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 |
|---|---|---|---|---|
| Ghs moderate sedation < 5 yr, 30 min, other CPT 99155 | $351.12 | $532.00 | $10.05 – $292.60 | 8 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $351.12 | $532.00 | $10.05 – $292.60 | 8 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $74.58 | $113.00 | $10.05 – $62.15 | 8 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $74.58 | $113.00 | $10.05 – $62.15 | 8 |
| Ghs nailbed repair/nail removal CPT 11760 | $657.36 | $996.00 | $29.40 – $1,626.25 | 14 |
| Ghs nerve blk intercostal, single level CPT 64420 | $799.92 | $1,212.00 | $176.37 – $1,553.22 | 14 |
| Ghs nerve block brachial plexus CPT 64415 | $949.74 | $1,439.00 | $565.72 – $1,946.19 | 14 |
| Ghs nerve block celiac plexus CPT 64530 | $2,809.62 | $4,257.00 | $565.72 – $1,946.19 | 16 |
| Ghs nerve block interscaline CPT 64510 | $1,314.72 | $1,992.00 | $565.72 – $1,946.19 | 16 |
| Ghs nerve block suprascapular CPT 64418 | $1,696.20 | $2,570.00 | $176.37 – $1,553.22 | 14 |
| Ghs ng placement w fluoro guidance CPT 43752 | $460.68 | $698.00 | $75.17 – $982.97 | 16 |
| Ghs o2 saturation CPT 82810 | $121.44 | $184.00 | $9.77 – $21.98 | 16 |
| Ghs opcc repair cvp without subq port CPT 36575 | $1,656.60 | $2,510.00 | $325.87 – $1,380.31 | 14 |
| Ghs opcc repair cvp w subq port CPT 36576 | $3,016.86 | $4,571.00 | $325.87 – $3,463.76 | 14 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | $66.00 | $100.00 | $13.39 – $47.51 | 14 |
| Ghs ot group caregiver training CPT 97552 | $43.56 | $66.00 | $21.22 – $47.75 | 14 |
| Ghs ot prosthetic training/15 min CPT 97761 | $69.96 | $106.00 | $16.89 – $106.00 | 16 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $67.32 | $102.00 | $16.89 – $132.05 | 16 |
| Ghs pacing - transcutaneous CPT 92953 | $1,087.02 | $1,647.00 | $273.97 – $1,454.34 | 14 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $369.60 | $560.00 | $337.74 – $358.00 | 7 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $395.34 | $599.00 | $337.74 – $358.00 | 7 |
| Ghs peritonsillar abscess i andd CPT 42700 | $583.44 | $884.00 | $74.89 – $521.16 | 14 |
| Ghs phenylketonurid CPT 84030 | $170.94 | $259.00 | $5.50 – $12.38 | 16 |
| Ghs picc line insert < 5 CPT 36568 | $1,794.54 | $2,719.00 | $485.09 – $3,463.76 | 14 |
| Ghs plngl fx pm cl CPT 26725 | $701.58 | $1,063.00 | $203.37 – $542.77 | 14 |
| Ghs ppd (tb intradermal) CPT 86580 | $59.40 | $90.00 | $4.14 – $63.64 | 16 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $89.76 | $136.00 | $9.66 – $21.74 | 16 |
| Ghs protoporphyrins fract CPT 84202 | $72.60 | $110.00 | $14.35 – $32.29 | 16 |
| Ghs pr without cont pulse ox CPT 94625 | $137.94 | $209.00 | $15.09 – $129.81 | 14 |
| Ghs quinidine CPT 80194 | $88.44 | $134.00 | $14.60 – $32.85 | 16 |
| Ghs removal intranasal foreign body CPT 30300 | $345.84 | $524.00 | $74.89 – $292.76 | 14 |
| Ghs removal pharyngeal foreign body CPT 42809 | $460.68 | $698.00 | $74.89 – $982.97 | 14 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $1,878.36 | $2,846.00 | $576.77 – $3,538.22 | 14 |
| Ghs reticulocyte count CPT 85044 | $129.36 | $196.00 | $4.31 – $9.70 | 16 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $99.00 | $150.00 | $13.91 – $31.30 | 16 |
| Ghs sedimentation rate CPT 85651 | $40.92 | $62.00 | $4.01 – $9.61 | 16 |
| Ghs semen analysis fert CPT 89320 | $48.18 | $73.00 | $12.31 – $27.70 | 16 |
| Ghs semen analysis, post-vas CPT 89300 | $66.66 | $101.00 | $9.84 – $22.14 | 16 |
| Ghs sensitivity (per antimicro) CPT 87184 | $67.32 | $102.00 | $7.48 – $16.83 | 16 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $658.68 | $998.00 | $80.58 – $894.49 | 14 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $731.28 | $1,108.00 | $80.58 – $894.49 | 14 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $701.58 | $1,063.00 | $80.58 – $894.49 | 14 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $751.08 | $1,138.00 | $80.58 – $894.49 | 14 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $701.58 | $1,063.00 | $80.58 – $441.47 | 14 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $602.58 | $913.00 | $80.58 – $441.47 | 14 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $721.38 | $1,093.00 | $80.58 – $441.47 | 14 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $721.38 | $1,093.00 | $80.58 – $441.47 | 14 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $770.22 | $1,167.00 | $80.58 – $441.47 | 14 |
| Ghs sleep study unattended CPT 95800 | $345.18 | $523.00 | $67.12 – $475.12 | 16 |
| Ghs somatosensory testing lower extremit CPT 95926 | $906.18 | $1,373.00 | $58.61 – $885.08 | 16 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $1,431.54 | $2,169.00 | $58.61 – $1,889.57 | 16 |
| Ghs strapping shoulder - 29240 CPT 29240 | $246.18 | $373.00 | $33.47 – $292.76 | 14 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $1,186.68 | $1,798.00 | $168.77 – $1,626.25 | 14 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $465.96 | $706.00 | $168.77 – $894.49 | 14 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $1,710.72 | $2,592.00 | $908.91 – $3,414.10 | 14 |
| Ghs trypsin (fecal) CPT 84488 | $74.58 | $113.00 | $7.30 – $16.43 | 16 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $701.58 | $1,063.00 | $203.37 – $542.77 | 14 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $471.90 | $715.00 | $203.37 – $542.77 | 14 |
| Ghs urine, hydroxproline total CPT 83505 | $144.54 | $219.00 | $24.30 – $54.68 | 16 |
| Ghs urine, porphyrins quant CPT 84120 | $134.64 | $204.00 | $14.71 – $33.10 | 16 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $4,775.10 | $7,235.00 | $198.12 – $821.09 | 16 |
| Ghs windowing of cast CPT 29730 | $655.38 | $993.00 | $79.49 – $357.56 | 14 |
| Gi inhouse confirmation CPT 87045 | $68.64 | $104.00 | $9.44 – $21.24 | 16 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | not published | not published | not published | 0 |
| Gi trc img intral esophagus CPT 91111 | not published | not published | not published | 0 |
| Gi wireless capsule measure CPT 91112 | not published | not published | not published | 0 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $875.95 | $1,327.20 | $51.22 – $370.94 | 16 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $790.52 | $1,197.75 | $51.22 – $322.32 | 16 |
| Glucagon plasma - sendout CPT 82943 | $50.16 | $76.00 | $13.88 – $32.15 | 16 |
| Glucose 1 hr post dose CPT 82950 | $72.60 | $110.00 | $4.75 – $10.69 | 16 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $15.84 | $24.00 | $3.28 – $7.38 | 16 |
| Glucose blood quantitative CPT 82947 | $24.42 | $37.00 | $3.93 – $8.84 | 16 |
| Glucose body fluid CPT 82945 | $43.56 | $66.00 | $3.93 – $8.84 | 16 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $89.76 | $136.00 | $12.87 – $28.96 | 16 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $25.08 | $38.00 | $3.92 – $8.82 | 16 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $9.74 | $14.76 | $0.63 – $0.78 | 5 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $99.75 | $151.14 | $11.63 – $151.14 | 16 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $117.48 | $178.00 | $18.58 – $41.81 | 16 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $117.48 | $178.00 | $18.52 – $41.67 | 16 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $60.72 | $92.00 | $49.88 – $273.83 | 11 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $8,843.47 | $13,399.20 | $51.33 – $273.83 | 11 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | $2,200.44 | $3,334.00 | $1,517.26 – $3,295.88 | 5 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $8,316.00 | $12,600.00 | $75.07 – $273.83 | 11 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $193.38 | $293.00 | $103.75 – $273.83 | 16 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $1,007.99 | $1,527.25 | $121.70 – $273.83 | 16 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $58.08 | $88.00 | $78.69 – $273.83 | 11 |
| Great toe with reduction 28495 CPT 28495 | $568.26 | $861.00 | $95.40 – $542.77 | 14 |
| G-tube reposition CPT 43761 | $830.28 | $1,258.00 | $171.97 – $549.77 | 16 |
| Gu dilat ureter/urethra s&i CPT 74485 | $2,366.10 | $3,585.00 | $89.39 – $4,599.67 | 16 |
| Guided cath fluid drainage 10030 CPT 10030 | $1,186.68 | $1,798.00 | $474.26 – $1,558.17 | 14 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $3,056.46 | $4,631.00 | $17.41 – $17.41 | 1 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $102.96 | $156.00 | $85.80 – $85.80 | 1 |
| Guid loc target vol rad tx CPT 77387 | $407.88 | $618.00 | $53.11 – $618.00 | 11 |
| Gw stiffened micro access kit HCPCS C1894 | $960.96 | $1,456.00 | $67.10 – $67.10 | 1 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $32.34 | $49.00 | $1.20 – $1.97 | 5 |
| Hand X-ray CPT 73130 | $388.74 | $589.00 | $24.82 – $456.60 | 16 |
| Haptoglobin quantitative CPT 83010 | $81.18 | $123.00 | $12.58 – $28.31 | 16 |
| Hba1/hba2 full gene sequence CPT 81259 | $698.94 | $1,059.00 | $480.00 – $1,350.00 | 16 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $684.42 | $1,037.00 | $161.92 – $455.40 | 16 |
| Hbb full gene sequence CPT 81364 | $374.88 | $568.00 | $259.66 – $730.31 | 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.