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 |
|---|---|---|---|---|
| Opn tx orbit fx combined CPT 21387 | not published | not published | $1,219.36 – $3,074.84 | 6 |
| Opn tx orbit fx periorbital CPT 21386 | not published | not published | $1,099.59 – $2,581.69 | 6 |
| Opn tx orbit fx transantral CPT 21385 | not published | not published | $1,168.56 – $2,946.63 | 6 |
| Opn tx orbit fx w/bone grft CPT 21408 | not published | not published | $1,432.93 – $3,562.53 | 6 |
| Opn tx orbit fx w/implant CPT 21407 | not published | not published | $1,043.02 – $2,555.45 | 6 |
| Opn tx orbit fx without impl 21406 CPT 21406 | not published | not published | $931.84 – $2,286.04 | 6 |
| Opn tx orbit periorbtl implt CPT 21390 | not published | not published | $1,292.14 – $3,179.39 | 6 |
| Opn tx orbit periorbt w/grft CPT 21395 | not published | not published | $1,597.49 – $3,989.18 | 6 |
| Opscpy extnd on/mac draw CPT 92202 | not published | not published | $23.92 – $127.20 | 9 |
| Opscpy extnd rta draw uni/bi CPT 92201 | not published | not published | $36.53 – $127.20 | 9 |
| Optical endomicroscpy interp CPT 88375 | not published | not published | $18.58 – $163.04 | 12 |
| Optokinetic nystagmus test CPT 92534 | not published | not published | $31.99 – $66.64 | 6 |
| Optx acrclv dslc aq/chrn grf CPT 23552 | not published | not published | $1,035.25 – $2,557.17 | 6 |
| Optx acromclv dislc aqt/chrn CPT 23550 | not published | not published | $916.62 – $2,245.28 | 6 |
| Optx acute shoulder dislc CPT 23660 | not published | not published | $2,041.50 – $2,286.61 | 5 |
| Optx carpl scphd fx int fixj CPT 25628 | not published | not published | $1,151.33 – $2,823.38 | 6 |
| Optx clavicular fx w/int fix CPT 23515 | not published | not published | $1,148.27 – $2,815.27 | 6 |
| Optx complicated mndblr fx CPT 21470 | not published | not published | $1,862.21 – $4,684.29 | 6 |
| Optx cranfcl sep comp mlt CPT 21433 | not published | not published | $2,735.86 – $6,861.51 | 6 |
| Optx cranfcl sep w/wiring CPT 21432 | not published | not published | $1,143.79 – $2,836.95 | 6 |
| Optx crnfcl sep comp mlt int CPT 21436 | not published | not published | $3,215.77 – $8,049.90 | 6 |
| Optx crnfc sep comp int&/xtr CPT 21435 | not published | not published | $2,227.58 – $5,547.59 | 6 |
| Optx crpl fx oth/thn scph ea CPT 25645 | not published | not published | $914.86 – $2,229.05 | 6 |
| Optx gr hmrl tbrs fx int fix CPT 23630 | not published | not published | $2,750.30 – $3,050.44 | 5 |
| Optx lunate dislocation CPT 25695 | not published | not published | $1,012.10 – $2,477.14 | 6 |
| Optx medial ankle fx CPT 27766 | not published | not published | $971.11 – $2,370.66 | 6 |
| Optx mndblr cndylr fx CPT 21465 | not published | not published | $1,291.05 – $3,437.33 | 6 |
| Optx mndblr fx wo ntrdntl CPT 21461 | not published | not published | $1,722.83 – $8,027.06 | 6 |
| Optx mndblr fx xtrnl fixj CPT 21454 | not published | not published | $792.22 – $2,130.33 | 6 |
| Optx mndblr/max alv ridge fx CPT 21445 | not published | not published | $1,040.06 – $3,108.91 | 6 |
| Optx palatal/max fracture CPT 21422 | not published | not published | $1,013.90 – $2,551.80 | 6 |
| Optx palatal/max fx comp CPT 21423 | not published | not published | $1,269.08 – $3,034.82 | 6 |
| Optx partclr fx&/dslc elbw w CPT 24587 | not published | not published | $1,716.39 – $4,244.07 | 6 |
| Optx post ankle fx CPT 27769 | not published | not published | $1,155.93 – $2,852.41 | 6 |
| Optx prox humrl fx w/int fix CPT 23615 | not published | not published | $1,400.88 – $3,452.73 | 6 |
| Optx prx hmrl fx fix rpr rpl CPT 23616 | not published | not published | $1,945.21 – $4,829.80 | 6 |
| Optx radial shaft fracture CPT 25515 | not published | not published | $1,071.66 – $2,620.68 | 6 |
| Optx rad/uln dislc aqt/chrnc CPT 25676 | not published | not published | $1,010.92 – $2,473.04 | 6 |
| Optx rdcrpl/ntrcrpl dislc 1+ CPT 25670 | not published | not published | $973.32 – $2,377.92 | 6 |
| Optx rdl shft fx&cltx rad/ul CPT 25525 | not published | not published | $1,261.99 – $3,085.37 | 6 |
| Optx rdl shft fx&dstl rad/ul CPT 25526 | not published | not published | $1,516.40 – $3,728.01 | 6 |
| Optx rdl&uln shft fx rds&uln CPT 25575 | not published | not published | $1,437.52 – $3,525.67 | 6 |
| Optx rdl&uln shft fx rds/uln CPT 25574 | not published | not published | $1,081.34 – $2,636.59 | 6 |
| Optx scapular fx w/int fixj CPT 23585 | not published | not published | $1,544.48 – $3,826.61 | 6 |
| Optx sho dislc fx CPT 23670 | not published | not published | $1,381.49 – $3,416.08 | 6 |
| Optx sho dislc neck fx fixj CPT 23680 | not published | not published | $3,266.33 – $3,632.03 | 5 |
| Optx strclv dslc aq/chrn grf CPT 23532 | not published | not published | $1,000.43 – $2,442.45 | 6 |
| Optx strnclav dislc aqt/chrn CPT 23530 | not published | not published | $920.86 – $2,244.05 | 6 |
| Optx thigh fx CPT 27269 | not published | not published | $1,945.77 – $4,850.26 | 6 |
| Optx tmprmand dislocation CPT 21490 | not published | not published | $1,271.96 – $3,332.56 | 6 |
| Optx trns-scphprlnr fx dislc CPT 25685 | not published | not published | $1,169.09 – $2,872.17 | 6 |
| Optx ulnar shft fx int fixj CPT 25545 | not published | not published | $1,002.44 – $2,439.91 | 6 |
| Optx ulnar styloid fracture CPT 25652 | not published | not published | $999.14 – $2,438.48 | 6 |
| Oral aprepitant HCPCS J8501 | $4.77 | $9.00 | $3.72 – $6.98 | 9 |
| Oral hiv-1/hiv-2 screen HCPCS G0435 | $60.95 | $115.00 | $12.58 – $46.32 | 13 |
| Orbitocranial approach/skull CPT 61584 | not published | not published | $4,372.04 – $10,697.97 | 6 |
| Orbitocranial approach/skull CPT 61585 | not published | not published | $4,917.05 – $12,048.55 | 6 |
| Orbitocranial approach/skull CPT 61592 | not published | not published | $4,762.36 – $11,832.40 | 6 |
| Orchiectomy partial CPT 54522 | not published | not published | $935.82 – $2,357.38 | 6 |
| Orchiopexy (fowler-stephens) CPT 54650 | not published | not published | $1,133.49 – $2,847.41 | 6 |
| Orchiopexy ingun/scrot appr CPT 54640 | not published | not published | $684.69 – $1,731.55 | 6 |
| Organic acids total quant ea spec CPT 83918 | $110.77 | $209.00 | $23.60 – $73.86 | 16 |
| Oropharyngeal biopsy 42800 CPT 42800 | $115.54 | $218.00 | $188.36 – $623.73 | 6 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | $29.19 | $55.08 | $4.93 – $50.45 | 10 |
| Ortho dvc repair per 15 min HCPCS L4205 | $18.02 | $34.00 | $23.74 – $23.74 | 3 |
| Ortho elbow without jnt cstm w/fit&adj HCPCS L3702 | $671.51 | $1,267.00 | $263.28 – $380.81 | 4 |
| Ortho ewhf rigd without jnt cstm w HCPCS L3765 | $2,980.72 | $5,624.00 | $1,169.09 – $1,691.00 | 4 |
| Ortho ewh rgd without jnt cstm w/fit&adj HCPCS L3763 | $1,739.46 | $3,282.00 | $682.30 – $986.91 | 4 |
| Ortho hnd/fngr without jnt cstm w/fit&adj HCPCS L3913 | $629.64 | $1,188.00 | $246.92 – $357.17 | 4 |
| Ortho hnd/fngr w/jnt cstm w/fit&adj HCPCS L3921 | $746.77 | $1,409.00 | $292.87 – $423.61 | 4 |
| Orthopantogram CPT 70355 | $144.16 | $272.00 | $13.31 – $188.56 | 10 |
| Orthop traing pfrmd phys/qhp CPT 92065 | not published | not published | $13.33 – $189.66 | 6 |
| Orthop traing supvj phys/qhp CPT 92066 | not published | not published | $57.82 – $127.20 | 8 |
| Orthovisc inj per dose HCPCS J7324 | $147.34 | $278.00 | $142.19 – $250.60 | 9 |
| Ortho whf rigd without jnt cstm w/fit&adj HCPCS L3808 | $827.86 | $1,562.00 | $324.78 – $469.77 | 4 |
| Ortho wrst/hnd w/jnt cstm w/fit&adj HCPCS L3905 | $2,305.50 | $4,350.00 | $904.16 – $1,307.81 | 4 |
| Oscillation chest wall mechanical per session CPT 94669 | not published | not published | $31.01 – $435.60 | 9 |
| Osmolality blood CPT 83930 | $54.06 | $102.00 | $6.61 – $28.64 | 16 |
| Osmolality urine CPT 83935 | $49.82 | $94.00 | $6.82 – $29.82 | 16 |
| Ostectomy complete 1st metatarsal head 28111 CPT 28111 | $434.60 | $820.00 | $516.97 – $1,965.46 | 6 |
| Ostectomy scapula partial CPT 23190 | not published | not published | $919.55 – $2,242.54 | 6 |
| Osteoart algrft w/surf & b1 CPT 20932 | not published | not published | $1,165.93 – $2,806.74 | 6 |
| Osteochondral knee allograft CPT 27415 | not published | not published | $2,158.73 – $5,353.12 | 6 |
| Osteochondral knee autograft CPT 27416 | not published | not published | $1,547.19 – $3,823.37 | 6 |
| Osteochondral talus autogrft CPT 28446 | not published | not published | $1,928.72 – $4,772.32 | 6 |
| Osteopath manip tx/5-6 body region 98927 CPT 98927 | not published | not published | $24.63 – $215.23 | 9 |
| Osteopath manip tx/7-8 body region 98928 CPT 98928 | not published | not published | $24.63 – $263.00 | 9 |
| Osteopath manip tx/9-10 body region98929 CPT 98929 | not published | not published | $24.63 – $312.87 | 9 |
| Osteoplasty humerus CPT 24420 | not published | not published | $1,694.10 – $4,016.52 | 6 |
| Osteot dsc ant 1 vrt sgm crv CPT 22220 | not published | not published | $2,485.67 – $6,184.69 | 6 |
| Osteot dsc ant 1vrt sgm ea CPT 22226 | not published | not published | $541.04 – $1,377.11 | 6 |
| Osteot dsc ant 1vrt sgm lmbr CPT 22224 | not published | not published | $2,460.17 – $6,125.32 | 6 |
| Osteot dsc ant 1vrt sgm thrc CPT 22222 | not published | not published | $2,634.91 – $6,441.35 | 6 |
| Osteot humerus w/wo int fixj CPT 24400 | not published | not published | $1,314.37 – $3,217.80 | 6 |
| Osteot mlt relignmt imed rod CPT 27712 | not published | not published | $1,736.86 – $4,299.92 | 6 |
| Osteotomy/graft tarsal/calcaneus/talus 28305 CPT 28305 | not published | not published | $1,076.85 – $2,668.94 | 6 |
| Ot evaluation high complexity patient/family CPT 97167 | $208.82 | $394.00 | $97.60 – $251.33 | 9 |
| Ot evaluation low complexity patient/family CPT 97165 | $127.73 | $241.00 | $97.60 – $251.33 | 9 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $191.33 | $361.00 | $97.60 – $251.33 | 9 |
| Other bone graft microvasc CPT 20962 | not published | not published | $4,176.00 – $10,371.57 | 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.