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 |
|---|---|---|---|---|
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $296.27 | $559.00 | $42.84 – $186.83 | 16 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $619.04 | $1,168.00 | $85.10 – $371.38 | 16 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $571.87 | $1,079.00 | $142.63 – $559.35 | 16 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $104.78 | $197.70 | $40.09 – $100.38 | 11 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | $83.21 | $157.00 | $32.72 – $86.41 | 10 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $157.48 | $297.13 | $19.06 – $56.21 | 11 |
| Influenza dna amp prob addl CPT 87503 | $111.83 | $211.00 | $29.22 – $91.45 | 16 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | $51.94 | $98.00 | $49.00 – $166.98 | 10 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $27.56 – $71.55 | 11 |
| Inf lwr xtr fscl pln blk uni w/wo image CPT 64474 | not published | not published | $949.81 – $949.81 | 1 |
| Infratemporal approach/skull CPT 61591 | not published | not published | $4,812.73 – $11,907.88 | 6 |
| Infratemporal approach/skull CPT 61590 | not published | not published | $4,772.48 – $11,858.10 | 6 |
| Inf thrc fascial pln blk bi w/wo image CPT 64469 | not published | not published | $1,469.19 – $1,469.19 | 1 |
| Inf thrc fascial pln blk uni w/wo image CPT 64467 | not published | not published | $961.57 – $961.57 | 1 |
| Infuse radioactive materials CPT 77750 | not published | not published | $210.87 – $563.22 | 9 |
| Ingest challenge ea addl 60 min CPT 95079 | $309.52 | $584.00 | $139.15 – $309.36 | 6 |
| Ingest challenge ini 120 min CPT 95076 | $619.04 | $1,168.00 | $199.14 – $1,136.37 | 9 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | not published | not published | $29.22 – $435.60 | 9 |
| Initial hosp neonate 28 d/less than not critically ill 99477 CPT 99477 | not published | not published | $551.14 – $932.25 | 6 |
| Initial nursing facility care/day 35 minutes CPT 99305 | not published | not published | $216.24 – $338.54 | 6 |
| Initial nursing facility care/day 45 minutes CPT 99306 | not published | not published | $296.46 – $432.01 | 6 |
| Initial nursing facility care/day low severity 99304 CPT 99304 | not published | not published | $130.54 – $237.78 | 6 |
| Initial observation care CPT 99218 | not published | not published | $156.55 – $156.55 | 1 |
| Initial observation care CPT 99219 | not published | not published | $213.52 – $213.52 | 1 |
| Initial observation care CPT 99220 | not published | not published | $289.15 – $289.15 | 1 |
| Initiation & management bipap/cpap initial day CPT 94660 | $1,311.22 | $2,474.00 | $102.88 – $435.60 | 9 |
| Init nb em per day non-fac CPT 99461 | not published | not published | $99.57 – $256.37 | 6 |
| Init pm e/m new pat 65+ yrs CPT 99387 | not published | not published | $199.63 – $429.27 | 6 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | $6.36 | $12.00 | $7.38 – $11.67 | 6 |
| Inj., aristada initio, 1 mg HCPCS J1943 | $3.71 | $7.00 | $3.42 – $6.29 | 8 |
| Inj bulking agent anal canal HCPCS L8605 | $1,310.69 | $2,473.00 | $718.93 – $1,039.88 | 4 |
| Inj calcitriol per 0.1 mcg HCPCS J0636 | $2.32 | $4.38 | $0.79 – $3.08 | 8 |
| Inj, clevidipine butyrate HCPCS C9248 | $234.74 | $442.92 | $3.07 – $10.34 | 5 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $451.56 | $852.00 | $64.23 – $626.56 | 6 |
| Inj., copanlisib, 1 mg HCPCS J9057 | $62.54 | $118.00 | $117.25 – $117.25 | 4 |
| Inj disk cerv-thor ea lev CPT 62291 | not published | not published | $235.09 – $1,337.91 | 6 |
| Inj dupuytren cord w/enzyme CPT 20527 | not published | not published | $103.19 – $632.19 | 9 |
| Inj, durolane 1 mg HCPCS J7318 | $12.72 | $24.00 | $8.57 – $18.73 | 11 |
| Inj dx for sinogram CPT 20501 | $902.59 | $1,703.00 | $58.73 – $547.35 | 6 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | $175.43 | $331.00 | $131.68 – $1,483.13 | 9 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $1,217.94 | $2,298.00 | $108.61 – $871.17 | 6 |
| Injection, cangrelor HCPCS C9460 | $27.75 | $52.35 | $30.11 – $31.05 | 4 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | not published | not published | $89.15 – $632.19 | 9 |
| Injection, daratumumab 10 mg HCPCS J9145 | $97.95 | $184.82 | $67.76 – $135.25 | 8 |
| Injection, doxercalciferol HCPCS J1270 | $3.76 | $7.09 | $0.37 – $1.34 | 10 |
| Injection during cath supravalvular aortography CPT 93567 | $3,691.45 | $6,965.00 | $56.54 – $446.69 | 6 |
| Injection epidural blood patch or clot CPT 62273 | $1,853.94 | $3,498.00 | $180.93 – $1,483.13 | 9 |
| Injection eye drug CPT 67028 | not published | not published | $147.34 – $710.36 | 9 |
| Injection for arthrography wrist (both sides) CPT 25246 | not published | not published | $571.16 – $737.02 | 5 |
| Injection for bladder x-ray CPT 51600 | $888.28 | $1,676.00 | $69.46 – $823.98 | 6 |
| Injection for hip x-ray CPT 27095 | not published | not published | $129.25 – $1,163.91 | 6 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $1,300.09 | $2,453.00 | $80.21 – $610.04 | 6 |
| Injection for spleen x-ray CPT 38200 | not published | not published | $208.78 – $540.13 | 6 |
| Injection for tear sac x-ray CPT 68850 | not published | not published | $83.47 – $251.37 | 6 |
| Injection for ureter x-ray CPT 50684 | not published | not published | $80.61 – $466.38 | 6 |
| Injection for ureter x-ray CPT 50690 | $126.67 | $239.00 | $111.69 – $432.47 | 6 |
| Injection, fulvestrant HCPCS J9395 | $113.84 | $214.80 | $9.76 – $28.88 | 11 |
| Injection, inclisiran, 1 mg HCPCS J1306 | $12.72 | $24.00 | $13.79 – $20.26 | 6 |
| Injection into brain canal CPT 61026 | not published | not published | $164.80 – $1,483.13 | 9 |
| Injection into brain canal CPT 61055 | not published | not published | $185.32 – $632.19 | 9 |
| Injection into hemorrhoid(s) CPT 46500 | $217.83 | $411.00 | $299.22 – $1,952.57 | 9 |
| Injection into spinal artery CPT 62294 | not published | not published | $866.68 – $3,500.70 | 9 |
| Injection into vocal cord CPT 31513 | not published | not published | $208.32 – $831.62 | 9 |
| Injection intraop add-on CPT 48400 | not published | not published | $161.14 – $411.11 | 6 |
| Injection jaw joint x-ray CPT 21116 | not published | not published | $72.18 – $786.91 | 6 |
| Injection of sinus tract CPT 20500 | $822.56 | $1,552.00 | $143.04 – $453.95 | 6 |
| Injection,onabotulinumtoxina HCPCS J0585 | $10.02 | $18.90 | $7.27 – $18.76 | 11 |
| Injection px peyronie ds CPT 54200 | not published | not published | $138.72 – $520.87 | 9 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $607.38 | $1,146.00 | $51.48 – $860.57 | 9 |
| Injection, renflexis HCPCS Q5104 | $125.38 | $236.56 | $35.33 – $108.43 | 10 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $168.01 | $317.00 | $101.63 – $1,483.13 | 9 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $76.85 | $145.00 | $67.10 – $1,483.13 | 9 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $1,539.12 | $2,904.00 | $177.84 – $1,906.70 | 9 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $84.80 | $160.00 | $94.72 – $380.48 | 6 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $1,605.90 | $3,030.00 | $168.30 – $1,906.70 | 9 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $1,002.76 | $1,892.00 | $81.86 – $354.45 | 6 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $2,005.52 | $3,784.00 | $144.28 – $1,906.70 | 9 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $287.26 | $542.00 | $171.05 – $1,483.13 | 9 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $1,351.50 | $2,550.00 | $158.39 – $1,483.13 | 9 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $46.64 | $88.00 | $61.98 – $632.19 | 9 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $253.34 | $478.00 | $59.18 – $632.19 | 9 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $67.84 | $128.00 | $67.46 – $632.19 | 9 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $117.66 | $222.00 | $25.09 – $98.82 | 9 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $117.66 | $222.00 | $16.56 – $46.07 | 6 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $182.85 | $345.00 | $60.54 – $451.22 | 9 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $420.29 | $793.00 | $23.10 – $152.42 | 9 |
| Injection treatment of eye CPT 66020 | not published | not published | $211.58 – $772.15 | 6 |
| Injection treatment of eye CPT 66030 | not published | not published | $179.59 – $690.93 | 6 |
| Injection treatment of nerve CPT 64605 | not published | not published | $548.96 – $2,594.89 | 6 |
| Injection treatment of nerve CPT 64610 | not published | not published | $725.27 – $2,984.39 | 6 |
| Injection treatment of nerve CPT 64681 | not published | not published | $357.63 – $2,211.42 | 9 |
| Injection treatment of nose CPT 30200 | $121.37 | $229.00 | $95.63 – $1,090.63 | 9 |
| Inject sacroiliac joint CPT 27096 | $1,299.56 | $2,452.00 | $133.21 – $646.45 | 6 |
| Inject/treat eye socket CPT 67500 | not published | not published | $102.63 – $640.20 | 9 |
| Inject/treat eye socket CPT 67505 | not published | not published | $116.30 – $640.20 | 9 |
| Inject/treat eye socket CPT 67515 | not published | not published | $76.04 – $640.20 | 9 |
| Inj epidural sgl cerv-thor without img CPT 62320 | $134.09 | $253.00 | $158.75 – $1,483.13 | 9 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $139.92 | $264.00 | $128.13 – $1,906.70 | 9 |
| Inj for ext venography CPT 36005 | $1,556.08 | $2,936.00 | $73.68 – $1,180.27 | 6 |
| Inj for mammo ductogram CPT 19030 | $1,312.81 | $2,477.00 | $121.86 – $673.02 | 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.