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 |
|---|---|---|---|---|
| Njx aa&/strd lmbr plex nfs CPT 64449 | not published | not published | $2,654.00 – $3,030.00 | 3 |
| Njx aa&/strd nrv nrvtg si jt CPT 64451 | $1,918.40 | $3,488.00 | $2,654.00 – $3,030.00 | 3 |
| Njx aa&/strd sc nrv nfs img CPT 64446 | $1,610.95 | $2,929.00 | $2,654.00 – $3,030.00 | 3 |
| Njx aa&/strd vagus nrv CPT 64408 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Njx cath slct p angrph mapca CPT 93575 | not published | not published | $1,887.00 – $2,334.00 | 2 |
| Njx cath slct p-art angrp bi CPT 93573 | not published | not published | $1,887.00 – $2,334.00 | 2 |
| Njx cath slct pulm vn angrph CPT 93574 | not published | not published | $1,887.00 – $2,334.00 | 2 |
| Njx chemonucleolysis lmbr CPT 62292 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Njx cth slct p-art angrp uni CPT 93569 | not published | not published | $1,887.00 – $2,334.00 | 2 |
| Njx interlaminar crv/thrc CPT 62324 | $1,128.05 | $2,051.00 | $2,654.00 – $3,030.00 | 3 |
| Njx interlaminar crv/thrc CPT 62325 | $1,630.20 | $2,964.00 | $2,654.00 – $3,030.00 | 3 |
| Njx interlaminar lmbr/sac CPT 62326 | $1,128.05 | $2,051.00 | $2,654.00 – $3,030.00 | 3 |
| Njx interlaminar lmbr/sac CPT 62327 | $1,691.80 | $3,076.00 | $2,654.00 – $3,030.00 | 3 |
| Njx px nfrosgrm &/urtrgrm CPT 50430 | $1,001.00 | $1,820.00 | $2,654.00 – $3,030.00 | 3 |
| Njx px peyronie ds exps plaq CPT 54205 | not published | not published | $4,428.00 – $8,770.00 | 3 |
| Nl comp cgen kdn abnormality CPT 50070 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Nl removal calculus CPT 50060 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Nl rmvl lg staghorn calculus CPT 50075 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Nl sec surg operj calculus CPT 50065 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Nm imaging bone/joint 3 phase study CPT 78315 | $1,936.00 | $3,520.00 | $1,027.03 – $1,027.03 | 1 |
| Nm imaging bone/joint whole body CPT 78306 | $1,936.00 | $3,520.00 | $726.90 – $726.90 | 1 |
| Nm imaging cardiac blood pooling planar single study at rest or stress CPT 78472 | $2,038.30 | $3,706.00 | $629.45 – $629.45 | 1 |
| Nm imaging gastric emptying study CPT 78264 | $1,936.00 | $3,520.00 | $1,030.60 – $1,030.60 | 1 |
| Nm imaging gastrointestinal acute blood loss CPT 78278 | $1,936.00 | $3,520.00 | $1,037.71 – $1,037.71 | 1 |
| Nm imaging hepatobiliary system w/pharmacologic intervention CPT 78227 | $1,936.00 | $3,520.00 | $1,403.19 – $1,403.19 | 1 |
| Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention CPT 78708 | $1,936.00 | $3,520.00 | $397.30 – $397.30 | 1 |
| Nm imaging pulmonary ventilation/perfusion CPT 78582 | $1,936.00 | $3,520.00 | $977.12 – $977.12 | 1 |
| Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s) CPT 78014 | $1,936.00 | $3,520.00 | $749.49 – $749.49 | 1 |
| Nm radiopharmaceutical therapy oral administration CPT 79005 | $1,936.00 | $3,520.00 | $164.18 – $164.18 | 1 |
| Non-blind interatrial shunt HCPCS C9760 | not published | not published | $7,609.00 – $54,996.00 | 3 |
| Non-card vasc flow imaging CPT 78445 | not published | not published | $523.72 – $523.72 | 1 |
| Non-imaging heart function CPT 78414 | not published | not published | $171.27 – $171.27 | 1 |
| Noninv pace analysis CPT 93724 | $706.75 | $1,285.00 | not published | 0 |
| Noonan spectrum disorders CPT 81442 | not published | not published | $894.41 – $3,751.30 | 4 |
| Novachor 1 sq cm HCPCS Q4194 | not published | not published | $791.31 – $2,338.41 | 4 |
| Npm1 gene CPT 81310 | not published | not published | $246.52 – $431.41 | 4 |
| Nps surg dilat eust tube bi CPT 69706 | not published | not published | $15,691.00 – $16,106.00 | 2 |
| Nps surg dilat eust tube uni CPT 69705 | not published | not published | $15,691.00 – $16,106.00 | 2 |
| Npsy tst eval phsy/qhp 1st hr CPT 96132 | $204.05 | $371.00 | not published | 0 |
| Npsy tst eval phsy/qhp ea l hr CPT 96133 | $199.10 | $362.00 | not published | 0 |
| Nqhp ol dig assmt&mgmt 11-20 CPT 98971 | $76.45 | $139.00 | not published | 0 |
| Nqhp ol dig assmt&mgmt 21+ CPT 98972 | $120.45 | $219.00 | not published | 0 |
| Nqhp ol dig assmt&mgmt 5-10 CPT 98970 | $43.45 | $79.00 | not published | 0 |
| Nras gene variants exon 2&3 CPT 81311 | $786.50 | $1,430.00 | $295.79 – $517.63 | 4 |
| Nr lnr acclrtr tx max 5 sessions CPT 77373 | $5,894.35 | $10,717.00 | $4,557.69 – $4,557.69 | 1 |
| Nrv grf 1strnd arm/leg >4 cm CPT 64893 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Nrv grf 1strnd arm/leg <4cm CPT 64892 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Nrv grf 1strnd hnd/foot <4cm CPT 64890 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Nrv grf 1strnd hnd/foot >4cm CPT 64891 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Nrv grf mltst arm/leg <4 cm CPT 64897 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Nrv grf mltst arm/leg >4 cm CPT 64898 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Nrv grf mltst hnd/foot <4 cm CPT 64895 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Nrv grf mltst hnd/foot >4 cm CPT 64896 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Nrv rpr w/nrv algrft 1st CPT 64912 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Nrv rpr w/nrv algrft ea addl CPT 64913 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Nsl/sins ndsc med&inf dcmprn CPT 31293 | not published | not published | $6,019.00 – $8,770.00 | 3 |
| Nsl/sins ndsc med/inf dcmprn CPT 31292 | not published | not published | $6,019.00 – $8,770.00 | 3 |
| Nsl/sins ndsc sphn tiss rmvl CPT 31259 | not published | not published | $6,019.00 – $8,770.00 | 3 |
| Nsl/sins ndsc surg frnt sins CPT 31296 | not published | not published | $6,019.00 – $8,770.00 | 3 |
| Nsl/sins ndsc surg frnt&sphn CPT 31298 | not published | not published | $6,019.00 – $8,770.00 | 3 |
| Nsl/sins ndsc surg max sins CPT 31295 | not published | not published | $6,019.00 – $8,770.00 | 3 |
| Nsl/sins ndsc surg on dcmprn CPT 31294 | not published | not published | $6,019.00 – $8,770.00 | 3 |
| Nsl/sins ndsc surg sphn sins CPT 31297 | not published | not published | $6,019.00 – $7,791.00 | 3 |
| Nsl/sins ndsc total CPT 31253 | not published | not published | $6,019.00 – $8,770.00 | 3 |
| Nsl/sins ndsc tot w/sphendt CPT 31257 | not published | not published | $6,019.00 – $8,770.00 | 3 |
| Nsl/sinus endoscopy surg dcr CPT 31239 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Nsl/sinus ndsc cryoabltj pnn CPT 31243 | not published | not published | $4,428.00 – $15,691.00 | 2 |
| Nsl/sinus ndsc rf abltj pnn CPT 31242 | not published | not published | $4,428.00 – $15,691.00 | 2 |
| Nsl/sns ndsc lig sphnptn art CPT 31241 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Ntraop hipec px ea add 30min CPT 96548 | not published | not published | $2,334.00 – $2,334.00 | 1 |
| Ntrk1 translocation analysis CPT 81191 | not published | not published | $207.31 – $362.79 | 4 |
| Ntrk2 translocation analysis CPT 81192 | not published | not published | $207.31 – $362.79 | 4 |
| Ntrk3 translocation analysis CPT 81193 | not published | not published | $207.31 – $362.79 | 4 |
| Ntrk translocation analysis CPT 81194 | not published | not published | $518.28 – $906.99 | 4 |
| Ntsty modul rad tx dlvr cplx CPT 77386 | $2,450.80 | $4,456.00 | $1,150.59 – $1,150.59 | 1 |
| Ntsty modul rad tx dlvr smpl CPT 77385 | $2,450.80 | $4,456.00 | $1,148.50 – $1,148.50 | 1 |
| Nuclear exam of tear flow CPT 78660 | not published | not published | $530.86 – $530.86 | 1 |
| Nuclear matrix protein 22 CPT 86386 | not published | not published | $21.78 – $38.12 | 4 |
| Nuclear rx intra-arterial CPT 79445 | $545.60 | $992.00 | $312.15 – $312.15 | 1 |
| Nuclear rx intra-articular CPT 79440 | not published | not published | $168.24 – $168.24 | 1 |
| Nuclear rx intracav admin CPT 79200 | not published | not published | $195.07 – $195.07 | 1 |
| Nuclear rx IV admin CPT 79101 | $1,936.00 | $3,520.00 | $159.92 – $159.92 | 1 |
| Nuclear Stress Test (Heart) CPT 78452 | $2,445.30 | $4,446.00 | $1,363.51 – $1,363.51 | 1 |
| Nuclr rx interstit colloid CPT 79300 | not published | not published | $175.53 – $175.53 | 1 |
| Nudt15 gene common variants CPT 81306 | $775.50 | $1,410.00 | $291.36 – $509.88 | 4 |
| Nushield 1 square cm HCPCS Q4160 | not published | not published | $101.92 – $1,007.00 | 4 |
| Nusinersen (pf) 12 mg/5 ml intrathecal solution HCPCS J2326 | not published | not published | $3,394.92 – $3,394.92 | 1 |
| Obinutuzumab 1,000 mg/40 ml intravenous solution HCPCS J9301 | not published | not published | $81.02 – $203.73 | 5 |
| Obltrj a-pulm sep def w/byp CPT 33814 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Observation direct referral from physician office for admission HCPCS G0379 | $74.80 | $136.00 | not published | 0 |
| Observation per hour HCPCS G0378 | $0.73 | $1.33 | not published | 0 |
| Obstetrical care 59410 CPT 59410 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Obstetric panel inc HIV tstg CPT 80081 | not published | not published | $74.86 – $151.46 | 4 |
| Obstetrics panel CPT 80055 | not published | not published | $47.81 – $96.72 | 4 |
| Obtaining screen pap smear HCPCS Q0091 | $20.24 | $36.80 | $22.99 – $22.99 | 1 |
| Ob Ultrasound nuchal meas 1 gest CPT 76813 | $291.50 | $530.00 | $202.71 – $202.71 | 1 |
| Ob Ultrasound nuchal meas add-on CPT 76814 | not published | not published | $100.52 – $100.52 | 1 |
| Occlude fallopian tube(s) device 58615 CPT 58615 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Ocrelizumab 30 mg/ml intravenous solution HCPCS J2350 | not published | not published | $63.59 – $160.00 | 5 |
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | not published | not published | $0.65 – $2.21 | 5 |
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.