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 |
|---|---|---|---|---|
| Lithium therapeutic drug level CPT 80178 | $57.77 | $109.00 | $6.61 – $28.64 | 16 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $1,368.46 | $2,582.00 | $541.68 – $541.68 | 4 |
| Litt icr 1 traj 1 smpl les CPT 61736 | not published | not published | $1,424.06 – $3,694.55 | 6 |
| Litt icr mlt trj mlt/cplx ls CPT 61737 | not published | not published | $1,693.22 – $4,389.26 | 6 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | $1,867.57 – $4,678.26 | 6 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | not published | not published | $176.19 – $694.69 | 10 |
| Liver elastography 91200 CPT 91200 | not published | not published | $17.20 – $335.08 | 9 |
| Liver Function Test CPT 80076 | $88.51 | $167.00 | $8.17 – $35.54 | 16 |
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | $2,205.53 – $5,591.91 | 6 |
| Liver imaging CPT 78201 | not published | not published | $33.37 – $1,152.80 | 10 |
| Liver imag w/vasclr flow CPT 78202 | not published | not published | $38.51 – $1,152.80 | 10 |
| Liver/spleen imag static only CPT 78215 | not published | not published | $37.89 – $860.57 | 10 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $43.42 – $860.57 | 10 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $117.78 – $267.07 | 6 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $751.38 – $2,638.72 | 6 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $2.12 | $4.00 | $1.72 – $4.00 | 11 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $2.19 | $4.14 | $1.04 – $3.42 | 10 |
| Loudness balance test CPT 92562 | $64.13 | $121.00 | $77.89 – $666.91 | 9 |
| Low back disk surgery CPT 63030 | not published | not published | $1,402.72 – $3,683.03 | 6 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,356.91 | $4,447.00 | $99.60 – $401.74 | 10 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $1,523.75 | $2,875.00 | $95.45 – $828.27 | 10 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,395.49 | $2,633.00 | $78.03 – $245.18 | 10 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $3,045.91 | $5,747.00 | $179.52 – $828.27 | 10 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,650.00 | $5,000.00 | $139.93 – $828.27 | 10 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,158.16 | $4,072.00 | $116.26 – $517.79 | 10 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $205.64 | $388.00 | $17.78 – $245.18 | 10 |
| Lower jaw bone graft CPT 21215 | not published | not published | $1,272.99 – $16,466.26 | 6 |
| Low frequency non-thermal Ultrasound CPT 97610 | not published | not published | $193.43 – $729.76 | 9 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $1,165.61 – $2,877.46 | 6 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $1,339.96 – $3,318.66 | 6 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $1,321.61 – $3,271.43 | 6 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $1,442.30 – $3,575.53 | 6 |
| L/s ratio fetal lung CPT 83661 | $71.02 | $134.00 | $21.99 – $96.28 | 16 |
| Lumbar diskogram s&i CPT 72295 | not published | not published | $65.50 – $3,947.38 | 7 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $2,426.99 – $6,055.25 | 6 |
| Lung function test (mbc/mvv) CPT 94200 | $180.73 | $341.00 | $4.15 – $127.20 | 9 |
| Lung Function Test (Spirometry) CPT 94010 | $609.50 | $1,150.00 | $13.26 – $335.08 | 9 |
| Lung perfusion imaging CPT 78580 | $1,897.93 | $3,581.00 | $57.03 – $860.57 | 10 |
| Lung transplant double CPT 32853 | not published | not published | $6,840.24 – $17,466.74 | 6 |
| Lung transplant single CPT 32851 | not published | not published | $4,904.30 – $12,498.89 | 6 |
| Lung transplant with bypass CPT 32852 | not published | not published | $5,319.32 – $13,577.19 | 6 |
| Lung transplant with bypass CPT 32854 | not published | not published | $7,248.36 – $18,547.21 | 6 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $2,224.21 – $5,623.03 | 6 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $292.69 | $552.25 | $213.88 – $410.07 | 8 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $59.88 | $112.99 | $44.24 – $82.49 | 8 |
| Lutetium lu 177 vipivotide HCPCS A9607 | $672.04 | $1,268.00 | $352.46 – $708.03 | 7 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $23.84 – $211.19 | 9 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $20.05 – $87.10 | 16 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $1,114.45 – $2,767.62 | 6 |
| Lymphatics/lymph node imaging CPT 78195 | $2,194.73 | $4,141.00 | $91.56 – $1,152.80 | 10 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $36.56 – $246.43 | 16 |
| Lymphocyte transformation mitogen CPT 86353 | $357.22 | $674.00 | $49.03 – $213.19 | 16 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $107.57 – $593.10 | 16 |
| Lymphocytotoxicity assay CPT 86806 | not published | not published | $47.59 – $207.47 | 16 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $66.35 – $1,324.09 | 10 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $92.02 – $3,163.82 | 7 |
| Lymph vessel x-ray trunk CPT 75805 | not published | not published | $63.80 – $6,438.74 | 7 |
| Lymph vessel x-ray trunk CPT 75807 | not published | not published | $85.82 – $6,438.74 | 7 |
| Lysis intranasal synechia 30560 CPT 30560 | $300.51 | $567.00 | $245.82 – $1,164.28 | 9 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $249.31 – $652.06 | 6 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $319.99 – $1,026.60 | 6 |
| Macro exam dissect molec study ea CPT 88387 | not published | not published | $7.36 – $29.35 | 12 |
| Macroscopic exam arthropod CPT 87168 | $65.19 | $123.00 | $4.27 – $18.32 | 16 |
| Macroscopic exam parasite CPT 87169 | $34.45 | $65.00 | $4.31 – $18.32 | 16 |
| Magnesium CPT 83735 | $57.77 | $109.00 | $6.70 – $28.64 | 16 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $8.55 | $16.14 | $0.61 – $2.84 | 11 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $125.90 – $517.79 | 10 |
| Makena, 10 mg HCPCS J1726 | $23.85 | $45.00 | $19.93 – $26.31 | 5 |
| Malaria antibody CPT 86750 | $32.86 | $62.00 | $13.19 – $57.32 | 16 |
| Male sling procedure CPT 53440 | not published | not published | $1,196.27 – $3,011.61 | 6 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $4,604.06 – $11,676.80 | 6 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $580.99 – $1,351.32 | 6 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $704.38 – $1,676.78 | 6 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $80.56 | $152.00 | $58.92 – $276.06 | 9 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $80.56 | $152.00 | $37.57 – $276.06 | 9 |
| Manipulation of hip joint CPT 27275 | not published | not published | $293.76 – $717.17 | 6 |
| Manipulation of spine CPT 22505 | not published | not published | $204.71 – $507.79 | 6 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $125.19 – $513.74 | 9 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $10.49 | $19.80 | $3.39 – $15.04 | 10 |
| Manual diff wbc count b-coat CPT 85009 | $13.78 | $26.00 | $5.07 – $16.05 | 16 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | not published | not published | $165.65 – $316.42 | 6 |
| Mapping io sentinel lymph node CPT 38900 | not published | not published | $208.15 – $529.11 | 6 |
| Map tachycard site(s) CPT 93609 | $8,065.01 | $15,217.00 | $188.21 – $395.20 | 6 |
| Marsupialization liver lesion 47300 CPT 47300 | not published | not published | $1,750.86 – $4,363.38 | 6 |
| Mastectomy partial CPT 19301 | not published | not published | $1,021.38 – $2,528.35 | 6 |
| Mast mod rad CPT 19307 | not published | not published | $1,824.13 – $4,644.07 | 6 |
| Mastoidectomy CPT 69501 | not published | not published | $1,154.08 – $2,816.70 | 6 |
| Mastoidectomy complete 69502 CPT 69502 | not published | not published | $1,531.26 – $3,742.03 | 6 |
| Mastoids complete CPT 70130 | $429.83 | $811.00 | $27.06 – $245.18 | 10 |
| Mastoid surgery revision CPT 69603 | not published | not published | $2,093.07 – $4,958.46 | 6 |
| Mastopexy CPT 19316 | not published | not published | $1,252.22 – $3,032.85 | 6 |
| Mast radical CPT 19305 | not published | not published | $1,780.85 – $4,384.87 | 6 |
| Mast rad urban type CPT 19306 | not published | not published | $1,887.83 – $4,655.96 | 6 |
| Mast simple complete CPT 19303 | not published | not published | $1,478.34 – $3,690.37 | 6 |
| M.avium-intra dna amp prob CPT 87561 | $109.71 | $207.00 | $35.09 – $152.46 | 16 |
| M.avium-intra dna dir prob CPT 87560 | not published | not published | $27.29 – $87.10 | 16 |
| M.avium-intra dna quant CPT 87562 | not published | not published | $42.84 – $186.83 | 16 |
| Maxillofacial fixation CPT 21100 | not published | not published | $576.52 – $3,641.00 | 6 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $75.26 | $142.00 | $14.46 – $63.05 | 16 |
| Mayo aathr protein s free CPT 85306 | $152.11 | $287.00 | $15.32 – $65.19 | 16 |
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.