St Clare Memorial Hospital Inc
St Clare Memorial Hospital Inc in Oconto Falls, WI publishes cash prices for 47 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.
855 S MAIN STREET, OCONTO FALLS, WI 54154 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN/PELVIS W/CONTRAST | $3,016.86 | $4,571.00 | 34% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN/PELVIS W/CONTRAST | $3,016.86 | $4,571.00 | 34% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD/BRAIN W/O CONTRAST | $1,259.28 | $1,908.00 | 34% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD/BRAIN W/O CONTRAST | $1,259.28 | $1,908.00 | 34% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W/CONTRAST | $1,539.12 | $2,332.00 | 34% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W/CONTRAST | $1,539.12 | $2,332.00 | 34% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI | $369.60 | $560.00 | 34% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DX MAMMO INCL CAD BI | $369.60 | $560.00 | 34% |
| Diagnostic mammogram, one breast CPT 77065 DX MAMMO INCL CAD UNI | $310.20 | $470.00 | 34% |
| Diagnostic mammogram, one breast inpatient CPT 77065 DX MAMMO INCL CAD UNI | $310.20 | $470.00 | 34% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LWR EXT JOINT W/O CONTRAST | $2,420.88 | $3,668.00 | 34% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LWR EXT JOINT W/O CONTRAST | $2,420.88 | $3,668.00 | 34% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LWR EXT JOINT W&W/O CONTRAST | $2,669.70 | $4,045.00 | 34% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LWR EXT JOINT W&W/O CONTRAST | $2,669.70 | $4,045.00 | 34% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN W/O CONTRAST | $2,360.16 | $3,576.00 | 34% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN W/O CONTRAST | $2,360.16 | $3,576.00 | 34% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN STEM W/O & W/DYE | $2,721.18 | $4,123.00 | 34% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN STEM W/O & W/DYE | $2,721.18 | $4,123.00 | 34% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI L-SPINE W/O CONTRAST | $2,337.72 | $3,542.00 | 34% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI L-SPINE W/O CONTRAST | $2,337.72 | $3,542.00 | 34% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US PREGNANCY >14 WEEKS SGL | $573.54 | $869.00 | 34% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US PREGNANCY >14 WEEKS SGL | $573.54 | $869.00 | 34% |
| Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD | $310.20 | $470.00 | 34% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 SCR MAMMO BI INCL CAD | $310.20 | $470.00 | 34% |
| Sleep study in a lab (polysomnography) CPT 95810 HC SLEEP STUDY | $3,812.16 | $5,776.00 | 34% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC SLEEP STUDY | $3,812.16 | $5,776.00 | 34% |
| Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL | $531.30 | $805.00 | 34% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL | $531.30 | $805.00 | 34% |
| Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMEN CMPL | $769.56 | $1,166.00 | 34% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOMEN CMPL | $769.56 | $1,166.00 | 34% |
| X-ray of the lower back, 4 or more views CPT 72110 HC XR L-SPINE 4+V | $582.78 | $883.00 | 34% |
| X-ray of the lower back, 4 or more views CPT 72110 HC XR L-SPINE 5V OBLIQUES | $582.78 | $883.00 | 34% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC XR L-SPINE 5V OBLIQUES | $582.78 | $883.00 | 34% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC XR L-SPINE 4+V | $582.78 | $883.00 | 34% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL | $85.80 | $130.00 | 34% |
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL-PRV 72 HR | $125.40 | $190.00 | 34% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL | $85.80 | $130.00 | 34% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL-PRV 72 HR | $125.40 | $190.00 | 34% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL | $89.10 | $135.00 | 34% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL-PRV 72 HR | $149.82 | $227.00 | 34% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL | $89.10 | $135.00 | 34% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL-PRV 72 HR | $149.82 | $227.00 | 34% |
| Complete blood count (CBC) with differential CPT 85025 HC CBC AUTO W/AUTO DIFF | $59.40 | $90.00 | 34% |
| Complete blood count (CBC) with differential CPT 85025 HC CBC AUTO W/AUTO DIFF-PRV 72 HR | $64.02 | $97.00 | 34% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC AUTO W/AUTO DIFF | $59.40 | $90.00 | 34% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC AUTO W/AUTO DIFF-PRV 72 HR | $64.02 | $97.00 | 34% |
| Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED | $43.56 | $66.00 | 34% |
| Complete blood count (CBC), no differential CPT 85027 HC CBC W/O DIFF-PRV 72 HR | $108.24 | $164.00 | 34% |
| Complete blood count (CBC), no differential inpatient CPT 85027 COMPLETE CBC AUTOMATED | $43.56 | $66.00 | 34% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC CBC W/O DIFF-PRV 72 HR | $108.24 | $164.00 | 34% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHEN METABOLIC PANEL | $118.80 | $180.00 | 34% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHEN METABOLIC PANEL | $118.80 | $180.00 | 34% |
| Kidney function blood test panel CPT 80069 HC RENAL PANEL | $113.52 | $172.00 | 34% |
| Kidney function blood test panel inpatient CPT 80069 HC RENAL PANEL | $113.52 | $172.00 | 34% |
| Liver function blood test panel CPT 80076 HC LIVER (HEPATIC) PANEL | $68.64 | $104.00 | 34% |
| Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL-PRV 72 HR | $131.34 | $199.00 | 34% |
| Liver function blood test panel inpatient CPT 80076 HC LIVER (HEPATIC) PANEL | $68.64 | $104.00 | 34% |
| Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL-PRV 72 HR | $131.34 | $199.00 | 34% |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL | $256.74 | $389.00 | 34% |
| Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL | $256.74 | $389.00 | 34% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA FREE | $117.48 | $178.00 | 34% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA FREE | $117.48 | $178.00 | 34% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA TOTAL | $117.48 | $178.00 | 34% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA TOTAL | $117.48 | $178.00 | 34% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT (LUPUS) | $46.86 | $71.00 | 34% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT | $49.50 | $75.00 | 34% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT-PRV 72 HR | $56.10 | $85.00 | 34% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC APTT | $91.08 | $138.00 | 34% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT (LUPUS) | $46.86 | $71.00 | 34% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT | $49.50 | $75.00 | 34% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT-PRV 72 HR | $56.10 | $85.00 | 34% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC APTT | $91.08 | $138.00 | 34% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME (PT) | $31.68 | $48.00 | 34% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME (PT)-PRV 72 HR | $65.34 | $99.00 | 34% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME (PT) | $31.68 | $48.00 | 34% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME (PT)-PRV 72 HR | $65.34 | $99.00 | 34% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORM | $99.00 | $150.00 | 34% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH WITH HAMA TREATMENT | $99.00 | $150.00 | 34% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORM-PRV 72 HR | $114.84 | $174.00 | 34% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH WITH HAMA TREATMENT | $99.00 | $150.00 | 34% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORM | $99.00 | $150.00 | 34% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORM-PRV 72 HR | $114.84 | $174.00 | 34% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS AUTO W/MICRO | $38.28 | $58.00 | 34% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS AUTO W/MICRO-PRV 72 HR | $84.48 | $128.00 | 34% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS AUTO W/MICRO | $38.28 | $58.00 | 34% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS AUTO W/MICRO-PRV 72 HR | $84.48 | $128.00 | 34% |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS SPECIFIC GRAVITY-PRV 72 HR | $33.00 | $50.00 | 34% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS SPECIFIC GRAVITY-PRV 72 HR | $33.00 | $50.00 | 34% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Colonoscopy with polyp removal CPT 45385 HC COLONOSCOPY,REVM LESN,SNARE-PRV 72 HR | $1,896.18 | $2,873.00 | 34% |
| Colonoscopy with polyp removal inpatient CPT 45385 HC COLONOSCOPY,REVM LESN,SNARE-PRV 72 HR | $1,896.18 | $2,873.00 | 34% |
| Colonoscopy with tissue sample CPT 45380 HC COLONOSCOPY W/BX | $1,472.46 | $2,231.00 | 34% |
| Colonoscopy with tissue sample inpatient CPT 45380 HC COLONOSCOPY W/BX | $1,472.46 | $2,231.00 | 34% |
| Colonoscopy, diagnostic CPT 45378 HC COLONOSCOPY DX | $1,338.48 | $2,028.00 | 34% |
| Colonoscopy, diagnostic inpatient CPT 45378 HC COLONOSCOPY DX | $1,338.48 | $2,028.00 | 34% |
| Gallbladder removal, laparoscopic CPT 47562 HC LAPROSCOPIC CHOLECYSTECTOMY | $6,738.60 | $10,210.00 | 34% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 HC LAPROSCOPIC CHOLECYSTECTOMY | $6,738.60 | $10,210.00 | 34% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ INTRLAMNR LUM/SAC W/GUIDE | $1,704.78 | $2,583.00 | 34% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ INTRLAMNR LUM/SAC W/GUIDE | $1,704.78 | $2,583.00 | 34% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC INJ INTRLAMNR LUM/SAC W/O GUIDE | $1,186.68 | $1,798.00 | 34% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC INJ INTRLAMNR LUM/SAC W/O GUIDE | $1,186.68 | $1,798.00 | 34% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ TRANSF LUMBAR SACRAL SINGLE | $1,779.36 | $2,696.00 | 34% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ TRANSF LUMBAR SACRAL SINGLE | $1,779.36 | $2,696.00 | 34% |
| Prostate biopsy CPT 55700 BIOPSY OF PROSTATE | $2,366.10 | $3,585.00 | 34% |
| Prostate biopsy inpatient CPT 55700 BIOPSY OF PROSTATE | $2,366.10 | $3,585.00 | 34% |
| Removal of a breast lump, open surgery CPT 19120 HC EXC FIBROADNOMA BREAST-PRV 72HR | $4,422.66 | $6,701.00 | 34% |
| Removal of a breast lump, open surgery inpatient CPT 19120 HC EXC FIBROADNOMA BREAST-PRV 72HR | $4,422.66 | $6,701.00 | 34% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC EGC W/BX SINGLE | $1,147.74 | $1,739.00 | 34% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC EGC W/BX SINGLE | $1,147.74 | $1,739.00 | 34% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC EGD DX W/WO SPECIMEN COLLECTION | $1,083.06 | $1,641.00 | 34% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC EGD DX W/WO SPECIMEN COLLECTION | $1,083.06 | $1,641.00 | 34% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 HC EKG COMPLETE-PRV 72 HR | $193.38 | $293.00 | 34% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 HC EKG COMPLETE-PRV 72 HR | $193.38 | $293.00 | 34% |
| New patient office visit, about 30 minutes CPT 99203 HC CLINIC VISIT INTERM NEW-PRV 72 HR | $94.38 | $143.00 | 34% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE O/P NEW LOW 30 MIN | $252.12 | $382.00 | 34% |
| New patient office visit, about 45 minutes CPT 99204 HC CLINIC VISIT COMPLEX NEW-PRV 72 HR | $141.24 | $214.00 | 34% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE O/P NEW MOD 45 MIN | $287.10 | $435.00 | 34% |
| New patient office visit, about 60 minutes CPT 99205 HC CLINIC VISIT COMPREH NEW-PRV 72 HR | $192.06 | $291.00 | 34% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE O/P NEW HI 60 MIN | $347.82 | $527.00 | 34% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERA EXER; EA 15 MIN | $80.52 | $122.00 | 34% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERA EXER; EA 15 MIN | $80.52 | $122.00 | 34% |