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 |
|---|---|---|---|---|
| Levalbuterol non-comp unit HCPCS J7614 | not published | not published | $0.08 – $0.21 | 12 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $0.37 | $0.74 | $0.05 – $0.24 | 12 |
| Levetiracetam therapeutic drug level CPT 80177 | $100.00 | $200.00 | $10.60 – $46.50 | 16 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | not published | not published | $1.03 – $4.61 | 12 |
| Levonorgestrel implant sys HCPCS J7306 | not published | not published | $406.00 – $479.28 | 2 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | not published | not published | $5.55 – $13.15 | 10 |
| Liberta rc ipg HCPCS C1820 | $28,587.70 | $57,175.40 | not published | 0 |
| Lidocaine injection HCPCS J2001 | not published | not published | $0.03 – $0.07 | 2 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | not published | not published | $0.01 – $0.02 | 3 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | not published | not published | $0.01 – $0.02 | 5 |
| Lidocaine therapeutic drug level CPT 80176 | $122.50 | $245.00 | $11.75 – $51.55 | 16 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | $3,385.00 | $6,770.00 | not published | 0 |
| Ligation/divis of long saph vein 37700 CPT 37700 | $4,255.00 | $8,510.00 | not published | 0 |
| Liletta, 52 mg HCPCS J7297 | not published | not published | $887.36 – $1,357.67 | 3 |
| Limited autopsy CPT 88036 | not published | not published | $0.01 – $6.18 | 2 |
| Limited autopsy CPT 88037 | not published | not published | $0.01 – $5.49 | 2 |
| Lincomycin injection HCPCS J2010 | not published | not published | $6.24 – $21.53 | 12 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | not published | not published | $3.07 – $13.58 | 12 |
| Lipase CPT 83690 | $105.00 | $210.00 | $5.51 – $24.18 | 16 |
| Lipoprotein blood high res frac & quant CPT 83701 | not published | not published | $27.09 – $118.83 | 16 |
| Lipoprotein blood quant CPT 83704 | $137.50 | $275.00 | $27.35 – $120.00 | 16 |
| Lipoprotein direct measurement hdl CPT 83718 | $60.00 | $120.00 | $6.55 – $28.74 | 16 |
| Lipoprotein direct measurement ldl CPT 83721 | $67.50 | $135.00 | $8.40 – $36.85 | 16 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $27.35 – $120.00 | 16 |
| Lisocabtagene mara car pos t HCPCS Q2054 | not published | not published | $0.01 – $1,260,225.76 | 10 |
| Listeria monocytogenes CPT 86723 | not published | not published | $10.55 – $46.29 | 16 |
| Lithium therapeutic drug level CPT 80178 | $62.50 | $125.00 | $5.29 – $23.19 | 16 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | not published | not published | $176.19 – $1,468.89 | 13 |
| Liver Function Test CPT 80076 | $140.00 | $280.00 | $6.54 – $28.67 | 16 |
| Liver imag w/vasclr flow CPT 78202 | $1,380.00 | $2,760.00 | not published | 0 |
| Liver/spleen imag static only CPT 78215 | $1,380.00 | $2,760.00 | not published | 0 |
| Lmtd oph exam general anes CPT 92019 | $3,275.00 | $6,550.00 | not published | 0 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | not published | not published | $0.93 – $2.94 | 12 |
| Lomustine 10 mg HCPCS S0178 | not published | not published | $107.99 – $172.11 | 3 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | not published | not published | $206.38 – $517.57 | 12 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $35.12 | $70.23 | $1.16 – $3.30 | 12 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,305.00 | $4,610.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $1,570.00 | $3,140.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,470.00 | $2,940.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $3,265.00 | $6,530.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,210.00 | $4,420.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,110.00 | $4,220.00 | not published | 0 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $285.00 | $570.00 | not published | 0 |
| Loxapine for inhalation 1 mg HCPCS J2062 | not published | not published | $14.40 – $22.95 | 3 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $17.59 – $77.17 | 16 |
| Lumbar diskogram s&i CPT 72295 | $1,940.00 | $3,880.00 | not published | 0 |
| Lumizyme injection HCPCS J0221 | not published | not published | $201.57 – $492.00 | 13 |
| Lung function test (mbc/mvv) CPT 94200 | $115.00 | $230.00 | not published | 0 |
| Lung Function Test (Spirometry) CPT 94010 | $265.00 | $530.00 | not published | 0 |
| Lung perfusion imaging CPT 78580 | $1,095.00 | $2,190.00 | not published | 0 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $534.56 | $1,069.11 | $203.60 – $499.95 | 12 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $106.38 | $212.76 | $40.62 – $100.71 | 12 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | not published | not published | $281.71 – $448.98 | 4 |
| Lutetium lu 177 vipivotide HCPCS A9607 | not published | not published | $228.31 – $363.87 | 4 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $16.04 – $70.37 | 16 |
| Lymphatics/lymph node imaging CPT 78195 | $1,385.00 | $2,770.00 | not published | 0 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $29.25 – $166.60 | 16 |
| Lymphocyte transformation mitogen CPT 86353 | not published | not published | $39.22 – $172.07 | 16 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $151.61 – $665.10 | 16 |
| Lymphocytotoxicity assay CPT 86806 | not published | not published | $38.07 – $167.02 | 16 |
| Lymph vessel x-ray arm/leg CPT 75801 | $815.00 | $1,630.00 | not published | 0 |
| Lymph vessel x-ray arms/legs CPT 75803 | $1,225.00 | $2,450.00 | not published | 0 |
| Lymph vessel x-ray trunk CPT 75805 | $815.00 | $1,630.00 | not published | 0 |
| Lymph vessel x-ray trunk CPT 75807 | $1,225.00 | $2,450.00 | not published | 0 |
| Lyumjev for insulin pump use HCPCS J1813 | not published | not published | $15.33 – $37.76 | 11 |
| Macro exam dissect molec study ea CPT 88387 | $10.00 | $20.00 | $20.40 – $28.87 | 2 |
| Macroscopic exam arthropod CPT 87168 | $20.00 | $40.00 | $3.42 – $14.98 | 16 |
| Macroscopic exam parasite CPT 87169 | $20.00 | $40.00 | $3.45 – $15.13 | 16 |
| Magnesium CPT 83735 | $75.00 | $150.00 | $5.36 – $23.51 | 16 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $34.42 | $68.83 | $0.47 – $1.19 | 12 |
| Magnetic image bone marrow CPT 77084 | $2,075.00 | $4,150.00 | not published | 0 |
| Makena, 10 mg HCPCS J1726 | not published | not published | $13.82 – $19.65 | 3 |
| Malaria antibody CPT 86750 | not published | not published | $10.55 – $46.29 | 16 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $60.00 | $120.00 | not published | 0 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $120.00 | $240.00 | not published | 0 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | not published | not published | $2.26 – $6.19 | 12 |
| Mannitol for inhaler HCPCS J7665 | not published | not published | $6.31 – $10.07 | 3 |
| Manual diff wbc count b-coat CPT 85009 | $37.50 | $75.00 | $4.06 – $17.79 | 16 |
| Mapping io sentinel lymph node CPT 38900 | $215.00 | $430.00 | not published | 0 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | not published | not published | $48.21 – $120.54 | 12 |
| Marker biop eviva buckle ss HCPCS A4648 | $380.00 | $760.00 | not published | 0 |
| Marker lymphatic sentimag magtrace 10 vial HCPCS A9697 | not published | not published | $1,137.96 – $1,137.96 | 1 |
| Mastectomy form HCPCS L8020 | $249.83 | $499.66 | not published | 0 |
| Matrion 1 sq cm HCPCS Q4201 | not published | not published | $87.59 – $207.48 | 10 |
| Matrix bone cryomatrix 2.0ml HCPCS Q4162 | not published | not published | $1,760.00 – $2,805.00 | 2 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | not published | not published | $19.77 – $50.16 | 10 |
| M.avium-intra dna amp prob CPT 87561 | not published | not published | $28.07 – $123.15 | 16 |
| M.avium-intra dna dir prob CPT 87560 | not published | not published | $21.83 – $95.77 | 16 |
| M.avium-intra dna quant CPT 87562 | not published | not published | $34.27 – $150.35 | 16 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $100.00 | $200.00 | $11.57 – $50.75 | 16 |
| Mayo aathr protein s free CPT 85306 | $160.00 | $320.00 | $12.26 – $53.77 | 16 |
| Mayo activated protein c resistance assay CPT 85307 | $140.00 | $280.00 | $12.26 – $53.77 | 16 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $357.50 | $715.00 | $30.86 – $135.37 | 15 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $147.50 | $295.00 | not published | 0 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $112.50 | $225.00 | $19.34 – $19.34 | 1 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $70.00 | $140.00 | $11.82 – $51.86 | 16 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $225.00 | $450.00 | $19.34 – $19.34 | 1 |
| Mayo alpha 1 antitrypsin CPT 82103 | $100.00 | $200.00 | $10.75 – $47.16 | 16 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $60.00 | $120.00 | $12.06 – $52.93 | 16 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | $90.00 | $180.00 | not published | 0 |
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.