Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)
13111 N Port Washington Rd, Mequon, WI · Ascension · · NPI 1316000706
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 |
|---|---|---|---|---|
| X-ray nasal bones complete > 3 views CPT 70160 | $243.27 | $459.00 | $13.80 – $188.56 | 10 |
| X-ray neck soft tissue CPT 70360 | $196.10 | $370.00 | $14.38 – $188.56 | 10 |
| X-ray nose to rectum for foreign body child CPT 76010 | $94.34 | $178.00 | $14.38 – $188.56 | 10 |
| X-ray of mammary ducts CPT 77054 | $361.46 | $682.00 | $35.04 – $517.79 | 10 |
| X-ray optic foramina CPT 70190 | $239.03 | $451.00 | $17.75 – $188.56 | 10 |
| X-ray pelvis 1-2 views CPT 72170 | $178.08 | $336.00 | $13.80 – $245.18 | 10 |
| X-ray pelvis complete > 3 views CPT 72190 | $237.97 | $449.00 | $20.06 – $245.18 | 10 |
| Xray place dist ext thor ao CPT 75959 | $1,818.43 | $3,431.00 | $0.03 – $9,528.00 | 7 |
| Xray place prox ext thor ao CPT 75958 | $1,818.43 | $3,431.00 | $0.03 – $9,528.00 | 7 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $541.66 | $1,022.00 | $40.17 – $828.27 | 10 |
| X-ray ribs 2 views left CPT 71100 | $250.16 | $472.00 | $17.78 – $188.56 | 10 |
| X-ray ribs 3 views bilateral CPT 71110 | $271.36 | $512.00 | $22.90 – $245.18 | 10 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $286.73 | $541.00 | $21.22 – $245.18 | 10 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $312.70 | $590.00 | $25.36 – $245.18 | 10 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $242.74 | $458.00 | $17.82 – $245.18 | 10 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $182.32 | $344.00 | $13.80 – $188.56 | 10 |
| X-ray scapula complete (both sides) CPT 73010 | $445.73 | $841.00 | $14.35 – $245.18 | 10 |
| X-ray sella turcica CPT 70240 | $298.92 | $564.00 | $14.96 – $188.56 | 10 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $178.61 | $337.00 | $12.10 – $188.56 | 10 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $396.44 | $748.00 | $17.24 – $188.56 | 10 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $493.43 | $931.00 | $40.60 – $1,174.27 | 10 |
| X-ray skull < 4 views CPT 70250 | $199.28 | $376.00 | $14.38 – $245.18 | 10 |
| X-ray skull > 4 views complete CPT 70260 | $302.63 | $571.00 | $22.34 – $245.18 | 10 |
| X-ray slg plne bdy sect without urogr CPT 76100 | not published | not published | $46.17 – $245.18 | 10 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $461.10 | $870.00 | $63.26 – $401.74 | 10 |
| X-ray small intestine follow-through study CPT 74248 | $179.67 | $339.00 | $54.72 – $115.84 | 6 |
| X-ray spine single view CPT 72020 | $208.82 | $394.00 | $12.68 – $188.56 | 10 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $244.86 | $462.00 | $17.24 – $188.56 | 10 |
| X-ray sternum > 2 views CPT 71120 | $224.19 | $423.00 | $15.54 – $188.56 | 10 |
| X-ray surgical specimen CPT 76098 | $289.38 | $546.00 | $24.79 – $1,174.27 | 10 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $253.87 | $479.00 | $41.65 – $401.74 | 10 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $307.40 | $580.00 | $18.94 – $188.56 | 10 |
| X-ray thoracic spine 2 views CPT 72070 | $166.95 | $315.00 | $16.08 – $245.18 | 10 |
| X-ray thoracic spine 3 views CPT 72072 | $250.16 | $472.00 | $17.82 – $245.18 | 10 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $209.88 | $396.00 | $16.66 – $188.56 | 10 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $116.07 | $219.00 | $20.64 – $188.56 | 10 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $152.64 | $288.00 | $24.79 – $245.18 | 10 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $171.72 | $324.00 | $12.68 – $188.56 | 10 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $160.59 | $303.00 | $10.40 – $188.56 | 10 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $359.34 | $678.00 | $70.09 – $401.74 | 10 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $269.24 | $508.00 | $63.22 – $401.74 | 10 |
| X-ray wrist 2 views (both sides) CPT 73100 | $242.21 | $457.00 | $13.23 – $188.56 | 10 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | not published | not published | $46.21 – $401.74 | 10 |
| Xtrnl ecg rec>48hr<7d CPT 93241 | not published | not published | $278.06 – $431.78 | 6 |
| Xtrnl ecg rec up to 48 hrs CPT 93224 | not published | not published | $118.78 – $315.72 | 6 |
| Xylose absorption test blood &/or urine CPT 84620 | $40.28 | $76.00 | $12.91 – $51.59 | 16 |
| Yersinia antibody CPT 86793 | not published | not published | $13.19 – $50.95 | 16 |
| Ziconotide injection HCPCS J2278 | $9.62 | $18.15 | $10.47 – $16.14 | 6 |
| Zika virus dna/rna amp probe CPT 87662 | not published | not published | $51.31 – $201.74 | 16 |
| Zika virus igm antibody CPT 86794 | not published | not published | $16.85 – $66.48 | 16 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $50.51 | $95.31 | $9.66 – $29.77 | 10 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | $9.54 | $18.00 | $8.06 – $16.60 | 9 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $85.57 | $161.46 | $8.41 – $27.72 | 11 |
| Zoster vaccine-live inj CPT 90736 | $233.20 | $440.00 | $219.35 – $726.48 | 9 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $193.25 – $425.15 | 11 |
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.