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 |
|---|---|---|---|---|
| Diagnostic Mammogram (both breasts) CPT 77066 | $241.15 | $455.00 | $78.03 – $263.00 | 10 |
| Diagnostic Mammogram (one breast) CPT 77065 | $193.45 | $365.00 | $63.26 – $205.70 | 10 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $85.71 – $188.56 | 8 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | not published | not published | $308.75 – $7,954.16 | 6 |
| Dialysis one evaluation CPT 90945 | $706.49 | $1,333.00 | $138.74 – $911.97 | 9 |
| Dialysis repeated eval CPT 90947 | not published | not published | $198.24 – $453.21 | 6 |
| Dialysis training complete CPT 90989 | not published | not published | $688.94 – $1,304.69 | 6 |
| Dialysis training incompl CPT 90993 | not published | not published | $149.21 – $283.83 | 6 |
| Diathermy eg microwave CPT 97024 | $18.02 | $34.00 | $6.69 – $20.20 | 9 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $26.35 | $49.71 | $7.58 – $16.68 | 11 |
| Dicyclomine injection HCPCS J0500 | $117.76 | $222.18 | $20.63 – $77.59 | 11 |
| Diffusing capacity CPT 94729 | $299.98 | $566.00 | $14.42 – $33.41 | 6 |
| Digital analysis of eeg CPT 95957 | $818.85 | $1,545.00 | $165.31 – $378.51 | 6 |
| Digit nerve surgery add-on CPT 64778 | not published | not published | $278.85 – $708.77 | 6 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $255.47 | $482.02 | $6.04 – $32.97 | 10 |
| Digoxin total therapeutic drug level CPT 80162 | $84.80 | $160.00 | $13.28 – $57.32 | 16 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $191.83 | $361.94 | $62.50 – $171.49 | 11 |
| Dilate biliary duct/ampulla CPT 47542 | $5,852.79 | $11,043.00 | $214.30 – $2,072.80 | 6 |
| Dilate esophagus CPT 43453 | $1,009.12 | $1,904.00 | $136.66 – $3,516.16 | 6 |
| Dilate esophagus 1/mult pass CPT 43450 | $1,490.36 | $2,812.00 | $126.62 – $2,007.94 | 9 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | $7,788.35 | $14,695.00 | $520.23 – $1,621.25 | 6 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | $7,788.35 | $14,695.00 | $260.12 – $810.52 | 6 |
| Dilate ic vasospasm init CPT 61640 | not published | not published | $740.30 – $2,306.77 | 6 |
| Dilate tear duct opening CPT 68801 | not published | not published | $128.42 – $854.61 | 9 |
| Dilate urethra stricture CPT 53600 | not published | not published | $100.69 – $520.87 | 9 |
| Dilate urethra stricture CPT 53601 | $67.84 | $128.00 | $84.35 – $321.56 | 9 |
| Dilate urethra stricture CPT 53605 | not published | not published | $100.89 – $258.34 | 6 |
| Dilate urethra stricture CPT 53621 | $94.34 | $178.00 | $113.14 – $555.14 | 9 |
| Dilation/female urethra/initial 53660 CPT 53660 | $77.91 | $147.00 | $65.69 – $335.08 | 9 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $270.49 – $662.15 | 6 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $75.53 – $276.91 | 6 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $306.03 – $756.78 | 6 |
| Dilation of salivary duct CPT 42660 | not published | not published | $136.92 – $1,090.63 | 9 |
| Dilation of urethra CPT 53661 | $71.02 | $134.00 | $64.09 – $276.50 | 9 |
| Dilation of urethra CPT 53665 | not published | not published | $59.82 – $153.26 | 6 |
| Dilation of vagina CPT 57400 | not published | not published | $204.24 – $519.68 | 6 |
| Dilation salivary duct 42650 CPT 42650 | $59.89 | $113.00 | $94.50 – $311.56 | 6 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $73.67 | $139.00 | $137.26 – $1,429.49 | 9 |
| Dilat xst trc ndurlgc px CPT 50436 | not published | not published | $235.99 – $606.76 | 6 |
| Dilat xst trc new access rcs CPT 50437 | not published | not published | $394.62 – $1,016.68 | 6 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $728.75 | $1,375.00 | $733.36 – $1,180.39 | 6 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | $1.06 | $2.00 | $0.03 – $0.06 | 6 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $5.05 | $9.53 | $0.95 – $2.59 | 11 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | $34.98 | $66.00 | $27.75 – $225.76 | 9 |
| Dipyridamole injection HCPCS J1245 | $3.71 | $7.00 | $4.26 – $6.39 | 6 |
| Dir nsl mucous membrane test CPT 95065 | $49.29 | $93.00 | $38.21 – $91.69 | 9 |
| Disability dlco CPT 94727 | $607.91 | $1,147.00 | $19.53 – $335.08 | 9 |
| Disaccharidases CPT 82657 | $335.49 | $633.00 | $22.17 – $79.09 | 16 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $755.67 – $1,834.50 | 6 |
| Disarticulation shoulder CPT 23920 | not published | not published | $1,769.07 – $4,383.23 | 6 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | not published | not published | $2,308.43 – $5,719.83 | 6 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $299.30 – $755.51 | 6 |
| Discography cerv/thor spine CPT 72285 | not published | not published | $92.17 – $3,947.38 | 7 |
| Dise eval slp do brth flx dx CPT 42975 | not published | not published | $153.02 – $457.36 | 6 |
| Dissect brain w/scope CPT 62161 | not published | not published | $2,266.47 – $5,576.12 | 6 |
| Dissolve clot heart vessel CPT 92975 | $3,787.91 | $7,147.00 | $561.88 – $1,304.58 | 6 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $1,694.56 – $4,360.97 | 6 |
| Div aberrant vsl w/reanast CPT 33803 | not published | not published | $1,732.96 – $4,403.93 | 6 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $1,256.74 – $3,075.16 | 6 |
| Division of fallopian tube 58605 CPT 58605 | not published | not published | $538.46 – $1,318.85 | 6 |
| #d/lmeth-l-methamphetamine CPT 80374 | not published | not published | $30.99 – $79.09 | 8 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | $2,867.83 | $5,411.00 | $434.45 – $1,136.11 | 6 |
| Dmd dup/delet analysis CPT 81161 | not published | not published | $204.87 – $873.17 | 16 |
| Dmpk gene charac alleles CPT 81239 | not published | not published | $274.83 – $873.41 | 13 |
| Dmpk gene detc abnor allele CPT 81234 | not published | not published | $137.00 – $435.57 | 13 |
| Dna antibody native/double stranded CPT 86225 | $111.30 | $210.00 | $13.74 – $59.60 | 16 |
| Dna gardnerella CPT 87510 | $51.41 | $97.00 | $20.05 – $87.10 | 16 |
| Dna probe chlamydia CPT 87490 | $119.78 | $226.00 | $22.75 – $87.10 | 16 |
| Dna probe gc CPT 87590 | $146.81 | $277.00 | $26.88 – $87.10 | 16 |
| Dna trichomonas CPT 87660 | $104.94 | $198.00 | $20.05 – $87.10 | 16 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $46.64 | $88.00 | $8.01 – $30.04 | 11 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $3.79 | $7.15 | $0.66 – $2.93 | 11 |
| Dolasetron mesylate HCPCS J1260 | $10.07 | $19.00 | $5.87 – $18.82 | 7 |
| Domicil/r-home visit est pat CPT 99334 | not published | not published | $97.97 – $97.97 | 1 |
| Domicil/r-home visit est pat CPT 99335 | not published | not published | $154.46 – $154.46 | 1 |
| Domicil/r-home visit est pat CPT 99336 | not published | not published | $218.65 – $218.65 | 1 |
| Domicil/r-home visit est pat CPT 99337 | not published | not published | $312.53 – $312.53 | 1 |
| Domicil/r-home visit new pat CPT 99324 | not published | not published | $87.99 – $87.99 | 1 |
| Domicil/r-home visit new pat CPT 99325 | not published | not published | $128.11 – $128.11 | 1 |
| Domicil/r-home visit new pat CPT 99326 | not published | not published | $223.31 – $223.31 | 1 |
| Domicil/r-home visit new pat CPT 99327 | not published | not published | $299.03 – $299.03 | 1 |
| Domicil/r-home visit new pat CPT 99328 | not published | not published | $351.37 – $351.37 | 1 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $3.22 | $6.07 | $0.71 – $2.35 | 11 |
| Doppler echo complete CPT 93320 | $1,038.27 | $1,959.00 | $29.19 – $67.64 | 6 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $3,158.27 | $5,959.00 | $110.30 – $305.78 | 6 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $514.10 | $970.00 | $34.12 – $335.08 | 9 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $392.20 | $740.00 | $18.95 – $276.06 | 9 |
| Dornase alfa non-comp unit HCPCS J7639 | $88.51 | $167.00 | $57.64 – $159.30 | 11 |
| Double transfer toe-hand CPT 26554 | not published | not published | $5,981.30 – $14,861.93 | 6 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $12.35 | $23.30 | $2.76 – $10.00 | 10 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $928.56 | $1,752.00 | $117.57 – $300.82 | 11 |
| Dpyd gene common variants CPT 81232 | not published | not published | $174.81 – $557.06 | 16 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $191.86 | $362.00 | $192.88 – $1,506.85 | 9 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $205.11 | $387.00 | $234.41 – $1,506.85 | 9 |
| Drainage external ear complex 69005 CPT 69005 | $180.20 | $340.00 | $258.47 – $855.34 | 6 |
| Drainage external ear simple 69000 CPT 69000 | $148.40 | $280.00 | $201.48 – $1,506.85 | 9 |
| Drainage lymph node lesion 38300 CPT 38300 | $205.64 | $388.00 | $328.87 – $1,284.90 | 6 |
| Drainage lymph node lesion 38305 CPT 38305 | not published | not published | $770.22 – $1,883.34 | 6 |
| Drainage mouth roof lesion CPT 42000 | not published | not published | $175.68 – $623.45 | 9 |
| Drainage of abdomen CPT 48000 | not published | not published | $2,870.43 – $7,245.77 | 6 |
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.