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 |
|---|---|---|---|---|
| Rmvl icd gen w/rplc icd gen dual lead sys CPT 33263 | $11,482.68 | $17,398.00 | $9,799.05 – $48,944.63 | 14 |
| Rmvl icd gen w/rplc icd gen mlt lead sys CPT 33264 | $15,016.32 | $22,752.00 | $9,799.05 – $69,067.87 | 14 |
| Rmvl icd gen w/rplc icd gen sgl lead sys CPT 33262 | $11,482.68 | $17,398.00 | $9,799.05 – $48,944.63 | 14 |
| Rmvl icd pulse gen only CPT 33241 | $4,203.54 | $6,369.00 | $3,194.40 – $8,222.78 | 14 |
| Rmvl ndwellg tun pleural cath CPT 32552 | $1,285.02 | $1,947.00 | $440.45 – $1,380.31 | 14 |
| Rmvl perm pm pulse gen CPT 33233 | $2,544.96 | $3,856.00 | $3,194.40 – $18,209.12 | 14 |
| Rmvl pm gen w/rplc pm gen mlt lead sys CPT 33229 | $7,155.06 | $10,841.00 | $3,478.75 – $42,383.31 | 14 |
| Rmvl pm gen w/rplc pm gen sgl lead sys CPT 33227 | $4,592.28 | $6,958.00 | $3,478.75 – $18,209.12 | 14 |
| Rmvl pq iabp CPT 33968 | $2,075.70 | $3,145.00 | $3,145.00 – $3,333.70 | 7 |
| Rmvl subq card rhythm mntr CPT 33286 | $1,197.24 | $1,814.00 | $692.52 – $1,558.17 | 14 |
| Rmvl tv pm lead dual CPT 33235 | $4,203.54 | $6,369.00 | $693.47 – $8,222.78 | 14 |
| Rmvl tv pm lead sgl CPT 33234 | $4,203.54 | $6,369.00 | $693.47 – $8,222.78 | 14 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $0.73 | $1.11 | $0.08 – $0.12 | 5 |
| Rpl non-tun cvc wo sbq prt/pmp CPT 36580 | $2,373.36 | $3,596.00 | $485.09 – $3,463.76 | 14 |
| Rp loclzj tum spect w/ct 1 CPT 78830 | $1,791.90 | $2,715.00 | $389.13 – $2,848.74 | 16 |
| Rpl picc wo subq port/pump incl image guidnc w/s&i CPT 36584 | $2,175.36 | $3,296.00 | $485.09 – $3,463.76 | 14 |
| Rpl tun-cvad w subq port CPT 36582 | $5,536.74 | $8,389.00 | $936.84 – $6,947.70 | 14 |
| Rpl tun cvc wo subq port CPT 36581 | $3,657.72 | $5,542.00 | $936.84 – $6,947.70 | 14 |
| Rpr aa hrn 1st > 10 rdc CPT 49595 | not published | not published | not published | 0 |
| Rpr aa hrn 1st 3-10 ncr/strn CPT 49594 | not published | not published | not published | 0 |
| Rpr aa hrn 1st 3-10 rdc CPT 49593 | not published | not published | not published | 0 |
| Rpr aa hrn 1st < 3 cm rdc CPT 49591 | not published | not published | not published | 0 |
| Rpr aa hrn 1st < 3 ncr/strn CPT 49592 | not published | not published | not published | 0 |
| Rpr aa hrn rcr 3-10 rdc CPT 49615 | not published | not published | not published | 0 |
| Rpr aa hrn rcr < 3 rdc CPT 49613 | not published | not published | not published | 0 |
| Rsv assay w/optic CPT 87807 | $99.00 | $150.00 | $13.10 – $29.48 | 16 |
| Rubella antibody igg CPT 86762 | $99.00 | $150.00 | $14.39 – $32.38 | 16 |
| Rubeola antibody igg CPT 86765 | $89.10 | $135.00 | $12.88 – $28.98 | 16 |
| Russell viper venom diluted CPT 85613 | $68.64 | $104.00 | $9.58 – $21.56 | 16 |
| Salmonella antibody CPT 86768 | $66.00 | $100.00 | $11.50 – $29.68 | 16 |
| Sarscov coronavirus ag ia CPT 87426 | $73.92 | $112.00 | $35.33 – $79.49 | 16 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $805.20 | $1,220.00 | $74.44 – $525.02 | 16 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $699.60 | $1,060.00 | $74.44 – $521.52 | 16 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $601.26 | $911.00 | $74.44 – $525.02 | 16 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $461.34 | $699.00 | $48.32 – $521.52 | 16 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $498.30 | $755.00 | $48.32 – $472.83 | 16 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $628.32 | $952.00 | $48.32 – $472.83 | 16 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $1,058.64 | $1,604.00 | $74.44 – $525.02 | 16 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $592.68 | $898.00 | $48.32 – $472.83 | 16 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $531.30 | $805.00 | $48.32 – $472.83 | 16 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | $2,373.36 | $3,596.00 | $318.99 – $3,634.16 | 14 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $519.42 | $787.00 | $432.85 – $432.85 | 1 |
| Screen cerv/vag thin layer HCPCS G0123 | $125.40 | $190.00 | $20.26 – $45.59 | 16 |
| Screening Colonoscopy (average risk) HCPCS G0121 | not published | not published | not published | 0 |
| Screening Colonoscopy (high risk) HCPCS G0105 | not published | not published | not published | 0 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $110.22 | $167.00 | $4.14 – $40.61 | 16 |
| Screening hepatitis c antibody high risk HCPCS G0472 | $99.66 | $151.00 | $14.63 – $104.29 | 16 |
| Screening Mammogram CPT 77067 | $310.20 | $470.00 | $10.55 – $196.07 | 14 |
| Screening prostate cancer PSA HCPCS G0103 | $117.48 | $178.00 | $19.31 – $43.45 | 16 |
| Screen pap by tech w md supv HCPCS P3000 | $53.46 | $81.00 | $14.86 – $41.72 | 16 |
| Sec art mech thrmbc non-intracranial add-on CPT 37186 | $3,237.96 | $4,906.00 | $4,729.17 – $5,012.92 | 7 |
| Sedimentation rate erythrocyte automated CPT 85652 | $36.96 | $56.00 | $2.70 – $6.08 | 16 |
| Semen analysis presence/motility CPT 89321 | $207.90 | $315.00 | $12.05 – $27.11 | 16 |
| Semen analysis w/count CPT 89310 | $229.68 | $348.00 | $8.61 – $19.37 | 16 |
| Serpina1 gene CPT 81332 | $663.30 | $1,005.00 | $16.71 – $98.21 | 16 |
| Sertraline (zoloft) - sendout CPT 80332 | $97.02 | $147.00 | $25.00 – $88.20 | 10 |
| Set radiation therapy field CPT 77280 | $867.24 | $1,314.00 | $52.58 – $1,314.00 | 16 |
| Set radiation therapy field CPT 77285 | $1,056.00 | $1,600.00 | $82.46 – $1,600.00 | 16 |
| Set radiation therapy field CPT 77290 | $2,221.56 | $3,366.00 | $82.46 – $2,025.50 | 16 |
| Sho arthrs srg bicp tenodsis CPT 29828 | not published | not published | not published | 0 |
| Sho arthrs srg capsulorraphy CPT 29806 | not published | not published | not published | 0 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | not published | not published | not published | 0 |
| Sho arthrs srg rmvl loose/fb CPT 29819 | not published | not published | not published | 0 |
| Sho arthrs srg rpr slap les CPT 29807 | not published | not published | not published | 0 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | not published | not published | not published | 0 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | not published | not published | not published | 0 |
| Shoulder MRI (with and without contrast) CPT 73223 | $2,669.70 | $4,045.00 | $179.97 – $1,444.47 | 16 |
| Shoulder MRI (with contrast) CPT 73222 | $2,542.32 | $3,852.00 | $179.97 – $1,724.93 | 16 |
| Shoulder MRI (without contrast) CPT 73221 | $2,420.88 | $3,668.00 | $106.68 – $1,444.47 | 16 |
| Shoulder X-ray CPT 73030 | $315.48 | $478.00 | $24.82 – $456.60 | 16 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $522.72 | $792.00 | $52.32 – $456.60 | 16 |
| Sialography s&i CPT 70390 | $519.42 | $787.00 | $52.32 – $525.02 | 16 |
| Sickling rbc CPT 85660 | $59.40 | $90.00 | $5.51 – $12.40 | 16 |
| Sigmoidoscopy and biopsy CPT 45331 | not published | not published | not published | 0 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | not published | not published | not published | 0 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | not published | not published | not published | 0 |
| Sigmoidoscopy w/tumr remove CPT 45338 | not published | not published | not published | 0 |
| Sig w/tndsc balloon dilation CPT 45340 | not published | not published | not published | 0 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $408.01 | $618.20 | $42.87 – $242.28 | 11 |
| Sinus CT scan (with and without contrast) CPT 70488 | $1,679.04 | $2,544.00 | $134.40 – $1,215.09 | 16 |
| Sinus CT scan (with contrast) CPT 70487 | $1,624.92 | $2,462.00 | $134.40 – $1,215.09 | 16 |
| Sinus CT scan (without contrast) CPT 70486 | $1,271.16 | $1,926.00 | $47.18 – $1,215.09 | 16 |
| Sinus/juglr venogram s&i CPT 75860 | $3,635.28 | $5,508.00 | $142.17 – $6,947.70 | 16 |
| Skin Biopsy CPT 11102 | $306.24 | $464.00 | $185.89 – $894.49 | 14 |
| Sleep Study (Polysomnography) CPT 95810 | $4,039.86 | $6,121.00 | $349.46 – $1,889.57 | 16 |
| Sleep study unattended CPT 95806 | $518.76 | $786.00 | $67.12 – $475.12 | 16 |
| Sleeve fing rolyan med HCPCS L3933 | $296.34 | $449.00 | $280.71 – $631.60 | 9 |
| Slp stdy unatnd w/anal CPT 95801 | $296.34 | $449.00 | $57.69 – $449.00 | 16 |
| Small bowel endoscopy CPT 44360 | not published | not published | not published | 0 |
| Small bowel endoscopy CPT 44382 | not published | not published | not published | 0 |
| Small bowel endoscopy/biopsy CPT 44361 | not published | not published | not published | 0 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $118.14 | $179.00 | $5.39 – $12.13 | 16 |
| Smear gram stain CPT 87205 | $65.34 | $99.00 | $4.27 – $9.61 | 16 |
| Smear nasal eosinophil CPT 89190 | $33.00 | $50.00 | $5.79 – $13.03 | 16 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $129.36 | $196.00 | $5.99 – $13.48 | 16 |
| Smear wet mount CPT 87210 | $39.60 | $60.00 | $5.82 – $13.10 | 16 |
| Snrpn/ube3a gene CPT 81331 | $327.36 | $496.00 | $51.07 – $114.91 | 16 |
| Sodium 24 hour urine CPT 84300 | $29.70 | $45.00 | $5.06 – $11.39 | 16 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $69.96 | $106.00 | $3.28 – $4.57 | 5 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $69.96 | $106.00 | $2.13 – $2.31 | 5 |
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.