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 |
|---|---|---|---|---|
| Trurl dstrj prst8 tiss rf wv CPT 53854 | not published | not published | not published | 0 |
| Tte w or without fol w/con,stres HCPCS C8928 | $1,657.92 | $2,512.00 | $95.73 – $862.47 | 16 |
| Tx atrial fib pulm vein isol CPT 93656 | $17,666.22 | $26,767.00 | $7,726.98 – $57,513.58 | 14 |
| Tx closed hip disl traumatic without anes CPT 27250 | $662.64 | $1,004.00 | $203.37 – $542.77 | 14 |
| Tx closed tib fx proximal w/w/o manip w/skel trac CPT 27532 | $6,407.94 | $9,709.00 | $203.37 – $7,199.69 | 14 |
| Tx l/r atrial fib addl CPT 93657 | $3,003.00 | $4,550.00 | $4,550.00 – $4,823.00 | 7 |
| Tx open dstl phlngl fx f/t internal fixation ea CPT 26765 | $7,569.54 | $11,469.00 | $2,332.20 – $7,199.69 | 14 |
| Tx phalangeal shaft fx open prox/middle ea CPT 26735 | not published | not published | not published | 0 |
| Ugt1a1 gene analy common variants CPT 81350 | $619.08 | $938.00 | $234.00 – $526.50 | 16 |
| Ultrasound abdomen aorta screening study aaa CPT 76706 | $386.76 | $586.00 | $40.90 – $230.04 | 16 |
| Ultrasound breast complete CPT 76641 | $546.48 | $828.00 | $48.32 – $521.52 | 16 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $392.70 | $595.00 | $48.32 – $521.52 | 16 |
| Ultrasound chest CPT 76604 | $405.24 | $614.00 | $40.90 – $521.52 | 16 |
| Ultrasound dx ophth b-scan CPT 76512 | $222.42 | $337.00 | $34.85 – $337.00 | 16 |
| Ultrasound encephalogram CPT 76506 | $629.64 | $954.00 | $48.32 – $521.52 | 16 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $573.54 | $869.00 | $48.32 – $521.52 | 16 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $398.64 | $604.00 | $44.52 – $521.52 | 16 |
| Ultrasound guidance for vascular access CPT 76937 | $370.26 | $561.00 | $47.89 – $561.00 | 11 |
| Ultrasound guided needle placement supervision & interpretation CPT 76942 | $699.60 | $1,060.00 | $49.70 – $574.00 | 11 |
| Ultrasound guide intraoperative CPT 76998 | $839.52 | $1,272.00 | $49.70 – $574.00 | 11 |
| Ultrasound hips infant dynamic CPT 76885 | $377.52 | $572.00 | $48.32 – $521.52 | 16 |
| Ultrasound joint complete left CPT 76881 | $566.28 | $858.00 | $21.12 – $521.52 | 16 |
| Ultrasound joint/nonvascular extremity limited left CPT 76882 | $384.78 | $583.00 | $40.90 – $521.52 | 16 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $307.56 | $466.00 | $44.52 – $466.00 | 11 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $251.46 | $381.00 | $41.14 – $381.00 | 11 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $650.10 | $985.00 | $44.52 – $525.02 | 16 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $321.42 | $487.00 | $44.52 – $487.00 | 16 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | $335.28 | $508.00 | $44.52 – $508.00 | 16 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | $440.22 | $667.00 | $44.52 – $521.52 | 16 |
| Ultrasound prostate/transrectal CPT 76872 | $228.36 | $346.00 | $48.32 – $346.00 | 16 |
| Ultrasound retroperitoneal limited CPT 76775 | $517.44 | $784.00 | $40.90 – $521.52 | 16 |
| Ultrasound scrotum and contents CPT 76870 | $578.16 | $876.00 | $40.90 – $521.52 | 16 |
| Ultrasound spinal canal and contents CPT 76800 | $349.80 | $530.00 | $48.32 – $521.52 | 16 |
| Ultrasound transabd ea addl gest CPT 76812 | $297.00 | $450.00 | $44.52 – $450.00 | 11 |
| Ultrasound transvaginal non obstetric CPT 76830 | $531.30 | $805.00 | $24.16 – $521.52 | 16 |
| Unlisted CT procedure CPT 76497 | $331.98 | $503.00 | $47.18 – $503.00 | 16 |
| Unlisted cv px dx nuc med CPT 78499 | $951.06 | $1,441.00 | $162.47 – $1,246.46 | 16 |
| Unlisted cytogenetic study CPT 88299 | $372.90 | $565.00 | $16.71 – $339.00 | 16 |
| Unlisted dialysis procedure CPT 90999 | $510.18 | $773.00 | $343.55 – $773.00 | 10 |
| Unlisted laparoscopic liver biopy 47379 CPT 47379 | not published | not published | not published | 0 |
| Unlisted laparoscopic procedure 49659 CPT 49659 | not published | not published | not published | 0 |
| Unlisted laps px esoph CPT 43289 | not published | not published | not published | 0 |
| Unlisted mr procedure CPT 76498 | $2,233.44 | $3,384.00 | $85.11 – $1,444.47 | 16 |
| Unlisted neurological dx px CPT 95999 | $394.02 | $597.00 | $58.61 – $283.13 | 14 |
| Unlisted procedure larynx CPT 31599 | $570.90 | $865.00 | $231.63 – $655.52 | 14 |
| Unlisted px ant segment eye CPT 66999 | not published | not published | not published | 0 |
| Unlisted px arthroscopy CPT 29999 | not published | not published | not published | 0 |
| Unlisted px casting/strpg CPT 29799 | $285.78 | $433.00 | $33.47 – $357.56 | 14 |
| Unlisted px foot/toes CPT 28899 | $545.82 | $827.00 | $203.37 – $542.77 | 14 |
| Unlisted px med radj physics CPT 77399 | $196.02 | $297.00 | $53.11 – $297.00 | 16 |
| Unlisted px small intestine CPT 44799 | $1,083.06 | $1,641.00 | $886.99 – $1,995.72 | 14 |
| Unlisted surgical path px CPT 88399 | $1,824.24 | $2,764.00 | $11.76 – $1,658.40 | 16 |
| Unlisted ultrasound procedure CPT 76999 | $293.70 | $445.00 | $48.32 – $445.00 | 16 |
| Unlisted urinalysis px CPT 81099 | $584.76 | $886.00 | $1.07 – $531.60 | 9 |
| Unlstd laps px sprmatic cord CPT 55559 | not published | not published | not published | 0 |
| Upgrade pm system CPT 33214 | $12,087.24 | $18,314.00 | $3,478.75 – $22,998.51 | 14 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $2,651.88 | $4,018.00 | $136.47 – $1,444.47 | 16 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $2,410.98 | $3,653.00 | $179.97 – $1,444.47 | 16 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $2,295.48 | $3,478.00 | $53.34 – $1,444.47 | 16 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | not published | not published | not published | 0 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | not published | not published | not published | 0 |
| Uppr gi scope w/submuc inj CPT 43236 | not published | not published | not published | 0 |
| Urea nitrogen CPT 84520 | $25.74 | $39.00 | $3.95 – $8.89 | 16 |
| Urea nitrogen 24 hour urine CPT 84540 | $54.12 | $82.00 | $5.56 – $12.51 | 16 |
| Urea nitrogen clearance CPT 84545 | $217.14 | $329.00 | $7.20 – $16.20 | 16 |
| Ureteral embolization/occl CPT 50705 | $369.60 | $560.00 | $560.00 – $593.60 | 7 |
| Ureteral reflux study CPT 78740 | $1,023.66 | $1,551.00 | $162.47 – $1,246.46 | 16 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $747.78 | $1,133.00 | $52.32 – $525.02 | 16 |
| Urethrocystography void s&i CPT 74455 | $747.78 | $1,133.00 | $52.32 – $525.02 | 16 |
| Uric acid blood CPT 84550 | $31.02 | $47.00 | $4.52 – $10.17 | 16 |
| Uric acid urine CPT 84560 | $31.02 | $47.00 | $5.08 – $11.43 | 16 |
| Urinalysis microscopic only CPT 81015 | $21.78 | $33.00 | $3.05 – $6.86 | 16 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | $64.68 | $98.00 | $2.17 – $4.88 | 16 |
| Urinalysis (with microscopy) CPT 81001 | $38.28 | $58.00 | $3.17 – $7.13 | 16 |
| Urinalysis (without microscopy) CPT 81003 | $35.64 | $54.00 | $2.25 – $5.06 | 16 |
| Urine Culture Test CPT 87086 | $59.40 | $90.00 | $8.07 – $18.16 | 16 |
| Urine pregnancy test CPT 81025 | $59.40 | $90.00 | $8.61 – $19.37 | 16 |
| Urography, antegrade CPT 74425 | $616.44 | $934.00 | $52.32 – $767.66 | 16 |
| Urography inf drip &/or bolus CPT 74410 | $747.78 | $1,133.00 | $52.32 – $456.60 | 16 |
| Vaccine dtap < 7 years im CPT 90700 | $142.33 | $215.65 | $9.41 – $61.12 | 9 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $141.90 | $215.00 | $9.41 – $116.10 | 16 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $101.11 | $153.20 | $9.41 – $82.73 | 16 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | $15.84 | $24.00 | $5.76 – $24.00 | 16 |
| Vaccine mmr live subcutaneous CPT 90707 | $320.86 | $486.15 | $9.41 – $193.28 | 9 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | $706.27 | $1,070.10 | $256.82 – $577.85 | 16 |
| Vaccine rabies im CPT 90675 | $1,084.28 | $1,642.85 | $49.76 – $719.43 | 16 |
| Vaccine tdap >=7 years im CPT 90715 | $158.99 | $240.90 | $9.41 – $71.05 | 11 |
| Vag hyst incl t/o complex CPT 58291 | not published | not published | not published | 0 |
| Vag hyst including t/o CPT 58262 | not published | not published | not published | 0 |
| Vaginal bx CPT 58999 | not published | not published | not published | 0 |
| Vaginal hysterectomy CPT 58260 | not published | not published | not published | 0 |
| Valproic acid total therapeutic drug level CPT 80164 | $77.88 | $118.00 | $13.54 – $30.47 | 16 |
| Valvuloplasty aortic CPT 92986 | $6,585.48 | $9,978.00 | $3,625.53 – $12,523.68 | 14 |
| Valvuloplasty mitral CPT 92987 | $13,098.36 | $19,846.00 | $3,625.53 – $25,401.76 | 14 |
| Vancomycin peak therapeutic drug level CPT 80202 | $95.70 | $145.00 | $13.54 – $30.47 | 16 |
| Varicella zoster antibody igg CPT 86787 | $68.64 | $104.00 | $8.17 – $28.98 | 16 |
| Veeg cont 2-12 hrs CPT 95713 | $3,153.48 | $4,778.00 | $146.51 – $821.09 | 16 |
| Veeg ea 12-26hr cont mntr CPT 95716 | $4,224.00 | $6,400.00 | $198.12 – $1,889.57 | 16 |
| Veeg intrmnt 2-12 hrs CPT 95712 | $2,702.70 | $4,095.00 | $146.51 – $821.09 | 16 |
| Veeg unmon 12-26 hrs CPT 95714 | $4,505.16 | $6,826.00 | $198.12 – $821.09 | 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.