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 |
|---|---|---|---|---|
| Complx repair fccmnaxghf 13133 CPT 13133 | $494.34 | $749.00 | $185.89 – $197.04 | 7 |
| Complx repair sal addl 5 cm/> 13122 CPT 13122 | $494.34 | $749.00 | $185.89 – $197.04 | 7 |
| Complx repair trunk 1.1-2.5 cm 13100 CPT 13100 | $898.92 | $1,362.00 | $185.89 – $1,626.25 | 14 |
| Complx repair trunk addl 5cm/< 13102 CPT 13102 | $494.34 | $749.00 | $185.89 – $197.04 | 7 |
| Concentration infection agents any type CPT 87015 | $40.92 | $62.00 | $5.25 – $15.03 | 16 |
| Condylomata destruction 56420 CPT 56420 | $463.98 | $703.00 | $93.40 – $444.86 | 14 |
| Conization/cerv/loop electrode exc 57522 CPT 57522 | not published | not published | not published | 0 |
| Conization of cervix CPT 57520 | not published | not published | not published | 0 |
| Consultation pathology during surgery CPT 88329 | $353.10 | $535.00 | $36.94 – $321.00 | 16 |
| Consultation pathology during surgery cytological exam initial site CPT 88333 | $820.38 | $1,243.00 | $36.94 – $1,772.81 | 16 |
| Consultation pathology during surgery frozen section each additional block CPT 88332 | $168.30 | $255.00 | $30.10 – $153.00 | 11 |
| Consultation pathology during surgery frozen section first tissue block CPT 88331 | $262.68 | $398.00 | $36.94 – $374.88 | 16 |
| Consultation/report referred material w/preparation of slides CPT 88323 | $366.96 | $556.00 | $36.94 – $333.60 | 16 |
| Consultation/report referred slides prepared elsewhere CPT 88321 | $456.72 | $692.00 | $36.53 – $415.20 | 16 |
| Consult comp w/report rfrd material CPT 88325 | $993.96 | $1,506.00 | $36.94 – $903.60 | 16 |
| Contrast exam abdominl aorta 75625-26 CPT 75625 | $3,833.94 | $5,809.00 | $117.12 – $6,947.70 | 16 |
| Contrast exam thoracic aorta 75605-26 CPT 75605 | $6,243.60 | $9,460.00 | $133.02 – $12,244.06 | 16 |
| Contrast x-ray of ankle CPT 73615 | $1,242.78 | $1,883.00 | $52.32 – $767.66 | 16 |
| Contrast x-ray of elbow CPT 73085 | $900.90 | $1,365.00 | $52.32 – $767.66 | 16 |
| Contrast x-ray of hip CPT 73525 | $1,657.92 | $2,512.00 | $52.32 – $767.66 | 16 |
| Contrast x-ray of knee joint CPT 73580 | $955.68 | $1,448.00 | $52.32 – $767.66 | 16 |
| Contrast x-ray of wrist CPT 73115 | $830.94 | $1,259.00 | $52.32 – $767.66 | 16 |
| Control nosebleed pack+caut 30905 CPT 30905 | $411.84 | $624.00 | $74.89 – $292.76 | 14 |
| Control of nosebleed ant comp 30903 CPT 30903 | $434.28 | $658.00 | $74.89 – $292.76 | 14 |
| Control of nosebleedantersmpl 30901 CPT 30901 | $357.72 | $542.00 | $74.89 – $292.76 | 14 |
| Conversion ext bil drg cath CPT 47535 | $4,076.16 | $6,176.00 | $365.43 – $7,878.29 | 16 |
| Convert nephrostomy catheter CPT 50434 | $6,106.32 | $9,252.00 | $647.32 – $4,599.67 | 14 |
| Coombs direct CPT 86880 | $59.40 | $90.00 | $5.57 – $129.81 | 16 |
| Coombs indirect qualitative each reagent red cell reference CPT 86885 | $172.26 | $261.00 | $5.91 – $374.88 | 16 |
| Coombs indirect titer reference CPT 86886 | $172.26 | $261.00 | $5.35 – $374.88 | 16 |
| Core ndl bx lng/med perq CPT 32408 | $4,041.18 | $6,123.00 | $440.45 – $3,634.16 | 14 |
| Cornea pre-cut midwest eye cornea pre-cut midwest eye HCPCS V2785 | $4,327.62 | $6,557.00 | $1,092.03 – $1,573.68 | 8 |
| Coronary angio/cath placement bypass graft/lv gram/lt heart CPT 93459 | $7,242.84 | $10,974.00 | $1,066.54 – $7,133.53 | 14 |
| Coronary angio/lv gram/lt heart CPT 93458 | $8,833.44 | $13,384.00 | $533.27 – $3,566.76 | 14 |
| Coronary angio/lv gram/rt< heart CPT 93460 | $7,684.38 | $11,643.00 | $1,066.54 – $7,133.53 | 14 |
| Coronary art/grft angio s&i CPT 93455 | $8,833.44 | $13,384.00 | $1,066.54 – $7,133.53 | 14 |
| Coronary catheterization w/angiography supervision & interpretation CPT 93454 | $9,716.52 | $14,722.00 | $1,066.54 – $7,133.53 | 14 |
| Coronary thrombolysis/iv infusion 92977 CPT 92977 | $603.24 | $914.00 | $204.01 – $216.25 | 7 |
| Correction of astigmatism CPT 65772 | not published | not published | not published | 0 |
| Corrj halux rigdus without implt CPT 28289 | not published | not published | not published | 0 |
| Cortisol total am CPT 82533 | $99.00 | $150.00 | $16.30 – $36.68 | 16 |
| Cosyntropin 0.25 mg solution for injection HCPCS J0834 | $350.33 | $530.80 | $34.07 – $36.96 | 5 |
| Counseling smoke cess interm >10mins CPT 99407 | $52.80 | $80.00 | $10.20 – $82.45 | 16 |
| Counseling visit to discuss need for ldct g0296 HCPCS G0296 | $106.92 | $162.00 | $95.40 – $223.54 | 9 |
| #coxa-coxsackie a serotype a16 CPT 86658 | $129.36 | $196.00 | $8.17 – $29.32 | 16 |
| C-peptide CPT 84681 | $81.18 | $123.00 | $7.34 – $46.82 | 16 |
| Crbrospnl fld flw imag cistern CPT 78630 | $1,828.86 | $2,771.00 | $389.13 – $1,246.46 | 16 |
| C-reactive protein CPT 86140 | $39.60 | $60.00 | $5.18 – $11.66 | 16 |
| C-reactive protein high sensitivity CPT 86141 | $147.84 | $224.00 | $12.95 – $29.14 | 16 |
| C-reactive protein, quantitative CPT 86406 | $71.28 | $108.00 | $9.85 – $23.94 | 16 |
| Create eardrum opening CPT 69436 | not published | not published | not published | 0 |
| Creatine kinase CPT 82550 | $42.24 | $64.00 | $6.51 – $14.65 | 16 |
| Creatine kinase isoenzymes CPT 82552 | $73.92 | $112.00 | $13.39 – $30.13 | 16 |
| Creatine kinase mb CPT 82553 | $54.12 | $82.00 | $8.66 – $25.99 | 16 |
| Creatine - sendout CPT 82540 | $33.66 | $51.00 | $4.64 – $10.44 | 16 |
| Creatinine CPT 82565 | $31.68 | $48.00 | $5.12 – $11.52 | 16 |
| Creatinine 24 hour urine CPT 82570 | $66.66 | $101.00 | $5.18 – $11.66 | 16 |
| Creatinine clearance urine CPT 82575 | $72.60 | $110.00 | $9.46 – $21.29 | 16 |
| #creutz-prot.,western blot CPT 84182 | $361.68 | $548.00 | $25.31 – $65.72 | 16 |
| Critical care 30-74 minutes CPT 99291 | $2,028.84 | $3,074.00 | $807.82 – $1,817.59 | 9 |
| Cryofibrinogen qualitative - sendout CPT 82585 | $42.24 | $64.00 | $9.02 – $31.82 | 16 |
| Cryoprecipitate each unit HCPCS P9012 | $155.10 | $235.00 | $71.95 – $161.89 | 14 |
| Cryptosporidium antigen CPT 87272 | $89.10 | $135.00 | $11.98 – $26.96 | 16 |
| Crystal identification light microscopy CPT 89060 | $49.50 | $75.00 | $7.33 – $16.49 | 16 |
| Csf leakage imaging CPT 78650 | $1,828.86 | $2,771.00 | $389.13 – $2,848.74 | 16 |
| Cstb gene full gene sequence CPT 81189 | $317.46 | $481.00 | $219.86 – $618.37 | 16 |
| CT 3d report other modality w/workstation CPT 76377 | $724.68 | $1,098.00 | $1,098.00 – $1,098.00 | 5 |
| Cta abdomen without & /or w/contrast CPT 74175 | $1,994.52 | $3,022.00 | $164.22 – $1,215.09 | 16 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $1,907.40 | $2,890.00 | $68.61 – $1,215.09 | 16 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $2,002.44 | $3,034.00 | $164.22 – $1,215.09 | 16 |
| Cta neck without &/or w/contrast CPT 70498 | $1,126.62 | $1,707.00 | $164.22 – $1,215.09 | 16 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $3,358.08 | $5,088.00 | $136.47 – $1,215.09 | 16 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $1,859.88 | $2,818.00 | $68.61 – $1,215.09 | 16 |
| CT Angiogram of the Head CPT 70496 | $2,091.54 | $3,169.00 | $164.22 – $1,215.09 | 16 |
| CT angio hrt w/3d image CPT 75574 | $1,259.28 | $1,908.00 | $164.22 – $1,308.14 | 16 |
| CT angio pelvis CPT 72191 | $1,818.96 | $2,756.00 | $164.22 – $1,215.09 | 16 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $1,818.96 | $2,756.00 | $164.22 – $1,215.09 | 16 |
| CT colonography dx CPT 74261 | $1,119.36 | $1,696.00 | $47.18 – $1,215.09 | 16 |
| CT guidance for needle placement CPT 77012 | $1,263.24 | $1,914.00 | $36.40 – $1,273.00 | 11 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $1,215.06 | $1,841.00 | $89.39 – $495.60 | 11 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | $1,259.28 | $1,908.00 | $134.40 – $1,215.09 | 16 |
| CT hrt w/3d image CPT 75572 | $1,448.04 | $2,194.00 | $134.40 – $1,308.14 | 16 |
| CT limited or localized follow-up study CPT 76380 | $769.56 | $1,166.00 | $47.18 – $1,166.00 | 16 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $1,574.76 | $2,386.00 | $134.40 – $1,215.09 | 16 |
| CT lower extremity without contrast (both sides) CPT 73700 | $1,430.88 | $2,168.00 | $47.18 – $1,215.09 | 16 |
| CT lwr extremity w/o&w/dye CPT 73702 | $1,818.96 | $2,756.00 | $134.40 – $1,215.09 | 16 |
| CT neck soft tissue w/contrast CPT 70491 | $1,595.22 | $2,417.00 | $134.40 – $1,215.09 | 16 |
| CT neck soft tissue without contrast CPT 70490 | $1,259.28 | $1,908.00 | $47.18 – $1,215.09 | 16 |
| CT neck soft tissue without & w/contrast CPT 70492 | $2,091.54 | $3,169.00 | $134.40 – $1,215.09 | 16 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $1,818.96 | $2,756.00 | $134.40 – $1,215.09 | 16 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $1,770.12 | $2,682.00 | $134.40 – $1,215.09 | 16 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $1,351.02 | $2,047.00 | $47.18 – $1,215.09 | 16 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | $322.74 | $489.00 | $74.89 – $521.16 | 14 |
| CT scan for localization CPT 77011 | $1,189.32 | $1,802.00 | $36.40 – $1,273.00 | 11 |
| CT scan for therapy guide CPT 77014 | $1,189.32 | $1,802.00 | $36.40 – $1,273.00 | 11 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $3,550.14 | $5,379.00 | $134.40 – $1,215.09 | 16 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $3,016.86 | $4,571.00 | $67.20 – $1,215.09 | 16 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $2,544.96 | $3,856.00 | $93.34 – $1,215.09 | 16 |
| CT thoracic spine w/contrast CPT 72129 | $1,539.12 | $2,332.00 | $134.40 – $1,215.09 | 16 |
| CT thoracic spine without contrast CPT 72128 | $1,448.04 | $2,194.00 | $47.18 – $1,215.09 | 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.