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 |
|---|---|---|---|---|
| Ureter endoscopy & biopsy CPT 50974 | not published | not published | $740.23 – $1,887.97 | 6 |
| Ureter endoscopy & catheter CPT 50972 | not published | not published | $561.68 – $1,430.57 | 6 |
| Ureter endoscopy & treatment CPT 50957 | not published | not published | $555.56 – $1,719.09 | 6 |
| Ureter endoscopy & treatment CPT 50961 | not published | not published | $497.25 – $1,549.60 | 6 |
| Ureter endoscopy & treatment CPT 50976 | not published | not published | $729.83 – $1,861.73 | 6 |
| Ureter endoscopy & treatment CPT 50980 | not published | not published | $558.28 – $1,423.27 | 6 |
| Ureteroneocystostomy 50780 CPT 50780 | not published | not published | $1,746.12 – $4,399.10 | 6 |
| Ureteroureterostomy 50760 CPT 50760 | not published | not published | $1,773.39 – $4,461.17 | 6 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $404.39 | $763.00 | $25.94 – $517.79 | 10 |
| Urethrlys transvag with scope CPT 53500 | not published | not published | $1,186.26 – $2,981.44 | 6 |
| Urethrocystography void s&i CPT 74455 | $437.25 | $825.00 | $25.75 – $517.79 | 10 |
| Uric acid blood CPT 84550 | $46.64 | $88.00 | $4.52 – $19.50 | 16 |
| Uric acid urine CPT 84560 | $49.29 | $93.00 | $5.08 – $20.64 | 16 |
| Urinalysis glass test CPT 81020 | not published | not published | $4.70 – $16.05 | 16 |
| Urinalysis microscopic only CPT 81015 | $25.44 | $48.00 | $3.05 – $13.77 | 16 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | $18.02 | $34.00 | $2.17 – $9.18 | 16 |
| Urinalysis (with microscopy) CPT 81001 | $25.44 | $48.00 | $3.17 – $13.77 | 16 |
| Urinalysis (without microscopy) CPT 81003 | $16.96 | $32.00 | $2.25 – $10.25 | 16 |
| Urinary bldr retent nuc study CPT 78730 | $130.38 | $246.00 | $11.92 – $25.56 | 6 |
| Urinary reflex study CPT 51792 | $464.81 | $877.00 | $57.82 – $221.81 | 9 |
| Urine Culture Test CPT 87086 | $64.66 | $122.00 | $8.07 – $35.54 | 16 |
| Urine flow measurement 51736 CPT 51736 | $50.88 | $96.00 | $8.38 – $276.06 | 9 |
| Urine pregnancy test CPT 81025 | $59.89 | $113.00 | $8.61 – $27.50 | 16 |
| Urine screen for bacteria CPT 81007 | $9.01 | $17.00 | $5.28 – $93.83 | 16 |
| Urine shunt to intestine CPT 50815 | not published | not published | $1,938.32 – $4,892.94 | 6 |
| Urography, antegrade CPT 74425 | $488.66 | $922.00 | $39.59 – $828.27 | 10 |
| Urography inf drip &/or bolus CPT 74410 | not published | not published | $37.89 – $401.74 | 10 |
| Urokinase 5000 iu injection HCPCS J3364 | $8.48 | $16.00 | $13.47 – $13.47 | 4 |
| Use 1st target lesion CPT 76982 | not published | not published | $46.75 – $245.18 | 10 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | $10.17 | $19.19 | $14.09 – $16.86 | 5 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | $210.94 | $398.00 | $178.25 – $319.83 | 8 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | not published | not published | $170.16 – $437.25 | 10 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | not published | not published | $154.80 – $437.25 | 10 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | not published | not published | $164.10 – $392.84 | 10 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | not published | not published | $92.40 – $263.03 | 10 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | not published | not published | $69.00 – $196.42 | 10 |
| Vaccine dtap < 7 years im CPT 90700 | $39.22 | $74.00 | $34.87 – $95.71 | 9 |
| Vaccine dtap-hep b-ipv im CPT 90723 | $106.53 | $201.00 | $117.56 – $307.62 | 9 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | $64.13 | $121.00 | $74.20 – $243.72 | 8 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | $140.45 | $265.00 | $181.02 – $594.40 | 7 |
| Vaccine dtap-ipv/hib im CPT 90698 | not published | not published | $137.42 – $391.19 | 9 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | $41.34 | $78.00 | $36.70 – $101.50 | 9 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | $39.75 | $75.00 | $15.43 – $85.80 | 9 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $87.98 | $166.00 | $98.52 – $269.77 | 12 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | $133.56 | $252.00 | $151.44 – $414.71 | 9 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | $63.60 | $120.00 | $46.12 – $126.12 | 9 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | $63.60 | $120.00 | $29.14 – $112.93 | 7 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $76.79 – $228.29 | 12 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $112.36 | $212.00 | $83.11 – $228.29 | 12 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | $163.53 | $308.55 | $174.89 – $480.28 | 12 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $64.13 | $121.00 | $33.80 – $92.63 | 12 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | $204.58 | $386.00 | $369.13 – $982.22 | 8 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | $204.58 | $386.00 | $173.46 – $547.14 | 9 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | $133.15 | $251.23 | $80.43 – $220.36 | 12 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | $51.94 | $98.00 | $49.00 – $178.79 | 10 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | $19.61 | $37.00 | $21.62 – $55.05 | 11 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $46.48 | $87.69 | $21.07 – $59.69 | 11 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | not published | not published | $26.38 – $11,591.00 | 10 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | not published | not published | $97.72 – $11,591.00 | 10 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | $21.20 | $40.00 | $20.00 – $65.27 | 8 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | $19.61 | $37.00 | $24.75 – $67.41 | 10 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | not published | not published | $13.19 – $11,591.00 | 10 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | $31.80 | $60.00 | $29.64 – $83.69 | 10 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | $44.52 | $84.00 | $80.43 – $11,591.00 | 10 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | not published | not published | $37.89 – $10,515.00 | 10 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | not published | not published | $10.23 – $21.86 | 11 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | $325.64 | $614.41 | $268.50 – $721.87 | 8 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | $159.53 | $301.00 | $213.72 – $613.84 | 8 |
| Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 | $121.37 | $229.00 | $200.38 – $570.41 | 7 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | $137.80 | $260.00 | $188.82 – $507.25 | 9 |
| Vaccine mmr live subcutaneous CPT 90707 | $160.67 | $303.15 | $112.62 – $306.98 | 9 |
| Vaccine mmrv live subcutaneous CPT 90710 | $195.04 | $368.00 | $218.94 – $922.84 | 9 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $94.34 | $178.00 | $140.50 – $399.95 | 12 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | $234.26 | $442.00 | $296.69 – $773.48 | 12 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | not published | not published | $275.04 – $802.79 | 12 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | $517.97 | $977.31 | $313.87 – $867.54 | 12 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | $41.34 | $78.00 | $51.17 – $145.67 | 9 |
| Vaccine rabies im CPT 90675 | $695.08 | $1,311.48 | $317.67 – $1,413.92 | 15 |
| Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 | $308.80 | $582.64 | $354.00 – $1,007.72 | 7 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 | not published | not published | $623.70 – $2,058.21 | 7 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im CPT 90381 | not published | not published | $623.70 – $1,690.92 | 7 |
| Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im CPT 90679 | not published | not published | $352.80 – $956.48 | 7 |
| Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 | $129.85 | $245.00 | $166.49 – $460.21 | 9 |
| Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 | $109.71 | $207.00 | $118.58 – $327.81 | 9 |
| Vaccine tdap >=7 years im CPT 90715 | $36.57 | $69.00 | $43.12 – $157.41 | 12 |
| Vaccine td preservative free >= 7 years im CPT 90714 | $36.57 | $69.00 | $44.52 – $95.62 | 12 |
| Vaccine typhoid vicps im CPT 90691 | $113.95 | $215.00 | $167.51 – $454.11 | 9 |
| Vaccine varicella live subcutaneous CPT 90716 | $292.01 | $550.97 | $219.60 – $595.48 | 9 |
| Vaccine yellow fever live subcutaneous CPT 90717 | not published | not published | $245.11 – $668.47 | 9 |
| Vaccinia vrs vac 0.3 ml perq CPT 90622 | not published | not published | $0.01 – $0.03 | 11 |
| Vag hys/<250g/rmv tube/rpr entero 58263 CPT 58263 | not published | not published | $1,579.57 – $3,932.56 | 6 |
| Vag hyst incl t/o complex CPT 58291 | not published | not published | $1,971.71 – $4,942.22 | 6 |
| Vag hyst including t/o CPT 58262 | not published | not published | $1,473.73 – $3,663.31 | 6 |
| Vag hyst t/o & repair compl CPT 58292 | not published | not published | $2,077.37 – $5,200.28 | 6 |
| Vag hyst w/enterocele compl 58294 CPT 58294 | not published | not published | $1,929.92 – $4,824.63 | 6 |
| Vag hyst w/enterocele repair CPT 58270 | not published | not published | $1,423.56 – $3,519.89 | 6 |
| Vag hyst w/uro repair compl 58293 CPT 58293 | not published | not published | $2,240.65 – $2,240.65 | 1 |
| Vaginal bx CPT 58999 | not published | not published | $195.83 – $430.83 | 3 |
| Vaginal delivery after cesarean delivery 59612 CPT 59612 | not published | not published | $1,354.34 – $3,181.15 | 6 |
| Vaginal Delivery (full care) CPT 59400 | not published | not published | $3,679.41 – $7,260.16 | 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.