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 |
|---|---|---|---|---|
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $180.20 | $340.00 | $27.26 – $53.99 | 7 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $157.41 | $297.00 | $63.51 – $199.26 | 7 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $260.23 | $491.00 | $197.68 – $292.25 | 4 |
| Tc-99m sulfur colloid HCPCS A9541 | $639.18 | $1,206.00 | $396.24 – $831.77 | 7 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $258.11 | $487.00 | $126.37 – $265.29 | 7 |
| Tc-99m tilmanocept diag HCPCS A9520 | $519.93 | $981.00 | $958.39 – $980.46 | 5 |
| Tca peel dermal 15789 CPT 15789 | not published | not published | $595.90 – $2,135.49 | 9 |
| Tcd emboli detect w/inj CPT 93893 | not published | not published | $96.70 – $227.74 | 9 |
| Tcd emboli detect without inj CPT 93892 | not published | not published | $95.80 – $227.74 | 9 |
| Tcd vasoreactivity study CPT 93890 | not published | not published | $82.42 – $188.92 | 5 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $126.91 – $936.30 | 9 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $347.15 | $655.00 | $46.98 – $205.19 | 16 |
| T cells absolute cd 4 count CPT 86361 | $162.71 | $307.00 | $26.78 – $116.92 | 16 |
| T cells total count CPT 86359 | $233.73 | $441.00 | $37.73 – $163.92 | 16 |
| Tcranial magn stim tx deli CPT 90868 | not published | not published | $303.14 – $790.39 | 9 |
| Tcranial magn stim tx plan CPT 90867 | not published | not published | $303.14 – $1,360.01 | 9 |
| Tcran magn stim redetemine CPT 90869 | not published | not published | $303.14 – $1,139.93 | 9 |
| Tdh sdrl/ventr pnxr CPT 61105 | not published | not published | $706.76 – $1,717.08 | 6 |
| Teaec w/wo patch graft iliofemoral CPT 35355 | not published | not published | $1,523.73 – $3,921.32 | 6 |
| Team conf without pat by hc pro CPT 99368 | not published | not published | $57.53 – $96.27 | 6 |
| Team conf without pat by phys CPT 99367 | not published | not published | $88.16 – $146.83 | 6 |
| Team conf w/pat by hc prof CPT 99366 | not published | not published | $65.47 – $111.80 | 6 |
| Telehealth original site facility fee HCPCS Q3014 | $55.65 | $105.00 | $48.69 – $98.61 | 5 |
| Telethx isodose plan cplx CPT 77307 | $4,756.22 | $8,974.00 | $217.99 – $783.99 | 9 |
| Telethx isodose plan simple CPT 77306 | $1,449.02 | $2,734.00 | $120.77 – $783.99 | 9 |
| Temperature gradient studies CPT 93740 | not published | not published | $4.69 – $335.08 | 9 |
| Temple bne implnt w/stimulat CPT 69715 | not published | not published | $2,116.33 – $2,116.33 | 1 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | $52.47 | $99.00 | $40.48 – $94.52 | 11 |
| Tendon lengthening CPT 26476 | not published | not published | $1,050.70 – $2,404.53 | 6 |
| Tendon lngth upr a/e ea tdn CPT 24305 | not published | not published | $929.49 – $2,274.52 | 6 |
| Tendon shortening CPT 26477 | not published | not published | $1,024.54 – $2,353.20 | 6 |
| Tendon transfer with graft CPT 26492 | not published | not published | $1,497.67 – $3,521.82 | 6 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $222.72 | $420.22 | $165.20 – $324.91 | 8 |
| Tenodesis biceps tdn at elbw CPT 24340 | not published | not published | $962.91 – $2,404.49 | 6 |
| Tenolysis extensor tendon hand/finger each CPT 26445 | not published | not published | $996.88 – $2,320.76 | 6 |
| Tenolysis triceps CPT 24332 | not published | not published | $2,147.31 – $2,398.09 | 5 |
| Tenoplasty elbow to sho 1 CPT 24320 | not published | not published | $1,238.25 – $3,048.06 | 6 |
| Tenosynovectomy radic 26145 CPT 26145 | not published | not published | $831.22 – $2,020.07 | 6 |
| Tenotomy hip flexor open CPT 27005 | not published | not published | $1,137.86 – $2,830.31 | 6 |
| Tenotomy length/rls abductor hallucis musc 28240 CPT 28240 | $304.22 | $574.00 | $475.66 – $1,808.63 | 6 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | $294.68 | $556.00 | $390.97 – $1,555.46 | 6 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $24.81 | $46.81 | $1.52 – $23.76 | 11 |
| Tert gene targeted seq alys CPT 81345 | not published | not published | $185.20 – $588.03 | 13 |
| Test for chlorohydrocarbons CPT 82441 | $25.97 | $49.00 | $6.01 – $26.36 | 16 |
| Test for porphobilinogen CPT 84106 | $15.37 | $29.00 | $5.82 – $18.32 | 16 |
| Test for urine cystines CPT 82615 | $27.03 | $51.00 | $9.55 – $35.54 | 16 |
| Testicular imaging w/vasc flow CPT 78761 | $345.56 | $652.00 | $55.86 – $860.57 | 10 |
| Testosterone response panel CPT 80414 | not published | not published | $51.64 – $199.52 | 16 |
| Testosterone undecanoate 1mg HCPCS J3145 | $1.59 | $3.00 | $2.06 – $2.54 | 5 |
| Test stress cardiovascular tracing only CPT 93017 | $1,591.59 | $3,003.00 | $57.83 – $666.91 | 9 |
| Test urine for lactose CPT 83633 | not published | not published | $11.25 – $35.21 | 16 |
| Test urine for porphyrins CPT 84119 | $31.27 | $59.00 | $13.36 – $41.81 | 16 |
| Test urine urobilinogen CPT 84578 | $11.66 | $22.00 | $4.47 – $13.99 | 16 |
| Tetanus ig im CPT 90389 | not published | not published | $348.91 – $2,217.56 | 9 |
| Tetanus immune globulin inj HCPCS J1670 | $546.43 | $1,031.00 | $603.08 – $954.71 | 6 |
| Tgfbi gene common variants CPT 81333 | not published | not published | $137.00 – $435.57 | 13 |
| Tgsap hl neo 5-50 rna alys CPT 81451 | not published | not published | $759.53 – $2,544.43 | 11 |
| Tgsap so/hl 51/< rna alys CPT 81456 | not published | not published | $3,065.58 – $9,780.66 | 8 |
| Tgsap so neo 5-50 rna alys CPT 81449 | not published | not published | $597.91 – $2,003.00 | 11 |
| Thaw cryoprsvrd reprod tiss CPT 89354 | not published | not published | $82.47 – $367.00 | 9 |
| Thawing cryopresrved embryo CPT 89352 | not published | not published | $82.47 – $367.00 | 9 |
| Thawing cryopresrved oocyte CPT 89356 | not published | not published | $82.47 – $367.00 | 9 |
| Thawing cryopresrved sperm CPT 89353 | not published | not published | $52.01 – $114.42 | 9 |
| Thaw preserved stem cells CPT 38208 | not published | not published | $45.39 – $936.30 | 9 |
| Theophylline therapeutic drug level CPT 80198 | $91.69 | $173.00 | $14.14 – $61.91 | 16 |
| Therapeutic procd strg endur HCPCS G0237 | $86.39 | $163.00 | $14.35 – $32.12 | 6 |
| Therapy activation ipnss CPT 93150 | not published | not published | $89.36 – $379.66 | 7 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $66.25 | $125.00 | $34.59 – $136.27 | 9 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $66.25 | $125.00 | $30.14 – $117.96 | 9 |
| Therapy photodnmc lght dstr lsn skn by staff rx per day CPT 96567 | $268.18 | $506.00 | $193.43 – $476.89 | 9 |
| Ther fx nasal inf turbinate CPT 30930 | not published | not published | $191.10 – $466.42 | 6 |
| Ther nma rdctj intus/obstrcj CPT 74283 | $545.37 | $1,029.00 | $163.78 – $401.74 | 10 |
| Ther/proph/diag inj ia CPT 96373 | not published | not published | $29.68 – $451.22 | 9 |
| Ther radiology tx plng cplx CPT 77263 | not published | not published | $274.62 – $542.67 | 6 |
| Ther radiology tx plng intrm CPT 77262 | not published | not published | $176.31 – $371.18 | 6 |
| Ther radiology tx plng smpl CPT 77261 | not published | not published | $115.74 – $248.60 | 6 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $9.27 | $17.49 | $2.33 – $7.63 | 11 |
| Thiethylperazine maleate inj HCPCS J3280 | $3.71 | $7.00 | $6.19 – $6.19 | 4 |
| Thigh/wght bear lacer molded HCPCS L2540 | $356.69 | $673.00 | $454.63 – $657.58 | 4 |
| Thorabd diaphr hern repair CPT 43336 | not published | not published | $2,182.43 – $5,552.06 | 6 |
| Thorabd diaphr hern repair CPT 43337 | not published | not published | $2,324.84 – $5,919.25 | 6 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | $1,479.76 | $2,792.00 | $601.86 – $1,324.09 | 8 |
| Thoracic aortic graft 33875 CPT 33875 | not published | not published | $4,102.02 – $10,463.08 | 6 |
| Thoracic duct procedure CPT 38380 | not published | not published | $909.64 – $2,234.01 | 6 |
| Thoracic duct procedure CPT 38381 | not published | not published | $1,224.92 – $3,079.06 | 6 |
| Thoracic duct procedure CPT 38382 | not published | not published | $1,048.22 – $2,611.37 | 6 |
| Thoracic lymphadenect/thoracotomy 38746 CPT 38746 | not published | not published | $318.92 – $818.24 | 6 |
| Thoracoabdominal graft 33877 CPT 33877 | not published | not published | $5,361.34 – $13,766.53 | 6 |
| Thoracoscop w/esoph musc exc CPT 32665 | not published | not published | $1,855.19 – $4,704.55 | 6 |
| Thoracoscopy bilobectomy 32670 CPT 32670 | not published | not published | $2,414.34 – $6,129.09 | 6 |
| Thoracoscopy diagnostic 32601 CPT 32601 | not published | not published | $1,085.53 – $1,179.49 | 5 |
| Thoracoscopy for lvrs CPT 32672 | not published | not published | $2,275.55 – $5,817.29 | 6 |
| Thoracoscopy lymph node exc CPT 32674 | not published | not published | $319.11 – $819.63 | 6 |
| Thoracoscopy pneumonectomy CPT 32671 | not published | not published | $2,659.50 – $6,774.68 | 6 |
| Thoracoscopy remove cortex CPT 32651 | not published | not published | $3,847.66 – $4,186.14 | 5 |
| Thoracoscopy remove segment CPT 32669 | not published | not published | $2,021.23 – $5,130.04 | 6 |
| Thoracoscopy remov fb/fibrin 32653 CPT 32653 | not published | not published | $1,605.06 – $4,062.53 | 6 |
| Thoracoscopy resect bullae 32655 CPT 32655 | not published | not published | $1,449.74 – $3,652.98 | 6 |
| Thoracoscopy surgical 32650 CPT 32650 | not published | not published | $2,338.05 – $2,554.71 | 5 |
| Thoracoscopy surgical with control of traumatic hemorrhage CPT 32654 | not published | not published | $4,122.89 – $4,485.15 | 5 |
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.