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 |
|---|---|---|---|---|
| Incision of facial nerve CPT 64742 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Incision of fibula CPT 27707 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Incision of finger tendon CPT 26455 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Incision of foot fascia CPT 28008 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Incision of foot tendon 28234 CPT 28234 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Incision of gallbladder 47480 CPT 47480 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Incision of heel bone CPT 28300 | not published | not published | $6,779.00 – $18,364.00 | 3 |
| Incision of hip bone CPT 27146 | not published | not published | $3,735.00 – $18,364.00 | 3 |
| Incision of hip bones CPT 27151 | not published | not published | $3,735.00 – $18,364.00 | 3 |
| Incision of hip tendon CPT 27000 | $2,653.75 | $4,825.00 | $3,388.00 – $7,791.00 | 3 |
| Incision of hip tendon CPT 27001 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Incision of hip tendon CPT 27003 | not published | not published | $6,779.00 – $8,770.00 | 3 |
| Incision of hip tendons CPT 27006 | $3,865.95 | $7,029.00 | $3,735.00 – $8,770.00 | 3 |
| Incision of iris CPT 66500 | not published | not published | $1,887.00 – $3,388.00 | 3 |
| Incision of iris CPT 66505 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Incision of jaw joint CPT 21010 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Incision of jaw nerve CPT 64738 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Incision of knee joint CPT 27435 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Incision of liver duct CPT 47400 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Incision of lymph channels CPT 38308 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Incision of metatarsal CPT 28306 | not published | not published | $6,779.00 – $7,791.00 | 3 |
| Incision of metatarsal CPT 28307 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Incision of metatarsal CPT 28308 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Incision of metatarsals CPT 28309 | not published | not published | $6,779.00 – $18,364.00 | 3 |
| Incision of midfoot bones CPT 28304 | not published | not published | $6,779.00 – $18,364.00 | 3 |
| Incision of neck of femur CPT 27161 | not published | not published | $3,735.00 – $18,364.00 | 3 |
| Incision of palm tendon CPT 26450 | not published | not published | $3,579.00 – $4,761.00 | 3 |
| Incision of prostate CPT 52450 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Incision of pyloric muscle 43520 CPT 43520 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Incision of rectal abscess CPT 46060 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Incision of small bowel 44010 CPT 44010 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Incision of sperm duct CPT 55200 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Incision of spinal nerve 64772 CPT 64772 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Incision of stomach nerves CPT 64755 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Incision of tendon & muscle CPT 23405 | $4,147.55 | $7,541.00 | $6,779.00 – $8,770.00 | 3 |
| Incision of tendon sheath CPT 25000 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Incision of thigh CPT 27448 | not published | not published | $3,735.00 – $18,364.00 | 3 |
| Incision of thigh CPT 27450 | not published | not published | $3,735.00 – $18,364.00 | 3 |
| Incision of thigh tendon CPT 27306 | $3,100.35 | $5,637.00 | $3,735.00 – $7,791.00 | 3 |
| Incision of thigh tendon CPT 27390 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Incision of thigh tendons CPT 27307 | $2,375.45 | $4,319.00 | $3,735.00 – $8,770.00 | 3 |
| Incision of thigh tendons CPT 27391 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Incision of thigh tendons CPT 27392 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Incision of tibia CPT 27705 | not published | not published | $6,779.00 – $16,106.00 | 3 |
| Incision of tibia & fibula CPT 27709 | not published | not published | $7,609.00 – $8,770.00 | 3 |
| Incision of toe tendons 28011 CPT 28011 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Incision of tongue fold CPT 41010 | $3,078.35 | $5,597.00 | $3,388.00 – $4,761.00 | 3 |
| Incision of tongue nerve CPT 64740 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Incision of urethra CPT 53000 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Incision of urethra CPT 53010 | not published | not published | $4,428.00 – $7,791.00 | 3 |
| Incision of urethra CPT 53020 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Incision of urethra CPT 53025 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Incision of vagus nerve CPT 64760 | not published | not published | $3,388.00 – $3,388.00 | 1 |
| Incision of windpipe CPT 31601 | not published | not published | $4,428.00 – $7,791.00 | 3 |
| Incision of windpipe CPT 31610 | not published | not published | $4,428.00 – $7,791.00 | 3 |
| Incision of wrist capsule CPT 25085 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Incision secondary cataract CPT 66820 | not published | not published | $1,887.00 – $3,388.00 | 3 |
| Incision tendon sheath CPT 26055 | $2,850.65 | $5,183.00 | $3,388.00 – $4,761.00 | 3 |
| Incisn of toe tndn CPT 28010 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Incisn windpipe CPT 31600 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Incis spine 3 column adl seg CPT 22208 | not published | not published | $1,887.00 – $6,779.00 | 3 |
| Incis spine 3 column lumbar CPT 22207 | not published | not published | $6,779.00 – $18,364.00 | 3 |
| Incis spine 3 column thorac CPT 22206 | not published | not published | $6,779.00 – $18,364.00 | 3 |
| Incobotulinumtoxin a HCPCS J0588 | not published | not published | $5.74 – $14.45 | 5 |
| Inc&subq plmt crnl bone grf CPT 61316 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Induced ab 1+vag supp d&c CPT 59856 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Induced ab 1+vag supp hyst CPT 59857 | not published | not published | $3,388.00 – $3,388.00 | 1 |
| Induced ab 1+ vag sup w/dlv fetus CPT 59855 | not published | not published | $3,388.00 – $3,388.00 | 1 |
| Induced abortion 1+njx d&c CPT 59851 | not published | not published | $3,388.00 – $3,388.00 | 1 |
| Induced abortion 1+njx hyst CPT 59852 | not published | not published | $3,388.00 – $3,388.00 | 1 |
| Induced abortion d&c CPT 59840 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Induced abortion dilat&evac CPT 59841 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s) CPT 87626 | not published | not published | $70.20 – $122.85 | 4 |
| Infect ag drug suscept pheno predict CPT 87900 | $537.90 | $978.00 | $130.35 – $263.75 | 4 |
| Infect ag eia chlamydia trachomatis CPT 87320 | not published | not published | $15.00 – $26.25 | 4 |
| Infect ag eia influenza a or b ea CPT 87400 | not published | not published | $14.13 – $24.73 | 4 |
| Infect ag genotype na cytomegalovirus CPT 87910 | not published | not published | $257.45 – $520.94 | 4 |
| Infect ag genotype na dna hepatitis b CPT 87912 | not published | not published | $257.45 – $520.94 | 4 |
| Infect ag genotype na hiv-1 other region CPT 87906 | $498.30 | $906.00 | $128.73 – $260.47 | 4 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $1,072.50 | $1,950.00 | $257.45 – $520.94 | 4 |
| Infect ag ia direct hiv-1 antgn CPT 87806 | not published | not published | $32.77 – $57.35 | 4 |
| Infect ag ia optc obs chlamydia trach CPT 87810 | not published | not published | $24.26 – $61.76 | 4 |
| Infect ag ia optc obs influenza CPT 87804 | not published | not published | $16.55 – $28.96 | 4 |
| Infect ag if ea plyvlnt antsrm CPT 87300 | not published | not published | $11.98 – $24.26 | 4 |
| Infect ag if hep delta agent CPT 87380 | not published | not published | $18.36 – $33.20 | 4 |
| Infect ag if influenza a CPT 87276 | $35.75 | $65.00 | $16.07 – $28.12 | 4 |
| Infect ag if influenza b CPT 87275 | $27.50 | $50.00 | $12.25 – $24.26 | 4 |
| Infect ag if legionella pneumophila CPT 87278 | $59.40 | $108.00 | $15.60 – $27.30 | 4 |
| Infect ag if nos ea CPT 87299 | $35.75 | $65.00 | $16.10 – $28.18 | 4 |
| Infect ag if pneumocystis carinii CPT 87281 | $26.40 | $48.00 | $11.98 – $24.26 | 4 |
| Infect ag if varicella zoster CPT 87290 | not published | not published | $13.42 – $24.26 | 4 |
| Infect ag na chlamydia trachomatis qnt CPT 87492 | not published | not published | $53.47 – $93.57 | 4 |
| Infect ag na hep b amp CPT 87516 | not published | not published | $35.09 – $71.00 | 4 |
| Infect ag na herpes simplex quant CPT 87530 | not published | not published | $42.84 – $86.68 | 4 |
| Infect ag na hpv high-risk types CPT 87624 | $246.95 | $449.00 | $35.09 – $71.00 | 4 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $364.65 | $663.00 | $95.80 – $172.20 | 4 |
| Infect ag na influenza revr/amp ea type CPT 87501 | not published | not published | $51.31 – $103.84 | 4 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | $86.35 | $157.00 | $51.17 – $89.79 | 4 |
| Infect ag na resp virus 12-25 targets CPT 87633 | not published | not published | $416.78 – $843.37 | 4 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | not published | not published | $488.66 – $988.79 | 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.