SSM Health Waupun Memorial Hospital
620 W Brown St, Waupun, WI · SSM Health · · NPI 1548248644
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 |
|---|---|---|---|---|
| Bx/exc lymph node/open/deep cervic 38510 CPT 38510 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Bx/exc lymph node/open/superfic 38500 CPT 38500 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Bx/exc xdrl spine lesn lmbr CPT 63277 | not published | not published | $6,779.00 – $27,583.00 | 3 |
| Bx leg/ankle soft tissue deep 27614 CPT 27614 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Bx liver with other CPT 47001 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Bx muscle CPT 20200 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Bx nasopharynx/unknown pri lesion 42806 CPT 42806 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Bx of breast open 19101 CPT 19101 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Bx of cervix w/scope leep 57460 CPT 57460 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Bx pancreas pq ndl CPT 48102 | $1,045.55 | $1,901.00 | $3,388.00 – $4,761.00 | 3 |
| Bx perianal mass CPT 46999 | not published | not published | $2,959.00 – $10,779.00 | 3 |
| Bx pleura pq ndl CPT 32400 | $378.40 | $688.00 | $3,388.00 – $4,761.00 | 3 |
| Bx prst8 ndl sat sampling CPT 55706 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Bx shoulder tissues deep 23066 CPT 23066 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Bx shoulder tissues supf 23065 CPT 23065 | $3,244.45 | $5,899.00 | $2,959.00 – $3,388.00 | 3 |
| Bx skin incisnl ea sep/add l les CPT 11107 | $624.80 | $1,136.00 | $1,887.00 – $5,512.00 | 3 |
| Bx skin punch ea sep/ addl les CPT 11105 | $394.35 | $717.00 | $1,887.00 – $5,512.00 | 3 |
| Bx skin tangential ea sep/ addl les CPT 11103 | $394.35 | $717.00 | $1,887.00 – $5,512.00 | 3 |
| Bx/soft tis/forearm/wrist/superfic 25065 CPT 25065 | not published | not published | $2,959.00 – $3,388.00 | 3 |
| Bx soft tiss pelvis+hip area supf 27040 CPT 27040 | not published | not published | $2,959.00 – $3,388.00 | 3 |
| Bx soft tiss pelvis/hip deep 27041 CPT 27041 | not published | not published | $2,959.00 – $3,388.00 | 3 |
| Bx soft tissue back/flank deep 21925 CPT 21925 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Bx soft tissue back/flank supf 21920 CPT 21920 | not published | not published | $2,959.00 – $3,388.00 | 3 |
| Bx spinal cord pq ndl CPT 62269 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Bx thigh/knee soft tiss supf 27323 CPT 27323 | not published | not published | $2,959.00 – $3,388.00 | 3 |
| Bx thyroid/percutan core needle 60100 CPT 60100 | $1,092.30 | $1,986.00 | $2,654.00 – $3,030.00 | 3 |
| Bx vag mucos smpl (sep proc) CPT 57100 | not published | not published | $2,654.00 – $3,030.00 | 3 |
| Bx vulva or perineum/1 lesion 56605 CPT 56605 | $227.15 | $413.00 | $2,654.00 – $3,030.00 | 3 |
| Bx vulva or perineum/ea add lesion 56606 CPT 56606 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Bypass temp external fem-fem CPT 37799 | $1,780.35 | $3,237.00 | $2,959.00 – $10,779.00 | 3 |
| C-1 esterase, berinert HCPCS J0597 | not published | not published | $78.45 – $197.27 | 5 |
| C-1 esterase, cinryze HCPCS J0598 | not published | not published | $69.37 – $174.44 | 5 |
| C1 esterase inhibitor func - sendout CPT 86161 | $87.45 | $159.00 | $12.00 – $24.29 | 4 |
| Cabazitaxel 10 mg/ml (first dilution) intravenous solution HCPCS J9043 | not published | not published | $242.62 – $610.09 | 5 |
| Cabergoline, oral 0.25mg HCPCS J8515 | not published | not published | $49.90 – $49.90 | 1 |
| Cabg 2 arterial grafts 33534 CPT 33534 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Cabg 3 arterial grafts 33535 CPT 33535 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Cabg arterial four or more 33536 CPT 33536 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Cabgsingle artery graft 33533 CPT 33533 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Cabgsingle coronary venous graft 33510 CPT 33510 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Cabg/valve reop >1 mo p org proced 33530 CPT 33530 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Cabg/vein only/2 cor venous gfts 33511 CPT 33511 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Cabg/vein only/3 cor venous gfts 33512 CPT 33512 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Cabg/vein only/4 cor venous gfts 33513 CPT 33513 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Cabg venous & art 1 vein graft 33517 CPT 33517 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Cabg venous & art 2 vein graft 33518 CPT 33518 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Cabg venous & art 3 vein graft 33519 CPT 33519 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Cabg venous & art 4 vein graft 33521 CPT 33521 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Cabg venous & art 5 vein graft 33522 CPT 33522 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Cabg venous & art 6 vein graft 33523 CPT 33523 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Cable cath 22-pin diag HCPCS C1730 | $1,101.74 | $2,003.16 | not published | 0 |
| Cabotegravir ER 400 mg/2 ml-rilpivirine ER 600 mg/2ml im suspension,er HCPCS J0741 | not published | not published | $25.09 – $63.08 | 5 |
| Cacna1a gene full gene seq CPT 81185 | not published | not published | $846.27 – $1,480.97 | 4 |
| Cadd pump refill CPT 96521 | $380.60 | $692.00 | not published | 0 |
| Caffeine citrate 20 mg/ml inj for po HCPCS J0706 | not published | not published | $5.48 – $5.48 | 1 |
| Calaspargase pegol-mknl 750 unit/ml intravenous solution HCPCS J9118 | not published | not published | $82.85 – $208.35 | 5 |
| Calcitonin (salmon) 200 unit/ml injection solution HCPCS J0630 | not published | not published | $1,236.91 – $3,110.22 | 3 |
| Calcium 24 hour urine CPT 82340 | $57.75 | $105.00 | $6.03 – $12.20 | 4 |
| Calcium acetate(phosphate binders) 667 mg tablet HCPCS J0615 | not published | not published | $0.08 – $0.08 | 1 |
| Calcium gluconate 100 mg/ml (10 %) intravenous solution HCPCS J0612 | not published | not published | $0.04 – $0.12 | 5 |
| Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution HCPCS J0613 | not published | not published | $0.09 – $0.30 | 5 |
| Calcium ionized CPT 82330 | $95.15 | $173.00 | $13.68 – $27.68 | 4 |
| Calcium total CPT 82310 | $43.45 | $79.00 | $5.16 – $10.44 | 4 |
| Calculi urinary-sendout CPT 82360 | not published | not published | $12.87 – $26.03 | 4 |
| Calculus analysis qual CPT 82355 | not published | not published | $11.58 – $23.42 | 4 |
| Calprotectin fecal CPT 83993 | $36.85 | $67.00 | $19.63 – $39.72 | 4 |
| Campylobacter antibody CPT 86625 | not published | not published | $11.77 – $22.96 | 4 |
| Canakinumab injection HCPCS J0638 | not published | not published | $147.12 – $369.93 | 5 |
| Candida dna CPT 87480 | not published | not published | $20.05 – $40.58 | 4 |
| Candida skin test CPT 86485 | not published | not published | $22.99 – $27.46 | 2 |
| Cannula declotting 36861 CPT 36861 | not published | not published | $4,428.00 – $18,364.00 | 3 |
| Cannula ercp contour 5-4-3 tip HCPCS C1889 | $13,352.53 | $24,277.32 | not published | 0 |
| Cantharidin top, applicator HCPCS J7354 | not published | not published | $750.49 – $1,937.74 | 5 |
| Canthotomy 67715 CPT 67715 | $3,741.65 | $6,803.00 | $3,388.00 – $7,791.00 | 3 |
| Capecitabine, oral, 50 mg HCPCS J8522 | not published | not published | $0.05 – $0.12 | 5 |
| Cap nerve 2x15mm HCPCS C1763 | $1,157.82 | $2,105.12 | not published | 0 |
| Capsaicin 8% patch HCPCS J7336 | not published | not published | $3.61 – $9.06 | 5 |
| Capsular contracture release CPT 23020 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Capsulotomy; interphalangeal joint, each joint (separate proc) CPT 28272 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Capsulotomy mpj ea joint (sep proc) CPT 28270 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Cap trach decann 15mm HCPCS C1750 | $716.59 | $1,302.89 | not published | 0 |
| Carbamazepine free CPT 80157 | not published | not published | $13.25 – $26.82 | 4 |
| Carbamazepine free -sendout CPT 80161 | $30.80 | $56.00 | $18.64 – $32.62 | 4 |
| Carbamazepine total therapeutic drug level CPT 80156 | $135.85 | $247.00 | $14.57 – $29.46 | 4 |
| Carbidopa levodopa ent 100ml HCPCS J7340 | not published | not published | $255.47 – $642.38 | 5 |
| Carbohydrate deficient transf - sendout CPT 82373 | not published | not published | $18.06 – $36.53 | 4 |
| Carbohydrate urine - sendout CPT 84377 | not published | not published | $5.50 – $11.12 | 4 |
| Carbon dioxide CPT 82374 | $45.65 | $83.00 | $4.88 – $9.90 | 4 |
| Carboplatin 10 mg/ml desensitization HCPCS J9045 | not published | not published | $3.22 – $9.88 | 5 |
| Carboxyhemoglobin quantitative CPT 82375 | $116.05 | $211.00 | $12.32 – $24.92 | 4 |
| Carcinoembryonic ag (cea) CPT 82378 | $158.40 | $288.00 | $18.96 – $38.38 | 4 |
| Cardiac MRI w/stress img CPT 75559 | not published | not published | $969.06 – $969.06 | 1 |
| Cardiac perf planar mult/ef/wm CPT 78454 | not published | not published | $1,282.01 – $1,282.01 | 1 |
| Cardiac perf planar sgl/ef/wm CPT 78453 | not published | not published | $880.89 – $880.89 | 1 |
| Cardiac perf spect sgl/ef/wm rst/strs CPT 78451 | $2,038.30 | $3,706.00 | $948.60 – $948.60 | 1 |
| Cardiac rehabilitation op phase 2 w/continous ecg monitoring CPT 93798 | $369.60 | $672.00 | not published | 0 |
| Cardiac rehabilitation op phase 2 without continous ecg monitoring CPT 93797 | $238.70 | $434.00 | not published | 0 |
| Cardiac shunt imaging CPT 78428 | not published | not published | $492.82 – $492.82 | 1 |
| Cardiokymography HCPCS Q0035 | not published | not published | $39.93 – $39.93 | 1 |
| Cardiolipin antibody iga CPT 86147 | $35.75 | $65.00 | $11.77 – $44.54 | 4 |
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.