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 |
|---|---|---|---|---|
| Ndl round specialty proguide HCPCS C1715 | $368.94 | $559.00 | $307.45 – $307.45 | 1 |
| Neck (Cervical Spine) CT scan (with and without contrast) CPT 72127 | $1,818.96 | $2,756.00 | $134.40 – $1,215.09 | 16 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | $1,539.12 | $2,332.00 | $134.40 – $1,215.09 | 16 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $1,357.62 | $2,057.00 | $47.18 – $1,215.09 | 16 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $2,001.12 | $3,032.00 | $136.47 – $1,444.47 | 16 |
| Neck (Cervical Spine) MRI (with contrast) CPT 72142 | $1,906.08 | $2,888.00 | $179.97 – $1,444.47 | 16 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $1,815.00 | $2,750.00 | $53.34 – $1,444.47 | 16 |
| Neck MRA (blood vessel MRI, with and without contrast) CPT 70549 | $2,080.98 | $3,153.00 | $217.39 – $1,444.47 | 16 |
| Neck MRA (blood vessel MRI, with contrast) CPT 70548 | $1,801.80 | $2,730.00 | $217.39 – $1,444.47 | 16 |
| Neck MRA (blood vessel MRI, without contrast) CPT 70547 | $1,716.00 | $2,600.00 | $217.39 – $1,444.47 | 16 |
| Neurectomy foot CPT 28055 | not published | not published | not published | 0 |
| Neurolysis celiac plexus CPT 64680 | $1,582.02 | $2,397.00 | $565.72 – $1,946.19 | 16 |
| New Patient Office Visit (level 2) CPT 99202 | $208.56 | $316.00 | $95.40 – $154.00 | 3 |
| New Patient Office Visit (level 3) CPT 99203 | $252.12 | $382.00 | $95.40 – $154.00 | 3 |
| New Patient Office Visit (level 4) CPT 99204 | $287.10 | $435.00 | $95.40 – $154.00 | 3 |
| New Patient Office Visit (level 5) CPT 99205 | $347.82 | $527.00 | $95.40 – $154.00 | 3 |
| Nicardipine 25 mg/10 ml intravenous solution HCPCS J2404 | $2.09 | $3.16 | $0.12 – $3.26 | 11 |
| N-invas est c ffr sw aly cta CPT 75580 | $3,977.16 | $6,026.00 | $829.56 – $1,889.57 | 16 |
| Nitroglycerin 50 mg/250 ml (200 mcg/ml) in 5 % dextrose intravenous HCPCS J2305 | $13.00 | $19.70 | $2.28 – $2.72 | 5 |
| Njx interlaminar lmbr/sac CPT 62326 | $1,186.68 | $1,798.00 | $337.74 – $1,946.19 | 14 |
| Njx interlaminar lmbr/sac CPT 62327 | $1,482.36 | $2,246.00 | $337.74 – $1,946.19 | 14 |
| Njx px nfrosgrm &/urtrgrm CPT 50430 | $1,865.16 | $2,826.00 | $178.39 – $1,534.33 | 14 |
| Nm imaging bone/joint 3 phase study CPT 78315 | $1,665.18 | $2,523.00 | $162.47 – $1,246.46 | 16 |
| Nm imaging bone/joint whole body CPT 78306 | $1,389.96 | $2,106.00 | $162.47 – $1,246.46 | 16 |
| Nm imaging cardiac blood pooling planar single study at rest or stress CPT 78472 | $1,620.96 | $2,456.00 | $162.47 – $1,246.46 | 16 |
| Nm imaging gastric emptying study CPT 78264 | $1,302.84 | $1,974.00 | $162.47 – $1,246.46 | 16 |
| Nm imaging gastrointestinal acute blood loss CPT 78278 | $1,316.70 | $1,995.00 | $389.13 – $1,246.46 | 16 |
| Nm imaging hepatobiliary system w/pharmacologic intervention CPT 78227 | $1,587.96 | $2,406.00 | $162.47 – $1,246.46 | 16 |
| Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention CPT 78708 | $1,722.60 | $2,610.00 | $162.47 – $1,246.46 | 16 |
| Nm imaging pulmonary ventilation/perfusion CPT 78582 | $1,170.18 | $1,773.00 | $389.13 – $1,246.46 | 16 |
| Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s) CPT 78014 | $1,097.58 | $1,663.00 | $162.47 – $1,246.46 | 16 |
| Nm radiopharmaceutical therapy oral administration CPT 79005 | $951.06 | $1,441.00 | $120.16 – $1,246.46 | 16 |
| Noninv pace analysis CPT 93724 | $1,801.80 | $2,730.00 | $62.97 – $675.82 | 14 |
| Npm1 gene CPT 81310 | $507.54 | $769.00 | $197.71 – $554.67 | 16 |
| Nras gene variants exon 2&3 CPT 81311 | $673.86 | $1,021.00 | $175.10 – $665.53 | 16 |
| Nr lnr acclrtr tx max 5 sessions CPT 77373 | $7,421.70 | $11,245.00 | $629.03 – $3,934.42 | 16 |
| Nsl/sins ndsc surg max sins CPT 31295 | not published | not published | not published | 0 |
| Ntrk translocation analysis CPT 81194 | $1,342.44 | $2,034.00 | $414.62 – $1,166.13 | 16 |
| Ntsty modul rad tx dlvr cplx CPT 77386 | $2,904.66 | $4,401.00 | $208.99 – $2,044.10 | 10 |
| Ntsty modul rad tx dlvr smpl CPT 77385 | $2,533.08 | $3,838.00 | $208.99 – $2,044.10 | 10 |
| Nuclear rx IV admin CPT 79101 | $1,097.58 | $1,663.00 | $120.16 – $1,246.46 | 16 |
| Nuclear Stress Test (Heart) CPT 78452 | $3,365.34 | $5,099.00 | $389.13 – $2,848.74 | 16 |
| Nushield 1 square cm HCPCS Q4160 | $508.86 | $771.00 | $121.70 – $771.00 | 11 |
| Observation direct referral from physician office for admission HCPCS G0379 | $643.50 | $975.00 | not published | 0 |
| Observation per hour HCPCS G0378 | $182.82 | $277.00 | not published | 0 |
| Obstetrical care 59410 CPT 59410 | $2,423.52 | $3,672.00 | $952.18 – $1,444.50 | 8 |
| Obstetric panel inc HIV tstg CPT 80081 | $356.40 | $540.00 | $74.86 – $168.44 | 16 |
| Obstetrics panel CPT 80055 | $256.74 | $389.00 | $18.84 – $107.57 | 16 |
| Ocrelizumab 30 mg/ml intravenous solution HCPCS J2350 | $133.50 | $202.28 | $59.32 – $202.28 | 16 |
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | $242.06 | $366.75 | $1.09 – $1.53 | 5 |
| Olanzapine 10 mg intramuscular solution HCPCS J2359 | $5.32 | $8.06 | $1.34 – $1.67 | 5 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $8.09 | $12.25 | $0.15 – $0.16 | 5 |
| Open bx/exc inguinofem nodes CPT 38531 | not published | not published | not published | 0 |
| Open periprosthetic breast capsule 19370 CPT 19370 | not published | not published | not published | 0 |
| Opioids & opiate analogs 3/4 CPT 80363 | $23.10 | $35.00 | $4.99 – $35.00 | 10 |
| Optx acromclv dislc aqt/chrn CPT 23550 | not published | not published | not published | 0 |
| Optx clavicular fx w/int fix CPT 23515 | not published | not published | not published | 0 |
| Optx medial ankle fx CPT 27766 | not published | not published | not published | 0 |
| Optx prox humrl fx w/int fix CPT 23615 | not published | not published | not published | 0 |
| Orchiopexy ingun/scrot appr CPT 54640 | not published | not published | not published | 0 |
| Organic acids total quant ea spec CPT 83918 | $531.30 | $805.00 | $23.14 – $53.10 | 16 |
| Ortho elbow without jnt cstm w/fit&adj HCPCS L3702 | $349.80 | $530.00 | $364.38 – $819.85 | 9 |
| Ortho ewh rgd without jnt cstm w/fit&adj HCPCS L3763 | $552.42 | $837.00 | $836.99 – $1,883.23 | 9 |
| Ortho hnd/fngr without jnt cstm w/fit&adj HCPCS L3913 | $371.58 | $563.00 | $354.92 – $798.57 | 9 |
| Ortho hnd/fngr w/jnt cstm w/fit&adj HCPCS L3921 | $283.80 | $430.00 | $232.21 – $840.20 | 14 |
| Ortho hnd without jnt w/fit&adj HCPCS L3919 | $208.56 | $316.00 | $305.52 – $687.42 | 9 |
| Orthopantogram CPT 70355 | $315.48 | $478.00 | $16.54 – $456.60 | 16 |
| Ortho whf rigd without jnt cstm w/fit&adj HCPCS L3808 | $485.76 | $736.00 | $465.94 – $1,048.37 | 9 |
| Oscillation chest wall mechanical per session CPT 94669 | $526.02 | $797.00 | $25.49 – $481.84 | 16 |
| Osmolality blood CPT 83930 | $40.26 | $61.00 | $6.61 – $14.87 | 16 |
| Osmolality urine CPT 83935 | $42.90 | $65.00 | $6.82 – $15.35 | 16 |
| Osteochondral knee autograft CPT 27416 | not published | not published | not published | 0 |
| Ot evaluation high complexity patient/family CPT 97167 | $155.76 | $236.00 | $62.66 – $221.09 | 16 |
| Ot evaluation low complexity patient/family CPT 97165 | $155.76 | $236.00 | $62.66 – $221.09 | 16 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $155.76 | $236.00 | $62.66 – $221.09 | 16 |
| Oth resp proc, group HCPCS G0239 | $167.64 | $254.00 | $15.09 – $90.89 | 16 |
| Oth resp proc, indiv HCPCS G0238 | $84.48 | $128.00 | $15.09 – $90.89 | 16 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $85.14 | $129.00 | $16.89 – $129.00 | 16 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $80.52 | $122.00 | $16.89 – $122.00 | 16 |
| Ot re-evaluation patient/family CPT 97168 | $104.94 | $159.00 | $62.66 – $150.14 | 16 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $95.70 | $145.00 | $16.89 – $145.00 | 16 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $71.94 | $109.00 | $18.01 – $109.00 | 16 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $71.94 | $109.00 | $18.86 – $109.00 | 16 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $80.52 | $122.00 | $16.89 – $122.00 | 16 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $93.72 | $142.00 | $16.89 – $142.00 | 16 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $89.10 | $135.00 | $14.19 – $135.00 | 16 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $40.62 | $61.55 | $1.29 – $4.44 | 2 |
| Palb2 gene full gene seq CPT 81307 | $892.32 | $1,352.00 | $226.30 – $1,522.13 | 16 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $34.52 | $52.30 | $14.34 – $14.34 | 1 |
| Parathormone (pth) intact CPT 83970 | $252.12 | $382.00 | $41.28 – $92.88 | 16 |
| Parathyroid planar imaging CPT 78070 | $1,170.18 | $1,773.00 | $389.13 – $1,246.46 | 16 |
| Parathyroid planar img w/tomo spect CPT 78071 | $1,609.74 | $2,439.00 | $162.47 – $1,246.46 | 16 |
| Parial mast w/lymph removal 19302 CPT 19302 | not published | not published | not published | 0 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $199.98 | $303.00 | $72.99 – $441.47 | 14 |
| Part hymenectomy/revi hymenal ring 56700 CPT 56700 | not published | not published | not published | 0 |
| Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah) CPT 28122 | not published | not published | not published | 0 |
| Partial removal finger bone CPT 26236 | $3,032.04 | $4,594.00 | $576.77 – $3,538.22 | 14 |
| Partial removal of eye fluid CPT 67005 | not published | not published | not published | 0 |
| Partial removal of eye fluid CPT 67010 | not published | not published | not published | 0 |
| Partial removal of foot bone CPT 28288 | 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.