59/100
#994 nationally
Ssm Health St Mary's Hospital - Janesville
3400 East Racine Street, Janesville, WI 53546 · (608) 373-8000
Charges well above the national norm
For every $1 of care Medicare actually paid for here, Ssm Health St Mary's Hospital - Janesville billed $4.49 in list charges. That gap does not change a Medicare patient's bill — but it is where an uninsured or out-of-network bill starts.
- Charge-to-payment
- 4.5x
- volume-weighted across all its priced work
- Procedures priced
- 37
- inpatient and outpatient combined
- Rank in WI
- #39
- lower markup ranks higher
- CMS quality stars
- 4/5
- shown for context, not in the grade
How this grade was reached
Each component is scored against every other U.S. hospital in the same federal files, so the grade is a position in the country, not a pass mark we invented.
Better than 41% of U.S. hospitals.
Better than 75% of U.S. hospitals.
Better than 64% of U.S. hospitals.
Better than 63% of U.S. hospitals.
What this hospital treats most
The ten procedures it billed Medicare for most often, with its charge beside the national middle.
| Procedure | Patients | Charged | Actually paid | vs national |
|---|---|---|---|---|
|
Level 1 Intraocular Procedures
APC 5491 · Hospital outpatient visit |
283 | $9,877 | $2,192 | -16% |
|
Comprehensive Observation Services
APC 8011 · Hospital outpatient visit |
163 | $21,011 | $2,549 | +8% |
|
Sepsis (severe)
MS-DRG 871 · Inpatient stay |
100 | $50,090 | $13,584 | -23% |
|
Heart Failure (severe)
MS-DRG 291 · Inpatient stay |
78 | $40,942 | $8,879 | -6% |
|
Level 5 Musculoskeletal Procedures
APC 5115 · Hospital outpatient visit |
65 | $41,459 | $12,360 | -34% |
|
Level 2 Upper GI Procedures
APC 5302 · Hospital outpatient visit |
65 | $6,584 | $1,789 | -44% |
|
Level 4 Urology and Related Services
APC 5374 · Hospital outpatient visit |
56 | $17,018 | $3,232 | -18% |
|
Level 5 Urology and Related Services
APC 5375 · Hospital outpatient visit |
43 | $22,169 | $4,866 | -19% |
|
Level 2 Excision/ Biopsy/ Incision and Drainage
APC 5072 · Hospital outpatient visit |
38 | $9,655 | $1,525 | -4% |
|
Level 3 Extraocular, Repair, and Plastic Eye Procedures
APC 5503 · Hospital outpatient visit |
35 | $8,610 | $2,198 | -40% |
Where its charges run furthest above the national middle
Only procedures it performed at least eleven times, so a single unusual case cannot produce the headline.
| Procedure | Charged | Actually paid | vs national |
|---|---|---|---|
|
Digestive Disorder (without major complications)
MS-DRG 392 · Inpatient stay |
$39,119 | $5,792 | +21% |
|
Fainting
MS-DRG 312 · Inpatient stay |
$42,498 | $8,279 | +16% |
|
Sepsis (without major complications)
MS-DRG 872 · Inpatient stay |
$45,066 | $8,109 | +15% |
|
Comprehensive Observation Services
APC 8011 · Hospital outpatient visit |
$21,011 | $2,549 | +8% |
|
Respiratory Infection (with complications)
MS-DRG 178 · Inpatient stay |
$39,018 | $6,850 | +5% |
|
Urinary Tract Infection (without major complications)
MS-DRG 690 · Inpatient stay |
$29,779 | $6,659 | about average |
|
Skin Infection (without major complications)
MS-DRG 603 · Inpatient stay |
$30,196 | $6,486 | about average |
|
Pneumonia (with complications)
MS-DRG 194 · Inpatient stay |
$31,009 | $6,594 | about average |
Where it charges least relative to everyone else
| Procedure | Charged | Actually paid | vs national |
|---|---|---|---|
|
Level 1 Abdominal/peritoneal/biliary and Related Procedures
APC 5341 · Hospital outpatient visit |
$8,961 | $3,254 | -61% |
|
Level 3 Urology and Related Services
APC 5373 · Hospital outpatient visit |
$6,458 | $1,861 | -50% |
|
Level 2 Intraocular Procedures
APC 5492 · Hospital outpatient visit |
$11,122 | $3,824 | -46% |
|
Level 2 Upper GI Procedures
APC 5302 · Hospital outpatient visit |
$6,584 | $1,789 | -44% |
|
Level 4 Musculoskeletal Procedures
APC 5114 · Hospital outpatient visit |
$23,216 | $6,728 | -42% |
|
Level 1 Nerve Procedures
APC 5431 · Hospital outpatient visit |
$6,704 | $1,758 | -41% |
|
Level 3 Extraocular, Repair, and Plastic Eye Procedures
APC 5503 · Hospital outpatient visit |
$8,610 | $2,198 | -40% |
|
Level 2 Musculoskeletal Procedures
APC 5112 · Hospital outpatient visit |
$6,703 | $1,451 | -40% |
What this page cannot tell you
- It is not your bill. These are averages across Medicare patients. What you pay depends on your insurance, your plan's negotiated rate and your own case.
- It is not a quality rating. A hospital with a high markup may be excellent, and one with a low markup may not be. We checked: across every U.S. hospital, markup and the CMS quality star rating barely move together.
- A charge is not a cost. Hospitals do not collect their list charges from insured patients. The number matters because it is the opening figure on an uninsured or out-of-network bill.
- Ask for the real number. Every U.S. hospital must publish a machine-readable price file and give you a written good-faith estimate on request.