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 |
|---|---|---|---|---|
| Resuscitation cardiopulmonary CPT 92950 | $669.90 | $1,218.00 | $1,887.00 – $2,334.00 | 2 |
| Reteplase injection HCPCS J2993 | not published | not published | $7,560.76 – $7,560.76 | 1 |
| Reticulated platelet assay CPT 85055 | not published | not published | $35.74 – $62.55 | 4 |
| Reticulocyte automated CPT 85045 | $34.65 | $63.00 | $3.99 – $8.10 | 4 |
| Reticulocyte direct measurement automated CPT 85046 | not published | not published | $5.57 – $11.27 | 4 |
| Retifanlimab-dlwr 500 mg/20 ml intravenous solution HCPCS J9345 | not published | not published | $31.68 – $79.66 | 5 |
| Retr bone flap to fix skull CPT 62148 | not published | not published | $3,388.00 – $3,388.00 | 1 |
| Retrieval of oocyte CPT 58970 | not published | not published | $2,654.00 – $3,030.00 | 3 |
| Retrograde ejaculation anal CPT 89331 | not published | not published | $19.59 – $36.92 | 4 |
| Revasc intra lithotrip-ather HCPCS C9766 | not published | not published | $7,609.00 – $27,583.00 | 3 |
| Revasc intra lithotrip-stent HCPCS C9765 | $17,672.05 | $32,131.00 | $7,609.00 – $27,583.00 | 3 |
| Revasc intravasc lithotripsy HCPCS C9764 | $17,074.20 | $31,044.00 | $6,019.00 – $18,364.00 | 3 |
| Revasc lithotr-ather tib/per HCPCS C9774 | not published | not published | $26,827.00 – $27,583.00 | 2 |
| Revasc lithotrip-stent-ather HCPCS C9767 | not published | not published | $8,923.00 – $27,583.00 | 3 |
| Revasc lithotrip tibi/perone HCPCS C9772 | $14,318.70 | $26,034.00 | $26,827.00 – $27,583.00 | 2 |
| Revasc lithotr-stent tib/per HCPCS C9773 | not published | not published | $26,827.00 – $27,583.00 | 2 |
| Revasc lith-sten-ath tib/per HCPCS C9775 | not published | not published | $26,827.00 – $27,583.00 | 2 |
| Revascularization penis CPT 37788 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Revefenacin inh non-com 1mcg HCPCS J7677 | not published | not published | $0.22 – $0.54 | 5 |
| Revise abdomen-venous shunt CPT 49426 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Revise additional leg tendon CPT 27692 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Revise aqueous shunt eye CPT 66185 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Revise arm/leg nerve CPT 64708 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Revise bladder & ureter(s) CPT 51565 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Revise breast reconst 19380 CPT 19380 | not published | not published | $6,019.00 – $16,106.00 | 3 |
| Revise circulation to head CPT 61708 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Revise circulation to head CPT 61705 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Revise circulation to head CPT 61710 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Revise esophagus & stomach 43325 CPT 43325 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Revise eye CPT 65091 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Revise eyelashes CPT 67825 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Revise eyelashes CPT 67835 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Revise eyelid defect CPT 67909 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Revise eyelid defect CPT 67911 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Revise eyelid lining CPT 68330 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Revise eyelid lining CPT 68360 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Revise eyelid lining CPT 68362 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Revise eye muscle CPT 67311 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Revise eye muscle CPT 67314 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Revise eye muscle add-on CPT 67340 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Revise eye muscle(s) CPT 67318 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Revise eye muscle(s) add-on CPT 67320 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Revise eye muscle w/suture CPT 67334 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Revise eye socket implant CPT 67560 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Revise eye sockets CPT 21260 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Revise eye sockets CPT 21261 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Revise eye sockets CPT 21263 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Revise eye sockets CPT 21267 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Revise eye sockets CPT 21268 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Revise eye with implant CPT 65093 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Revise finger joint each CPT 26135 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Revise finger joint each CPT 26140 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Revise gastric port open 43886 CPT 43886 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Revise/graft eyelid lining CPT 68320 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Revise/graft eyelid lining CPT 68325 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Revise/graft eyelid lining CPT 68326 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Revise/graft eyelid lining CPT 68328 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Revise/graft eyelid lining CPT 68335 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Revise graft w/vein CPT 35879 | not published | not published | $4,428.00 – $18,364.00 | 3 |
| Revise graft w/vein 35881 CPT 35881 | not published | not published | $4,428.00 – $18,364.00 | 3 |
| Revise hand/finger tendon CPT 26390 | not published | not published | $6,779.00 – $8,770.00 | 3 |
| Revise head/neck of femur CPT 27179 | not published | not published | $6,779.00 – $18,364.00 | 3 |
| Revise hernia & sperm veins CPT 55540 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Revise hip joint replacement CPT 27134 | not published | not published | $6,779.00 – $27,583.00 | 3 |
| Revise hip joint replacement CPT 27138 | not published | not published | $6,779.00 – $27,583.00 | 3 |
| Revise hip joint replacement CPT 27137 | not published | not published | $6,779.00 – $27,583.00 | 3 |
| Revise/implant finger joint CPT 26536 | not published | not published | $6,779.00 – $16,106.00 | 3 |
| Revise kneecap CPT 27437 | not published | not published | $6,779.00 – $16,106.00 | 3 |
| Revise kneecap with implant CPT 27438 | not published | not published | $7,609.00 – $18,364.00 | 3 |
| Revise knuckle joint CPT 26530 | not published | not published | $3,735.00 – $16,106.00 | 3 |
| Revise knuckle with implant CPT 26531 | not published | not published | $6,779.00 – $16,106.00 | 3 |
| Revise low back nerve(s) CPT 64714 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Revise lower leg tendon CPT 27690 | not published | not published | $6,779.00 – $16,106.00 | 3 |
| Revise lower leg tendon CPT 27691 | not published | not published | $6,779.00 – $16,106.00 | 3 |
| Revise lower leg tendons CPT 27686 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Revise middle ear bone CPT 69660 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Revise middle ear bone CPT 69661 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Revise middle ear bone CPT 69662 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Revise middle ear & mastoid CPT 69641 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Revise middle ear & mastoid CPT 69642 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Revise middle ear & mastoid CPT 69643 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Revise middle ear & mastoid CPT 69644 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Revise middle ear & mastoid CPT 69646 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Revise middle ear & mastoid 69645 CPT 69645 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Revise ocular implant CPT 65125 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Revise ocular implant CPT 65150 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Revise ovarian tube(s) CPT 58752 | not published | not published | $4,428.00 – $8,770.00 | 3 |
| Revise palsy hand tendon(s) CPT 25315 | not published | not published | $6,779.00 – $8,770.00 | 3 |
| Revise palsy hand tendon(s) CPT 25316 | not published | not published | $6,779.00 – $18,364.00 | 3 |
| Revise penis/urethra CPT 54328 | not published | not published | $3,735.00 – $16,106.00 | 3 |
| Revise penis/urethra CPT 54332 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Revise penis/urethra CPT 54336 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Revise prosth vag graft lap CPT 57426 | not published | not published | $7,609.00 – $8,770.00 | 3 |
| Revise radius or ulna CPT 25370 | not published | not published | $3,735.00 – $16,106.00 | 3 |
| Revise radius & ulna CPT 25365 | not published | not published | $7,609.00 – $16,106.00 | 3 |
| Revise radius & ulna CPT 25375 | not published | not published | $3,735.00 – $16,106.00 | 3 |
| Revise reconst elbow joint CPT 24370 | not published | not published | $7,609.00 – $27,583.00 | 3 |
| Revise reconst elbow joint CPT 24371 | not published | not published | $8,923.00 – $27,583.00 | 3 |
| Revise/remove neuroelectrode CPT 61880 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Revise/remove neuroreceiver CPT 61888 | not published | not published | $7,609.00 – $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.