Aurora Medical Center Fond du Lac
210 Wisconsin American Dr., Fond Du Lac, WI · Aurorahealthcare · · NPI 1275578064
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 |
|---|---|---|---|---|
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $35.00 | $70.00 | $3.14 – $13.76 | 16 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $18.07 | $36.13 | $0.51 – $1.41 | 12 |
| Gold sodium thiomaleate inj HCPCS J1600 | not published | not published | $0.01 – $45.23 | 2 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $102.81 | $205.62 | $10.54 – $37.29 | 13 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $137.50 | $275.00 | $14.86 – $65.21 | 16 |
| Gonadotropin hormone panel CPT 80426 | not published | not published | $118.73 – $520.85 | 16 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $95.00 | $190.00 | $14.82 – $64.99 | 16 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $2,821.21 | $5,642.42 | $674.77 – $1,715.47 | 13 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $44.98 | $89.96 | $30.57 – $74.36 | 11 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | not published | not published | $1,194.40 – $2,829.46 | 10 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $89.97 | $179.94 | $77.72 – $184.11 | 10 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $57.50 | $115.00 | $24.89 – $46.67 | 2 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | not published | not published | $718.00 – $1,211.82 | 3 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $4,849.52 | $9,699.03 | not published | 0 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $13,584.76 | $27,169.51 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $210.00 | $420.00 | $65.41 – $159.59 | 10 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $314.50 | $629.00 | $95.56 – $257.88 | 11 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $330.00 | $660.00 | $136.96 – $338.56 | 11 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $464.97 | $929.93 | $48.87 – $118.23 | 11 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | not published | not published | $129.66 – $243.12 | 2 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $330.00 | $660.00 | $140.96 – $333.92 | 11 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $5,417.84 | $10,835.68 | not published | 0 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $1,472.60 | $2,945.20 | not published | 0 |
| Granisetron 1 mg tab HCPCS Q0166 | not published | not published | $2.88 – $4.59 | 4 |
| Granisetron hcl injection HCPCS J1626 | not published | not published | $0.23 – $0.72 | 12 |
| Group train without patient HCPCS G0543 | $37.50 | $75.00 | not published | 0 |
| Growth hormone antibody CPT 86277 | not published | not published | $12.59 – $55.23 | 16 |
| Growth hormone panel CPT 80428 | $115.00 | $230.00 | $53.36 – $234.08 | 16 |
| Growth hormone panel CPT 80430 | not published | not published | $103.46 – $453.90 | 16 |
| Growth stimulation gene 2 CPT 83006 | $72.50 | $145.00 | $60.48 – $265.31 | 16 |
| Gu dilat ureter/urethra s&i CPT 74485 | $1,380.00 | $2,760.00 | not published | 0 |
| Guided cath fluid drainage 10030 CPT 10030 | $1,175.00 | $2,350.00 | not published | 0 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $5,091.05 | $10,182.09 | not published | 0 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $78.03 | $156.06 | not published | 0 |
| Guid loc target vol rad tx CPT 77387 | $1,375.00 | $2,750.00 | not published | 0 |
| Gw stiffened micro access kit HCPCS C1894 | $888.00 | $1,776.00 | not published | 0 |
| Hair analysis HCPCS P2031 | not published | not published | $3.96 – $17.37 | 15 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | not published | not published | $4.61 – $27.74 | 12 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $36.43 | $72.86 | $0.78 – $2.95 | 12 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | not published | not published | $2.00 – $5.80 | 4 |
| Hand X-ray CPT 73130 | $560.00 | $1,120.00 | not published | 0 |
| Haptoglobin quantitative CPT 83010 | $70.00 | $140.00 | $10.06 – $44.15 | 16 |
| Hba1/hba2 full gene sequence CPT 81259 | $565.00 | $1,130.00 | $480.00 – $2,105.75 | 16 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $1,070.00 | $2,140.00 | $161.92 – $710.34 | 16 |
| Hba1/hba2 gene fam vrnt CPT 81258 | not published | not published | $300.20 – $1,316.96 | 16 |
| Hbb full gene sequence CPT 81364 | $565.00 | $1,130.00 | $259.66 – $1,139.14 | 16 |
| Hbb gene com variants CPT 81361 | $482.50 | $965.00 | $139.85 – $613.52 | 16 |
| Hbb gene dup/del variants CPT 81363 | $845.00 | $1,690.00 | $161.92 – $710.34 | 16 |
| Hbb gene known fam variant CPT 81362 | not published | not published | $300.20 – $1,316.96 | 16 |
| Hb glycosylated a1c home dev CPT 83037 | not published | not published | $7.77 – $34.08 | 16 |
| Hbot, full body chamber, 30m HCPCS G0277 | $555.00 | $1,110.00 | not published | 0 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | $705.00 | $1,410.00 | not published | 0 |
| Hcg free betachain test CPT 84704 | $112.50 | $225.00 | $12.23 – $53.65 | 16 |
| Hcg qualitative CPT 84703 | $105.00 | $210.00 | $6.02 – $26.40 | 16 |
| Hcg quantitative CPT 84702 | $160.00 | $320.00 | $12.04 – $52.82 | 16 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $127.50 | $255.00 | $120.44 – $120.44 | 1 |
| Hc nm fusion spect CT unlisted CPT 78999 | $1,355.00 | $2,710.00 | not published | 0 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | $4,060.00 | $8,120.00 | not published | 0 |
| Head CT scan (with and without contrast) CPT 70470 | $2,305.00 | $4,610.00 | not published | 0 |
| Head CT scan (with contrast) CPT 70460 | $1,570.00 | $3,140.00 | not published | 0 |
| Head CT scan (without contrast) CPT 70450 | $1,470.00 | $2,940.00 | not published | 0 |
| Hearing loss dup/del analys CPT 81431 | not published | not published | $543.66 – $2,385.00 | 16 |
| Hearing loss sequence analys CPT 81430 | not published | not published | $1,300.00 – $5,703.06 | 16 |
| Heart image spect CPT 78494 | $1,590.00 | $3,180.00 | not published | 0 |
| Heavy metal qual any number CPT 83015 | not published | not published | $16.75 – $73.49 | 16 |
| Heinz bodies direct CPT 85441 | $37.50 | $75.00 | $3.36 – $14.73 | 16 |
| Heinz bodies induced CPT 85445 | $25.00 | $50.00 | $5.46 – $23.94 | 16 |
| Helicobacter pylori antibody igm CPT 86677 | $110.00 | $220.00 | $13.48 – $59.13 | 16 |
| Helicoll, per square cm HCPCS Q4164 | not published | not published | $1,248.00 – $2,240.04 | 5 |
| Hemagglutination inhibition CPT 86280 | not published | not published | $6.55 – $28.74 | 16 |
| Hematocrit CPT 85014 | $17.50 | $35.00 | $1.90 – $8.32 | 16 |
| Hematopoietic nuclear tx CPT 79403 | $1,285.00 | $2,570.00 | not published | 0 |
| Hemin 350 mg intravenous powder for solution HCPCS J1640 | not published | not published | $32.20 – $80.82 | 13 |
| Hemodialysis one evaluation CPT 90935 | $1,020.00 | $2,040.00 | not published | 0 |
| Hemoglobin CPT 85018 | $17.50 | $35.00 | $1.90 – $8.32 | 16 |
| Hemoglobin copper sulfate CPT 83026 | not published | not published | $3.21 – $14.07 | 16 |
| Hemoglobin fetal qualitative CPT 83033 | $20.00 | $40.00 | $6.40 – $28.08 | 16 |
| Hemoglobin f (fetal) chemical CPT 83030 | not published | not published | $8.59 – $37.69 | 16 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $30.00 | $60.00 | $6.56 – $28.77 | 16 |
| Hemoglobin-oxygen affinity CPT 82820 | not published | not published | $10.67 – $46.81 | 16 |
| Hemoglobin plasma CPT 83051 | $60.00 | $120.00 | $5.85 – $25.66 | 16 |
| Hemoglobin thermolabile CPT 83065 | not published | not published | $7.20 – $31.58 | 16 |
| Hemoglobin urine CPT 83069 | not published | not published | $3.16 – $13.85 | 16 |
| Hemolysin acid CPT 85475 | not published | not published | $7.10 – $31.13 | 16 |
| Hemolysins/agglutinins auto CPT 86940 | not published | not published | $7.02 – $30.77 | 16 |
| Hemolysins and agglutinins incubated CPT 86941 | not published | not published | $9.69 – $42.49 | 16 |
| Hemophilus influenza antibdy CPT 86684 | $82.50 | $165.00 | $12.67 – $55.60 | 16 |
| Hepagam b im injection HCPCS J1571 | not published | not published | $65.15 – $160.88 | 13 |
| Hepagam b intravenous, inj HCPCS J1573 | not published | not published | $65.15 – $160.88 | 11 |
| Heparin assay CPT 85520 | $167.50 | $335.00 | $10.47 – $45.94 | 16 |
| Heparin bolus from bag HCPCS J1644 | $71.66 | $143.32 | $0.21 – $0.49 | 12 |
| Heparin neutralization CPT 85525 | $20.00 | $40.00 | $9.47 – $41.56 | 16 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | not published | not published | $0.02 – $0.29 | 12 |
| Heparin-protamine tolerance CPT 85530 | not published | not published | $10.47 – $45.94 | 16 |
| Hepatitis a antibody igm CPT 86709 | $92.50 | $185.00 | $9.01 – $39.52 | 16 |
| Hepatitis b core antibody igm CPT 86705 | $77.50 | $155.00 | $9.42 – $41.31 | 16 |
| Hepatitis b core antibody total CPT 86704 | $77.50 | $155.00 | $9.64 – $42.29 | 16 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | not published | not published | $139.93 – $357.00 | 13 |
| Hepatitis b surface ag quan CPT 87467 | not published | not published | $12.04 – $69.88 | 9 |
| Hepatitis b surface antibody CPT 86706 | $77.50 | $155.00 | $8.59 – $37.69 | 16 |
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.