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 |
|---|---|---|---|---|
| Remove foreign body from eye CPT 65260 | $2,634.06 | $3,991.00 | $453.50 – $5,078.12 | 14 |
| Remove foreign body from eye CPT 65265 | $5,758.50 | $8,725.00 | $453.50 – $5,078.12 | 14 |
| Remove/graft foot lesion CPT 28107 | not published | not published | not published | 0 |
| Remove in/ex hem groups 2+ CPT 46260 | not published | not published | not published | 0 |
| Remove intact mammary implant CPT 19328 | not published | not published | not published | 0 |
| Remove int/ext hem 1 group CPT 46255 | not published | not published | not published | 0 |
| Remove pilonidal cyst compl CPT 11772 | not published | not published | not published | 0 |
| Remove prostate regrowth CPT 52630 | not published | not published | not published | 0 |
| Remove renal tube w/fluoro CPT 50389 | $925.32 | $1,402.00 | $99.98 – $1,534.33 | 16 |
| Remove spinal lamina add-on 63048 CPT 63048 | not published | not published | not published | 0 |
| Remove stent via transureth CPT 50386 | $2,366.10 | $3,585.00 | $305.96 – $4,599.67 | 16 |
| Remove tonsils and adenoids CPT 42820 | not published | not published | not published | 0 |
| Remove tonsils and adenoids CPT 42821 | not published | not published | not published | 0 |
| Remove ureter stent percut CPT 50384 | $2,570.04 | $3,894.00 | $422.00 – $4,599.67 | 16 |
| Remove ventilating tube CPT 69424 | not published | not published | not published | 0 |
| Remove wrist joint lining CPT 25105 | not published | not published | not published | 0 |
| Remove wrist tendon lesion CPT 25111 | not published | not published | not published | 0 |
| Renal cyst study s&i CPT 74470 | $633.60 | $960.00 | $52.32 – $1,202.33 | 16 |
| Renal function panel CPT 80069 | $113.52 | $172.00 | $8.68 – $19.53 | 16 |
| Renal venogram bil s&i CPT 75833 | $3,635.28 | $5,508.00 | $154.57 – $6,947.70 | 16 |
| Reopen fallopian tube CPT 58350 | not published | not published | not published | 0 |
| Repair achilles tendon CPT 27650 | not published | not published | not published | 0 |
| Repair biceps tendon CPT 23430 | not published | not published | not published | 0 |
| Repair bladder defect CPT 57288 | not published | not published | not published | 0 |
| Repair blood vessel direct hand finger CPT 35207 | $3,635.28 | $5,508.00 | $926.02 – $6,947.70 | 14 |
| Repair blood vessel dir lower extr CPT 35226 | $1,312.08 | $1,988.00 | $692.52 – $1,558.17 | 14 |
| Repair blood vessel dir upper extr CPT 35206 | $3,635.28 | $5,508.00 | $926.02 – $6,947.70 | 14 |
| Repair complex wound scalp/arms/legs 2.6 - 7.5 cm CPT 13121 | $1,186.68 | $1,798.00 | $185.89 – $894.49 | 14 |
| Repair dental ellis ii fx CPT 41899 | $542.52 | $822.00 | $231.63 – $560.70 | 14 |
| Repair elbow deb/attch open CPT 24359 | not published | not published | not published | 0 |
| Repair elbow w/deb open CPT 24358 | not published | not published | not published | 0 |
| Repair extns tendon finger without grft ea CPT 26418 | $1,878.36 | $2,846.00 | $576.77 – $3,538.22 | 14 |
| Repair eyelid defect CPT 67904 | not published | not published | not published | 0 |
| Repair eyelid defect CPT 67917 | not published | not published | not published | 0 |
| Repair eyelid defect CPT 67921 | not published | not published | not published | 0 |
| Repair eyelid defect CPT 67924 | not published | not published | not published | 0 |
| Repair finger/hand tendon CPT 26350 | not published | not published | not published | 0 |
| Repair forearm tendon/muscle CPT 25272 | not published | not published | not published | 0 |
| Repair hand joint with graft CPT 26541 | not published | not published | not published | 0 |
| Repair lip full thkns =<one-half vert height CPT 40652 | $988.02 | $1,497.00 | $74.89 – $1,186.74 | 14 |
| Repair lip full thkns >one-half vert height/cmplx CPT 40654 | $1,710.72 | $2,592.00 | $618.42 – $3,414.10 | 14 |
| Repair of ankle ligament CPT 27695 | not published | not published | not published | 0 |
| Repair of humerus CPT 24430 | not published | not published | not published | 0 |
| Repair of hydrocele 55060 CPT 55060 | not published | not published | not published | 0 |
| Repair of kneecap tendon CPT 27380 | $9,804.30 | $14,855.00 | $1,383.03 – $15,966.53 | 14 |
| Repair of leg tendon each CPT 27658 | not published | not published | not published | 0 |
| Repair of metatarsals CPT 28322 | not published | not published | not published | 0 |
| Repair of nasal septum CPT 30520 | not published | not published | not published | 0 |
| Repair of ruptured tendon CPT 24342 | not published | not published | not published | 0 |
| Repair of thigh muscle CPT 27385 | not published | not published | not published | 0 |
| Repair pm/icd lead sgl CPT 33218 | $6,358.44 | $9,634.00 | $693.47 – $8,222.78 | 14 |
| Repair rotator cuff acute CPT 23410 | not published | not published | not published | 0 |
| Repair rotator cuff chronic CPT 23412 | not published | not published | not published | 0 |
| Repair rpr lip full thickness vermilion only CPT 40650 | $988.02 | $1,497.00 | $74.89 – $1,186.74 | 14 |
| Repair tendon extensor foot 1/2 each tendon CPT 28208 | $7,792.62 | $11,807.00 | $944.88 – $7,199.69 | 14 |
| Repair toe dislocation CPT 28645 | not published | not published | not published | 0 |
| Replace duod/jej tube perc CPT 49451 | $1,364.88 | $2,068.00 | $165.33 – $1,995.72 | 16 |
| Replace g/c tube perc CPT 49450 | $2,228.82 | $3,377.00 | $122.32 – $1,995.72 | 16 |
| Replace g-j tube perc CPT 49452 | $1,250.04 | $1,894.00 | $171.97 – $1,995.72 | 14 |
| Replace tunneled cv cath CPT 36578 | $2,728.44 | $4,134.00 | $325.87 – $6,947.70 | 14 |
| Reposition pm/icd lead CPT 33215 | $3,635.28 | $5,508.00 | $693.47 – $6,947.70 | 14 |
| Repos lv lead pm/icd CPT 33226 | $3,635.28 | $5,508.00 | $3,087.87 – $6,947.70 | 14 |
| Reptilase test CPT 85635 | $108.90 | $165.00 | $9.85 – $22.16 | 16 |
| Rerepair ing hernia reduce CPT 49520 | not published | not published | not published | 0 |
| Resect inferior turbinate CPT 30140 | not published | not published | not published | 0 |
| Respirator motion mgmt simul CPT 77293 | $582.12 | $882.00 | $53.11 – $882.00 | 10 |
| #resp virpnl dfa-adenovirus CPT 87260 | $75.24 | $114.00 | $14.43 – $32.47 | 16 |
| #resp virpnl dfa-parainfluenza CPT 87279 | $75.24 | $114.00 | $16.43 – $36.97 | 16 |
| Resuscitation cardiopulmonary CPT 92950 | $601.92 | $912.00 | $211.16 – $912.00 | 16 |
| Resuscitation delivery/birthing room CPT 99465 | $755.70 | $1,145.00 | $310.75 – $1,454.34 | 14 |
| Reticulated platelet assay CPT 85055 | $178.86 | $271.00 | $18.97 – $80.42 | 16 |
| Reticulocyte automated CPT 85045 | $30.36 | $46.00 | $3.99 – $8.98 | 16 |
| Revasc intravasc lithotripsy HCPCS C9764 | not published | not published | not published | 0 |
| Revasc lithotr-ather tib/per HCPCS C9774 | $18,078.06 | $27,391.00 | $4,729.17 – $40,336.82 | 14 |
| Revasc lithotrip tibi/perone HCPCS C9772 | $7,914.72 | $11,992.00 | $2,731.45 – $25,401.76 | 14 |
| Revasc lithotr-stent tib/per HCPCS C9773 | $18,078.06 | $27,391.00 | $4,729.17 – $40,336.82 | 14 |
| Revasc lith-sten-ath tib/per HCPCS C9775 | $18,078.06 | $27,391.00 | $4,729.17 – $40,336.82 | 14 |
| Revise arm/leg nerve CPT 64708 | not published | not published | not published | 0 |
| Revise lower leg tendon CPT 27691 | not published | not published | not published | 0 |
| Revise/remove sling repair CPT 57287 | not published | not published | not published | 0 |
| Revise spermatic cord veins CPT 55530 | not published | not published | not published | 0 |
| Revise spermatic cord veins CPT 55535 | not published | not published | not published | 0 |
| Revise ulnar nerve at wrist CPT 64719 | not published | not published | not published | 0 |
| Revision of bladder neck CPT 52500 | not published | not published | not published | 0 |
| Revision of calf tendon CPT 27687 | not published | not published | not published | 0 |
| Revision of cervix CPT 59320 | not published | not published | not published | 0 |
| Revision of foot tendon CPT 28238 | not published | not published | not published | 0 |
| Revision open av fistula without thromb CPT 36832 | not published | not published | not published | 0 |
| Revision tips CPT 37183 | $10,876.14 | $16,479.00 | $2,731.45 – $12,523.68 | 14 |
| Rev/rmv perph nstim eltrd ra CPT 64585 | not published | not published | not published | 0 |
| Rev/rmv prph sac/gstr npg/r CPT 64595 | not published | not published | not published | 0 |
| Revsc opn/prq tib/pero stent CPT 37234 | $6,666.00 | $10,100.00 | $4,729.17 – $5,012.92 | 7 |
| Rf abltj nrv nrvtg si jt CPT 64625 | $3,262.38 | $4,943.00 | $595.28 – $4,296.76 | 14 |
| Rheumatoid factor qualitative CPT 86430 | $42.24 | $64.00 | $6.14 – $13.82 | 16 |
| Rheumatoid factor quantitative CPT 86431 | $38.94 | $59.00 | $5.67 – $12.76 | 16 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | $37.28 | $56.49 | $7.97 – $45.44 | 11 |
| Rho d immune globulin inj HCPCS J2790 | $94.94 | $143.85 | $42.87 – $131.44 | 10 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | $259.87 | $393.74 | $30.15 – $391.88 | 16 |
| Rmv implant contraceptive capsule 11976 CPT 11976 | $1,223.64 | $1,854.00 | $95.40 – $1,558.17 | 14 |
| Rmvl icd by tv extr CPT 33244 | $4,203.54 | $6,369.00 | $693.47 – $8,222.78 | 14 |
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.