Aurora Medical Center Manitowoc
5000 Memorial Dr, Two Rivers, WI · Aurorahealthcare · · NPI 1477508687
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 |
|---|---|---|---|---|
| Pelvic CT scan (with contrast) CPT 72193 | $1,570.00 | $3,140.00 | not published | 0 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,470.00 | $2,940.00 | not published | 0 |
| Pelvic MRI (with and without contrast) CPT 72197 | $3,265.00 | $6,530.00 | not published | 0 |
| Pelvic MRI (without contrast) CPT 72195 | $2,110.00 | $4,220.00 | not published | 0 |
| Pelvic Ultrasound (complete) CPT 76856 | $540.00 | $1,080.00 | not published | 0 |
| Pelvic Ultrasound (limited) CPT 76857 | $350.00 | $700.00 | not published | 0 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | not published | not published | $57.60 – $140.55 | 13 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | not published | not published | $3.77 – $108.85 | 13 |
| Peng benzathine/procaine inj HCPCS J0558 | not published | not published | $17.37 – $42.38 | 13 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | not published | not published | $22.14 – $65.44 | 13 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $3.92 | $7.84 | $0.77 – $1.83 | 12 |
| Penicillin g procaine inj HCPCS J2510 | not published | not published | $44.11 – $70.31 | 5 |
| Penile injection CPT 54235 | $305.00 | $610.00 | not published | 0 |
| Pentamidine non-comp unit HCPCS J2545 | not published | not published | $79.50 – $193.70 | 12 |
| Pentastarch 10% solution HCPCS J2513 | not published | not published | $0.01 – $19.08 | 3 |
| Pentazocine injection HCPCS J3070 | not published | not published | $0.01 – $173.18 | 4 |
| Pentobarbital sodium inj HCPCS J2515 | not published | not published | $50.71 – $80.82 | 4 |
| Pentostatin 10 mg intravenous solution HCPCS J9268 | not published | not published | $2,541.77 – $6,667.38 | 13 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $177.50 | $355.00 | $40.92 – $101.52 | 12 |
| Peripheral vascular rehab CPT 93668 | $132.50 | $265.00 | not published | 0 |
| Peri-proc device eval pm CPT 93286 | $310.00 | $620.00 | not published | 0 |
| Perphenazine 4mg oral HCPCS Q0175 | not published | not published | $0.45 – $0.72 | 3 |
| Perphenazine injeciton HCPCS J3310 | not published | not published | $6.01 – $9.57 | 2 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | $457.50 | $915.00 | not published | 0 |
| Pertussis ag if CPT 87265 | not published | not published | $9.58 – $42.06 | 16 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | not published | not published | $16.12 – $39.50 | 13 |
| Pertuzu, trastuzu, 10 mg HCPCS J9316 | not published | not published | $62.99 – $155.87 | 12 |
| Pet CT skull-mid thgh initial CPT 78815 | $4,060.00 | $8,120.00 | not published | 0 |
| Pet CT whole body initial CPT 78816 | $4,060.00 | $8,120.00 | not published | 0 |
| Pet fdg brain metoblic eval sb CPT 78608 | $4,060.00 | $8,120.00 | not published | 0 |
| Pet image w/ct lmtd CPT 78814 | $4,060.00 | $8,120.00 | not published | 0 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $7,908.44 | $15,816.87 | not published | 0 |
| Ph1 assmt&mgmt nqhp 11-20 CPT 98967 | $82.50 | $165.00 | not published | 0 |
| Ph1 assmt&mgmt nqhp 21-30 CPT 98968 | $105.00 | $210.00 | not published | 0 |
| Ph1 assmt&mgmt nqhp 5-10 CPT 98966 | $50.00 | $100.00 | not published | 0 |
| Ph body fluid CPT 83986 | $35.00 | $70.00 | $2.86 – $12.56 | 16 |
| Phencyclidine (pcp) CPT 83992 | $90.00 | $180.00 | $34.65 – $105.12 | 2 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | not published | not published | $29.44 – $75.04 | 12 |
| Phenobarbital therapeutic drug level CPT 80184 | $112.50 | $225.00 | $12.24 – $53.71 | 16 |
| Phentolaine mesylate inj HCPCS J2760 | not published | not published | $367.12 – $962.89 | 12 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $3.44 | $6.88 | $0.01 – $0.02 | 3 |
| Phenylep ketorolac opth soln HCPCS J1097 | not published | not published | $113.28 – $180.54 | 3 |
| Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 | not published | not published | $0.44 – $1.66 | 12 |
| Phenytoin total therapeutic drug level CPT 80185 | $97.50 | $195.00 | $10.60 – $46.50 | 16 |
| Phlebotomy therapeutic CPT 99195 | $125.00 | $250.00 | not published | 0 |
| Phosphorus CPT 84100 | $47.50 | $95.00 | $3.79 – $16.64 | 16 |
| Phosphorus 24 hour urine CPT 84105 | $47.50 | $95.00 | $4.62 – $20.28 | 16 |
| Phys blood bank serv authrj CPT 86079 | not published | not published | $45.04 – $91.95 | 2 |
| Phys blood bank serv reactj CPT 86078 | $207.50 | $415.00 | $45.04 – $91.95 | 2 |
| Phys blood bank serv xmatch CPT 86077 | not published | not published | $45.04 – $91.95 | 2 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $70.12 | $140.24 | $2.27 – $6.77 | 12 |
| Piflu f-18, dia 1 millicurie HCPCS A9595 | $890.00 | $1,780.00 | $332.44 – $887.87 | 4 |
| Pik3ca gene trgt seq alys CPT 81309 | not published | not published | $219.86 – $964.54 | 15 |
| Pinworm exam CPT 87172 | $52.50 | $105.00 | $3.42 – $14.98 | 16 |
| Pinworm examinations HCPCS Q0113 | not published | not published | $3.42 – $15.96 | 16 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $9.45 | $18.90 | $1.10 – $3.10 | 12 |
| Pituitary evaluation panel CPT 80418 | not published | not published | $463.58 – $2,033.73 | 16 |
| Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides) CPT 19281 | $1,060.00 | $2,120.00 | not published | 0 |
| Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left CPT 19282 | $795.00 | $1,590.00 | not published | 0 |
| Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) CPT 19285 | $1,165.00 | $2,330.00 | not published | 0 |
| Placental lactogen CPT 83632 | $140.00 | $280.00 | $16.18 – $70.96 | 16 |
| Plasmaprotein fract,5%,250ml HCPCS P9048 | not published | not published | $50.78 – $80.93 | 3 |
| Plasma protein fract,5%,50ml HCPCS P9043 | not published | not published | $21.62 – $34.46 | 3 |
| Platelet aggregation each agent teg CPT 85576 | $105.00 | $210.00 | $19.93 – $87.42 | 16 |
| Platelet automated CPT 85049 | $30.00 | $60.00 | $3.58 – $15.72 | 16 |
| Platelets hla matched leukocytes reduced apheresis/pheresis each unit HCPCS P9052 | $1,125.00 | $2,250.00 | not published | 0 |
| Platelets leukoreduced cmv negative apheresis/phresis each unit HCPCS P9055 | $790.00 | $1,580.00 | not published | 0 |
| Platelets pheresis leukocytes reduced cmv negative irradiated each unit HCPCS P9053 | $1,075.00 | $2,150.00 | not published | 0 |
| Platelets pheresis leukocytes reduced each unit HCPCS P9035 | $1,035.00 | $2,070.00 | not published | 0 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $1,075.00 | $2,150.00 | not published | 0 |
| Platelets pheresis pathogen-reduced each unit HCPCS P9073 | $960.00 | $1,920.00 | not published | 0 |
| Plcg2 gene common variants CPT 81320 | not published | not published | $233.09 – $1,022.55 | 16 |
| Plcmt sft tiss loc pq w/img 1st lsn CPT 10035 | $1,230.00 | $2,460.00 | not published | 0 |
| Plcmt sft tiss loc pq w/img ea addl lsn CPT 10036 | $920.00 | $1,840.00 | not published | 0 |
| Plc pq device breast ea addl lesion Ultrasound guide CPT 19286 | $870.00 | $1,740.00 | not published | 0 |
| Plerixafor injection HCPCS J2562 | not published | not published | $24.98 – $528.08 | 13 |
| Plethysmography lung volumes/airway resistance CPT 94726 | $367.50 | $735.00 | not published | 0 |
| Pm device progr eval dual CPT 93280 | $307.50 | $615.00 | not published | 0 |
| Pm device progr eval multi CPT 93281 | $307.50 | $615.00 | not published | 0 |
| Pml/raralpha 1 breakpoint CPT 81316 | not published | not published | $165.85 – $933.05 | 16 |
| Pmp22 gene dup/delet CPT 81324 | not published | not published | $606.69 – $2,661.52 | 16 |
| Pmp22 gene full sequence CPT 81325 | not published | not published | $615.66 – $2,700.90 | 16 |
| Pmp22 gene known fam variant CPT 81326 | not published | not published | $37.28 – $163.55 | 16 |
| Pm phone r-strip device eval CPT 93293 | $105.00 | $210.00 | not published | 0 |
| Pms2 gene dup/delet variants CPT 81319 | not published | not published | $162.80 – $714.20 | 16 |
| Pms2 gene full seq analysis CPT 81317 | not published | not published | $541.20 – $2,374.23 | 16 |
| Pms2 known familial variants CPT 81318 | not published | not published | $264.80 – $1,161.67 | 16 |
| #pnh-flow cytometry interp CPT 88187 | not published | not published | $31.47 – $67.05 | 2 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $70.00 | $140.00 | $20.86 – $91.49 | 16 |
| Polatuzumab vedotin-piiq 140 mg intravenous solution HCPCS J9309 | not published | not published | $129.78 – $324.32 | 12 |
| Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 | $3,385.00 | $6,770.00 | not published | 0 |
| Polyvalent mult org ea ag ia CPT 87451 | not published | not published | $8.41 – $36.88 | 16 |
| Porfimer sodium injection HCPCS J9600 | not published | not published | $22,390.08 – $35,684.19 | 4 |
| Post-coital mucous exam HCPCS Q0115 | not published | not published | $16.43 – $87.73 | 16 |
| Potassium 24 hour urine CPT 84133 | $55.00 | $110.00 | $3.78 – $16.60 | 16 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $4.59 | $9.17 | $0.11 – $0.25 | 12 |
| Potassium hydroxide preps HCPCS Q0112 | not published | not published | $4.66 – $20.47 | 16 |
| Potassium serum/plasma/whole blood CPT 84132 | $35.00 | $70.00 | $3.81 – $16.70 | 16 |
| Ppp2r2b gen detc abnor allel CPT 81343 | not published | not published | $109.60 – $480.81 | 16 |
| Pralatrexate injection HCPCS J9307 | not published | not published | $373.77 – $911.99 | 13 |
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.