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 |
|---|---|---|---|---|
| Appendectomy add-on 44955 CPT 44955 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Appendectomy/open/rup/w/absc/peri 44960 CPT 44960 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Appendix Removal (Laparoscopic) CPT 44970 | not published | not published | $5,257.00 – $18,364.00 | 3 |
| App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm CPT 15277 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| App high cost ss f/n/g/h/f >100sq cm addl 100sq cm CPT 15278 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| App high cost ss f/n/g/h/f <100sq cm addl <25sq cm CPT 15276 | $232.65 | $423.00 | $1,887.00 – $5,512.00 | 3 |
| App high cost ss t/a/l >100sq cm 1st 100sq cm CPT 15273 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| App high cost ss t/a/l >100sq cm addl 100sq cm CPT 15274 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| App high cost ss t/a/l <100sq cm addl <25sq cm CPT 15272 | $223.85 | $407.00 | $1,887.00 – $5,512.00 | 3 |
| Appl bdy cst sho to hip 1thi CPT 29044 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Appl bdy cst sho to hip b th CPT 29046 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Appl bdy cst sho to hip head CPT 29040 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Appl body cast sho to hips CPT 29035 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Appl cast figure-of-eight CPT 29049 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Appl cast plaster velpeau CPT 29058 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Appl cast shoulder spica CPT 29055 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Appl halo type body cast CPT 29000 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Appl hip spica cast1&1/2 CPT 29325 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Appl hip spica cast 1 leg CPT 29305 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Application clubfoot cast CPT 29450 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Application finger splntstatic 29130 CPT 29130 | $179.30 | $326.00 | $1,887.00 – $2,654.00 | 3 |
| Application halo femoral CPT 20663 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Application halo pelvic CPT 20662 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Application long leg splint 29505 CPT 29505 | $314.60 | $572.00 | $1,887.00 – $2,654.00 | 3 |
| Application lower leg splint 29515 CPT 29515 | $314.60 | $572.00 | $1,887.00 – $2,654.00 | 3 |
| Application multi layer compression below knee (both sides) CPT 29581 | $702.90 | $1,278.00 | $1,887.00 – $2,654.00 | 3 |
| Application of body cast CPT 29010 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Application of body cast CPT 29015 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Application of cylinder cast 29365 CPT 29365 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Application of forearm cast 29075 CPT 29075 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Application of long arm cast 29065 CPT 29065 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Application of long leg cast CPT 29355 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Application of long leg cast 29345 CPT 29345 | $534.05 | $971.00 | $1,887.00 – $2,654.00 | 3 |
| Application of paste boot 29580 CPT 29580 | $715.00 | $1,300.00 | $1,887.00 – $2,654.00 | 3 |
| Application short leg cast 29405 CPT 29405 | $605.55 | $1,101.00 | $1,887.00 – $2,654.00 | 3 |
| Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm CPT 15275 | $1,110.45 | $2,019.00 | $3,388.00 – $4,761.00 | 3 |
| Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm CPT 15271 | $1,167.10 | $2,122.00 | $3,388.00 – $4,761.00 | 3 |
| Applicator tag rfid localizer 12gx7cm HCPCS C1819 | $423.40 | $769.81 | not published | 0 |
| Appl long leg cast brace CPT 29358 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Appl mltpln uni ext fixj sys CPT 20692 | not published | not published | $7,609.00 – $8,770.00 | 3 |
| Appl modality 1/> areas paraffin bath 97018 CPT 97018 | $38.50 | $70.00 | not published | 0 |
| Appl modality 1/> areas vasopneumatic devices 97016 CPT 97016 | $46.75 | $85.00 | not published | 0 |
| Appl multlay comprs arm/hand CPT 29584 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Appl patllr tdn bearing cast CPT 29435 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Appl unipln uni ext fixj sys CPT 20690 | not published | not published | $6,779.00 – $8,770.00 | 3 |
| Apply finger cast 29086 CPT 29086 | $288.75 | $525.00 | $1,887.00 – $2,654.00 | 3 |
| Apply forearm splintdynamic 29126 CPT 29126 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Apply halo w/removal cranial CPT 20661 | not published | not published | $2,334.00 – $3,388.00 | 3 |
| Apply hand/wrist cast 29085 CPT 29085 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Apply interstit radiat compl CPT 77778 | not published | not published | $1,227.54 – $1,227.54 | 1 |
| Apply intrcav radiat compl CPT 77763 | not published | not published | $953.31 – $953.31 | 1 |
| Apply intrcav radiat interm CPT 77762 | not published | not published | $737.34 – $737.34 | 1 |
| Apply intrcav radiat simple CPT 77761 | not published | not published | $642.76 – $642.76 | 1 |
| Apply of finger splint 29131 CPT 29131 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Apply rem fixation device CPT 20660 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Apply rigid leg cast 29445 CPT 29445 | $925.65 | $1,683.00 | $1,887.00 – $2,654.00 | 3 |
| Apply short leg castambul type 29425 CPT 29425 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Apply surf ldr radionuclide CPT 77789 | not published | not published | $202.71 – $202.71 | 1 |
| App mltpln uni xtrnl fix 1st CPT 20696 | not published | not published | $8,657.00 – $8,923.00 | 3 |
| App mltpln uni xtrnl fix xch CPT 20697 | not published | not published | $2,959.00 – $3,388.00 | 3 |
| App skn cll ssp f/n/g/hf 1st CPT 15017 | not published | not published | $3,388.00 – $3,388.00 | 1 |
| App skn cl ssp agrft t/a/l 1 CPT 15015 | not published | not published | $3,388.00 – $3,388.00 | 1 |
| Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion HCPCS J0185 | not published | not published | $1.85 – $4.64 | 5 |
| #aptt mix-1:1 incubated CPT 87532 | not published | not published | $35.09 – $71.00 | 4 |
| Aqaprn-4 antb flo cytmtry ea CPT 86053 | $62.15 | $113.00 | $12.05 – $66.03 | 4 |
| Aquaporin-4 antibody cba each CPT 86052 | $593.45 | $1,079.00 | $12.05 – $21.09 | 4 |
| Aquaporin-4 antibody elisa CPT 86051 | not published | not published | $11.53 – $20.18 | 4 |
| Aqua therapy w/exercise/ea 15 min 97113 CPT 97113 | $89.10 | $162.00 | not published | 0 |
| Aquatic exercise - group charge CPT 97150 | $50.05 | $91.00 | not published | 0 |
| Aqueous shunt eye w/graft CPT 66180 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Aqueous shunt eye without graft CPT 66179 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Argatroban nonesrd (accord) HCPCS J0891 | not published | not published | $4.95 – $4.95 | 1 |
| Argatroban nonesrd (auromed) HCPCS J0898 | not published | not published | $1.47 – $3.86 | 3 |
| Argatroban nonesrd use 1mg HCPCS J0883 | not published | not published | $1.05 – $2.18 | 3 |
| Aripiprazole 441 mg/1.6 ml inj HCPCS J1944 | not published | not published | $3.50 – $8.79 | 5 |
| Aripiprazole injection HCPCS J0400 | not published | not published | $0.87 – $0.87 | 1 |
| Arsenic trioxide 2 mg/ml intravenous solution HCPCS J9017 | not published | not published | $5.07 – $12.74 | 5 |
| Art byp aor celiac msn and renal 35631 CPT 35631 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Art byp aortofemoral 35647 CPT 35647 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Art byp aortoiliac 35637 CPT 35637 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Art bypass aorsubcl/carot/innom 35626 CPT 35626 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Art bypass aortobifemoral 35646 CPT 35646 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Art bypass aortobi-iliac 35638 CPT 35638 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Art bypass axillary-femoral 35621 CPT 35621 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Art bypass axill-fem-femoral 35654 CPT 35654 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Art bypass carotid-subclavian 35606 CPT 35606 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Art bypass common ipsi carotid 35601 CPT 35601 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Art bypass fem-ant-post tib/prl 35666 CPT 35666 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Art bypass femoral-femoral 35661 CPT 35661 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Art bypass femoral-popliteal 35656 CPT 35656 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Art bypass iliofemoral 35665 CPT 35665 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Art bypass subclav-subclavian 35612 CPT 35612 | $12,057.10 | $21,922.00 | $4,428.00 – $4,428.00 | 1 |
| Art byp axillary-axillary 35650 CPT 35650 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Art byp grft aortbifemoral 35540 CPT 35540 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Art byp grft aortobi-iliac 35538 CPT 35538 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Art byp grft fem-femoral 35558 CPT 35558 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Art byp grft fem-popliteal 35556 CPT 35556 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Art byp ilioiliac 35663 CPT 35663 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Art byp pop-tibl-prl-other 35571 CPT 35571 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Arterial blood draw/perc 36620 CPT 36620 | $198.55 | $361.00 | $1,887.00 – $5,512.00 | 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.