SSM Health · Janesville, WI
26
In-network payers
139
Disclosed rate categories
50
Beds
5
Care quality
Ssm Health St. Mary S Hospital - Janesville is a 50-bed voluntary non-profit - other hospital in Janesville, WI, affiliated with SSM Health. Below you'll find publicly disclosed negotiated rates and facility details, including 26 in-network payers and 139 disclosed rate categories.
CCN (Medicare provider number)
520208
NPI
1194004408
Type
Short Term Acute Care Hospital
Ownership
Voluntary Non-Profit - Other
Beds
50
Care Quality
5
Insurance acceptance may vary by specific plan, network status, and services required. Contact your insurance provider or the hospital's billing department to confirm coverage details.
The 24 services Ssm Health St. Mary S Hospital - Janesville most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data.
Childbirth · Inpatient
MS-DRG 807
$9,660 - $12,303
from 2 insurers · median $10,981
CMS lists this service as CPT 59400, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
CT imaging
CPT 74177
$1,896 - $5,033
from 3 insurers · median $2,398
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 66984
$4,584 - $5,475
from 2 insurers · median $5,029
283 Medicare claims in Level 1 Intraocular Procedures (CMS 2024)
CT imaging
CPT 70450
$608 - $2,019
from 2 insurers · median $1,313
Common here, based on CMS Medicare volume
Urology
CPT 50590
$23,189 - $30,258
from 2 insurers · median $26,723
56 Medicare claims in Level 4 Urology and Related Services (CMS 2024)
Medicine & Surgery
CPT 47562
$15,812 - $23,693
from 3 insurers · median $16,166
26 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
CT imaging
CPT 74176
$900 - $4,843
from 2 insurers · median $2,872
Common here, based on CMS Medicare volume
Mammography
CPT 77067
$249 - $864
from 2 insurers · median $557
Common here, based on CMS Medicare volume
Childbirth · Inpatient
MS-DRG 788
$18,768
negotiated rate
CMS lists this service as CPT 59510, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 788, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Cardiology and vascular testing
CPT 93306
$1,322 - $3,241
from 2 insurers · median $2,281
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45385
$4,135 - $5,399
from 3 insurers · median $4,584
Common here, based on CMS Medicare volume
CT imaging
CPT 71260
$1,439 - $2,510
from 2 insurers · median $1,974
Common here, based on CMS Medicare volume
Digestive procedures
CPT 49650
$7,110 - $23,693
from 3 insurers · median $15,491
26 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Medicine & Surgery
CPT 49505
$3,659 - $12,144
from 2 insurers · median $7,901
25 Medicare claims in Level 1 Abdominal/Peritoneal/Biliary and Related Procedures (CMS 2024)
MRI imaging
CPT 70553
$2,262 - $4,750
from 3 insurers · median $2,398
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45380
$2,943 - $5,399
from 3 insurers · median $5,065
Common here, based on CMS Medicare volume
Nuclear imaging
CPT 78452
$3,546 - $4,716
from 2 insurers · median $4,131
Common here, based on CMS Medicare volume
Gynecology
CPT 58571
$14,365 - $16,442
from 2 insurers · median $15,404
Typical for a hospital with this service line
Digestive procedures
CPT 43239
$288 - $4,280
from 3 insurers · median $4,044
Common here, based on CMS Medicare volume
X-ray and bone density
CPT 71046
$168 - $562
from 2 insurers · median $365
Common here, based on CMS Medicare volume
MRI imaging
CPT 72148
$1,238 - $3,408
from 2 insurers · median $2,323
Common here, based on CMS Medicare volume
MRI imaging
CPT 73721
$1,450 - $3,804
from 2 insurers · median $2,627
Common here, based on CMS Medicare volume
Gynecology
CPT 58661
$3,314 - $23,693
from 3 insurers · median $16,223
Typical for a hospital with this service line
Ultrasound
CPT 76705
$536 - $1,256
from 2 insurers · median $896
Common here, based on CMS Medicare volume
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 10 | 442% | 6 | 3 |
| Insurer B* | 21 | 436% | 12 | 8 |
| Insurer C* | 24 | 395% | 17 | 5 |
How we chose these services: 5 appear in this hospital's own Medicare claims, 15 are common here based on CMS Medicare volume, and 4 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Ssm Health St. Mary S Hospital - Janesville.
3400 East Racine Steeet, Janesville, WI 53546
(608) 373-8000
The nearest hospitals of similar type and size. Their rates are compared with Ssm Health St. Mary S Hospital - Janesville for the same insurers and services above.
Beloit Memorial Hospital
▼ Rates typically 23% lower than Ssm Health St. Mary S Hospital - Janesville (22 services)
Fort Atkinson Memorial Hospital
▼ Rates typically 54% lower than Ssm Health St. Mary S Hospital - Janesville (22 services)
Watertown Regional Medical Center
▼ Rates typically 21% lower than Ssm Health St. Mary S Hospital - Janesville (22 services)
Fhn Memorial Hospital
▼ Rates typically 17% lower than Ssm Health St. Mary S Hospital - Janesville (22 services)
Northwestern Medicine Kishwaukee Hospital
▲ Rates typically 6% higher than Ssm Health St. Mary S Hospital - Janesville (22 services)
Aurora Medical Center Kenosha
▲ Rates typically 16% higher than Ssm Health St. Mary S Hospital - Janesville (21 services)
Mercyhealth Hospital And Trauma Center–Janesville
Monroe Clinic Hospital
St. Agnes Hospital
Ssm Health St. Mary S Hospital - Madison
About Ssm Health St. Mary S Hospital - Janesville's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Ssm Health St. Mary S Hospital - Janesville range from $2,262 to $4,750 across 3 insurers. Blue Cross Blue Shield's rate is $2,262. The median at nearby comparable hospitals is $2,159. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Ssm Health St. Mary S Hospital - Janesville range from $1,896 to $5,033 across 3 insurers. Aetna's rate is $5,033. The median at nearby comparable hospitals is $3,045. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Ssm Health St. Mary S Hospital - Janesville range from $4,135 to $5,399 across 3 insurers. Blue Cross Blue Shield's rate is $4,584. The median at nearby comparable hospitals is $3,191. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at Ssm Health St. Mary S Hospital - Janesville range from $9,660 to $12,303 across 2 insurers. Blue Cross Blue Shield's rate is $9,660. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Ssm Health St. Mary S Hospital - Janesville range from $249 to $864 across 2 insurers. Aetna's rate is $249. The median at nearby comparable hospitals is $322. What a patient pays depends on their plan's deductible, coinsurance and network status.
Ssm Health St. Mary S Hospital - Janesville has 50 beds. Facility type: Short Term Acute Care Hospital.
Ssm Health St. Mary S Hospital - Janesville is located at 3400 East Racine Steeet, Janesville, WI 53546. Its main phone number is (608) 373-8000.
Ssm Health St. Mary S Hospital - Janesville's CMS Certification Number (CCN), also called its Medicare provider number, is 520208.
The National Provider Identifier (NPI) on file for Ssm Health St. Mary S Hospital - Janesville is 1194004408.
Ssm Health St. Mary S Hospital - Janesville is affiliated with SSM Health.
Ssm Health St. Mary S Hospital - Janesville lists 26 in-network payers, including Aetna, Aspirus Health Plan, Avera Health Plans, BCBS, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
139 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
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{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers