Hshs St Clare Memorial Hospital

855 S Main St, Oconto Falls, WI 54154 · (920) 846-3444

Critical Access HospitalsVoluntary non-profit - PrivateGreen Bay, WI metro Website ↗Website taken from the domain of its price file

Price file

Prices published

File dated 2026-03-24

3,173 price rows for 48 procedures

Published prices

cash · negotiated range · list

Basic metabolic panel (blood test)

CPT 80048 · lowest of 2 lines · metro median $15

$86

cash

$8 to $190

100 negotiated rates

$130

list

CT scan of the abdomen and pelvis, with contrast

CPT 74177 · metro median $1,723

$3,017

cash

$356 to $4,571

50 negotiated rates

$4,571

list

CT scan of the head, no contrast

CPT 70450 · metro median $885

$1,259

cash

$107 to $1,908

50 negotiated rates

$1,908

list

CT scan of the pelvis, with contrast

CPT 72193 · metro median $1,539

$1,539

cash

$179 to $2,332

50 negotiated rates

$2,332

list

Chlamydia test (DNA)

CPT 87491 · metro median $113

$217

cash

$35 to $329

50 negotiated rates

$329

list

Colonoscopy (diagnostic)

CPT 45378 · metro median $1,338

$1,338

cash

$176 to $2,028

47 negotiated rates

$2,028

list

Colonoscopy with biopsy

CPT 45380 · metro median $1,472

$1,472

cash

$191 to $2,231

47 negotiated rates

$2,231

list

Colonoscopy with polyp removal

CPT 45385 · metro median $1,896

$1,896

cash

$241 to $2,873

47 negotiated rates

$2,873

list

Complete blood count (CBC) with differential

CPT 85025 · lowest of 2 lines · metro median $59

$59

cash

$8 to $97

100 negotiated rates

$90

list

Comprehensive metabolic panel (blood test)

CPT 80053 · metro median $31

$119

cash

$11 to $180

50 negotiated rates

$180

list

Diagnostic mammogram (both breasts)

CPT 77066 · metro median $370

$370

cash

$77 to $560

50 negotiated rates

$560

list

Electrocardiogram (ECG) with interpretation

CPT 93000 · metro median $193

$193

cash

$42 to $293

49 negotiated rates

$293

list

Established patient office visit (about 40 minutes)

CPT 99215 · lowest of 2 lines · metro median $153

$153

cash

$56 to $514

84 negotiated rates

$232

list

Gallbladder removal (laparoscopic)

CPT 47562 · metro median $6,739

$6,739

cash

$646 to $10,210

47 negotiated rates

$10,210

list

Gonorrhea test (DNA)

CPT 87591 · lowest of 2 lines · metro median $122

$217

cash

$35 to $360

100 negotiated rates

$329

list

Hip or knee replacement, no major complications

MS-DRG 470

—

cash

—

list

Hospital stay for digestive disorders, no complications

MS-DRG 392

—

cash

—

list

Inguinal hernia repair (age 5 and up)

CPT 49505

—

cash

—

list

Knee arthroscopy with meniscus repair

CPT 29881

—

cash

—

list

Lipid panel (cholesterol test)

CPT 80061 · lowest of 2 lines · metro median $65

$89

cash

$13 to $227

100 negotiated rates

$135

list

Liver function panel

CPT 80076 · lowest of 2 lines · metro median $69

$69

cash

$8 to $199

100 negotiated rates

$104

list

MRI of the brain, with and without contrast

CPT 70553 · metro median $2,176

$2,721

cash

$356 to $4,123

50 negotiated rates

$4,123

list

MRI of the knee or other lower joint, no contrast

CPT 73721 · metro median $1,179

$2,421

cash

$244 to $3,668

50 negotiated rates

$3,668

list

MRI of the lower back (lumbar spine), no contrast

CPT 72148 · metro median $1,287

$2,338

cash

$244 to $3,542

50 negotiated rates

$3,542

list

MRI of the neck (cervical spine), no contrast

CPT 72141 · metro median $1,270

$1,815

cash

$244 to $2,750

50 negotiated rates

$2,750

list

Nerve block injection, lower back, with imaging guidance

CPT 64483 · metro median $1,779

$1,779

cash

$647 to $2,696

50 negotiated rates

$2,696

list

New patient office visit (about 30 minutes)

CPT 99203 · lowest of 2 lines · metro median $179

$94

cash

$34 to $382

84 negotiated rates

$143

list

New patient office visit (about 45 minutes)

CPT 99204 · lowest of 2 lines · metro median $185

$141

cash

$51 to $435

84 negotiated rates

$214

list

New patient office visit (about 60 minutes)

CPT 99205 · lowest of 2 lines · metro median $209

$192

cash

$70 to $527

84 negotiated rates

$291

list

PSA test (prostate)

CPT 84153 · metro median $90

$117

cash

$18 to $178

50 negotiated rates

$178

list

Partial thromboplastin time (blood clotting test)

CPT 85730 · lowest of 4 lines · metro median $47

$47

cash

$6 to $138

200 negotiated rates

$71

list

Physical therapy, therapeutic exercise (15 minutes)

CPT 97110 · metro median $81

$81

cash

$28 to $122

50 negotiated rates

$122

list

Pregnancy ultrasound (after first trimester)

CPT 76805 · metro median $524

$574

cash

$107 to $869

50 negotiated rates

$869

list

Prostate biopsy

CPT 55700 · metro median $2,213

$2,366

cash

$860 to $3,585

46 negotiated rates

$3,585

list

Prothrombin time (blood clotting test)

CPT 85610 · lowest of 2 lines · metro median $28

$32

cash

$4 to $99

100 negotiated rates

$48

list

Removal of a breast lump (biopsy by excision)

CPT 19120 · metro median $2,645

$4,423

cash

$422 to $6,701

47 negotiated rates

$6,701

list

Screening mammogram (both breasts)

CPT 77067 · metro median $280

$310

cash

$77 to $470

49 negotiated rates

$470

list

Shoulder arthroscopy with decompression

CPT 29826

—

cash

—

list

Sleep study (overnight, attended)

CPT 95810 · metro median $3,385

$3,812

cash

$456 to $5,776

50 negotiated rates

$5,776

list

Spinal injection, lower back, no imaging guidance

CPT 62322 · metro median $1,187

$1,187

cash

$432 to $1,798

50 negotiated rates

$1,798

list

Spinal injection, lower back, with imaging guidance

CPT 62323 · metro median $1,705

$1,705

cash

$620 to $2,583

50 negotiated rates

$2,583

list

TSH test (thyroid)

CPT 84443 · lowest of 3 lines · metro median $49

$99

cash

$17 to $174

150 negotiated rates

$150

list

Transvaginal ultrasound

CPT 76830 · metro median $398

$531

cash

$107 to $805

50 negotiated rates

$805

list

Ultrasound of the abdomen (complete)

CPT 76700 · metro median $524

$770

cash

$107 to $1,166

50 negotiated rates

$1,166

list

Upper endoscopy (EGD)

CPT 43235 · metro median $1,361

$1,083

cash

$119 to $1,660

47 negotiated rates

$1,641

list

Upper endoscopy with biopsy

CPT 43239 · metro median $1,361

$1,148

cash

$133 to $1,739

47 negotiated rates

$1,739

list

Urinalysis with microscope

CPT 81001 · lowest of 2 lines · metro median $38

$38

cash

$3 to $128

100 negotiated rates

$58

list

X-ray of the lower spine (4 or more views)

CPT 72110 · lowest of 2 lines · metro median $311

$583

cash

$91 to $883

100 negotiated rates

$883

list

Source files

The machine-readable files this hospital lists in its cms-hpt.txt. Every price above comes from one of them.

https://www.hshs.org/getmedia/aa25aee9-926d-4a3b-9697-b98148e40f18/390848401_st-clare-memorial-hospital-inc_standardcharges.zip
HSHS St. Clare Memorial Hospital · parsed · tall v3.0.0 · file dated 2026-03-24 · 4.8 MB · 3173 price rows read · read Nov 2026