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 |
|---|---|---|---|---|
| Carbamazepine free CPT 80157 | $99.66 | $151.00 | $13.25 – $29.81 | 16 |
| Carbamazepine free -sendout CPT 80161 | $106.92 | $162.00 | $14.91 – $41.94 | 16 |
| Carbamazepine total therapeutic drug level CPT 80156 | $87.12 | $132.00 | $14.57 – $32.78 | 16 |
| Carbohydrate deficient transf - sendout CPT 82373 | $415.80 | $630.00 | $10.38 – $40.64 | 16 |
| Carbon dioxide CPT 82374 | $81.18 | $123.00 | $4.88 – $10.98 | 16 |
| Carboxyhemoglobin quantitative CPT 82375 | $134.64 | $204.00 | $12.32 – $27.72 | 16 |
| Carcinoembryonic ag (cea) CPT 82378 | $135.30 | $205.00 | $18.96 – $42.66 | 16 |
| Cardiac perf spect sgl/ef/wm rst/strs CPT 78451 | $3,072.96 | $4,656.00 | $389.13 – $2,848.74 | 16 |
| Cardiac rehabilitation op phase 2 w/continous ecg monitoring CPT 93798 | $374.22 | $567.00 | $68.99 – $487.00 | 16 |
| Cardiac rehabilitation op phase 2 without continous ecg monitoring CPT 93797 | $145.20 | $220.00 | $68.99 – $283.65 | 16 |
| Cardiolipin antibody iga CPT 86147 | $68.64 | $104.00 | $8.17 – $57.26 | 16 |
| Cardioversion elective electrical conversion arrhythmia external CPT 92960 | $1,704.78 | $2,583.00 | $273.97 – $1,454.34 | 16 |
| Caregiver training strategies&tq 1st 30 minutes CPT 97550 | $102.96 | $156.00 | $51.46 – $116.42 | 14 |
| Caregiver training strategies&tq ea addl 15 min CPT 97551 | $51.48 | $78.00 | $25.72 – $57.87 | 14 |
| Car ion chnnlpath inc 10 gns CPT 81413 | $772.20 | $1,170.00 | $467.92 – $1,316.03 | 16 |
| Car ion chnnlpath inc 2 gns CPT 81414 | $772.20 | $1,170.00 | $467.92 – $1,316.03 | 16 |
| Carotene CPT 82380 | $46.20 | $70.00 | $9.22 – $20.75 | 16 |
| Carotid Artery Ultrasound (Duplex) CPT 93880 | $1,024.32 | $1,552.00 | $74.44 – $525.02 | 16 |
| Carpal Tunnel Release Surgery CPT 64721 | not published | not published | not published | 0 |
| Cataract Surgery CPT 66984 | not published | not published | not published | 0 |
| Cath ablt rx lasr 2.0mm turbo HCPCS C1885 | $5,773.02 | $8,747.00 | $3,267.00 – $3,267.00 | 1 |
| Cath acuity innr ic130 6f 63cm HCPCS C1887 | $760.98 | $1,153.00 | $34.10 – $34.10 | 1 |
| Cath acunav ge 10frx90cm HCPCS C1759 | $4,333.56 | $6,566.00 | $3,611.30 – $3,611.30 | 1 |
| Cath adherent clot 10mm 6f 10 HCPCS C1757 | $9,999.00 | $15,150.00 | $722.15 – $722.15 | 1 |
| Cath baloon occl urnry 34f 7x2x65 HCPCS C2628 | $566.18 | $857.85 | $471.82 – $471.82 | 1 |
| Cath bi-dir df smarttouch HCPCS C1732 | $4,158.00 | $6,300.00 | $1,818.85 – $1,818.85 | 1 |
| Cath blazer dx/20 2-10-2 space HCPCS C1731 | $2,037.42 | $3,087.00 | $1,697.85 – $1,697.85 | 1 |
| Cath combo lt&rt heart w/inj/s CPT 93453 | $5,838.36 | $8,846.00 | $1,066.54 – $7,133.53 | 14 |
| Cath cv dl inj 7fx16cm HCPCS C1751 | $270.60 | $410.00 | $225.50 – $225.50 | 1 |
| Cath del ampltz 12f 45d 80cm HCPCS C1893 | $1,867.80 | $2,830.00 | $1,556.50 – $1,556.50 | 1 |
| Catheter declot mechanical CPT 36596 | $1,794.54 | $2,719.00 | $325.87 – $3,463.76 | 14 |
| Catheterization collection of specimen single patient all places of service HCPCS P9612 | $107.58 | $163.00 | $1.19 – $21.02 | 16 |
| Catheter stripping venous CPT 36595 | $3,657.72 | $5,542.00 | $325.87 – $6,947.70 | 14 |
| Cath left heart/lv gram CPT 93452 | $5,239.74 | $7,939.00 | $1,066.54 – $7,133.53 | 14 |
| Cath left heart transseptal punc CPT 93462 | $3,967.26 | $6,011.00 | $1,066.54 – $1,130.53 | 7 |
| Cath lt/rt pulm art CPT 36014 | $823.02 | $1,247.00 | $302.34 – $320.48 | 7 |
| Cath malecot 28fr 4-wing ltx HCPCS C1729 | $763.62 | $1,157.00 | $0.41 – $0.41 | 1 |
| Cath place 1st order venous 36011 CPT 36011 | $711.48 | $1,078.00 | $302.34 – $320.48 | 7 |
| Cath plc art ang/grft lt/rt hr CPT 93461 | $8,234.16 | $12,476.00 | $1,066.54 – $7,133.53 | 14 |
| Cath plc art/angio/rt hrt cath CPT 93456 | $6,586.80 | $9,980.00 | $1,066.54 – $7,133.53 | 14 |
| Cath plc art/grft/angio right hrt CPT 93457 | $7,260.66 | $11,001.00 | $1,066.54 – $7,133.53 | 14 |
| Cath ptca pcltxl agent 3x20mm HCPCS C9610 | $10,593.00 | $16,050.00 | $4,397.70 – $9,894.83 | 9 |
| Cath right heart w/o2 sat & card CPT 93451 | $4,769.16 | $7,226.00 | $1,066.54 – $7,133.53 | 14 |
| Cath right hrt mnpul art CPT 36013 | $561.66 | $851.00 | $302.34 – $320.48 | 7 |
| Cath/saline/contrast/sis/hysteosal 58340 CPT 58340 | $528.00 | $800.00 | $109.57 – $495.60 | 11 |
| Cath segmntl pulm art CPT 36015 | $593.34 | $899.00 | $302.34 – $320.48 | 7 |
| Cath steerable flex adv 12f HCPCS C1766 | $2,574.00 | $3,900.00 | $1,556.50 – $1,556.50 | 1 |
| Cath stripping venous s&i CPT 75901 | $745.14 | $1,129.00 | $89.39 – $495.60 | 11 |
| Cath uret open tp 6fx70cm HCPCS C1758 | $163.35 | $247.50 | $0.80 – $0.80 | 1 |
| Cauterization chemical granulation tissue CPT 17250 | $405.24 | $614.00 | $72.99 – $441.47 | 14 |
| Ccnd1/igh translocation alys CPT 81168 | $478.50 | $725.00 | $165.85 – $466.45 | 16 |
| Cdna analysis for variants CPT 81403 | $396.66 | $601.00 | $148.16 – $416.70 | 16 |
| Cebpa gene full sequence CPT 81218 | $415.14 | $629.00 | $195.07 – $544.28 | 16 |
| Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr HCPCS J0690 | $16.17 | $24.50 | $1.37 – $1.49 | 5 |
| Cefepime 1 gram solution for injection HCPCS J0692 | $16.17 | $24.50 | $1.44 – $2.18 | 5 |
| Cefoxitin 1 gram intravenous solution HCPCS J0694 | $34.06 | $51.60 | $7.62 – $8.48 | 5 |
| Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr HCPCS J0713 | $13.40 | $20.30 | $2.43 – $2.75 | 5 |
| Ceftazidime and avibactam HCPCS J0714 | $324.86 | $492.21 | $83.22 – $235.60 | 16 |
| Ceftriaxone 1 gram solution for injection HCPCS J0696 | $56.81 | $86.08 | $0.76 – $0.82 | 5 |
| Cefuroxime in ns IV syringe 30 mg/ml (neo/ped) - cnr HCPCS J0697 | $16.17 | $24.50 | $3.18 – $3.67 | 5 |
| #celiac hla-dq8 CPT 81383 | $629.64 | $954.00 | $109.13 – $245.54 | 16 |
| Cell count w differential body fluid CPT 89051 | $79.86 | $121.00 | $5.60 – $12.60 | 16 |
| Cell cryopreserve/storage CPT 88240 | $39.60 | $60.00 | $9.83 – $29.41 | 16 |
| Cell marker study CPT 88182 | $546.48 | $828.00 | $11.76 – $121.80 | 16 |
| Certolizumab pegol 400 mg (200 mg x 2 vials) subcutaneous kit HCPCS J0717 | $27.75 | $42.04 | $3.87 – $42.04 | 16 |
| #cf-97variants CPT 81220 | $1,009.14 | $1,529.00 | $210.00 – $1,252.35 | 16 |
| Change cystostomy tube; complex 51710 CPT 51710 | $1,779.36 | $2,696.00 | $178.39 – $1,534.33 | 14 |
| Change cystostomy tube simple CPT 51705 | $543.84 | $824.00 | $38.07 – $549.77 | 14 |
| Change g-tube to g-j perc CPT 49446 | $2,191.20 | $3,320.00 | $171.97 – $4,222.35 | 16 |
| Change nephroureteral cath CPT 50387 | $2,366.10 | $3,585.00 | $155.49 – $4,599.67 | 16 |
| Change of windpipe airway 31502 CPT 31502 | $444.84 | $674.00 | $74.89 – $521.16 | 16 |
| Change stent via transureth CPT 50385 | $3,237.96 | $4,906.00 | $403.87 – $4,599.67 | 16 |
| Change ureter stent percut CPT 50382 | $3,657.72 | $5,542.00 | $422.00 – $4,599.67 | 16 |
| Chemo adm cns w/lmbr punct CPT 96450 | $885.06 | $1,341.00 | $204.01 – $1,341.00 | 16 |
| Chemodenervation anal musc CPT 46505 | not published | not published | not published | 0 |
| Chest 2 vws w oblique CPT 71048 | $355.08 | $538.00 | $24.82 – $456.60 | 16 |
| Chest apical lordotic proj CPT 71047 | $275.88 | $418.00 | $24.82 – $418.00 | 16 |
| Chest CT scan (with and without contrast) CPT 71270 | $1,818.96 | $2,756.00 | $68.61 – $1,215.09 | 16 |
| Chest CT scan (with contrast) CPT 71260 | $1,539.12 | $2,332.00 | $68.61 – $1,215.09 | 16 |
| Chest CT scan (without contrast) CPT 71250 | $1,264.56 | $1,916.00 | $47.18 – $1,215.09 | 16 |
| Chest X-ray CPT 71046 | $275.88 | $418.00 | $24.82 – $418.00 | 16 |
| Chest X-ray (single view) CPT 71045 | $259.38 | $393.00 | $24.82 – $393.00 | 16 |
| Chg pr pul rehab for copd patients CPT 94626 | $137.94 | $209.00 | $15.09 – $129.81 | 14 |
| Chimerism anal no cell selec CPT 81267 | $450.12 | $682.00 | $207.46 – $466.79 | 16 |
| Chlamydia culture CPT 87110 | $131.34 | $199.00 | $19.60 – $44.10 | 16 |
| Chlamydia trachomatis ag if CPT 87270 | $96.36 | $146.00 | $11.98 – $26.96 | 16 |
| Chlamydia type CPT 87140 | $49.50 | $75.00 | $5.57 – $12.53 | 16 |
| Chloride CPT 82435 | $54.12 | $82.00 | $4.60 – $10.35 | 16 |
| Chloride 24 hour urine CPT 82436 | $38.94 | $59.00 | $5.75 – $12.94 | 16 |
| Chloroprocaine hcl injection HCPCS J2401 | $0.26 | $0.39 | $0.05 – $0.07 | 5 |
| Cholangiogram percutaneous compl CPT 47532 | $4,076.16 | $6,176.00 | $393.37 – $7,878.29 | 16 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $691.02 | $1,047.00 | $89.39 – $495.60 | 11 |
| Cholecystostomy complete w/supervision & interpretation CPT 47490 | $4,076.16 | $6,176.00 | $979.32 – $7,878.29 | 14 |
| Cholesterol CPT 82465 | $51.48 | $78.00 | $4.35 – $9.79 | 16 |
| Cholesterol body fluid CPT 84999 | $199.32 | $302.00 | $4.30 – $94.20 | 9 |
| Cholesterol (Lipid) Test CPT 80061 | $89.10 | $135.00 | $13.39 – $30.13 | 16 |
| Chrom analysis CPT 88273 | $398.64 | $604.00 | $34.81 – $78.32 | 16 |
| Chromatography CPT 83021 | $152.46 | $231.00 | $18.06 – $40.64 | 16 |
| Chromogenic substrate assay CPT 85130 | $444.84 | $674.00 | $11.89 – $26.75 | 16 |
| Chromo high res and frag x - sendout CPT 81243 | $237.60 | $360.00 | $54.46 – $128.34 | 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.