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 |
|---|---|---|---|---|
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $9.69 | $17.00 | $4.40 – $16.98 | 16 |
| T3 (triiodothyronine) free CPT 84481 | $34.20 | $60.00 | $16.91 – $65.39 | 16 |
| T3 (triiodothyronine) total CPT 84480 | $35.34 | $62.00 | $14.18 – $54.73 | 16 |
| T4 (thyroxine) free CPT 84439 | $34.20 | $60.00 | $9.02 – $34.82 | 16 |
| T4 (thyroxine) total CPT 84436 | $25.65 | $45.00 | $6.87 – $26.52 | 16 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $2.68 | $4.71 | $0.37 – $1.40 | 6 |
| Tacrolimus therapeutic drug level CPT 80197 | $27.36 | $48.00 | $13.73 – $53.00 | 16 |
| Tah rad debulk/lymph remove 58954 CPT 58954 | not published | not published | $2,238.42 – $7,776.30 | 7 |
| Tah rad dissect for debulk 58953 CPT 58953 | not published | not published | $2,070.31 – $7,177.28 | 7 |
| Tah w/mmk 58152 CPT 58152 | not published | not published | $1,277.37 – $4,520.33 | 7 |
| Tap block bilat cont infusion 64489 CPT 64489 | not published | not published | $80.73 – $1,027.58 | 6 |
| Tap block uni by cont infusion 64487 CPT 64487 | not published | not published | $66.29 – $663.60 | 6 |
| Target gsa panel hmtlmph neop CPT 81450 | not published | not published | $122.59 – $2,931.79 | 15 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | not published | not published | $3,065.58 – $11,269.66 | 7 |
| Target gsa panel organ neop CPT 81445 | not published | not published | $122.59 – $2,307.93 | 15 |
| Tas congenital car anomal CPT 33741 | not published | not published | $731.64 – $2,692.69 | 6 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | not published | not published | $134.43 – $1,235.81 | 12 |
| Tavr perq femoral CPT 33361 | not published | not published | $1,177.47 – $4,245.71 | 7 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $1.73 | $3.04 | $0.59 – $2.88 | 7 |
| Tbp gene detc abnor alleles CPT 81344 | not published | not published | $137.00 – $528.82 | 12 |
| Tbs dxa cal w/i&r fx risk CPT 77089 | not published | not published | $42.79 – $101.16 | 6 |
| Tbs i&r fx rsk qhp CPT 77092 | not published | not published | $10.43 – $25.84 | 6 |
| Tbs techl calculation only CPT 77091 | not published | not published | $29.74 – $177.77 | 11 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $2.62 – $177.77 | 11 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $144.21 | $253.00 | $100.00 – $386.00 | 16 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $71.82 | $126.00 | $61.98 – $239.24 | 16 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | $2,625.99 | $4,607.00 | $2,851.61 – $2,851.61 | 2 |
| Tc-99m labeled rbc HCPCS A9560 | $220.02 | $386.00 | $172.21 – $172.21 | 2 |
| Tc-99m maa HCPCS A9540 | $313.50 | $550.00 | $54.80 – $54.80 | 2 |
| Tc-99m mebrofenin HCPCS A9537 | $112.86 | $198.00 | $187.21 – $187.21 | 2 |
| Tc-99m medronate HCPCS A9503 | $262.20 | $460.00 | $45.29 – $45.29 | 2 |
| Tc-99m pentetate dtpa HCPCS A9539 | $171.00 | $300.00 | $50.89 – $50.89 | 2 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $232.56 | $408.00 | $35.23 – $35.23 | 2 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $2.28 | $4.00 | $2.31 – $2.31 | 2 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $71.82 | $126.00 | $79.40 – $79.40 | 2 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $199.50 | $350.00 | $225.34 – $225.34 | 2 |
| Tc-99m tilmanocept diag HCPCS A9520 | $645.24 | $1,132.00 | $696.24 – $696.24 | 2 |
| Tca peel dermal 15789 CPT 15789 | not published | not published | $435.56 – $1,953.19 | 12 |
| Tcd emboli detect w/inj CPT 93893 | not published | not published | $62.77 – $214.68 | 12 |
| Tcd emboli detect without inj CPT 93892 | not published | not published | $62.52 – $214.68 | 12 |
| Tcd vasoreactivity study CPT 93890 | not published | not published | $53.95 – $172.58 | 7 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $82.27 – $882.61 | 11 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $108.87 | $191.00 | $46.98 – $181.34 | 16 |
| T cells absolute cd 4 count CPT 86361 | $64.41 | $113.00 | $26.78 – $103.37 | 16 |
| T cells total count CPT 86359 | $86.64 | $152.00 | $37.73 – $145.64 | 16 |
| Tcranial magn stim tx deli CPT 90868 | $507.87 | $891.00 | $299.37 – $722.04 | 7 |
| Tcranial magn stim tx plan CPT 90867 | not published | not published | $299.37 – $1,242.39 | 7 |
| Tcran magn stim redetemine CPT 90869 | not published | not published | $299.37 – $1,041.34 | 7 |
| Tdh sdrl/ventr pnxr CPT 61105 | not published | not published | $466.08 – $1,570.50 | 7 |
| Teaec w/wo patch graft iliofemoral CPT 35355 | not published | not published | $991.54 – $3,586.58 | 7 |
| Team conf without pat by hc pro CPT 99368 | not published | not published | $81.97 – $81.97 | 2 |
| Team conf without pat by phys CPT 99367 | not published | not published | $124.59 – $124.59 | 2 |
| Team conf w/pat by hc prof CPT 99366 | not published | not published | $95.30 – $95.30 | 2 |
| Telethx isodose plan cplx CPT 77307 | $864.69 | $1,517.00 | $163.47 – $739.05 | 11 |
| Telethx isodose plan simple CPT 77306 | $441.75 | $775.00 | $78.98 – $739.05 | 11 |
| Temperature gradient studies CPT 93740 | not published | not published | $26.87 – $315.86 | 7 |
| Temple bne implnt w/stimulat CPT 69715 | not published | not published | $2,945.60 – $6,026.27 | 3 |
| Tendon lengthening CPT 26476 | not published | not published | $682.81 – $2,199.26 | 7 |
| Tendon lngth upr a/e ea tdn CPT 24305 | not published | not published | $610.60 – $2,080.35 | 7 |
| Tendon shortening CPT 26477 | not published | not published | $668.92 – $2,152.31 | 7 |
| Tendon transfer with graft CPT 26492 | not published | not published | $973.83 – $3,221.18 | 7 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $296.65 | $520.43 | $119.15 – $390.54 | 7 |
| Tenodesis biceps tdn at elbw CPT 24340 | not published | not published | $629.07 – $2,199.23 | 7 |
| Tenolysis extensor tendon hand/finger each CPT 26445 | not published | not published | $643.54 – $2,122.65 | 7 |
| Tenolysis triceps CPT 24332 | not published | not published | $646.47 – $2,193.38 | 7 |
| Tenoplasty elbow to sho 1 CPT 24320 | not published | not published | $811.31 – $2,787.86 | 7 |
| Tenosynovectomy radic 26145 CPT 26145 | not published | not published | $546.14 – $1,847.63 | 7 |
| Tenotomy hip flexor open CPT 27005 | not published | not published | $750.12 – $2,588.70 | 7 |
| Tenotomy length/rls abductor hallucis musc 28240 CPT 28240 | not published | not published | $314.45 – $1,654.24 | 7 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | not published | not published | $259.33 – $1,422.68 | 7 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $39.18 | $68.73 | $1.39 – $68.73 | 6 |
| Tert gene targeted seq alys CPT 81345 | not published | not published | $185.20 – $714.87 | 12 |
| Test for chlorohydrocarbons CPT 82441 | not published | not published | $6.01 – $23.20 | 16 |
| Test for porphobilinogen CPT 84106 | not published | not published | $5.82 – $22.47 | 16 |
| Test for urine cystines CPT 82615 | $11.40 | $20.00 | $9.55 – $36.86 | 16 |
| Testicular imaging w/vasc flow CPT 78761 | not published | not published | $35.88 – $811.23 | 12 |
| Testosterone response panel CPT 80414 | not published | not published | $51.64 – $199.33 | 16 |
| Test stress cardiovascular tracing only CPT 93017 | $501.60 | $880.00 | $39.85 – $628.68 | 12 |
| Test urine for lactose CPT 83633 | not published | not published | $7.86 – $43.43 | 16 |
| Test urine for porphyrins CPT 84119 | not published | not published | $12.33 – $51.57 | 16 |
| Test urine urobilinogen CPT 84578 | not published | not published | $4.47 – $17.25 | 16 |
| Tetanus ig im CPT 90389 | not published | not published | $1,211.56 – $1,211.56 | 2 |
| Tetanus immune globulin inj HCPCS J1670 | $1,095.18 | $1,921.37 | $451.88 – $1,921.37 | 8 |
| Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe HCPCS J2356 | $33.21 | $58.25 | $26.01 – $58.25 | 6 |
| Tgfbi gene common variants CPT 81333 | not published | not published | $137.00 – $528.82 | 12 |
| Tgsap hl neo 5-50 rna alys CPT 81451 | not published | not published | $759.53 – $2,931.79 | 12 |
| Tgsap so/hl 51/< rna alys CPT 81456 | not published | not published | $3,065.58 – $11,269.66 | 7 |
| Tgsap so neo 5-50 rna alys CPT 81449 | not published | not published | $597.91 – $2,307.93 | 12 |
| Thaw cryoprsvrd reprod tiss CPT 89354 | not published | not published | $76.99 – $345.95 | 8 |
| Thawing cryopresrved embryo CPT 89352 | not published | not published | $76.99 – $345.95 | 8 |
| Thawing cryopresrved oocyte CPT 89356 | not published | not published | $76.99 – $345.95 | 8 |
| Thawing cryopresrved sperm CPT 89353 | not published | not published | $51.37 – $107.88 | 8 |
| Thaw preserved stem cells CPT 38208 | not published | not published | $29.47 – $882.61 | 11 |
| Theophylline therapeutic drug level CPT 80198 | $34.77 | $61.00 | $14.14 – $54.58 | 16 |
| Therapeutic procd strg endur HCPCS G0237 | $64.41 | $113.00 | $11.90 – $29.34 | 6 |
| Therapy activation ipnss CPT 93150 | not published | not published | $44.92 – $185.30 | 9 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $51.30 | $90.00 | $34.59 – $72.64 | 12 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $43.89 | $77.00 | $30.14 – $63.29 | 12 |
| Therapy photodnmc lght dstr lsn skn by staff rx per day CPT 96567 | not published | not published | $146.41 – $435.65 | 12 |
| Ther fx nasal inf turbinate CPT 30930 | not published | not published | $125.75 – $426.60 | 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.