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 |
|---|---|---|---|---|
| X-ray pelvis complete > 3 views CPT 72190 | $360.00 | $720.00 | not published | 0 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $925.00 | $1,850.00 | not published | 0 |
| X-ray ribs 2 views left CPT 71100 | $255.00 | $510.00 | not published | 0 |
| X-ray ribs 3 views bilateral CPT 71110 | $387.50 | $775.00 | not published | 0 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $387.50 | $775.00 | not published | 0 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $450.00 | $900.00 | not published | 0 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $322.50 | $645.00 | not published | 0 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $332.50 | $665.00 | not published | 0 |
| X-ray scapula complete (both sides) CPT 73010 | $285.00 | $570.00 | not published | 0 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $287.50 | $575.00 | not published | 0 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $425.00 | $850.00 | not published | 0 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $417.50 | $835.00 | not published | 0 |
| X-ray skull < 4 views CPT 70250 | $280.00 | $560.00 | not published | 0 |
| X-ray skull > 4 views complete CPT 70260 | $417.50 | $835.00 | not published | 0 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $530.00 | $1,060.00 | not published | 0 |
| X-ray small intestine follow-through study CPT 74248 | $352.50 | $705.00 | not published | 0 |
| X-ray spine single view CPT 72020 | $225.00 | $450.00 | not published | 0 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $267.50 | $535.00 | not published | 0 |
| X-ray sternum > 2 views CPT 71120 | $290.00 | $580.00 | not published | 0 |
| X-ray surgical specimen CPT 76098 | $375.00 | $750.00 | not published | 0 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $437.50 | $875.00 | not published | 0 |
| X-ray thoracic spine 2 views CPT 72070 | $270.00 | $540.00 | not published | 0 |
| X-ray thoracic spine 3 views CPT 72072 | $307.50 | $615.00 | not published | 0 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $290.00 | $580.00 | not published | 0 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $590.00 | $1,180.00 | not published | 0 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $265.00 | $530.00 | not published | 0 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $705.00 | $1,410.00 | not published | 0 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $655.00 | $1,310.00 | not published | 0 |
| X-ray wrist 2 views (both sides) CPT 73100 | $700.00 | $1,400.00 | not published | 0 |
| Xwrap 1 sq cm HCPCS Q4204 | not published | not published | $2,736.00 – $4,360.50 | 5 |
| Xylose absorption test blood &/or urine CPT 84620 | not published | not published | $10.33 – $45.31 | 16 |
| Xyntha inj HCPCS J7185 | not published | not published | $1.48 – $3.66 | 13 |
| Yersinia antibody CPT 86793 | not published | not published | $10.55 – $46.29 | 16 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | not published | not published | $56,824.55 – $99,234.09 | 4 |
| Zenith amniotic membrane psc HCPCS Q4253 | not published | not published | $123.01 – $291.40 | 10 |
| Ziconotide injection HCPCS J2278 | not published | not published | $9.65 – $23.86 | 13 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | not published | not published | $1.51 – $3.69 | 12 |
| Zidovudine, oral, 100 mg HCPCS S0104 | not published | not published | $1.46 – $2.33 | 3 |
| Zika virus dna/rna amp probe CPT 87662 | $212.50 | $425.00 | $41.05 – $180.08 | 16 |
| Zika virus igm antibody CPT 86794 | $170.00 | $340.00 | $13.48 – $59.13 | 16 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | not published | not published | $5.18 – $28.93 | 12 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | not published | not published | $6.50 – $19.48 | 13 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | not published | not published | $5.77 – $20.36 | 12 |
| Zoster vaccine-live inj CPT 90736 | not published | not published | $0.01 – $357.29 | 3 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $154.60 – $626.13 | 14 |
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.