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 |
|---|---|---|---|---|
| Amputation thru metatarsal CPT 28805 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Amputation toe interphalangeal joint CPT 28825 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Amputation toe metatarsophalangeal joint CPT 28820 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Amylase CPT 82150 | $62.70 | $114.00 | $6.48 – $13.12 | 4 |
| Anacaulase-bcdb 8.8% gel 1 g HCPCS J7353 | not published | not published | $155.15 – $155.15 | 1 |
| Ana ds-dna CPT 86226 | not published | not published | $12.11 – $24.48 | 4 |
| Analgesics non-opioid definitive assay 1 or 2 acetaminophen CPT 80329 | $34.65 | $63.00 | $35.06 – $35.06 | 1 |
| Anal pressure record CPT 91122 | not published | not published | $1,887.00 – $2,334.00 | 2 |
| Anal/urinary muscle study CPT 51784 | $464.97 | $845.40 | $1,887.00 – $5,512.00 | 3 |
| Anal/urinary muscle study CPT 51785 | $602.80 | $1,096.00 | $1,887.00 – $5,512.00 | 3 |
| Analysis gene f2 20210g>a variant CPT 81240 | $315.70 | $574.00 | $65.69 – $114.96 | 4 |
| Analysis gene f5 leiden variant CPT 81241 | $434.50 | $790.00 | $73.37 – $128.40 | 4 |
| Analysis nerve CPT 88356 | not published | not published | $49.47 – $118.33 | 2 |
| Analysis; simple cranial nerv pulse gen prgrmg 95976 CPT 95976 | $216.48 | $393.60 | not published | 0 |
| Analysis tumor CPT 88358 | not published | not published | $56.20 – $143.50 | 2 |
| Anaplsma phgcytophlm amp prb CPT 87468 | $64.90 | $118.00 | $35.09 – $61.41 | 4 |
| Anastamo/extrahep bil duct/gi trac 47760 CPT 47760 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Anastamo/roux-en-y/extrahep bil/gi 47780 CPT 47780 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Anastomosis of facial/other nerve 64868 CPT 64868 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Anca screen with reflex to titer -quest CPT 86021 | $24.75 | $45.00 | $15.05 – $30.47 | 4 |
| An cholangiogram percutaneous compl CPT 47531 | $2,426.60 | $4,412.00 | $3,735.00 – $8,770.00 | 3 |
| Androstanediol CPT 82154 | not published | not published | $28.83 – $58.36 | 4 |
| An fluoro guide for cvp CPT 77001 | $365.20 | $664.00 | $171.09 – $171.09 | 1 |
| Angio balloon ctrl dialysis seg add-on CPT 36907 | $326.15 | $593.00 | $1,887.00 – $2,334.00 | 2 |
| Angioplasty fem/pop unilat 37224 CPT 37224 | $7,081.80 | $12,876.00 | $6,019.00 – $18,364.00 | 3 |
| Angioplasty/iliac/init ves/unilat 37220 CPT 37220 | $7,102.15 | $12,913.00 | $6,019.00 – $18,364.00 | 3 |
| Angioplasty tib/pero/unilat/ea add 37232 CPT 37232 | $5,981.25 | $10,875.00 | $5,512.00 – $18,364.00 | 3 |
| Angiotensin ii CPT 82163 | not published | not published | $20.52 – $40.27 | 4 |
| Angio tib/peroneal/init ves/unila 37228 CPT 37228 | $8,132.85 | $14,787.00 | $7,609.00 – $18,364.00 | 3 |
| Angio trnslmnl balloon same artery ea addl CPT 37247 | $3,987.50 | $7,250.00 | $1,887.00 – $2,334.00 | 2 |
| Angio trnslmnl balloon same artery ini CPT 37246 | $8,050.90 | $14,638.00 | $17,314.00 – $18,364.00 | 2 |
| Angio trnslmnl balloon same vein ea addl CPT 37249 | not published | not published | $1,887.00 – $2,334.00 | 2 |
| Angio trnslmnl balloon same vein ini CPT 37248 | $7,935.95 | $14,429.00 | $17,314.00 – $18,364.00 | 2 |
| Anidulafungin injection HCPCS J0348 | not published | not published | $0.52 – $1.39 | 5 |
| Ankle arthroscopy/surgery CPT 29891 | not published | not published | $3,735.00 – $18,364.00 | 3 |
| Ankle arthroscopy/surgery CPT 29892 | not published | not published | $6,779.00 – $16,106.00 | 3 |
| Ankle arthroscopy/surgery CPT 29894 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Ankle arthroscopy/surgery CPT 29895 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Ankle arthroscopy/surgery CPT 29897 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Ankle arthroscopy/surgery CPT 29898 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Ankle arthroscopy/surgery CPT 29899 | not published | not published | $10,779.00 – $18,364.00 | 3 |
| Ankle X-ray CPT 73610 | $304.15 | $553.00 | $74.37 – $74.37 | 1 |
| Anl sp inf pmp w/mdreprg&fil CPT 62370 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Anodyne therapy charges pt CPT 97026 | $37.40 | $68.00 | not published | 0 |
| Anora (draw only) CPT 99001 | not published | not published | $6.14 – $6.14 | 1 |
| Anorectal myomectomy CPT 45108 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Anoscopy CPT 46611 | not published | not published | $2,654.00 – $4,761.00 | 3 |
| Anoscopy ablation lesion 46615 CPT 46615 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Anoscopy and biopsy CPT 46606 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Anoscopy and dilation 46604 CPT 46604 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Anoscopy control bleeding 46614 CPT 46614 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Anoscopy remove fb 46608 CPT 46608 | $1,208.35 | $2,197.00 | $2,654.00 – $4,761.00 | 3 |
| Anoscopy remove lesion 46610 CPT 46610 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Anoscopy remove lesions w/cautery/snare 46612 CPT 46612 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Ant colporrhaphy/rpr cyctocele 57240 CPT 57240 | not published | not published | $4,428.00 – $8,770.00 | 3 |
| Antibody CPT 86744 | not published | not published | $11.77 – $27.98 | 4 |
| Antibody bacterium, not elsewhere specified CPT 86609 | $21.45 | $39.00 | $11.77 – $22.54 | 4 |
| Antibody elution rbc reference CPT 86860 | $99.55 | $181.00 | $43.19 – $143.50 | 2 |
| Antibody htlv/hiv confirm test CPT 86689 | $98.45 | $179.00 | $19.35 – $39.17 | 4 |
| Antibody htlv-i CPT 86687 | not published | not published | $9.09 – $16.98 | 4 |
| Antibody htlv-ii CPT 86688 | not published | not published | $14.00 – $28.34 | 4 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $271.15 | $493.00 | $18.37 – $37.16 | 4 |
| Antibody id rbc panel CPT 86870 | $446.60 | $812.00 | $59.47 – $283.41 | 2 |
| Antibody influenza virus CPT 86710 | not published | not published | $13.55 – $27.43 | 4 |
| Antibody lymphocytic choriomeningitis CPT 86727 | not published | not published | $11.77 – $22.52 | 4 |
| Antibody screen rbc CPT 86850 | $76.45 | $139.00 | $7.75 – $17.10 | 4 |
| Antibody tetanus CPT 86774 | not published | not published | $14.80 – $29.95 | 4 |
| Antidepressant not specified CPT 80338 | $188.10 | $342.00 | not published | 0 |
| Antihemophilic factor-vwf 250 unit-600 unit intravenous solution HCPCS J7187 | not published | not published | $1.56 – $3.94 | 5 |
| Antihemophilic viii/vwf comp HCPCS J7186 | not published | not published | $1.30 – $3.27 | 5 |
| Anti-inhibitor HCPCS J7198 | not published | not published | $2.56 – $6.42 | 5 |
| Anti mog serum - sendout CPT 86362 | $69.85 | $127.00 | $12.05 – $21.09 | 4 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $19.80 | $36.00 | $12.05 – $21.09 | 4 |
| Antineutrophil cytoplasmic antibody titer each antibody CPT 86037 | not published | not published | $12.05 – $21.09 | 4 |
| Ant instr 2-3 vert segm 22845 CPT 22845 | not published | not published | $5,512.00 – $18,364.00 | 3 |
| Ant instrumentation/4-7 vert seg 22846 CPT 22846 | not published | not published | $3,388.00 – $18,364.00 | 3 |
| Antinuclear antibodies CPT 86038 | $89.10 | $162.00 | $12.09 – $21.16 | 4 |
| Antinuclear antibodies titer CPT 86039 | $94.05 | $171.00 | $11.16 – $22.57 | 4 |
| Antiphosphatidylserine antibody CPT 86148 | not published | not published | $11.77 – $28.12 | 4 |
| Antistreptolysin o screen CPT 86063 | not published | not published | $5.77 – $11.68 | 4 |
| Antistreptolysin o titer CPT 86060 | $62.70 | $114.00 | $7.30 – $14.77 | 4 |
| Antithrombin iii activity CPT 85300 | $102.85 | $187.00 | $11.85 – $24.00 | 4 |
| Antithrombin iii injection HCPCS J7197 | not published | not published | $4.29 – $10.77 | 5 |
| Anti-thymocyte glob (equine)(1:1000) intradermal test dose HCPCS J7504 | not published | not published | $4,716.06 – $11,858.47 | 5 |
| Antithymocyte globuln rabbit HCPCS J7511 | not published | not published | $1,028.87 – $2,587.08 | 5 |
| Ant/post colporrhap/enterocele rpr 57265 CPT 57265 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Aortic circulation assist 33971 CPT 33971 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Aortic dysfunction/dilation CPT 81410 | not published | not published | $504.00 – $882.00 | 4 |
| Aortic dysfunction/dilation CPT 81411 | not published | not published | $1,350.19 – $2,362.83 | 4 |
| Aortic hemiarch graft 33866 CPT 33866 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Apc gene dup/delet variants CPT 81203 | not published | not published | $200.00 – $350.00 | 4 |
| Apc gene full sequence CPT 81201 | not published | not published | $780.00 – $1,365.00 | 4 |
| Apc gene known fam variants CPT 81202 | not published | not published | $280.00 – $490.00 | 4 |
| Apheresis immunoads slctv CPT 36516 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Apheresis plasma CPT 36514 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Apheresis platelets CPT 36513 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Apheresis rbc CPT 36512 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Apheresis wbc CPT 36511 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Apl(pml-rara) quant - sendout CPT 81315 | not published | not published | $207.31 – $419.51 | 4 |
| Appendectomy CPT 44950 | not published | not published | $3,735.00 – $8,770.00 | 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.