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 |
|---|---|---|---|---|
| Cardioversion elective electrical conversion arrhythmia external CPT 92960 | $1,458.05 | $2,651.00 | $2,959.00 – $3,030.00 | 2 |
| Cardioversion/elective/internal 92961 CPT 92961 | not published | not published | $2,959.00 – $3,030.00 | 2 |
| Card MRI veloc flow mapping CPT 75565 | not published | not published | $141.39 – $141.39 | 1 |
| Caregiver training strategies&tq 1st 30 minutes CPT 97550 | $75.90 | $138.00 | not published | 0 |
| Caregiver training strategies&tq ea addl 15 min CPT 97551 | $66.00 | $120.00 | not published | 0 |
| Carfilzomib 10 mg intravenous solution HCPCS J9047 | not published | not published | $56.26 – $141.49 | 5 |
| Car ion chnnlpath inc 10 gns CPT 81413 | not published | not published | $584.90 – $1,191.84 | 4 |
| Car ion chnnlpath inc 2 gns CPT 81414 | not published | not published | $584.90 – $1,191.84 | 4 |
| Carmustine 100 mg intravenous powder for solution HCPCS J9050 | not published | not published | $160.16 – $695.11 | 5 |
| Carotene CPT 82380 | $17.05 | $31.00 | $9.22 – $18.67 | 4 |
| Carotid Artery Ultrasound (Duplex) CPT 93880 | $963.05 | $1,751.00 | not published | 0 |
| Car outp meas drg cath chd CPT 93598 | not published | not published | $1,887.00 – $2,334.00 | 2 |
| Carpal Tunnel Release Surgery CPT 64721 | $6,884.35 | $12,517.00 | $3,170.00 – $7,791.00 | 4 |
| Car seat/bed test 60 minutes CPT 94780 | $277.75 | $505.00 | not published | 0 |
| Car seat/bed test additional 30 minutes CPT 94781 | $137.50 | $250.00 | not published | 0 |
| Ca screen;flexi sigmoidscope HCPCS G0104 | not published | not published | $2,654.00 – $3,030.00 | 3 |
| Caspofungin acetate HCPCS J0637 | not published | not published | $3.67 – $13.78 | 5 |
| Cataract Surgery CPT 66984 | not published | not published | $3,388.00 – $7,791.00 | 4 |
| Cataract surg w/iol 1 stage CPT 66983 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Catecholamines,fractionated, urine CPT 82382 | not published | not published | $27.30 – $47.78 | 4 |
| Cath 2lum 14.5frx43cm maxid kt mahurkar HCPCS C1752 | $245.46 | $446.30 | not published | 0 |
| Cath ablat bi-d d-d 8fr 115cm HCPCS C2630 | $5,652.30 | $10,276.91 | not published | 0 |
| Cath ablt clsfast 7fx100cmx HCPCS C1888 | $1,215.42 | $2,209.85 | not published | 0 |
| Cath ablt rx lasr 2.0mm turbo HCPCS C1885 | $3,473.59 | $6,315.62 | not published | 0 |
| Cath access del ds spyscop 2.0 HCPCS C1748 | $5,244.39 | $9,535.25 | not published | 0 |
| Cath acuity innr ic130 6f 63cm HCPCS C1887 | $431.89 | $785.26 | not published | 0 |
| Cath acunav ge 10frx90cm HCPCS C1759 | $2,516.53 | $4,575.51 | not published | 0 |
| Cath adherent clot 10mm 6f 10 HCPCS C1757 | $5,393.98 | $9,807.24 | not published | 0 |
| Cath blazer dx/20 2-10-2 space HCPCS C1731 | $421.43 | $766.23 | not published | 0 |
| Cath combo lt&rt heart w/inj/s CPT 93453 | $8,723.00 | $15,860.00 | $3,735.00 – $16,106.00 | 3 |
| Cath cv dl inj 7fx16cm HCPCS C1751 | $1,072.48 | $1,949.96 | not published | 0 |
| Cath del ampltz 12f 45d 80cm HCPCS C1893 | $1,154.24 | $2,098.61 | not published | 0 |
| Catheter declot mechanical CPT 36596 | $1,073.05 | $1,951.00 | $2,959.00 – $3,388.00 | 3 |
| Catheter insert artery CPT 36625 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Catheterization collection of specimen single patient all places of service HCPCS P9612 | not published | not published | $3.00 – $15.91 | 4 |
| Catheter stripping venous CPT 36595 | $3,239.50 | $5,890.00 | $3,735.00 – $8,770.00 | 3 |
| Cath groshong MRI 8fr plstc port HCPCS C1788 | $537.61 | $977.47 | not published | 0 |
| Cath hawkone s directional HCPCS C1714 | $3,306.29 | $6,011.43 | not published | 0 |
| Cath imag ivus pv 8.5fx90 .035 HCPCS C1753 | $2,595.30 | $4,718.73 | not published | 0 |
| Cathj rmvl dev ischmc rmdlg CPT 53866 | not published | not published | $2,654.00 – $2,654.00 | 1 |
| Cathj umbilical vein dx/ther nb CPT 36510 | $106.15 | $193.00 | $1,887.00 – $5,512.00 | 3 |
| Cath left heart/lv gram CPT 93452 | not published | not published | $3,735.00 – $16,106.00 | 3 |
| Cath left heart transseptal punc CPT 93462 | $4,416.50 | $8,030.00 | $1,887.00 – $5,512.00 | 3 |
| Cath lt/rt pulm art CPT 36014 | $1,823.80 | $3,316.00 | $1,887.00 – $5,512.00 | 3 |
| Cath malecot 28fr 4-wing ltx HCPCS C1729 | $911.50 | $1,657.28 | not published | 0 |
| Cath occl flo-rester 2.25x12mm cor internal vessel occluder HCPCS C1817 | $20,316.15 | $36,938.45 | not published | 0 |
| Cath place 1st order venous 36011 CPT 36011 | $1,492.70 | $2,714.00 | $1,887.00 – $5,512.00 | 3 |
| Cath place cardio brachytx CPT 92974 | not published | not published | $1,887.00 – $2,334.00 | 2 |
| Cath plc art ang/grft lt/rt hr CPT 93461 | $5,959.80 | $10,836.00 | $3,735.00 – $16,106.00 | 3 |
| Cath plc art/angio/rt hrt cath CPT 93456 | $8,820.90 | $16,038.00 | $3,735.00 – $16,106.00 | 3 |
| Cath plc art/grft/angio right hrt CPT 93457 | not published | not published | $3,735.00 – $16,106.00 | 3 |
| Cath right heart w/o2 sat & card CPT 93451 | $3,161.95 | $5,749.00 | $3,735.00 – $16,106.00 | 3 |
| Cath right hrt mnpul art CPT 36013 | $1,617.55 | $2,941.00 | $1,887.00 – $5,512.00 | 3 |
| Cath/saline/contrast/sis/hysteosal 58340 CPT 58340 | $237.60 | $432.00 | $1,887.00 – $5,512.00 | 3 |
| Cath segmntl pulm art CPT 36015 | $1,662.65 | $3,023.00 | $1,887.00 – $5,512.00 | 3 |
| Cath steerable flex adv 12f HCPCS C1766 | $1,911.44 | $3,475.34 | not published | 0 |
| Cath stripping venous s&i CPT 75901 | $983.40 | $1,788.00 | $510.42 – $510.42 | 1 |
| Cath uret open tp 6fx70cm HCPCS C1758 | $116.00 | $210.90 | not published | 0 |
| Cauterization chemical granulation tissue CPT 17250 | $564.85 | $1,027.00 | $1,887.00 – $2,654.00 | 3 |
| Cauterization of cervix 57510 CPT 57510 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| #cbg+cort-cbg CPT 84449 | not published | not published | $18.00 – $36.43 | 4 |
| Ccnd1/igh translocation alys CPT 81168 | not published | not published | $207.31 – $362.79 | 4 |
| Cdna analysis for variants CPT 81403 | $493.90 | $898.00 | $185.20 – $324.10 | 4 |
| Cebpa gene full sequence CPT 81218 | not published | not published | $241.90 – $489.48 | 4 |
| Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr HCPCS J0690 | not published | not published | $0.89 – $2.21 | 5 |
| Cefepime 1 gram solution for injection HCPCS J0692 | not published | not published | $1.32 – $3.38 | 5 |
| Cefotaxime sodium injection HCPCS J0698 | not published | not published | $16.45 – $16.45 | 1 |
| Cefoxitin 1 gram intravenous solution HCPCS J0694 | not published | not published | $4.82 – $12.11 | 5 |
| Ceftaroline fosamil 600 mg intravenous solution HCPCS J0712 | not published | not published | $4.27 – $10.76 | 5 |
| Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr HCPCS J0713 | not published | not published | $1.76 – $4.49 | 5 |
| Ceftazidime and avibactam HCPCS J0714 | not published | not published | $109.06 – $274.23 | 5 |
| Ceftriaxone 1 gram solution for injection HCPCS J0696 | not published | not published | $0.48 – $1.22 | 5 |
| Cefuroxime in ns IV syringe 30 mg/ml (neo/ped) - cnr HCPCS J0697 | not published | not published | $2.04 – $5.15 | 5 |
| #celiac hla-dq2 CPT 81377 | not published | not published | $94.74 – $185.77 | 4 |
| #celiac hla-dq8 CPT 81383 | $289.85 | $527.00 | $109.13 – $220.84 | 4 |
| Cell count body fluid CPT 89050 | not published | not published | $4.72 – $9.58 | 4 |
| Cell count w differential body fluid CPT 89051 | $70.95 | $129.00 | $5.60 – $11.15 | 4 |
| Cell cryopreserve/storage CPT 88240 | not published | not published | $13.07 – $22.87 | 4 |
| Cell enumeration & id CPT 86152 | not published | not published | $250.78 – $497.20 | 4 |
| Cell function assay w/stim CPT 86352 | $224.40 | $408.00 | $135.86 – $274.91 | 4 |
| Cell marker study CPT 88182 | $124.85 | $227.00 | $49.47 – $107.12 | 2 |
| Cemiplimab-rwlc 50 mg/ml intravenous solution HCPCS J9119 | not published | not published | $30.54 – $76.81 | 5 |
| Centralization wrist on ulna CPT 25335 | not published | not published | $3,735.00 – $16,106.00 | 3 |
| Centruroides immune f(ab) HCPCS J0716 | not published | not published | $13,065.56 – $13,065.56 | 1 |
| Cerclage cervix pregnancy abdominal 59325 CPT 59325 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Cerclage of uterine cervix nonob 57700 CPT 57700 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Cerebrospinal fld flw imag CPT 78645 | $855.80 | $1,556.00 | $1,019.92 – $1,019.92 | 1 |
| Certolizumab pegol 400 mg (200 mg x 2 vials) subcutaneous kit HCPCS J0717 | not published | not published | $4.22 – $10.63 | 5 |
| Cervical lymphadenectomy 38720 CPT 38720 | not published | not published | $7,529.00 – $7,791.00 | 3 |
| Cervical or vaginal cancer screening g0101 HCPCS G0101 | $47.93 | $87.15 | not published | 0 |
| Cesarean section delivery only 59514 CPT 59514 | not published | not published | $3,388.00 – $3,388.00 | 1 |
| Cetuximab 100 mg/50 ml intravenous solution HCPCS J9055 | not published | not published | $83.47 – $209.91 | 5 |
| #cf-97variants CPT 81220 | $1,322.75 | $2,405.00 | $556.60 – $974.05 | 4 |
| Cftr gene dup/delet variants CPT 81222 | not published | not published | $435.07 – $761.37 | 4 |
| Cftr gene intron poly t CPT 81224 | not published | not published | $168.75 – $295.31 | 4 |
| Cftr gene known fam variants CPT 81221 | not published | not published | $97.22 – $170.14 | 4 |
| Change cystostomy tube; complex 51710 CPT 51710 | not published | not published | $2,654.00 – $3,030.00 | 3 |
| Change cystostomy tube simple CPT 51705 | $738.65 | $1,343.00 | $1,887.00 – $2,654.00 | 3 |
| Change gastric port open CPT 43888 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Change g-tube to g-j perc CPT 49446 | $1,558.70 | $2,834.00 | $3,388.00 – $4,761.00 | 3 |
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.