Hospital Profile Acute Care Hospitals Voluntary non-profit - Private

SSM Health St Agnes Hospital-Fond Du Lac

430 E DIVISION ST, Fond Du Lac, WI 54935

CMS Overall Rating ★★★★☆

How this hospital's prices compare 121 procedures scored

1.0×

the fair BaseRate, typically

about the fair price

Across 121 shoppable procedures, SSM Health St Agnes Hospital-Fond Du Lac typically charges about the fair BaseRate for the procedures it prices. 8 of them run 30%+ above the fair BaseRate.

Where it's most above the fair price

Injection procedure for pain management fair $1,234 → $2,959 2.4×
Varicella (chickenpox) vaccine fair $341 → $597 1.7×
DTaP vaccine (diphtheria, tetanus, pertussis) fair $57 → $96 1.7×

How we calculate the BaseRate →

SSM Health St Agnes Hospital-Fond Du Lac publishes prices for 127 shoppable procedures in Fond Du Lac, WI. It's classified by CMS as Acute Care Hospitals (Voluntary non-profit - Private). CMS rates it 4/5 stars, and 66% of patients would recommend it.

Facility Overview

Setting: urban Bed Count: 79 Beds Teaching Status: Non-Teaching Annual Discharges: 6,660

Patient Experience

Recommendation Rate: 66% High Patient Rating: 70% ER Wait Time (Med): 157 min Readmission Rate: same

Pricing & Transparency

Procedures Mapped: 127 codes Typical vs Fair BaseRate: 1.0× Price File In Index: Yes MRF Version: 3.0.0

Prices at SSM Health St Agnes Hospital-Fond Du Lac

Every shoppable procedure, ranked by how far its price sits above the fair BaseRate. Fair BaseRate is the modeled typical charge; vs Fair is how many times higher this hospital's price is.

Search Procedures & Codes

Procedure & Code	Cash Price	This Hospital	Fair BaseRate	vs Fair
Injection procedure for pain management HCPCS Code: `G0260`	$2,529	$2,959	$1,234	2.4×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$597	$341	1.7×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	—	$96	$57	1.7×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	—	$305	$181	1.7×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$2,995	$1,923	1.6×
Upper endoscopy with biopsy CPT Code: `43239`	—	$2,995	$1,960	1.5×
Colonoscopy with biopsy CPT Code: `45380`	—	$3,484	$2,502	1.4×
Group therapy session CPT Code: `90853`	$119	$101	$80	1.3×
Typhoid vaccine HCPCS Code: `90675`	—	$593	$496	1.2×
X-ray, hip CPT Code: `73502`	$304	$99	$83	1.2×
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	—	$43,222	$36,537	1.2×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$119	$17	$14	1.2×
Blood test, basic metabolic panel CPT Code: `80048`	$99	$11	$10	1.2×
Rabies immune globulin HCPCS Code: `90375`	—	$506	$440	1.1×
Culture, blood CPT Code: `87040`	$127	$13	$11	1.1×
Blood test, vitamin B12 CPT Code: `82607`	$91	$19	$17	1.1×
Ultrasound, abdomen (limited) CPT Code: `76705`	$508	$200	$177	1.1×
Hepatitis B immune globulin HCPCS Code: `90371`	—	$248	$220	1.1×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	—	$75	$67	1.1×
Hepatitis C antibody test CPT Code: `86803`	$125	$18	$16	1.1×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$133	$13	$12	1.1×
Blood test, PSA (prostate screen) CPT Code: `84153`	$124	$23	$21	1.1×
Blood test, ferritin (iron stores) CPT Code: `82728`	$119	$17	$15	1.1×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$172	$59	$53	1.1×
Culture, bacterial CPT Code: `87070`	$94	$11	$10	1.1×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	—	$33	$30	1.1×
Flu vaccine (high dose) HCPCS Code: `90656`	—	$42	$38	1.1×
MRI, lower back (no contrast) CPT Code: `72148`	$2,257	$455	$418	1.1×
Pneumococcal vaccine HCPCS Code: `90732`	—	$254	$233	1.1×
Blood test, thyroid (TSH) CPT Code: `84443`	$139	$21	$19	1.1×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$86	$12	$11	1.1×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$137	$24	$22	1.1×
Blood test, vitamin D CPT Code: `82306`	$232	$37	$35	1.1×
MRI, brain (no contrast) CPT Code: `70551`	$1,672	$455	$430	1.1×
Ultrasound, pelvis CPT Code: `76856`	$401	$200	$191	1.0×
Blood test, liver function panel CPT Code: `80076`	$94	$10	$10	1.0×
X-ray, ankle CPT Code: `73610`	$304	$77	$74	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$29	$5	$5	1.0×
Hepatitis B vaccine HCPCS Code: `90744`	—	$60	$58	1.0×
Flu vaccine injection HCPCS Code: `G0008`	$50	$47	$45	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$75	$10	$10	1.0×
Blood test, lipase CPT Code: `83690`	$66	$9	$9	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$20	$8	$8	1.0×
Blood test, hemoglobin CPT Code: `85018`	$19	$3	$3	1.0×
Breathing treatment (nebulizer) CPT Code: `94640`	$121	$219	$212	1.0×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,713	$666	$645	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$36	$5	$5	1.0×
X-ray, chest (single view) CPT Code: `71045`	$261	$65	$63	1.0×
Vaginal delivery (full package) CPT Code: `59400`	—	$4,589	$4,484	1.0×
CT scan, head (with contrast) CPT Code: `70460`	$1,444	$335	$328	1.0×
X-ray, neck (cervical spine) CPT Code: `72040`	$304	$75	$73	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$58	$4	$4	1.0×
X-ray, foot CPT Code: `73630`	$304	$71	$70	1.0×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$23,589	$23,347	1.0×
Colorectal cancer screening HCPCS Code: `G0010`	$35	$47	$47	1.0×
Pneumonia vaccine injection HCPCS Code: `G0009`	$50	$47	$47	1.0×
X-ray, hand CPT Code: `73130`	$304	$75	$75	1.0×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,516	$335	$334	1.0×
Blood test, potassium CPT Code: `84132`	$35	$6	$6	1.0×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,844	$666	$666	1.0×
Ultrasound, abdomen (complete) CPT Code: `76700`	$674	$200	$201	1.0×
Blood test, sodium CPT Code: `84295`	$31	$6	$6	1.0×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$25,990	$26,168	1.0×
Speech therapy (language evaluation) CPT Code: `92507`	$164	$75	$76	1.0×
X-ray, shoulder CPT Code: `73030`	$304	$66	$67	1.0×
Blood test, amylase CPT Code: `82150`	$63	$8	$8	1.0×
MRI, knee or other leg joint CPT Code: `73721`	$2,297	$455	$462	1.0×
Cataract surgery with lens implant CPT Code: `66984`	—	$4,109	$4,181	1.0×
X-ray, chest (two views) CPT Code: `71046`	$261	$67	$68	1.0×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$25,808	$26,422	1.0×
Occupational therapy (self-care training) CPT Code: `97535`	$48	$32	$33	1.0×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$10,431	$10,791	1.0×
Physical therapy (manual therapy) CPT Code: `97140`	$68	$27	$28	1.0×
C-section delivery (full package) CPT Code: `59510`	—	$4,589	$4,798	1.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$27	$5	$5	1.0×
X-ray, lower back CPT Code: `72110`	$304	$109	$114	1.0×
Ultrasound, thyroid and neck CPT Code: `76536`	$409	$200	$210	1.0×
Orthotic fitting and training CPT Code: `97760`	$67	$45	$48	0.9×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$67	$32	$34	0.9×
Blood test, magnesium CPT Code: `83735`	$69	$8	$9	0.9×
Physical therapy (gait training) CPT Code: `97116`	$54	$29	$31	0.9×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$69	$29	$31	0.9×
Blood test, creatinine (kidney) CPT Code: `82565`	$28	$6	$6	0.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$74	$33	$35	0.9×
CT scan, head (no contrast) CPT Code: `70450`	$1,375	$200	$215	0.9×
Prosthetic fitting and training CPT Code: `97761`	$51	$40	$43	0.9×
Blood test, calcium CPT Code: `82310`	$43	$6	$6	0.9×
Speech therapy (group session) CPT Code: `92508`	$16	$24	$26	0.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$62	$34	$37	0.9×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,632	$371	$405	0.9×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$4,828	$5,348	0.9×
CT scan, chest (no contrast) CPT Code: `71250`	$1,555	$200	$223	0.9×
CT scan, pelvis CPT Code: `72192`	$1,484	$200	$223	0.9×
X-ray, pelvis CPT Code: `72170`	$304	$78	$87	0.9×
Drug screening test HCPCS Code: `G0480`	$189	$131	$147	0.9×
Bunion correction surgery CPT Code: `28296`	—	$4,589	$5,155	0.9×
CT scan, sinuses CPT Code: `70486`	$1,367	$200	$227	0.9×
Inguinal hernia repair CPT Code: `49505`	—	$5,002	$5,701	0.9×
Psychotherapy session (60 minutes) CPT Code: `90837`	$131	$177	$202	0.9×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,375	$200	$233	0.9×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,495	$200	$233	0.9×
Psychiatric evaluation (first visit) CPT Code: `90791`	$213	$177	$207	0.9×
Family therapy session CPT Code: `90847`	$125	$177	$209	0.8×
Breast lump removal CPT Code: `19120`	—	$4,589	$5,489	0.8×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$7,194	$8,629	0.8×
Total hip replacement CPT Code: `27130`	—	$12,826	$15,428	0.8×
Electrical stimulation therapy HCPCS Code: `G0283`	$68	$12	$15	0.8×
Total knee replacement CPT Code: `27447`	—	$12,826	$16,054	0.8×
Trauma team activation HCPCS Code: `G0390`	$4,544	$1,332	$1,681	0.8×
Psychotherapy session (45 minutes) CPT Code: `90834`	$103	$177	$240	0.7×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,359	$238	$331	0.7×
Sleep study (overnight, in lab) CPT Code: `95810`	$3,568	$858	$1,226	0.7×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,695	$546	$811	0.7×
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$23	$35	0.7×
Screening mammogram (both breasts) CPT Code: `77067`	$163	$89	$141	0.6×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$399	$108	$176	0.6×
Blood antibody screen CPT Code: `86850`	$71	$15	$30	0.5×
New patient office visit (30-44 min) CPT Code: `99203`	$144	—	—	—
Office visit, established patient (20-29 min) CPT Code: `99213`	$131	—	—	—
Care planning with family CPT Code: `90887`	$106	—	—	—
Blood transfusion CPT Code: `36430`	$623	—	$617	—
Office visit, established patient (30-39 min) CPT Code: `99214`	$180	—	—	—
Neurobehavioral status check CPT Code: `96116`	$89	—	$344	—
Hospital observation (per hour) HCPCS Code: `G0378`	—	—	—	—
Psychological testing evaluation CPT Code: `96136`	$50	—	$111	—
Psychological testing by technician CPT Code: `96138`	$92	—	$366	—
Review of medical records for care CPT Code: `90889`	$143	—	—	—