St Marys Hospital Medical Center of Green Bay INC Hospital Sisters
St Marys Hospital Medical Center of Green Bay INC Hospital Sisters in Green Bay, WI publishes cash prices for 39 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.
1726 SHAWANO AVE, GREEN BAY, WI 54303 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 CONTR SHUNT EVAL LIMITED | $372.90 | $565.00 | 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 CONTR SHUNT EVAL LIMITED | $372.90 | $565.00 | 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 HC MRI BRAIN W&W/O CONTRAST | $2,721.18 | $4,123.00 | 34% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W&W/O CONTRAST PITUITARY | $2,857.80 | $4,330.00 | 34% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN W&W/O CONTRAST | $2,721.18 | $4,123.00 | 34% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN W&W/O CONTRAST PITUITARY | $2,857.80 | $4,330.00 | 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% |
| 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 X-RAY EXAM L-2 SPINE 4/>VWS | $582.78 | $883.00 | 34% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS | $582.78 | $883.00 | 34% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HC SURGICAL VET PANEL | $7.92 | $12.00 | 34% |
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL | $85.80 | $130.00 | 34% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC SURGICAL VET PANEL | $7.92 | $12.00 | 34% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL | $85.80 | $130.00 | 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 inpatient CPT 80061 HC LIPID PANEL | $89.10 | $135.00 | 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 inpatient CPT 85025 HC CBC AUTO W/AUTO DIFF | $59.40 | $90.00 | 34% |
| Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED | $43.56 | $66.00 | 34% |
| Complete blood count (CBC), no differential inpatient CPT 85027 COMPLETE CBC AUTOMATED | $43.56 | $66.00 | 34% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE METABOL PANEL VET | $15.84 | $24.00 | 34% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE METABOL PANEL | $118.80 | $180.00 | 34% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE METABOL PANEL VET | $15.84 | $24.00 | 34% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE METABOL 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 inpatient CPT 80076 HC LIVER (HEPATIC) PANEL | $68.64 | $104.00 | 34% |
| Obstetric blood test panel CPT 80055 HC PRENATAL PANEL | $256.74 | $389.00 | 34% |
| Obstetric blood test panel inpatient CPT 80055 HC PRENATAL 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 THROMBOPLASTIN TIME PARTIAL | $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 APTT | $91.08 | $138.00 | 34% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL | $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 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 inpatient CPT 85610 HC PROTHROMBIN TIME (PT) | $31.68 | $48.00 | 34% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE | $99.00 | $150.00 | 34% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY THYROID STIM HORMONE | $99.00 | $150.00 | 34% |
| Urinalysis with microscope exam, automated 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 | $38.28 | $58.00 | 34% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cataract surgery with lens implant CPT 66984 HC REM CATARACT W/IOL | $5,325.54 | $8,069.00 | 34% |
| Cataract surgery with lens implant inpatient CPT 66984 HC REM CATARACT W/IOL | $5,325.54 | $8,069.00 | 34% |
| Left heart catheterization, diagnostic CPT 93452 HC LHC ONLY NO COROS 93452 | $5,239.74 | $7,939.00 | 34% |
| Left heart catheterization, diagnostic inpatient CPT 93452 HC LHC ONLY NO COROS 93452 | $5,239.74 | $7,939.00 | 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 HC BX PROSTATE NEEDLE/PUNCH | $2,366.10 | $3,585.00 | 34% |
| Prostate biopsy inpatient CPT 55700 HC BX PROSTATE NEEDLE/PUNCH | $2,366.10 | $3,585.00 | 34% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| New patient office visit, about 30 minutes CPT 99203 HC CLINIC VISIT INTERM NEW | $252.12 | $382.00 | 34% |
| New patient office visit, about 45 minutes CPT 99204 HC CLINIC VISIT COMPLEX NEW | $287.10 | $435.00 | 34% |
| New patient office visit, about 60 minutes CPT 99205 HC CLINIC VISIT COMPREH NEW | $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% |