Visits & medical services prices at SSM Health Monroe Hospital
Monroe, WI · every code in this section with a posted price and a Medicare benchmark.
216 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Admn Sarscov2 Vacc 1 Dose (90480) | $56.65 | $103 | 1.4× |
| Advncd Care Plan 30 Min (99497) | $84.15 | $153 | 0.9× |
| Aep Hearing Status Deter Broadband Stimuli I&R (92651) | $311.85 | $567 | 1.5× |
| Aep threshold estimation mlt frequencies i&r (92652) | $472.45 | $859 | 2.3× |
| Airway Inhalation Treatment (94640) range across 3 matching MRF lines |
$121.55–$200.20 | $221–$364 | varies |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $141.35 | $257 | 9.8× |
| Assessment of aphasia per hr (96105) | $347.60 | $632 | 3.6× |
| Behavral qualit analys voice (92524) | $343.20 | $624 | 3.1× |
| Bfb traing w/EMG &/manometry 1st 15 min cntct (90912) | $320.10 | $582 | 3.9× |
| Bfb training ea addl 15 min (90913) | $130.35 | $237 | 4.0× |
| Biofeedback training any modality (90901) | $29.15 | $53 | 0.7× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $232.65 | $423 | 0.6× |
| Canalith repositioning proc (95992) | $226.60 | $412 | 5.6× |
| Car seat/bed test 60 min (94780) | $66 | $120 | 1.8× |
| Cardiac Stress Tst,Tracing Only (93017) | $556.60 | $1,012 | 2.7× |
| Cardiopulmonary resuscitation (92950) range across 2 matching MRF lines |
$499.40–$574.75 | $908–$1,045 | varies |
| Cardioversion (92960) range across 2 matching MRF lines |
$795.30–$914.65 | $1,446–$1,663 | varies |
| Cardioversion elective internal (92961) | $1,408 | $2,560 | 2.2× |
| Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) | $10,395 | $18,900 | 3.3× |
| Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) | $9,121.20 | $16,584 | 2.9× |
| Cbt 1st hour (94644) range across 2 matching MRF lines |
$128.15–$147.40 | $233–$268 | varies |
| Chemo Anti-Neopl Sq/Im (96401) | $152.90 | $278 | 2.2× |
| Chemo Hormon Antineopl Sq/Im (96402) | $88 | $160 | 1.3× |
| Chemo IV infusion addl hr (96415) | $124.30 | $226 | 1.8× |
| Chemo IV push addl drug (96411) | $218.35 | $397 | 3.1× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $184.25 | $335 | 2.6× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $490.05 | $891 | 1.5× |
| Chest Wall Manipulation (94668) | $99.55 | $181 | 0.8× |
| Color/duplex Doppler, complete (93975) | $444.40 | $808 | 1.9× |
| Color/duplex Doppler, limited (93976) | $245.85 | $447 | 2.4× |
| Comprehensive Hearing Test (92557) | $181.50 | $330 | 1.5× |
| Computerized Ophthalmic Imaging Optic Nerve (92133) | $50.60 | $92 | 0.9× |
| Computerized Ophthalmic Imaging Retina (92134) | $52.25 | $95 | 0.9× |
| Cont Gluc Mntr Pt Prov Eqp (95249) | $183.70 | $334 | 3.2× |
| Continuous Pulse Ox (94762) | $368.50 | $670 | 2.9× |
| Coronary Art/Grft Angio S&I (93455) | $7,688.45 | $13,979 | 2.4× |
| Coronary Artery Angio S&I (93454) | $7,194 | $13,080 | 2.3× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) range across 2 matching MRF lines |
$127.60–$381.70 | $232–$694 | varies |
| Cpt initial (94667) | $144.10 | $262 | 1.1× |
| Critical care first hour (99291) | $1,837 | $3,340 | 2.3× |
| Debridement Open Wound 20 Sq Cm< (97597) | $277.20 | $504 | 1.4× |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) | $297 | $540 | 1.3× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $2,191.20 | $3,984 | 9.5× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $739.75 | $1,345 | 7.3× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $2,378.20 | $4,324 | 10.3× |
| Dup-scan xtr veins unilateral/limited study (93971) | $1,189.10 | $2,162 | 11.7× |
| Duplex Scan Artl Infl&Ven O/F Hemo Compl Bi Std (93985) | $785.40 | $1,428 | 3.4× |
| Duplex Scan Artl Infl&Ven O/F Hemo Compl Uni Std (93986) | $392.15 | $713 | 3.9× |
| Duplex Scan Hemodialysis Access (93990) | $451 | $820 | 4.4× |
| Duplex up extrem art unilat/ltd (93931) | $1,825.45 | $3,319 | 18.0× |
| Echo Congenital Complete (93303) | $1,822.15 | $3,313 | 3.4× |
| Echo Heart Xthoracic,Limited (93308) range across 2 matching MRF lines |
$319.55–$367.95 | $581–$669 | varies |
| Echo transesophag montr cardiac pump functj (93318) | $922.90 | $1,678 | 1.7× |
| Echo transesophageal (93312) | $2,295.70 | $4,174 | 4.3× |
| Echo Transesophageal - Congenital Tee Complete (93315) | $922.90 | $1,678 | 1.7× |
| Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) | $3,388.55 | $6,161 | 6.4× |
| EEG awake drowsy (95816) | $194.70 | $354 | 0.9× |
| Electrical Stimulation Ea 15 Min (97032) | $148.50 | $270 | 10.1× |
| Electrocardiogram Tracing (93005) | $224.40 | $408 | 3.9× |
| Electrophysiology Evaluation (93642) | $2,003.10 | $3,642 | 1.7× |
| Emergency Dept Visit Level 2 (99282) | $370.70 | $674 | 2.5× |
| Emergency Dept Visit Level 3 (99283) | $614.35 | $1,117 | 2.3× |
| Emergency Dept Visit Level 4 (99284) | $920.15 | $1,673 | 2.3× |
| Er level 1 (99281) | $257.95 | $469 | 3.1× |
| Er level v (99285) | $1,736.35 | $3,157 | 3.0× |
| Evaluate Speech Production (92522) range across 7 matching MRF lines |
$267.85–$313.50 | $487–$570 | varies |
| Evaluate Swallowing Function (92610) | $464.20 | $844 | 5.5× |
| Evaluation of speech fluency (92521) range across 7 matching MRF lines |
$327.80–$343.20 | $596–$624 | varies |
| Evoked Auditory Test,Limited (92587) | $454.30 | $826 | 2.2× |
| Exercise test for bronchospasm (94617) | $164.45 | $299 | 1.3× |
| External ECG rec>48hr<7d recording (93242) | $46.20 | $84 | 1.3× |
| External ECG rec>7d<15d recording (93246) | $46.20 | $84 | 1.3× |
| Extracranial Bilat Study (93880) | $849.20 | $1,544 | 3.7× |
| Extracranial Uni/Ltd Study (93882) | $878.90 | $1,598 | 8.7× |
| F-up/limited tthrc echo congenital car anomaly (93304) | $1,245.75 | $2,265 | 2.3× |
| Gastroesophag reflx test w/telemtry ph eltrd (91035) | $1,595.55 | $2,901 | 1.9× |
| Group Therapeutic Procedures (97150) | $70.40 | $128 | 3.9× |
| Heart catheterization, both sides, with coronary and bypass graft angiography (93461) | $11,183.15 | $20,333 | 3.6× |
| Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935) | $1,141.25 | $2,075 | 1.7× |
| Holter monitor recording (93225) | $389.61 | $708.38 | 3.0× |
| Icd Device Interrogate (93289) | $193.60 | $352 | 5.3× |
| Icd device progr eval dual (93283) | $248.05 | $451 | 6.8× |
| Icd Device Progr Eval Mult (93284) | $251.90 | $458 | 6.9× |
| Icm Device Eval (93290) | $110.55 | $201 | 3.0× |
| Ilr Device Eval Progr (93285) | $257.40 | $468 | 7.1× |
| Ilr Device Interrogate (93291) | $173.25 | $315 | 6.2× |
| Im Adm Intransl/Oral 1 Vaccine (90473) | $48.40 | $88 | 0.7× |
| Immunization administration (90471) | $44 | $80 | 0.6× |
| Insert/Place Heart Catheter (93503) | $237.60 | $432 | 0.2× |
| Intra-atrial recording (93602) | $6,545 | $11,900 | 0.9× |
| Intracutaneous tests w/allergenic extracts (95024) | $10.45 | $19 | 0.2× |
| Intraventricular pacing (93612) | $6,857.95 | $12,469 | 0.9× |
| Iontophoresis 15 min (97033) | $148.50 | $270 | 7.8× |
| Irrig Drug Delivery Device (96523) | $81.95 | $149 | 1.4× |
| IV infusion hydration each additional hour (96361) range across 3 matching MRF lines |
$78.82–$158.40 | $143.31–$288 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) range across 2 matching MRF lines |
$174.90–$201.30 | $318–$366 | varies |
| IV infusion ther proph addl sequential to 1 hr (96367) range across 2 matching MRF lines |
$139.15–$159.50 | $253–$290 | varies |
| IV infusion therapy prophylaxis/dx ea hour (96366) range across 2 matching MRF lines |
$141.35–$162.25 | $257–$295 | varies |
| IV push initial (96374) range across 2 matching MRF lines |
$167.75–$192.50 | $305–$350 | varies |
| L Hrt Art/Grft Angio (93459) | $9,953.35 | $18,097 | 3.2× |
| Lung Function Test (Mbc/Mvv) (94200) | $73.70 | $134 | 1.3× |
| Lwr Xtr Vasc Stdy Bilat (93924) | $902 | $1,640 | 4.3× |
| Mechanical chest wall oscillation per session (94669) | $275.55 | $501 | 1.3× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $100.65 | $183 | 2.7× |
| Methacholine challenge (94070) | $232.65 | $423 | 0.6× |
| Motility study esophagus (91010) | $433.40 | $788 | 1.2× |
| Motion Fluoroscopy/Swallow (92611) | $549.45 | $999 | 6.0× |
| Multiple Sleep Latency Test (95805) range across 2 matching MRF lines |
$1,595.55–$2,127.40 | $2,901–$3,868 | varies |
| Muscle Test Nonparaspinal (95870) | $203.50 | $370 | 1.6× |
| Nasopharyngoscopy (92511) range across 2 matching MRF lines |
$114.40–$131.45 | $208–$239 | varies |
| Needle Electromyography Cranial Nrv Muscle Bi (95868) | $354.20 | $644 | 1.7× |
| Needle Electromyography Cranial Nrv Muscle Uni (95867) | $177.10 | $322 | 0.8× |
| Needle electromyography larynx (95865) | $174.90 | $318 | 1.4× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) | $77.55 | $141 | 0.4× |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $506.55 | $921 | 1.3× |
| Nerve Conduction Studies 1-2 Studies (95907) | $118.25 | $215 | 0.6× |
| Nerve conduction studies 13 or more studies (95913) | $824.45 | $1,499 | 2.3× |
| Nerve Conduction Studies 3-4 Studies (95908) | $321.75 | $585 | 1.5× |
| Nerve conduction studies 7-8 studies (95910) | $563.20 | $1,024 | 1.6× |
| Nerve Conduction Studies 9-10 Studies (95911) | $627.55 | $1,141 | 1.7× |
| Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) | $128.15 | $233 | 1.0× |
| Neuromuscular Reeducation (97112) | $133.65 | $243 | 4.1× |
| Nrpsyc tst eval phys/qhp 1st (96132) | $157.30 | $286 | 0.4× |
| Ophth Medical Xm&Eval Compre New Pt 1/> Vst (92004) | $125.95 | $229 | 1.0× |
| Ophth medical xm&eval comprhnsv estab pt 1/> (92014) | $97.90 | $178 | 0.8× |
| Oral Function Therapy (92526) | $272.25 | $495 | 3.2× |
| Oral Speech Device Eval (92597) | $268.95 | $489 | 3.8× |
| Orthc/Prostc Mgmt Sbsq Enc (97763) | $102.30 | $186 | 2.0× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $124.30 | $226 | 2.7× |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) | $45.10 | $82 | 2.2× |
| Osteopathic manipulative tx 3-4 body regions (98926) | $50.60 | $92 | 2.4× |
| Osteopathic manipulative tx 5-6 body regions (98927) | $66.55 | $121 | 3.2× |
| Ot Contrast Bath Ea 15 Min (97034) | $75.35 | $137 | 5.4× |
| Ot eval high complexity (97167) | $290.95 | $529 | 2.9× |
| Ot Eval Low Complex (97165) | $200.75 | $365 | 2.0× |
| Ot Eval Moderate Complexity (97166) range across 6 matching MRF lines |
$182.60–$229.90 | $332–$418 | varies |
| Ot manual therapy 15 min (97140) | $123.20 | $224 | 4.4× |
| Ot paraffin bath (97018) | $75.35 | $137 | 12.5× |
| Ot Re-Eval Est Plan Care (97168) | $137.50 | $250 | 2.0× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) | $227.70 | $414 | 1.8× |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) | $154.55 | $281 | 1.2× |
| Peripheral arterial disease rehab per session (93668) | $119.35 | $217 | 2.1× |
| Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) | $8,578.90 | $15,598 | 1.6× |
| Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) | $9,088.20 | $16,524 | 0.8× |
| Phlebotomy therapeutic (99195) range across 2 matching MRF lines |
$105.05–$121 | $191–$220 | varies |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) | $220 | $400 | 3.8× |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) | $175.45 | $319 | 3.1× |
| Physical Performance Test (97750) | $58.30 | $106 | 1.7× |
| Plethysmography (94726) | $299.20 | $544 | 0.8× |
| Pm device eval in person (93288) | $138.05 | $251 | 3.8× |
| Pm device progr eval dual (93280) | $248.05 | $451 | 6.8× |
| Pm device progr eval multi (93281) | $261.80 | $476 | 7.2× |
| Pm Device Progr Eval Sngl (93279) | $194.15 | $353 | 5.4× |
| Pm/Icd Remote Tech Serv (93296) range across 2 matching MRF lines |
$85.80–$99 | $156–$180 | varies |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) range across 3 matching MRF lines |
$2,777.50–$3,472.15 | $5,050–$6,313 | varies |
| Positional nystagmus test (92542) | $163.90 | $298 | 1.3× |
| Prepj& allergen immunotherapy 1/mlt antigen (95165) | $18.70 | $34 | 0.4× |
| Prgrmng Dev Eval Implantable in Persn 1 Ld Dfb (93282) | $190.85 | $347 | 5.3× |
| Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) | $35.20 | $64 | 0.8× |
| Prq Card Angio/Athrect 1 Art (92924) | $14,834.05 | $26,971 | 1.3× |
| Prq Card Stent W/Angio 1 Vsl (92928) | $9,088.20 | $16,524 | 0.8× |
| Prq Card Stent/Ath/Angio (92933) | $9,458.90 | $17,198 | 0.5× |
| Prq Revasc Byp Graft 1 Vsl (92937) | $9,088.20 | $16,524 | 0.8× |
| Psych diag eval w/med srvcs (90792) | $169.95 | $309 | 1.0× |
| Psytx Crisis Initial 60 Min (90839) | $301.95 | $549 | 1.8× |
| Pt Eval High Complex (97163) range across 7 matching MRF lines |
$259.05–$283.25 | $471–$515 | varies |
| Pt eval low complex 20 min (97161) | $214.50 | $390 | 2.2× |
| Pt Eval Mod Complex (97162) range across 7 matching MRF lines |
$238.15–$257.40 | $433–$468 | varies |
| Pt gait training 15 min (97116) | $80.30 | $146 | 2.8× |
| Pt mechanical traction (97012) | $70.95 | $129 | 4.9× |
| Pt Re-Eval Est Plan Care (97164) | $145.75 | $265 | 2.2× |
| Pt-focused hlth risk assmt score doc stnd instrm (96160) | $52.25 | $95 | 1.4× |
| Pulmonary service/procedure (94799) range across 3 matching MRF lines |
$145.20–$291.50 | $264–$530 | varies |
| Pulmonary Stress Testing (94618) | $92.40 | $168 | 0.7× |
| R Hrt Art/Grft Angio (93457) | $10,714.55 | $19,481 | 3.4× |
| R hrt coronary artery angio (93456) | $9,348.35 | $16,997 | 3.0× |
| R&L Hrt Cath W/Ventriclgrphy (93453) | $8,723.55 | $15,861 | 2.8× |
| Refill/Maint Portable Pump (96521) | $238.70 | $434 | 1.2× |
| Rem Interrog Scrms <30 D Phys/Qhp (93298) | $51.04 | $92.80 | 1.4× |
| Remote 30 Day Ecg Rev/Report (93270) | $311.30 | $566 | 8.6× |
| Respiratory flow volume loop (94375) | $147.40 | $268 | 0.7× |
| Right Heart Cath (93451) | $5,437.30 | $9,886 | 1.7× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) | $292.05 | $531 | 1.5× |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) | $235.40 | $428 | 1.9× |
| Self Care Mngment Training (97535) | $99 | $180 | 3.1× |
| Sensory Integration Ea 15 Min (97533) | $133.65 | $243 | 2.2× |
| Sleep study unattended (95806) | $449.90 | $818 | 2.1× |
| Speech sound lang comprehen (92523) | $554.95 | $1,009 | 2.5× |
| Spirometry (94010) | $84.70 | $154 | 0.4× |
| Stress Tte Only (93350) | $703.45 | $1,279 | 1.3× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) | $60.50 | $110 | 2.7× |
| Ther Ivntj Ea Addl 15 Min (97130) | $57.75 | $105 | 2.7× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $73.70 | $134 | 2.0× |
| Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) | $337.70 | $614 | 3.3× |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 2 matching MRF lines |
$68.75–$72.05 | $125–$131 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) range across 2 matching MRF lines |
$227.15–$261.25 | $413–$475 | varies |
| Therapeutic Activities (97530) | $102.30 | $186 | 2.9× |
| Tilt table test with heart rhythm and blood pressure monitoring (93660) | $1,161.60 | $2,112 | 3.2× |
| Trans Care Mgmt 14 Day Disch (99495) | $157.30 | $286 | 1.2× |
| Trans Care Mgmt 7 Day Disch (99496) | $214.50 | $390 | 1.7× |
| Tte w/doppler, complete (93306) | $2,345.20 | $4,264 | 4.4× |
| Tte W/O Doppler Complete (93307) | $755.15 | $1,373 | 3.3× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) range across 5 matching MRF lines |
$208.45–$477.95 | $379–$869 | varies |
| Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) | $67.65 | $123 | 2.8× |
| Tx/Pro/Dx Inj New Drug Addon (96375) range across 2 matching MRF lines |
$124.85–$143.55 | $227–$261 | varies |
| Tympanometry (92567) | $94.60 | $172 | 2.6× |
| Unlisted cardiovascular service/procedure (93799) range across 3 matching MRF lines |
$790.35–$1,562.55 | $1,437–$2,841 | varies |
| Upr/L Xtremity Art 2 Levels (93922) | $63.80 | $116 | 0.5× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $754.60 | $1,372 | 3.6× |
| Vasopneumatic device (97016) | $85.25 | $155 | 7.1× |
| Vent Mgmt Inpat Init Day (94002) | $1,261.70 | $2,294 | 2.1× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $1,488.30 | $2,706 | 2.5× |
| Visual Field Exam Extended (92083) | $81.40 | $148 | 0.6× |
| Vital capacity, total (94150) | $122.10 | $222 | 1.0× |
| Wheelchair Mgmt Ea 15 Min (97542) | $70.95 | $129 | 2.3× |
| Whirlpool Therapy (97022) | $177.65 | $323 | 11.3× |
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.