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 |
|---|---|---|---|---|
| Ghs sedimentation rate CPT 85651 | $36.57 | $69.00 | $4.27 – $14.91 | 16 |
| Ghs semen analysis fert CPT 89320 | $102.82 | $194.00 | $12.31 – $52.73 | 16 |
| Ghs semen analysis, post-vas CPT 89300 | not published | not published | $9.84 – $38.96 | 16 |
| Ghs sensitivity (per antimicro) CPT 87184 | $53.00 | $100.00 | $7.48 – $29.82 | 16 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $134.09 | $253.00 | $145.91 – $855.65 | 9 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $173.84 | $328.00 | $197.00 – $855.65 | 9 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $157.94 | $298.00 | $179.38 – $855.65 | 9 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | not published | not published | $235.08 – $855.65 | 9 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $122.43 | $231.00 | $115.02 – $545.71 | 9 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $107.06 | $202.00 | $113.02 – $503.97 | 9 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $154.23 | $291.00 | $145.01 – $659.32 | 9 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $187.62 | $354.00 | $193.43 – $895.77 | 9 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | not published | not published | $193.43 – $672.85 | 9 |
| Ghs sleep study unattended CPT 95800 | $1,217.41 | $2,297.00 | $66.11 – $335.08 | 9 |
| Ghs somatosensory testing lower extremit CPT 95926 | $248.04 | $468.00 | $44.61 – $666.91 | 9 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $814.08 | $1,536.00 | $73.25 – $1,136.37 | 9 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $74.73 | $141.00 | $46.07 – $188.55 | 9 |
| Ghs sphenopalatine ganglion block CPT 64505 | not published | not published | $160.94 – $632.19 | 9 |
| Ghs spont nystagmus CPT 92541 | $40.81 | $77.00 | $6.75 – $276.06 | 9 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $209.35 | $395.00 | $97.86 – $395.49 | 9 |
| Ghs st - eval for alt comm CPT 92567 | not published | not published | $27.03 – $84.06 | 9 |
| Ghs strapping shoulder - 29240 CPT 29240 | $29.15 | $55.00 | $29.94 – $276.06 | 9 |
| Ghs st - re-eval for alt comm CPT 92597 | $269.24 | $508.00 | $69.04 – $267.14 | 9 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $37.10 | $70.00 | $25.33 – $98.82 | 9 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $364.11 | $687.00 | $205.10 – $610.60 | 9 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $173.31 | $327.00 | $299.51 – $1,310.98 | 9 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | not published | not published | $224.86 – $855.65 | 9 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | not published | not published | $497.44 – $1,257.47 | 6 |
| Ghs trypsin (fecal) CPT 84488 | $23.85 | $45.00 | $7.30 – $32.09 | 16 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | not published | not published | $233.52 – $1,249.35 | 9 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $233.52 – $1,183.10 | 9 |
| Ghs urine, hydroxproline total CPT 83505 | $110.77 | $209.00 | $24.30 – $105.46 | 16 |
| Ghs urine, porphyrins quant CPT 84120 | $122.43 | $231.00 | $14.71 – $64.19 | 16 |
| Ghs vaginal delivery only CPT 59409 | not published | not published | $1,212.34 – $2,833.37 | 6 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | not published | not published | $516.53 – $2,413.29 | 9 |
| Ghs windowing of cast CPT 29730 | $41.87 | $79.00 | $70.01 – $337.94 | 9 |
| Giardia ag if CPT 87269 | $40.28 | $76.00 | $13.61 – $52.73 | 16 |
| Giardia lamblia antibody CPT 86674 | $64.13 | $121.00 | $14.72 – $64.19 | 16 |
| Gi endoscopic ultrasound CPT 76975 | $448.91 | $847.00 | $67.08 – $517.79 | 10 |
| Gi inhouse confirmation CPT 87045 | $84.80 | $160.00 | $9.44 – $41.27 | 16 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $487.08 – $1,773.74 | 6 |
| Gi protein loss CPT 78282 | not published | not published | $25.36 – $860.57 | 10 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $3,917.23 | $7,391.00 | $183.94 – $2,007.94 | 9 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | $198.29 – $1,952.57 | 9 |
| Gi trc img intral esophagus CPT 91111 | $1,635.05 | $3,085.00 | $73.92 – $2,007.94 | 9 |
| Gi wireless capsule measure CPT 91112 | not published | not published | $172.77 – $2,007.94 | 9 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $101.12 – $6,990.00 | 16 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $61.52 – $6,990.00 | 16 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $35.00 – $6,990.00 | 16 |
| Glaucoma surgery CPT 66150 | not published | not published | $1,415.73 – $3,491.44 | 6 |
| Glaucoma surgery CPT 66155 | not published | not published | $1,414.60 – $3,488.53 | 6 |
| Glaucoma surgery CPT 66160 | not published | not published | $1,590.18 – $3,931.04 | 6 |
| Glaucoma surgery CPT 66170 | not published | not published | $1,761.91 – $4,354.28 | 6 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $243.27 | $459.00 | $199.84 – $384.61 | 9 |
| Glucagon plasma - sendout CPT 82943 | $89.57 | $169.00 | $14.29 – $55.21 | 16 |
| Glucagon tolerance panel CPT 80422 | not published | not published | $46.07 – $224.65 | 16 |
| Glucagon tolerance panel CPT 80424 | not published | not published | $50.50 – $224.65 | 16 |
| Glucagon tolerance test CPT 82946 | not published | not published | $17.59 – $58.24 | 16 |
| Glucose 1 hr post dose CPT 82950 | $40.28 | $76.00 | $4.75 – $20.64 | 16 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | $50.35 | $95.00 | $6.05 – $26.36 | 16 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $20.67 | $39.00 | $3.28 – $10.32 | 16 |
| Glucose blood quantitative CPT 82947 | $41.34 | $78.00 | $3.93 – $17.19 | 16 |
| Glucose body fluid CPT 82945 | $37.63 | $71.00 | $3.93 – $17.19 | 16 |
| Glucose monitoring continual min 72hr pt CPT 95249 | $224.72 | $424.00 | $57.82 – $192.62 | 9 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $92.75 | $175.00 | $12.87 – $56.18 | 16 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $29.15 | $55.00 | $3.92 – $17.19 | 16 |
| Gold sodium thiomaleate inj HCPCS J1600 | $13.78 | $26.00 | $21.88 – $22.75 | 5 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $158.47 | $299.00 | $18.58 – $81.37 | 16 |
| Gonadotropin hormone panel CPT 80426 | not published | not published | $148.41 – $620.12 | 16 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $181.79 | $343.00 | $18.52 – $80.23 | 16 |
| Gonioscopy CPT 92020 | not published | not published | $33.54 – $276.06 | 9 |
| Goniotomy CPT 65820 | not published | not published | $1,337.02 – $3,126.62 | 6 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $1,749.74 | $3,301.40 | $653.12 – $1,871.39 | 10 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $56.71 | $107.00 | $39.74 – $61.27 | 6 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $1,488.11 – $3,518.25 | 6 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $1,224.83 | $2,311.00 | $49.31 – $130.81 | 10 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $1,664.37 – $4,123.70 | 6 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $1,126.25 | $2,125.00 | $157.70 – $418.98 | 10 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $68.90 | $130.00 | $50.95 – $103.57 | 8 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $1,145.60 | $2,161.50 | $75.00 – $871.54 | 10 |
| Granisetron 1 mg tab HCPCS Q0166 | $88.51 | $167.00 | $4.02 – $85.14 | 7 |
| Granisetron hcl injection HCPCS J1626 | $0.53 | $1.00 | $0.36 – $0.63 | 9 |
| Great toe-hand transfer CPT 26551 | not published | not published | $5,179.12 – $12,837.67 | 6 |
| Great toe with reduction 28495 CPT 28495 | not published | not published | $233.52 – $711.19 | 9 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $797.73 – $2,289.89 | 6 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $805.09 – $2,268.08 | 6 |
| Grfg autol fat lipo ea addl CPT 15772 | not published | not published | $231.88 – $711.97 | 6 |
| Grfg autol soft tiss dir exc CPT 15769 | not published | not published | $760.61 – $1,890.88 | 6 |
| Group behave couns 2-10 HCPCS G0473 | $94.87 | $179.00 | $18.56 – $46.36 | 4 |
| Group mnt 2 or more 30 mins HCPCS G0271 | $66.25 | $125.00 | $23.29 – $61.68 | 6 |
| Group train without patient HCPCS G0543 | $47.17 | $89.00 | $86.91 – $86.91 | 1 |
| Growth hormone antibody CPT 86277 | $63.60 | $120.00 | $15.74 – $68.78 | 16 |
| Growth hormone panel CPT 80428 | not published | not published | $66.70 – $342.71 | 16 |
| Growth hormone panel CPT 80430 | not published | not published | $129.33 – $404.76 | 16 |
| Growth stimulation gene 2 CPT 83006 | not published | not published | $43.76 – $236.60 | 16 |
| Grp adapt bhv tx by phy/qhp CPT 97158 | not published | not published | $19.80 – $63.80 | 8 |
| Grp adapt bhv tx by tech CPT 97154 | not published | not published | $17.17 – $63.80 | 8 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | not published | not published | $2,935.32 – $7,401.77 | 6 |
| Gstr rstcv oth/thn v-band CPT 43843 | not published | not published | $1,967.00 – $4,936.81 | 6 |
| Gstr rstcv px shrt roux-en-y CPT 43846 | not published | not published | $2,527.70 – $6,263.00 | 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.