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 |
|---|---|---|---|---|
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $1,463.19 | $2,567.00 | $47.90 – $1,071.21 | 12 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $76.95 | $135.00 | $46.07 – $98.06 | 12 |
| Ghs sphenopalatine ganglion block CPT 64505 | not published | not published | $106.65 – $595.94 | 12 |
| Ghs spont nystagmus CPT 92541 | not published | not published | $13.11 – $260.23 | 12 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $186.96 | $328.00 | $97.86 – $307.35 | 12 |
| Ghs st - eval for alt comm CPT 92567 | not published | not published | $11.50 – $79.23 | 12 |
| Ghs strapping shoulder - 29240 CPT 29240 | not published | not published | $19.07 – $260.23 | 12 |
| Ghs st - re-eval for alt comm CPT 92597 | $80.37 | $141.00 | $69.04 – $144.98 | 12 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | not published | not published | $17.18 – $93.16 | 12 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | not published | not published | $150.91 – $519.54 | 12 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | not published | not published | $196.42 – $1,235.81 | 12 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | not published | not published | $147.43 – $806.59 | 12 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | not published | not published | $322.79 – $1,150.13 | 7 |
| Ghs trypsin (fecal) CPT 84488 | not published | not published | $7.30 – $28.18 | 16 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | not published | not published | $230.61 – $1,142.70 | 12 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $230.61 – $1,082.10 | 12 |
| Ghs urine, hydroxproline total CPT 83505 | not published | not published | $24.30 – $93.80 | 16 |
| Ghs urine, porphyrins quant CPT 84120 | $64.98 | $114.00 | $14.71 – $56.78 | 16 |
| Ghs vaginal delivery only CPT 59409 | not published | not published | $788.43 – $2,110.56 | 7 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $969.57 | $1,701.00 | $510.10 – $1,641.36 | 7 |
| Ghs windowing of cast CPT 29730 | not published | not published | $45.98 – $318.55 | 12 |
| Giardia ag if CPT 87269 | not published | not published | $13.61 – $52.53 | 16 |
| Giardia lamblia antibody CPT 86674 | $46.74 | $82.00 | $14.72 – $56.82 | 16 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $43.41 – $488.00 | 12 |
| Gi inhouse confirmation CPT 87045 | $19.95 | $35.00 | $9.44 – $36.44 | 16 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $320.95 – $1,622.33 | 7 |
| Gi protein loss CPT 78282 | not published | not published | $16.43 – $811.23 | 12 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | not published | not published | $119.70 – $1,892.79 | 12 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | $129.01 – $1,840.61 | 11 |
| Gi trc img intral esophagus CPT 91111 | $1,239.18 | $2,174.00 | $48.20 – $1,892.79 | 12 |
| Gi wireless capsule measure CPT 91112 | not published | not published | $112.34 – $1,892.79 | 12 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $101.12 – $390.32 | 12 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $61.52 – $237.47 | 12 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $35.00 – $135.10 | 12 |
| Glaucoma surgery CPT 66150 | not published | not published | $930.03 – $3,193.39 | 7 |
| Glaucoma surgery CPT 66155 | not published | not published | $929.66 – $3,190.73 | 7 |
| Glaucoma surgery CPT 66160 | not published | not published | $1,043.81 – $3,595.46 | 7 |
| Glaucoma surgery CPT 66170 | not published | not published | $1,157.43 – $3,982.58 | 7 |
| Glucagon plasma - sendout CPT 82943 | $19.95 | $35.00 | $14.11 – $55.16 | 16 |
| Glucagon tolerance panel CPT 80422 | not published | not published | $46.07 – $177.83 | 16 |
| Glucagon tolerance panel CPT 80424 | not published | not published | $50.50 – $194.93 | 16 |
| Glucagon tolerance test CPT 82946 | not published | not published | $10.63 – $68.59 | 16 |
| Glucose 1 hr post dose CPT 82950 | $18.81 | $33.00 | $4.75 – $18.34 | 16 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | not published | not published | $6.05 – $23.35 | 16 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $11.40 | $20.00 | $3.28 – $12.66 | 16 |
| Glucose blood quantitative CPT 82947 | $9.69 | $17.00 | $3.93 – $15.17 | 16 |
| Glucose body fluid CPT 82945 | $21.09 | $37.00 | $3.93 – $15.17 | 16 |
| Glucose monitoring continual min 72hr pt CPT 95249 | not published | not published | $57.10 – $175.96 | 11 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $31.92 | $56.00 | $12.87 – $49.68 | 16 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $10.26 | $18.00 | $3.92 – $15.13 | 16 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $71.56 | $125.55 | $17.62 – $125.55 | 7 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $76.95 | $135.00 | $18.58 – $71.72 | 16 |
| Gonadotropin hormone panel CPT 80426 | not published | not published | $148.41 – $572.86 | 16 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $45.03 | $79.00 | $18.52 – $71.49 | 16 |
| Gonioscopy CPT 92020 | not published | not published | $21.77 – $260.23 | 12 |
| Goniotomy CPT 65820 | not published | not published | $873.51 – $2,859.71 | 7 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $1,598.97 | $2,805.21 | $356.10 – $2,805.21 | 8 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $1,218.09 | $2,137.00 | $42.42 – $2,137.00 | 7 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $966.34 – $3,217.91 | 7 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $141.36 | $248.00 | $144.86 – $248.00 | 6 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $1,092.46 – $3,771.68 | 7 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $2,492.61 | $4,373.00 | $197.15 – $1,400.00 | 7 |
| Great toe-hand transfer CPT 26551 | not published | not published | $3,369.31 – $11,741.78 | 7 |
| Great toe with reduction 28495 CPT 28495 | not published | not published | $163.10 – $650.48 | 12 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $522.75 – $2,094.41 | 6 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $532.50 – $2,074.46 | 6 |
| Grfg autol fat lipo ea addl CPT 15772 | not published | not published | $150.62 – $651.19 | 6 |
| Grfg autol soft tiss dir exc CPT 15769 | not published | not published | $497.93 – $1,729.46 | 6 |
| Group behave couns 2-10 HCPCS G0473 | $62.13 | $109.00 | $12.59 – $42.35 | 6 |
| Growth hormone antibody CPT 86277 | not published | not published | $15.74 – $60.76 | 16 |
| Growth hormone panel CPT 80428 | not published | not published | $66.70 – $257.46 | 16 |
| Growth hormone panel CPT 80430 | not published | not published | $112.26 – $499.21 | 16 |
| Growth stimulation gene 2 CPT 83006 | not published | not published | $31.46 – $291.82 | 15 |
| Grp adapt bhv tx by phy/qhp CPT 97158 | not published | not published | $28.64 – $60.14 | 5 |
| Grp adapt bhv tx by tech CPT 97154 | not published | not published | $28.64 – $60.14 | 5 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | not published | not published | $1,915.00 – $6,769.91 | 7 |
| Gstr rstcv oth/thn v-band CPT 43843 | not published | not published | $1,283.42 – $4,515.38 | 7 |
| Gstr rstcv px shrt roux-en-y CPT 43846 | not published | not published | $1,648.25 – $5,728.35 | 7 |
| Gstr rstcv px sm int rcnstj CPT 43847 | not published | not published | $1,801.72 – $6,353.78 | 7 |
| Gstr rstcv px v-banded gstp CPT 43842 | not published | not published | $1,214.22 – $4,293.56 | 6 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $711.12 – $2,484.53 | 7 |
| G-tube reposition CPT 43761 | $2,061.12 | $3,616.00 | $105.07 – $491.00 | 12 |
| Gu dilat ureter/urethra s&i CPT 74485 | $1,533.87 | $2,691.00 | $41.66 – $98.93 | 7 |
| Guided cath fluid drainage 10030 CPT 10030 | $1,589.73 | $2,789.00 | $138.82 – $2,248.35 | 11 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $1,152.59 | $2,022.08 | $555.54 – $555.54 | 2 |
| Guid loc target vol rad tx CPT 77387 | not published | not published | $232.43 – $232.43 | 2 |
| Gum graft CPT 41870 | not published | not published | $1,082.36 – $1,082.36 | 2 |
| Gynecomastia (males) 19300 CPT 19300 | $1,155.39 | $2,027.00 | $445.90 – $1,969.61 | 7 |
| Hair removal by electrolysis 17380 CPT 17380 | not published | not published | $268.05 – $1,235.81 | 7 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $260.81 – $1,331.81 | 12 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $356.72 – $1,824.15 | 12 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $43.17 | $75.73 | $10.12 – $75.73 | 6 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $2.21 | $3.87 | $1.74 – $3.87 | 6 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | not published | not published | $7.38 – $9.28 | 3 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $885.72 – $2,919.60 | 7 |
| Hand tendon reconstruction CPT 26500 | not published | not published | $727.89 – $2,295.86 | 7 |
| Hand tendon reconstruction CPT 26502 | not published | not published | $796.86 – $2,607.38 | 7 |
| Hand X-ray CPT 73130 | $103.74 | $182.00 | $8.96 – $177.77 | 12 |
| Haptoglobin quantitative CPT 83010 | $31.35 | $55.00 | $12.58 – $48.56 | 16 |
| Harvest allogeneic stem cell CPT 38205 | not published | not published | $88.91 – $316.09 | 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.