Supplies, drugs & other prices at SSM Health Monroe Hospital
Monroe, WI · every code in this section with a posted price and a Medicare benchmark.
53 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) | $2,295.70 | $4,174 | 3.0× |
| 2d tte w or w/o fol w/con,fu (C8924) | $710.60 | $1,292 | 2.1× |
| Adm tocilizu covid-19 1st (M0249) | $858.55 | $1,561 | 2.0× |
| Adm tocilizu covid-19 2nd (M0250) | $858.55 | $1,561 | 2.0× |
| Admin hepatitis b vaccine (G0010) | $64.90 | $118 | 1.4× |
| Admin influenza virus vac (G0008) | $29.15 | $53 | 0.6× |
| Admin pneumococcal vaccine (G0009) | $39.05 | $71 | 0.9× |
| Ca screen;pelvic/breast exam (G0101) | $52.25 | $95 | 0.5× |
| Catheterize for urine spec (P9612) | $18.15 | $33 | 1.9× |
| Chemo extend iv infus w/pump (G0498) | $544.50 | $990 | 1.7× |
| Diab manage trn per indiv (G0108) | $135.30 | $246 | 2.4× |
| Direct refer hospital observ (G0379) | $393.80 | $716 | 0.7× |
| Drug test def 1-7 classes (G0480) range across 2 matching MRF lines |
$95.85–$270.05 | $174.27–$491 | varies |
| Elec stim other than wound (G0283) | $78.10 | $142 | 6.2× |
| Fecal microbiota prep instil (G0455) | $124.30 | $226 | 0.1× |
| Hospital outpt clinic visit (G0463) | $113.30 | $206 | 0.9× |
| Initial preventive exam (G0402) | $127.60 | $232 | 1.0× |
| Inj for sacroiliac jt anesth (G0260) range across 2 matching MRF lines |
$887.15–$1,773.20 | $1,613–$3,224 | varies |
| Mra w/cont, abd (C8900) | $2,512.40 | $4,568 | 7.4× |
| Mra w/o cont, abd (C8901) | $2,454.10 | $4,462 | 10.6× |
| Mra w/o fol w/cont, abd (C8902) | $2,619.65 | $4,763 | 7.7× |
| Mra w/o fol w/cont, chest (C8911) | $2,903.45 | $5,279 | 8.6× |
| Mra w/o fol w/cont, lwr ext (C8914) | $2,895.20 | $5,264 | 8.5× |
| Mra, w/o&w/dye, upper extr (C8936) | $2,637.25 | $4,795 | 7.8× |
| Mri w/cont, breast, bi (C8906) | $4,948.90 | $8,998 | 14.6× |
| Mri w/o fol w/cont, breast, (C8908) | $5,394.40 | $9,808 | 15.9× |
| Mri w/o fol w/cont, brst, un (C8905) | $2,050.95 | $3,729 | 6.1× |
| Neuro csf prion prtn qual (0035U) | $1,641.75 | $2,985 | 3.0× |
| Obtaining screen pap smear (Q0091) | $38.50 | $70 | 1.4× |
| Onc Merkel Cll Carc Srm Quan (0058U) | $1,898.05 | $3,451 | 5.9× |
| Oth resp proc, group (G0239) | $191.40 | $348 | 5.3× |
| Oth resp proc, indiv (G0238) | $50.05 | $91 | 1.8× |
| Perc d-e cor revasc chro sin (C9607) | $9,088.20 | $16,524 | 0.5× |
| Perc d-e cor revasc t cabg s (C9604) | $9,088.20 | $16,524 | 0.8× |
| Perc d-e cor stent ather s (C9602) | $28,639.05 | $52,071 | 1.6× |
| Perc drug-el cor stent sing (C9600) | $9,495.75 | $17,265 | 0.8× |
| Prostate biopsy, any mthd (G0416) range across 2 matching MRF lines |
$282.70–$623.15 | $514–$1,133 | varies |
| Psa screening (G0103) | $115.50 | $210 | 6.0× |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) | $2,008.60 | $3,652 | 2.8× |
| Revasc intra lithotrip-ather (C9766) | $28,639.05 | $52,071 | 1.6× |
| Revasc intra lithotrip-stent (C9765) | $18,703.30 | $34,006 | 1.1× |
| Revasc intravasc lithotripsy (C9764) | $17,697.90 | $32,178 | 1.6× |
| Revasc lithotr-ather tib/per (C9774) | $18,564.70 | $33,754 | 1.0× |
| Revasc lithotrip tibi/perone (C9772) | $17,697.90 | $32,178 | 1.6× |
| Screen cerv/vag thin layer (G0123) | $90.20 | $164 | 4.5× |
| Therapeutic procd strg endur (G0237) | $50.05 | $91 | 1.8× |
| Tomosynthesis, mammo (G0279) | $123.75 | $225 | 9.8× |
| Trauma respons w/hosp criti (G0390) range across 4 matching MRF lines |
$2,858.35–$4,784.45 | $5,197–$8,699 | varies |
| Trluml Perip Athrc Iliac Art (0238T) | $11,732.05 | $21,331 | 0.7× |
| Tte w or w/o contr, cont ecg (C8930) | $2,422.20 | $4,404 | 3.2× |
| Tte w or w/o fol w/con,stres (C8928) | $1,380.50 | $2,510 | 1.8× |
| Tte w or wo fol wcon,doppler (C8929) | $2,422.20 | $4,404 | 3.2× |
| Unsched dialysis esrd pt hos (G0257) | $872.30 | $1,586 | 1.3× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.