SSM HEALTH ST AGNES HOSPITAL-FOND DU LAC

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
29085	Apply hand/wrist cast	—	—	$121	$3,335	11
29086	Apply finger cast	—	—	$121	$3,335	11
29105	Apply long arm splint	—	—	$121	$3,335	11
29125	Apply forearm splint	—	—	$98.7	$3,335	11
29126	Apply forearm splint	—	—	$98.7	$3,335	11
29130	Application of finger splint	—	—	$98.7	$3,335	11
29131	Application of finger splint	—	—	$43.76	$3,335	11
29200	Strapping of chest	—	—	$121	$3,335	11
29240	Strapping of shoulder	—	—	$98.7	$3,335	11
29260	Strapping of elbow or wrist	—	—	$43.76	$3,335	11
29280	Strapping of hand or finger	—	—	$43.76	$3,335	11
29305	Application of hip cast	—	—	$207	$3,335	11
29325	Application of hip casts	—	—	$207	$3,335	11
29345	Application of long leg cast	—	—	$207	$3,335	11
29355	Application of long leg cast	—	—	$207	$3,335	11
29358	Apply long leg cast brace	—	—	$207	$3,335	11
29365	Application of long leg cast	—	—	$207	$3,335	11
29405	Apply short leg cast	—	—	$207	$3,335	11
29425	Apply short leg cast	—	—	$207	$3,335	11
29435	Apply short leg cast	—	—	$207	$3,335	11
29440	Addition of walker to cast	—	—	$121	$3,335	11
29445	Apply rigid leg cast	—	—	$207	$3,335	11
29450	Application of leg cast	—	—	$121	$3,335	11
29505	Application long leg splint	—	—	$121	$3,335	11
29515	Application lower leg splint	—	—	$121	$3,335	11
29520	Strapping of hip	—	—	$98.7	$3,335	11
29530	Strapping of knee	—	—	$98.7	$3,335	11
29540	Strapping of ankle and/or ft	—	—	$121	$3,335	11
29550	Strapping of toes	—	—	$43.76	$3,335	11
29580	Application of paste boot	—	—	$121	$3,335	11
29581	Apply multlay comprs lwr leg	—	—	$121	$3,335	11
29584	Appl multlay comprs arm/hand	—	—	$121	$3,335	11
29700	Removal/revision of cast	—	—	$207	$3,335	11
29705	Removal/revision of cast	—	—	$207	$3,335	11
29710	Removal/revision of cast	—	—	$207	$3,335	11
29720	Repair of body cast	—	—	$121	$3,335	11
29730	Windowing of cast	—	—	$121	$3,335	11
29740	Wedging of cast	—	—	$207	$3,335	11
29750	Wedging of clubfoot cast	—	—	$207	$3,335	11
29799	Casting/strapping procedure	—	—	$121	$13,249	11
29800	Jaw arthroscopy/surgery	—	—	$2,427	$8,770	11
29804	Jaw arthroscopy/surgery	—	—	$2,427	$8,770	11
29805	Shoulder arthroscopy dx	—	—	$2,427	$8,770	11
29806	Shoulder arthroscopy/surgery	—	—	$5,383	$18,364	11
29807	Shoulder arthroscopy/surgery	—	—	$5,383	$18,364	11
29819	Shoulder arthroscopy/surgery	—	—	$2,427	$18,364	11
29820	Shoulder arthroscopy/surgery	—	—	$5,383	$18,364	11
29821	Shoulder arthroscopy/surgery	—	—	$2,427	$18,364	11
29822	Shoulder arthroscopy/surgery	—	—	$2,427	$8,770	11
29823	Shoulder arthroscopy/surgery	—	—	$2,427	$18,364	11

Showing top 50 of 13,688 priced procedures, sorted by gross charge.

Data straight from this hospital's federally-mandated machine-readable file (45 CFR § 180). The compliance grade reflects how completely the hospital published the six required data elements, not the quality of care.