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 |
|---|---|---|---|---|
| Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< CPT 11310 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm CPT 11311 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm CPT 11312 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Shave sgl skin lsn f/e/e/n/l/m >2cm CPT 11313 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm CPT 11306 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Shave sgl skin lsn s/n/h/f/g 1.1-2cm CPT 11307 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Shave sgl skin lsn s/n/h/f/g >2cm CPT 11308 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Shave sgl skin lsn t/a/l 0.5cm/< CPT 11300 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Shave sgl skin lsn t/a/l 0.6-1.0cm CPT 11301 | $176.55 | $321.00 | $1,887.00 – $2,654.00 | 3 |
| Shave sgl skin lsn t/a/l 1.1-2.0cm CPT 11302 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Shigella antibody CPT 86771 | not published | not published | $22.72 – $42.84 | 4 |
| Sho arthrs dx +- synovial bx CPT 29805 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Sho arthrs srg bicp tenodsis CPT 29828 | not published | not published | $6,779.00 – $18,364.00 | 3 |
| Sho arthrs srg capsulorraphy CPT 29806 | not published | not published | $6,779.00 – $18,364.00 | 3 |
| Sho arthrs srg compl synvct CPT 29821 | not published | not published | $3,735.00 – $18,364.00 | 3 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Sho arthrs srg lss&rescj ads CPT 29825 | not published | not published | $3,735.00 – $18,364.00 | 3 |
| Sho arthrs srg prtl synvct CPT 29820 | not published | not published | $6,779.00 – $18,364.00 | 3 |
| Sho arthrs srg rmvl loose/fb CPT 29819 | not published | not published | $3,735.00 – $18,364.00 | 3 |
| Sho arthrs srg rpr slap les CPT 29807 | not published | not published | $6,779.00 – $18,364.00 | 3 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | not published | not published | $3,735.00 – $18,364.00 | 3 |
| Shortening of hand tendon CPT 26479 | not published | not published | $3,579.00 – $4,761.00 | 3 |
| Shortening of thigh bone CPT 27465 | not published | not published | $3,735.00 – $18,364.00 | 3 |
| Shorten/lengthen thighs CPT 27468 | not published | not published | $3,735.00 – $18,364.00 | 3 |
| Shorten radius or ulna CPT 25390 | not published | not published | $6,779.00 – $16,106.00 | 3 |
| Shorten radius & ulna CPT 25392 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | not published | not published | $6,779.00 – $18,364.00 | 4 |
| Shoulder MRI (with and without contrast) CPT 73223 | $2,514.05 | $4,571.00 | $1,199.10 – $1,199.10 | 1 |
| Shoulder MRI (with contrast) CPT 73222 | $2,394.70 | $4,354.00 | $984.03 – $984.03 | 1 |
| Shoulder MRI (without contrast) CPT 73221 | $2,280.30 | $4,146.00 | $556.30 – $556.30 | 1 |
| Shoulder prosthesis removal CPT 23334 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Shoulder prosthesis removal CPT 23335 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Shoulder X-ray CPT 73030 | $304.15 | $553.00 | $63.69 – $63.69 | 1 |
| Shunt as-aort to pulm art CPT 33755 | not published | not published | $6,019.00 – $6,019.00 | 1 |
| Shunt central w/prostc graft CPT 33764 | not published | not published | $6,019.00 – $6,019.00 | 1 |
| Shunt desc aorta to pulm art CPT 33762 | not published | not published | $6,019.00 – $6,019.00 | 1 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $222.20 | $404.00 | $251.40 – $251.40 | 1 |
| Shunt subclavian to pulm art CPT 33750 | not published | not published | $6,019.00 – $6,019.00 | 1 |
| Shunt supr v/c p-art 1 lung CPT 33766 | not published | not published | $6,019.00 – $6,019.00 | 1 |
| Shunt supr v/c p-art bth lng CPT 33767 | not published | not published | $6,019.00 – $6,019.00 | 1 |
| Sialidase enzyme assay CPT 87905 | not published | not published | $12.22 – $24.72 | 4 |
| Sialography s&i CPT 70390 | $469.15 | $853.00 | $249.03 – $249.03 | 1 |
| Sialolithotomy 42330 CPT 42330 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Sickling rbc CPT 85660 | $156.20 | $284.00 | $5.51 – $11.16 | 4 |
| Sigmoidoscopy and biopsy CPT 45331 | not published | not published | $2,654.00 – $3,030.00 | 3 |
| Sigmoidoscopy flex decompression 45337 CPT 45337 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Sigmoidoscopy for bleeding CPT 45334 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | not published | not published | $2,654.00 – $3,030.00 | 3 |
| Sigmoidoscopy w/ablation CPT 45346 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Sigmoidoscopy w/plcmt stent CPT 45347 | not published | not published | $3,579.00 – $4,761.00 | 3 |
| Sigmoidoscopy w/resection CPT 45349 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Sigmoidoscopy w/tumr remove CPT 45338 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Sigmoidoscopy w/ultrasound CPT 45341 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Sigmoidoscopy w/us guide bx CPT 45342 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | not published | not published | $2,654.00 – $3,030.00 | 3 |
| Sig w/tndsc balloon dilation CPT 45340 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Simple cystometrogram 51725 CPT 51725 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | not published | not published | $123.85 – $311.42 | 5 |
| Single energy x-ray study HCPCS G0130 | not published | not published | $75.56 – $75.56 | 1 |
| Single transfer toe-hand CPT 26553 | not published | not published | $3,735.00 – $16,106.00 | 3 |
| Sinus CT scan (with and without contrast) CPT 70488 | $1,506.45 | $2,739.00 | $468.84 – $468.84 | 1 |
| Sinus CT scan (with contrast) CPT 70487 | $1,434.95 | $2,609.00 | $369.03 – $369.03 | 1 |
| Sinus CT scan (without contrast) CPT 70486 | $1,366.75 | $2,485.00 | $321.52 – $321.52 | 1 |
| Sinus/juglr venogram s&i CPT 75860 | $1,096.70 | $1,994.00 | $290.61 – $290.61 | 1 |
| Sinusotomy maxillary sinus 31020 CPT 31020 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Sinusotomy sinus remove polyps 31032 CPT 31032 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Sinusotomy sphenoid w/wo bx 31050 CPT 31050 | not published | not published | $4,428.00 – $16,106.00 | 3 |
| Sipuleucel-t - su HCPCS Q2043 | not published | not published | $62,718.81 – $151,198.13 | 4 |
| Sirolimus, oral HCPCS J7520 | not published | not published | $1.15 – $2.89 | 5 |
| Sirolimus-protein bound 100 mg intravenous suspension HCPCS J9331 | not published | not published | $127.17 – $319.75 | 5 |
| Skeletal muscle relaxant 1/2 CPT 80369 | $102.30 | $186.00 | $35.06 – $35.06 | 1 |
| Skin and muscle repair face CPT 15845 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Skin Biopsy CPT 11102 | $589.60 | $1,072.00 | $1,887.00 – $2,654.00 | 3 |
| Skin full graft 20sq cm less 15200 CPT 15200 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Skin full graft add-on 15241 CPT 15241 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Skin pedicle flap arms/legs CPT 15572 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Skin pedicle flap trunk CPT 15570 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Skin test unlisted antigen ea CPT 86486 | not published | not published | $6.91 – $22.99 | 2 |
| Skull base/brainstem surgery CPT 61575 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Skull base/brainstem surgery CPT 61576 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Skyla, 13.5 mg HCPCS J7301 | not published | not published | $3,146.83 – $3,146.83 | 1 |
| Slco1b1 gene com variants CPT 81328 | not published | not published | $174.81 – $305.92 | 4 |
| Sleep study attended CPT 95807 | $3,598.65 | $6,543.00 | not published | 0 |
| Sleep Study (Polysomnography) CPT 95810 | $3,920.95 | $7,129.00 | not published | 0 |
| Sleeve fing rolyan med HCPCS L3933 | $178.85 | $325.18 | not published | 0 |
| Sleeve pneumonectomy CPT 32442 | not published | not published | $7,609.00 – $7,609.00 | 1 |
| Sling suprapubic suburetheral HCPCS C1771 | $1,340.82 | $2,437.85 | not published | 0 |
| Slitting of prepuce CPT 54000 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Slitting of prepuce CPT 54001 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Sm-153 lexidron ther HCPCS A9604 | not published | not published | $11,747.34 – $11,747.34 | 1 |
| Small animal inoculation CPT 87003 | not published | not published | $16.84 – $34.07 | 4 |
| Small bowel endoscopy CPT 44360 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Small bowel endoscopy CPT 44364 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Small bowel endoscopy CPT 44366 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Small bowel endoscopy CPT 44369 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Small bowel endoscopy CPT 44376 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Small bowel endoscopy CPT 44378 | not published | not published | $3,388.00 – $4,761.00 | 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.