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 |
|---|---|---|---|---|
| Stimulants synthetic CPT 80371 | not published | not published | $35.06 – $35.06 | 1 |
| Stimulation of spinal cord CPT 63610 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Storage/year embryo(s) CPT 89342 | not published | not published | $143.50 – $143.50 | 1 |
| Storage/year oocyte(s) CPT 89346 | not published | not published | $283.41 – $283.41 | 1 |
| Storage/year reprod tissue CPT 89344 | not published | not published | $143.50 – $143.50 | 1 |
| Storage/year sperm/semen CPT 89343 | not published | not published | $143.50 – $143.50 | 1 |
| Stot/tot hysterectomy after cesaren delivery 59525 CPT 59525 | not published | not published | $3,388.00 – $3,388.00 | 1 |
| Strapping of ankle and/or ft 29540 CPT 29540 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Strapping of chest CPT 29200 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Strapping of elbow or wrist 29260 CPT 29260 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Strapping of hand or finger CPT 29280 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Strapping of hip CPT 29520 | $138.60 | $252.00 | $1,887.00 – $2,654.00 | 3 |
| Strapping of knee CPT 29530 | $307.45 | $559.00 | $1,887.00 – $2,654.00 | 3 |
| Strapping of toes 29550 CPT 29550 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Strep a ag ia CPT 87430 | $123.75 | $225.00 | $16.81 – $29.42 | 4 |
| Strep a dna dir probe CPT 87650 | not published | not published | $20.05 – $40.58 | 4 |
| Strep a dna quant CPT 87652 | not published | not published | $41.76 – $84.49 | 4 |
| Strep b assay w/optic CPT 87802 | not published | not published | $12.73 – $24.26 | 4 |
| Strep b dna amp probe CPT 87653 | $201.85 | $367.00 | $35.09 – $71.00 | 4 |
| Streptokinase 1.5 m-units inj HCPCS J2995 | not published | not published | $193.73 – $193.73 | 1 |
| Streptokinase antibody CPT 86590 | not published | not published | $12.66 – $22.34 | 4 |
| Streptomycin injection HCPCS J3000 | not published | not published | $28.15 – $76.94 | 5 |
| Streptozocin injection HCPCS J9320 | not published | not published | $1,140.94 – $1,140.94 | 1 |
| Stress test pulmonary CPT 94618 | $522.50 | $950.00 | not published | 0 |
| Str markers spec anal addl CPT 81266 | not published | not published | $304.81 – $533.42 | 4 |
| Str markers specimen anal CPT 81265 | not published | not published | $233.07 – $435.16 | 4 |
| St treatment speech individual CPT 92507 | $163.90 | $298.00 | not published | 0 |
| St treatment swallow dysfunction/oral CPT 92526 | $363.00 | $660.00 | not published | 0 |
| Subdural tap fontanelle/sutur infant init 61000 CPT 61000 | not published | not published | $2,654.00 – $3,030.00 | 3 |
| Subq njx filling matrl 1cc/< CPT 11950 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Subq njx fil matrl 5.1-10cc CPT 11952 | not published | not published | $1,887.00 – $2,654.00 | 3 |
| Subsequent repair of nerve CPT 64872 | not published | not published | $1,887.00 – $5,512.00 | 3 |
| Subtalar arthro w/deb CPT 29906 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Subtalar arthro w/exc CPT 29905 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Subtalar arthro w/fb rmvl CPT 29904 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Subtalar arthro w/fusion CPT 29907 | not published | not published | $7,609.00 – $18,364.00 | 3 |
| Subtemporal cranial dcmprn CPT 61340 | not published | not published | $6,779.00 – $6,779.00 | 1 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | not published | not published | $4.31 – $4.31 | 1 |
| Suction lipectomy head&neck CPT 15876 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Suction lipectomy lwr extrem CPT 15879 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Suction lipectomy trunk CPT 15877 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Suction lipectomy upr extrem CPT 15878 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Sugars multiple quant CPT 84379 | not published | not published | $11.53 – $23.33 | 4 |
| Sugars single quant CPT 84378 | not published | not published | $11.53 – $23.33 | 4 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | not published | not published | $0.07 – $0.10 | 2 |
| Sulfonylurea screen qn-sendout CPT 80377 | $258.50 | $470.00 | $35.06 – $35.06 | 1 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | not published | not published | $440.85 – $440.85 | 1 |
| Supprelin la implant HCPCS J9226 | not published | not published | $49,006.08 – $123,225.25 | 5 |
| Surg dx exam anorectal CPT 45990 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Surg ect salp-oophorectomy 59120 CPT 59120 | not published | not published | $4,428.00 – $8,770.00 | 3 |
| Surg ect without salp-oophorectomy 59121 CPT 59121 | not published | not published | $4,428.00 – $8,770.00 | 3 |
| Surgery for urethra pouch CPT 53240 | not published | not published | $3,388.00 – $8,770.00 | 3 |
| Surgery of pancreatic cyst CPT 48500 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Surgery to stop leg growth CPT 27475 | not published | not published | $6,779.00 – $8,770.00 | 3 |
| Surgery to stop leg growth CPT 27477 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Surgery to stop leg growth CPT 27479 | not published | not published | $6,779.00 – $8,770.00 | 3 |
| Surgery to stop leg growth CPT 27485 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Surgical exposure prostate 55860 CPT 55860 | not published | not published | $4,428.00 – $7,791.00 | 3 |
| Surgical opening esophagus CPT 43351 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Surgical opening esophagus CPT 43352 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Surgical opening of stomach CPT 43510 | not published | not published | $2,654.00 – $4,761.00 | 3 |
| Surgical opening of stomach 43500 CPT 43500 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Surgical opening of throat CPT 42955 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Surgical pathology level 1 gross examination only CPT 88300 | $125.40 | $228.00 | $15.05 – $22.99 | 2 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $131.45 | $239.00 | $22.99 – $35.88 | 2 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $274.45 | $499.00 | $48.59 – $49.47 | 2 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $271.70 | $494.00 | $48.59 – $49.47 | 2 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $384.45 | $699.00 | $283.41 – $318.25 | 2 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $372.35 | $677.00 | $451.73 – $628.20 | 2 |
| Surgical repair stomach bleedin ulcer 43501 CPT 43501 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Surgical repair stomach gastric lac 43502 CPT 43502 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Surgical revision intestine CPT 44680 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Surgigraft, 1 sq cm HCPCS Q4183 | not published | not published | $438.11 – $438.11 | 1 |
| Surg tx anal fistula 2nd stage 46285 CPT 46285 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Susceptibility agar dilution per agent CPT 87181 | $30.80 | $56.00 | $4.75 – $9.62 | 4 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $51.70 | $94.00 | $4.75 – $9.62 | 4 |
| Susceptibility mic per plate CPT 87186 | $118.80 | $216.00 | $8.65 – $17.50 | 4 |
| Suscept studies macrobroth dilution ea CPT 87188 | $210.65 | $383.00 | $6.64 – $13.43 | 4 |
| Suspend bowel w/prosthesis CPT 44700 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Suspension of testis CPT 54620 | not published | not published | $3,735.00 – $7,791.00 | 3 |
| Suspension of uterus CPT 58410 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Suspension of uterus 58400 CPT 58400 | not published | not published | $4,428.00 – $8,770.00 | 3 |
| Sutr lg intestine 1/mult perf without colostomy 44604 CPT 44604 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Suture bile duct injury 47900 CPT 47900 | not published | not published | $3,735.00 – $3,735.00 | 1 |
| Svc venogram s&i CPT 75827 | $1,815.00 | $3,300.00 | $273.99 – $273.99 | 1 |
| Sweat collection by iontophoresis CPT 89230 | not published | not published | $7.42 – $49.47 | 2 |
| Sympathectomy cervical CPT 64802 | not published | not published | $3,388.00 – $4,761.00 | 3 |
| Sympathectomy digital artery CPT 64820 | not published | not published | $3,388.00 – $7,791.00 | 3 |
| Sympathectomy lumbar CPT 64818 | $1,147.85 | $2,087.00 | $4,428.00 – $4,428.00 | 1 |
| Sympathectomy supfc palmar CPT 64823 | not published | not published | $3,735.00 – $8,770.00 | 3 |
| Sympathectomy thoracolumbar CPT 64809 | not published | not published | $4,428.00 – $4,428.00 | 1 |
| Synojoynt, inj., 1 mg HCPCS J7331 | not published | not published | $9.27 – $24.24 | 5 |
| Synvisc or synvisc-one HCPCS J7325 | not published | not published | $9.92 – $24.93 | 5 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $35.20 | $64.00 | $4.40 – $8.90 | 4 |
| System cardiomems hosp electronics HCPCS C2624 | $31,779.69 | $57,781.25 | not published | 0 |
| System pacing micra av HCPCS C1786 | $6,863.20 | $12,478.55 | not published | 0 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $4,180.35 | $7,600.64 | not published | 0 |
| T3 (triiodothyronine) free CPT 84481 | $106.70 | $194.00 | $16.94 – $29.65 | 4 |
| T3 (triiodothyronine) total CPT 84480 | $122.10 | $222.00 | $14.18 – $28.68 | 4 |
| T4 (thyroxine) free CPT 84439 | $81.40 | $148.00 | $9.02 – $18.24 | 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.