Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)
1506 S. Oneida St, Appleton, WI · Ascension · · NPI 1407803638
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Developmental screen/score/document 96110 CPT 96110 | $132.24 | $232.00 | $12.25 – $31.64 | 6 |
| Devel tst phys/qhp 1st hr CPT 96112 | not published | not published | $132.26 – $456.30 | 11 |
| Device intraute mirena HCPCS J7298 | $1,042.33 | $1,828.64 | $1,432.21 – $1,432.21 | 2 |
| Dev interrog remote 1/2/mlt CPT 93295 | not published | not published | $38.55 – $131.67 | 7 |
| Devise bowel pouch CPT 44316 | not published | not published | $1,410.84 – $4,976.63 | 7 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | not published | not published | $60.52 – $204.05 | 6 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $58.71 | $103.00 | $10.35 – $177.77 | 12 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $7.08 | $12.42 | $0.11 – $1.24 | 6 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $1.25 | $2.20 | $0.17 – $0.59 | 6 |
| Dexamethasone panel CPT 80420 | not published | not published | $103.05 – $624.86 | 16 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $454.35 | $797.11 | $156.02 – $797.11 | 7 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $53.58 | $94.00 | $22.23 – $85.81 | 16 |
| Diabetes (HbA1c) Test CPT 83036 | $34.20 | $60.00 | $9.71 – $37.48 | 16 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $176.26 – $647.63 | 7 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $334.42 – $1,164.00 | 7 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $97.33 – $805.60 | 11 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $128.78 – $729.94 | 6 |
| Diagnostic anoscopy spx 46600 CPT 46600 | not published | not published | $43.02 – $373.76 | 12 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | not published | not published | $122.36 – $122.36 | 2 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | not published | not published | $99.42 – $99.42 | 2 |
| Diagnostic laryngoscopy 31505 CPT 31505 | not published | not published | $52.27 – $391.94 | 12 |
| Diagnostic laryngoscopy 31575 CPT 31575 | not published | not published | $71.74 – $444.53 | 12 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $711.93 | $1,249.00 | $50.39 – $216.93 | 11 |
| Diagnostic Mammogram (one breast) CPT 77065 | $570.00 | $1,000.00 | $41.04 – $170.12 | 11 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $84.65 – $182.03 | 7 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $10,710.30 | $18,790.00 | $199.69 – $7,275.15 | 6 |
| Dialysis one evaluation CPT 90945 | $759.81 | $1,333.00 | $90.79 – $859.68 | 12 |
| Dialysis repeated eval CPT 90947 | not published | not published | $129.00 – $414.02 | 7 |
| Dialysis training complete CPT 90989 | not published | not published | $1,191.86 – $1,191.86 | 2 |
| Dialysis training incompl CPT 90993 | not published | not published | $259.28 – $259.28 | 2 |
| Diathermy eg microwave CPT 97024 | not published | not published | $6.69 – $14.05 | 12 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $27.99 | $49.10 | $8.45 – $17.56 | 6 |
| Dicyclomine injection HCPCS J0500 | $153.53 | $269.35 | $30.52 – $269.35 | 6 |
| Diffusing capacity CPT 94729 | $189.24 | $332.00 | $9.35 – $30.52 | 7 |
| Digital analysis of eeg CPT 95957 | not published | not published | $107.99 – $345.78 | 7 |
| Digit nerve surgery add-on CPT 64778 | not published | not published | $180.93 – $648.26 | 7 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $7.50 | $13.16 | $5.80 – $13.16 | 7 |
| Digoxin total therapeutic drug level CPT 80162 | $51.87 | $91.00 | $13.28 – $51.26 | 16 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $294.84 | $517.27 | $65.13 – $517.27 | 6 |
| Dilate biliary duct/ampulla CPT 47542 | not published | not published | $137.79 – $1,895.85 | 6 |
| Dilate esophagus CPT 43453 | not published | not published | $89.88 – $3,216.00 | 7 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $82.88 – $1,892.79 | 12 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | not published | not published | $337.42 – $1,223.44 | 6 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | not published | not published | $168.71 – $611.70 | 6 |
| Dilate ic vasospasm init CPT 61640 | not published | not published | $480.17 – $1,740.98 | 6 |
| Dilate tear duct opening CPT 68801 | not published | not published | $85.06 – $805.60 | 12 |
| Dilate urethra stricture CPT 53600 | not published | not published | $65.52 – $491.00 | 12 |
| Dilate urethra stricture CPT 53601 | not published | not published | $55.14 – $294.11 | 12 |
| Dilate urethra stricture CPT 53605 | not published | not published | $65.75 – $236.29 | 7 |
| Dilate urethra stricture CPT 53621 | not published | not published | $74.19 – $507.75 | 12 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $43.28 – $315.86 | 12 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $177.35 – $605.63 | 7 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $49.93 – $253.28 | 7 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $201.02 – $692.18 | 7 |
| Dilation of salivary duct CPT 42660 | not published | not published | $88.28 – $1,028.10 | 12 |
| Dilation of urethra CPT 53661 | not published | not published | $41.87 – $260.23 | 12 |
| Dilation of urethra CPT 53665 | not published | not published | $39.08 – $140.18 | 7 |
| Dilation of vagina CPT 57400 | not published | not published | $134.04 – $475.31 | 7 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $62.18 – $284.96 | 7 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $89.98 – $1,347.53 | 12 |
| Dilat xst trc ndurlgc px CPT 50436 | $3,256.98 | $5,714.00 | $153.96 – $554.96 | 6 |
| Dilat xst trc new access rcs CPT 50437 | $5,647.56 | $9,908.00 | $255.48 – $929.89 | 6 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $7.33 | $12.86 | $1.19 – $12.86 | 6 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | not published | not published | $29.07 – $29.07 | 2 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $30.81 – $83.76 | 12 |
| Disability dlco CPT 94727 | $163.02 | $286.00 | $12.67 – $315.86 | 12 |
| Disaccharidases CPT 82657 | $224.58 | $394.00 | $22.17 – $85.58 | 16 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $497.44 – $1,677.90 | 7 |
| Disarticulation shoulder CPT 23920 | not published | not published | $1,158.54 – $4,009.05 | 7 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | not published | not published | $1,493.41 – $5,231.55 | 7 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $195.08 – $691.01 | 7 |
| Discography cerv/thor spine CPT 72285 | not published | not published | $59.80 – $144.63 | 7 |
| Dise eval slp do brth flx dx CPT 42975 | not published | not published | $100.99 – $418.31 | 6 |
| Dissect brain w/scope CPT 62161 | not published | not published | $1,490.00 – $5,100.11 | 7 |
| Dissolve clot heart vessel CPT 92975 | $1,905.51 | $3,343.00 | $365.38 – $1,191.75 | 7 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $1,100.42 – $3,988.69 | 7 |
| Div aberrant vsl w/reanast CPT 33803 | not published | not published | $1,129.07 – $4,027.99 | 7 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $820.19 – $2,812.65 | 7 |
| Division of fallopian tube 58605 CPT 58605 | not published | not published | $351.74 – $1,206.26 | 7 |
| #d/lmeth-l-methamphetamine CPT 80374 | not published | not published | $28.93 – $31.67 | 3 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | not published | not published | $281.44 – $1,039.13 | 6 |
| Dmd dup/delet analysis CPT 81161 | not published | not published | $147.15 – $1,076.94 | 15 |
| Dmpk gene charac alleles CPT 81239 | not published | not published | $274.83 – $1,060.84 | 12 |
| Dmpk gene detc abnor allele CPT 81234 | not published | not published | $137.00 – $528.82 | 12 |
| Dna antibody native/double stranded CPT 86225 | $33.63 | $59.00 | $13.74 – $53.04 | 16 |
| Dna gardnerella CPT 87510 | $41.04 | $72.00 | $20.05 – $77.39 | 16 |
| Dna probe chlamydia CPT 87490 | not published | not published | $22.75 – $87.82 | 16 |
| Dna probe gc CPT 87590 | not published | not published | $26.88 – $103.76 | 16 |
| Dna trichomonas CPT 87660 | $35.34 | $62.00 | $20.05 – $77.39 | 16 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $20.69 | $36.30 | $10.77 – $24.82 | 6 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $4.48 | $7.86 | $0.76 – $6.92 | 7 |
| Domicil/r-home visit est pat CPT 99334 | not published | not published | $110.96 – $124.41 | 3 |
| Domicil/r-home visit est pat CPT 99335 | not published | not published | $173.85 – $196.27 | 3 |
| Domicil/r-home visit est pat CPT 99336 | not published | not published | $246.81 – $279.15 | 3 |
| Domicil/r-home visit est pat CPT 99337 | not published | not published | $352.93 – $400.09 | 3 |
| Domicil/r-home visit new pat CPT 99324 | not published | not published | $101.95 – $113.99 | 3 |
| Domicil/r-home visit new pat CPT 99325 | not published | not published | $147.38 – $165.38 | 3 |
| Domicil/r-home visit new pat CPT 99326 | not published | not published | $255.57 – $287.03 | 3 |
| Domicil/r-home visit new pat CPT 99327 | not published | not published | $340.86 – $384.82 | 3 |
| Domicil/r-home visit new pat CPT 99328 | not published | not published | $396.38 – $452.95 | 3 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.