 12.6 - 20.0 cm -12045 CPT 12045 | $840.18 | $1,273.00 | $168.77 – $1,626.25 | 14 |
| Ghs layered repair 12.6 - 20.0 cm -12055 CPT 12055 | $865.26 | $1,311.00 | $168.77 – $894.49 | 14 |
| Ghs layered repair 20.1 - 30.0 cm -12046 CPT 12046 | $898.92 | $1,362.00 | $168.77 – $1,626.25 | 14 |
| Ghs layered repair 20.1 - 30.0 cm -12056 CPT 12056 | $898.92 | $1,362.00 | $168.77 – $894.49 | 14 |
| Ghs layered repair over 30.0 cm -12047 CPT 12047 | $2,112.66 | $3,201.00 | $168.77 – $4,540.03 | 14 |
| Ghs layered repair over 3.0 cm -12057 CPT 12057 | $1,186.68 | $1,798.00 | $168.77 – $894.49 | 14 |
| Ghs leukocyte alkaline phos (mayo) CPT 85540 | $123.42 | $187.00 | $8.60 – $19.35 | 16 |
| Ghs mbp CPT 83873 | $89.76 | $136.00 | $17.20 – $38.70 | 16 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $351.12 | $532.00 | $10.05 – $292.60 | 8 |
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.