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 |
|---|---|---|---|---|
| Drng salivary gland submax/subling 42310 CPT 42310 | not published | not published | $143.83 – $1,028.10 | 12 |
| Dronabinol 2.5mg oral HCPCS Q0167 | $3.39 | $5.95 | $0.87 – $5.95 | 6 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $21.59 | $37.88 | $17.04 – $17.04 | 2 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | $1,459.20 | $2,560.00 | $17.67 – $1,400.00 | 7 |
| Drug admin & hemodynmic meas CPT 93463 | $646.95 | $1,135.00 | $101.51 – $328.94 | 7 |
| Drug assay caffeine CPT 80155 | not published | not published | $20.23 – $148.88 | 15 |
| Drug assay posaconazole CPT 80187 | $91.77 | $161.00 | $27.11 – $104.64 | 12 |
| Drug assay rufinamide CPT 80210 | $63.84 | $112.00 | $27.11 – $104.64 | 12 |
| Drug assay vedolizumab CPT 80280 | not published | not published | $38.57 – $148.88 | 12 |
| Drug assay voriconazole CPT 80285 | $163.59 | $287.00 | $27.11 – $104.64 | 12 |
| Drug asy hydroxychloroquine CPT 80220 | not published | not published | $18.64 – $71.95 | 12 |
| Drug of abuse screen urine CPT 80305 | $78.66 | $138.00 | $12.60 – $48.64 | 13 |
| Drug screening tapentadol CPT 80372 | not published | not published | $29.42 – $31.67 | 3 |
| Drug screen quant tiagabine CPT 80199 | not published | not published | $25.83 – $104.64 | 15 |
| Drug/substance nos 4-6 CPT 80376 | not published | not published | $31.67 – $33.73 | 3 |
| Drug test def 1-7 classes HCPCS G0480 | $165.30 | $290.00 | $83.94 – $157.91 | 9 |
| Drug test def 8-14 classes HCPCS G0481 | $181.26 | $318.00 | $129.14 – $216.09 | 9 |
| Drug test prsmv instrmnt CPT 80306 | $35.34 | $62.00 | $17.14 – $66.16 | 13 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $177.84 | $312.00 | $62.14 – $239.86 | 13 |
| Drvvt confirm - quest CPT 85597 | not published | not published | $17.98 – $69.40 | 16 |
| Dstrj extensive retinopathy CPT 67227 | not published | not published | $268.69 – $1,344.49 | 7 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | $3,818.43 | $6,699.00 | $154.20 – $1,482.86 | 6 |
| Dstr mal les s/n/h/f/g >4.0 CPT 17276 | not published | not published | $212.19 – $1,032.60 | 12 |
| Dstr mal ls f/e/e/n/l/m2.1-3 CPT 17283 | not published | not published | $179.51 – $886.99 | 12 |
| Dstr mal ls f/e/e/n/l/m3.1-4 CPT 17284 | not published | not published | $208.77 – $1,235.81 | 12 |
| Dstr mal ls f/e/e/n/l/m>4.0 CPT 17286 | not published | not published | $283.43 – $1,298.51 | 12 |
| Ductogram sgl duct CPT 77053 | $238.83 | $419.00 | $18.31 – $488.00 | 12 |
| Duodenal exclusion CPT 48547 | not published | not published | $1,780.72 – $6,307.39 | 7 |
| Duodenal motility study CPT 91022 | not published | not published | $77.14 – $1,071.21 | 12 |
| Duplex scan bilateral study 93985 CPT 93985 | $1,046.52 | $1,836.00 | $38.09 – $488.00 | 11 |
| Duplex scan unilateral study 93986 CPT 93986 | $524.40 | $920.00 | $23.79 – $214.68 | 11 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $740.43 | $1,299.00 | $23.55 – $214.68 | 12 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $1,243.74 | $2,182.00 | $24.38 – $315.86 | 12 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $1,072.17 | $1,881.00 | $39.38 – $488.00 | 12 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | $137.19 | $240.68 | $111.64 – $240.68 | 6 |
| Dxa bone density axl vrt fx CPT 77085 | not published | not published | $15.23 – $214.68 | 11 |
| Dx aly aud oi snd prcsr 1st CPT 92622 | not published | not published | $71.23 – $315.86 | 9 |
| Dx aly aud oi snd prcsr each CPT 92623 | not published | not published | $18.85 – $18.85 | 4 |
| Dx bronchoscope/brush 31623 CPT 31623 | $2,672.16 | $4,688.00 | $136.93 – $983.29 | 7 |
| Dx bronchoscope/lavage 31624 CPT 31624 | $2,672.16 | $4,688.00 | $138.48 – $918.23 | 7 |
| Dx bronchoscope/wash 31622 CPT 31622 | $2,672.16 | $4,688.00 | $135.97 – $879.45 | 7 |
| Dx dark adaptation exam i&r CPT 92284 | not published | not published | $25.21 – $805.60 | 12 |
| Dx duod intub w/asp spec 43756 CPT 43756 | not published | not published | $53.37 – $1,892.79 | 12 |
| Dx duod intub w/asp specs CPT 43757 | not published | not published | $80.22 – $1,892.79 | 12 |
| Dx gastr intub w/asp spec CPT 43754 | not published | not published | $39.06 – $660.75 | 12 |
| Dx gastr intub w/asp specs CPT 43755 | not published | not published | $62.45 – $626.89 | 12 |
| Dx intraop epcar Ultrasound chd i&r CPT 76989 | not published | not published | $36.02 – $36.02 | 4 |
| Dx intraop epicar car Ultrasound chd CPT 76987 | not published | not published | $97.24 – $97.24 | 4 |
| Dx intraop thoracic aorta Ultrasound CPT 76984 | not published | not published | $31.22 – $31.22 | 4 |
| Dx laryngoscopy newborn CPT 31520 | not published | not published | $162.21 – $783.95 | 12 |
| Dx laryngoscopy w/oper scope CPT 31526 | not published | not published | $162.59 – $560.85 | 7 |
| Dx ntrop epcr Ultrasound chd img acq CPT 76988 | not published | not published | $61.59 – $61.59 | 4 |
| Dynamic cavernosometry CPT 54231 | not published | not published | $120.76 – $516.45 | 12 |
| Dynamic fine wire emg CPT 96003 | not published | not published | $17.84 – $58.27 | 7 |
| Dynamic surface emg CPT 96002 | not published | not published | $22.43 – $628.68 | 12 |
| Ear and throat examination CPT 92502 | not published | not published | $101.77 – $1,028.10 | 12 |
| Ear canal biopsy 69105 CPT 69105 | not published | not published | $67.07 – $510.26 | 7 |
| Ear cartilage graft CPT 21235 | not published | not published | $602.39 – $2,628.90 | 7 |
| Ear irrigation 69209 CPT 69209 | $123.69 | $217.00 | $16.89 – $119.91 | 11 |
| Ear protector evaluation CPT 92596 | not published | not published | $37.73 – $212.23 | 12 |
| Ecg 12 lead tracing only CPT 93005 | $144.21 | $253.00 | $6.55 – $119.91 | 12 |
| Ecg/1-3 leads/interp & report only 93042 CPT 93042 | not published | not published | $7.14 – $23.32 | 7 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | $181.83 | $319.00 | $6.55 – $119.91 | 12 |
| Ecg < 30 days transmission & analysis CPT 93271 | not published | not published | $88.24 – $539.85 | 12 |
| Ecg external < 48 hours recording CPT 93225 | $467.40 | $820.00 | $19.39 – $260.23 | 12 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $420.66 | $738.00 | $37.94 – $119.91 | 12 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | not published | not published | $12.61 – $79.23 | 11 |
| Ecg external >7 days up to 15 days recording CPT 93246 | not published | not published | $12.61 – $79.23 | 11 |
| Ecg record/review CPT 93268 | not published | not published | $187.21 – $653.08 | 7 |
| Ecg/review interpret only CPT 93272 | not published | not published | $25.70 – $85.04 | 7 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $1,723.68 | $3,024.00 | $73.25 – $1,106.93 | 12 |
| Echocardiography doppler color flow mapping CPT 93325 | $337.44 | $592.00 | $3.32 – $10.85 | 7 |
| Echocardiography transthoracic 2d followup/limited CPT 93308 | $938.22 | $1,646.00 | $26.43 – $488.00 | 12 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $337.44 | $592.00 | $7.50 – $24.47 | 7 |
| Echo exam of eye CPT 76516 | not published | not published | $23.96 – $214.68 | 12 |
| Echo exam of eye CPT 76519 | not published | not published | $32.39 – $214.68 | 12 |
| Echo exam of eye CPT 76529 | not published | not published | $34.58 – $177.77 | 12 |
| Echo exam of eye thickness CPT 76514 | not published | not published | $8.20 – $49.43 | 12 |
| Echo exam of fetal heart CPT 76825 | not published | not published | $85.23 – $1,106.93 | 12 |
| Echo exam of fetal heart CPT 76826 | not published | not published | $42.25 – $488.00 | 12 |
| Echo exam of fetal heart CPT 76827 | not published | not published | $29.72 – $214.68 | 12 |
| Echo exam of fetal heart CPT 76828 | not published | not published | $28.49 – $214.68 | 12 |
| Echo exam uterus 76831- CPT 76831 | not published | not published | $37.08 – $488.00 | 12 |
| Echograp trans r pros study CPT 76873 | $180.69 | $317.00 | $81.72 – $214.68 | 12 |
| Echo guidance radiotherapy CPT 76965 | $78.09 | $137.00 | $56.81 – $72.34 | 7 |
| Echo guide cardiocentesis CPT 76930 | not published | not published | $74.89 – $145.82 | 3 |
| Echo guide for amniocentesis CPT 76946 | not published | not published | $19.64 – $32.20 | 7 |
| Echo guide for artery repair CPT 76936 | $373.92 | $656.00 | $96.76 – $628.68 | 12 |
| Echo guide for heart biopsy CPT 76932 | not published | not published | $36.79 – $83.50 | 7 |
| Echo guide for transfusion CPT 76941 | not published | not published | $68.88 – $161.01 | 7 |
| Echo guide ova aspiration CPT 76948 | not published | not published | $33.00 – $81.77 | 7 |
| Echo guide villus sampling CPT 76945 | not published | not published | $34.38 – $81.77 | 7 |
| Echo stress CPT 93350 | $808.83 | $1,419.00 | $73.25 – $1,106.93 | 12 |
| Echo tee cngntl wo ctrst probe plcmnt CPT 93316 | not published | not published | $26.91 – $1,106.93 | 12 |
| Echo tee guidance CPT 93355 | $2,830.05 | $4,965.00 | $234.54 – $766.21 | 6 |
| Echo tee probe placement image acquisition interpretation & report CPT 93312 | $1,668.96 | $2,928.00 | $112.78 – $1,106.93 | 12 |
| Echo transesophageal CPT 93313 | $808.83 | $1,419.00 | $11.72 – $1,106.93 | 12 |
| Echo transesophageal CPT 93314 | not published | not published | $92.00 – $299.87 | 7 |
| Echo transesophageal CPT 93315 | not published | not published | $133.87 – $1,106.93 | 12 |
| Echo transesophageal CPT 93317 | not published | not published | $91.84 – $305.18 | 7 |
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.