HSHS St. Clare Memorial Hospital — price list
← Hospital overviewVerified from HSHS St. Clare Memorial Hospital’s published price file
Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
119 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| Anchor/screw bn/bn,tis/bn Inpatient & outpatient | C1713 HCPCS | $926 | $611 | $222 – $926 | — | |
| Cath, inf, per/cent/midline Inpatient & outpatient | C1751 HCPCS | $511 | $337 | $123 – $511 | — | |
| Cerv semi-rig adj molded chn Inpatient & outpatient | L0150 HCPCS | $141 | $93.06 | $33.84 – $141 | — | |
| Conn tiss, human(inc fascia) Inpatient & outpatient | C1762 HCPCS | $3,095 | $2,043 | $743 – $3,095 | — | |
| Foot drop splint pre ots Inpatient & outpatient | L4398 HCPCS | $180 | $119 | $43.20 – $180 | — | |
| 1.3mm ti t/y plt 3hls hd/8hls Inpatient & outpatient | C1713 HCPCS | $887 | $585 | $213 – $887 | — | |
| 1.5mm ti cndlr plt 7hls/36mm r/l Inpatient & outpatient | C1713 HCPCS | $1,151 | $760 | $276 – $1,151 | — | |
| 2.0mm ti condylar plt 7hl/39mm r/l Inpatient & outpatient | C1713 HCPCS | $1,195 | $789 | $287 – $1,195 | — | |
| 2.0mm ti lc-dcp plt 6hls 36mm Inpatient & outpatient | C1713 HCPCS | $1,093 | $721 | $262 – $1,093 | — | |
| 2.0mm ti stght plt 8hls/35mm Inpatient & outpatient | C1713 HCPCS | $845 | $558 | $203 – $845 | — | |
| 2.0mm ti t/yplt 3hls hd/8hls shft Inpatient & outpatient | C1713 HCPCS | $199 | $131 | $47.76 – $199 | — | |
| 2.4mm ti cndlr plt 8hls/57mm r/l Inpatient & outpatient | C1713 HCPCS | $1,214 | $801 | $291 – $1,214 | — | |
| 2.4mm ti lc-dcp plt 6hls/47mm Inpatient & outpatient | C1713 HCPCS | $267 | $176 | $64.08 – $267 | — | |
| 2.4mm ti tplt 2hls/8hls shft/54mm Inpatient & outpatient | C1713 HCPCS | $299 | $197 | $71.76 – $299 | — | |
| 2.4mm ti tplt 3hls hd/8hls shft 54mm Inpatient & outpatient | C1713 HCPCS | $1,108 | $731 | $266 – $1,108 | — | |
| Accessory kit 3550-63 Inpatient & outpatient | 272 RC | $249 | $164 | $59.76 – $249 | — | |
| Airwalker splint including fitting Inpatient & outpatient | L4360 HCPCS | $580 | $383 | $139 – $580 | — | |
| Bone putty Inpatient & outpatient | C1713 HCPCS | $2,414 | $1,593 | $579 – $2,414 | — | |
| Cannula cement verteport 10g Inpatient & outpatient | 272 RC | $276 | $182 | $66.24 – $276 | — | |
| Car fib rod 8mm x 200mm Inpatient & outpatient | 278 RC | $530 | $350 | $127 – $530 | — | |
| Cement Inpatient & outpatient | 278 RC | $3,377 | $2,229 | $810 – $3,377 | — | |
| Cervical collar two piece Inpatient & outpatient | L0172 HCPCS | $324 | $214 | $77.76 – $324 | — | |
| Clavicle strap/fit & adj Inpatient & outpatient | L3650 HCPCS | $175 | $116 | $42.00 – $175 | — | |
| Cutter endo ets reload Inpatient & outpatient | 272 RC | $318 | $210 | $76.32 – $318 | — | |
| Digoxin levels Inpatient & outpatient | 80162 CPT | $173 | $114 | $13.28 – $173 | — | |
| Dilator single step 12fr Inpatient & outpatient | 272 RC | $629 | $415 | $151 – $629 | — | |
| Doxepin Inpatient & outpatient | 80335 CPT | $66.00 | $43.56 | $15.84 – $66.00 | — | |
| Drain channel hubless 10f Inpatient & outpatient | 272 RC | $55.00 | $36.30 | $13.20 – $55.00 | — | |
| Drill bit 3 fluted qc-125mm Inpatient & outpatient | 272 RC | $407 | $269 | $97.68 – $407 | — | |
| Drill bit mini .76 6-14mm Inpatient & outpatient | 272 RC | $583 | $385 | $140 – $583 | — |