SSM Health Waupun Memorial Hospital prices. From its own published file.

SSM Health Waupun Memorial Hospital in Waupun, WI publishes its standard charges as required by federal rule. Here's what it lists for common services, and how to check your bill against it.

12,131prices published

Apr 2026file last updated

$2,257cash price for mri lower back without contrast (list $4,104)

Common services

Service	Cash price	List price	Insurers pay
Emergency visit, moderate (level 3) `99283`	$240	$713	—
Emergency visit, high (level 4) `99284`	$358	$1,842	—
Emergency visit, highest (level 5) `99285`	$523	$1,755	—
Comprehensive metabolic panel `80053`	$133	$241	$10.56–$21.40
Basic metabolic panel `80048`	$97.35	$180	$8.46–$17.11
Complete blood count (CBC) `85025`	$75.35	$137	$7.77–$15.72
Blood draw (venipuncture) `36415`	$20.90	$38.00	$3.00–$15.91
Urinalysis `81001`	$57.75	$105	$3.17–$6.41
Troponin (heart test) `84484`	$87.45	$159	$12.47–$21.82
EKG tracing `93005`	$172	$312	—
Chest X-ray, 2 views `71046`	$261	$475	$64.74–$67.02
CT head without contrast `70450`	$1,375	$2,500	$242–$251
CT abdomen and pelvis with contrast `74177`	$1,713	$3,115	$729–$755
MRI lower back without contrast `72148`	$2,257	$4,104	$490–$508
Ultrasound, abdomen `76700`	$674	$1,226	$275–$285
IV push, single drug `96374`	$186	$363	—
IV fluids, first hour `96360`	$255	$499	$574–$574
Ketorolac injection, 15 mg `J1885`	—	—	$0.55–$2.05
Ondansetron injection `J2405`	—	—	$0.09–$0.25
Colonoscopy, diagnostic `45378`	—	—	$1,543–$4,761
Upper GI endoscopy with biopsy `43239`	—	—	$1,484–$4,761
Knee arthroscopy `29881`	—	—	$3,735–$8,770
Vaginal delivery, routine care `59400`	—	—	$3,735–$4,589
Cesarean delivery, routine care `59510`	—	—	$3,735–$4,589

Cash price: the discounted price for self-pay patients. List price: the hospital's gross charge. Insurers pay: the lowest and highest rates it lists for insurance plans. Source: SSM Health Waupun Memorial Hospital price transparency page.

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Common billing problems to look for

Billed above the posted cash priceIf you're paying yourself, ask the hospital to apply its published cash price.
Panels billed inside panelsA basic metabolic panel (80048) billed with a comprehensive one (80053) on the same day.
Duplicate linesThe same service billed twice without explanation.
No itemized billYou can ask for every line with its code, date and amount.