SelfPayRates
Hospital Milwaukee-Waukesha, WI

Children's Hospital of Wisconsin

Children's Hospital of Wisconsin in Milwaukee, WI publishes cash prices for 43 common procedures listed here, from its own machine-readable price file updated Mar 23, 2026. Click a procedure to compare it with other hospitals nearby.

9000 W Wisconsin Ave, Milwaukee WI 53226 Collected Sep 22, 2026 Source price file

Scans and imaging

ProcedureCash price List priceOff list
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HBC CT ABDOMEN & PELVIS W CONTRAST $1,980.00 $3,600.00 45%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HBC CT ABDOMEN & PELVIS W CONTRAST $1,980.00 $3,600.00 45%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HBC CT ABDOMEN & PELVIS W CONTRAST $1,980.00 $3,600.00 45%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HBC CT ABDOMEN & PELVIS W CONTRAST $1,980.00 $3,600.00 45%
CT scan of the head or brain, no contrast dye CPT 70450 HBC CT HEAD WO CONTRAST $1,208.49 $2,197.25 45%
CT scan of the head or brain, no contrast dye CPT 70450 HBC CT HEAD WO CONTRAST $1,208.49 $2,197.25 45%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HBC CT HEAD WO CONTRAST $1,208.49 $2,197.25 45%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HBC CT HEAD WO CONTRAST $1,208.49 $2,197.25 45%
CT scan of the pelvis, with contrast dye CPT 72193 HBC CT PELVIS W CONTRAST $1,652.61 $3,004.75 45%
CT scan of the pelvis, with contrast dye CPT 72193 HBC CT PELVIS W CONTRAST $1,652.61 $3,004.75 45%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HBC CT PELVIS W CONTRAST $1,652.61 $3,004.75 45%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HBC CT PELVIS W CONTRAST $1,652.61 $3,004.75 45%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HBC MRI LOWER EXTREMITY JOINT WO CONTRAST $2,516.94 $4,576.25 45%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HBC MRI LOWER EXTREMITY JOINT WO CONTRAST $2,516.94 $4,576.25 45%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HBC MRI LOWER EXTREMITY JOINT WO CONTRAST $2,516.94 $4,576.25 45%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HBC MRI LOWER EXTREMITY JOINT WO CONTRAST $2,516.94 $4,576.25 45%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HBC MRI LOWER EXTREMITY JOINT W & WO CONTRAST $3,424.03 $6,225.50 45%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HBC MRI LOWER EXTREMITY JOINT W & WO CONTRAST $3,424.03 $6,225.50 45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HBC MRI LOWER EXTREMITY JOINT W & WO CONTRAST $3,424.03 $6,225.50 45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HBC MRI LOWER EXTREMITY JOINT W & WO CONTRAST $3,424.03 $6,225.50 45%
MRI of the brain, no contrast dye CPT 70551 HBC MRI BRAIN LIMITED WO CONTRAST $976.94 $1,776.25 45%
MRI of the brain, no contrast dye CPT 70551 HBC MRI BRAIN LIMITED WO CONTRAST $976.94 $1,776.25 45%
MRI of the brain, no contrast dye CPT 70551 HBC MRI BRAIN WO CONTRAST $2,739.83 $4,981.50 45%
MRI of the brain, no contrast dye CPT 70551 HBC MRI BRAIN WO CONTRAST $2,739.83 $4,981.50 45%
MRI of the brain, no contrast dye inpatient CPT 70551 HBC MRI BRAIN LIMITED WO CONTRAST $976.94 $1,776.25 45%
MRI of the brain, no contrast dye inpatient CPT 70551 HBC MRI BRAIN LIMITED WO CONTRAST $976.94 $1,776.25 45%
MRI of the brain, no contrast dye inpatient CPT 70551 HBC MRI BRAIN WO CONTRAST $2,739.83 $4,981.50 45%
MRI of the brain, no contrast dye inpatient CPT 70551 HBC MRI BRAIN WO CONTRAST $2,739.83 $4,981.50 45%
MRI of the brain, with and without contrast dye CPT 70553 HBC MRI BRAIN W & WO CONTRAST $3,586.69 $6,521.25 45%
MRI of the brain, with and without contrast dye CPT 70553 HBC MRI BRAIN W & WO CONTRAST $3,586.69 $6,521.25 45%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HBC MRI BRAIN W & WO CONTRAST $3,586.69 $6,521.25 45%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HBC MRI BRAIN W & WO CONTRAST $3,586.69 $6,521.25 45%
MRI of the lower back, no contrast dye CPT 72148 HBC MRI LUMBAR SPINE WO CONTRAST $2,783.96 $5,061.75 45%
MRI of the lower back, no contrast dye CPT 72148 HBC MRI LUMBAR SPINE WO CONTRAST $2,783.96 $5,061.75 45%
MRI of the lower back, no contrast dye CPT 72148 HBC LUMBAR SPINE WO CONTRAST $2,783.96 $5,061.75 45%
MRI of the lower back, no contrast dye CPT 72148 HBC LUMBAR SPINE WO CONTRAST $2,783.96 $5,061.75 45%
MRI of the lower back, no contrast dye inpatient CPT 72148 HBC LUMBAR SPINE WO CONTRAST $2,783.96 $5,061.75 45%
MRI of the lower back, no contrast dye inpatient CPT 72148 HBC MRI LUMBAR SPINE WO CONTRAST $2,783.96 $5,061.75 45%
MRI of the lower back, no contrast dye inpatient CPT 72148 HBC LUMBAR SPINE WO CONTRAST $2,783.96 $5,061.75 45%
MRI of the lower back, no contrast dye inpatient CPT 72148 HBC MRI LUMBAR SPINE WO CONTRAST $2,783.96 $5,061.75 45%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HBC US PREGNANT UTERUS AFTER 1ST TRIMESTER ABDL 1ST GESTATION $604.73 $1,099.50 45%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HBC US PREGNANT UTERUS AFTER 1ST TRIMESTER ABDL 1ST GESTATION $604.73 $1,099.50 45%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HBC US PREGNANT UTERUS AFTER 1ST TRIMESTER ABDL 1ST GESTATION $604.73 $1,099.50 45%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HBC US PREGNANT UTERUS AFTER 1ST TRIMESTER ABDL 1ST GESTATION $604.73 $1,099.50 45%
Sleep study in a lab (polysomnography) CPT 95810 HBC SLEEP STUDY PARTIAL/SETUP 6+ YR OLD MIN 6 HOURS RECORDING $2,843.78 $5,170.50 45%
Sleep study in a lab (polysomnography) CPT 95810 HBC SLEEP STUDY PARTIAL/SETUP 6+ YR OLD MIN 6 HOURS RECORDING $2,843.78 $5,170.50 45%
Sleep study in a lab (polysomnography) CPT 95810 HBC NOCTURNAL SLEEP STUDY >=6 YRS OLD W 4+ PARAMETERS $3,327.23 $6,049.50 45%
Sleep study in a lab (polysomnography) CPT 95810 HBC NOCTURNAL SLEEP STUDY >=6 YRS OLD W 4+ PARAMETERS $3,327.23 $6,049.50 45%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HBC SLEEP STUDY PARTIAL/SETUP 6+ YR OLD MIN 6 HOURS RECORDING $2,843.78 $5,170.50 45%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HBC SLEEP STUDY PARTIAL/SETUP 6+ YR OLD MIN 6 HOURS RECORDING $2,843.78 $5,170.50 45%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HBC NOCTURNAL SLEEP STUDY >=6 YRS OLD W 4+ PARAMETERS $3,327.23 $6,049.50 45%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HBC NOCTURNAL SLEEP STUDY >=6 YRS OLD W 4+ PARAMETERS $3,327.23 $6,049.50 45%
Transvaginal pelvic ultrasound CPT 76830 HBC TRANSVAGINAL ULTRASOUND $495.14 $900.25 45%
Transvaginal pelvic ultrasound CPT 76830 HBC TRANSVAGINAL ULTRASOUND $495.14 $900.25 45%
Transvaginal pelvic ultrasound inpatient CPT 76830 HBC TRANSVAGINAL ULTRASOUND $495.14 $900.25 45%
Transvaginal pelvic ultrasound inpatient CPT 76830 HBC TRANSVAGINAL ULTRASOUND $495.14 $900.25 45%
Ultrasound of the abdomen, complete CPT 76700 HBC ULTRASOUND ABDOMEN COMPLETE $864.19 $1,571.25 45%
Ultrasound of the abdomen, complete CPT 76700 HBC ULTRASOUND ABDOMEN COMPLETE $864.19 $1,571.25 45%
Ultrasound of the abdomen, complete inpatient CPT 76700 HBC ULTRASOUND ABDOMEN COMPLETE $864.19 $1,571.25 45%
Ultrasound of the abdomen, complete inpatient CPT 76700 HBC ULTRASOUND ABDOMEN COMPLETE $864.19 $1,571.25 45%
X-ray of the lower back, 4 or more views CPT 72110 HBC LUMBAR SPINE 4+ VIEWS $359.84 $654.25 45%
X-ray of the lower back, 4 or more views CPT 72110 HBC LUMBAR SPINE 4+ VIEWS $359.84 $654.25 45%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HBC LUMBAR SPINE 4+ VIEWS $359.84 $654.25 45%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HBC LUMBAR SPINE 4+ VIEWS $359.84 $654.25 45%

Lab tests

ProcedureCash price List priceOff list
Basic metabolic panel (blood test) CPT 80048 HBC BASIC METABOLIC PANEL $116.88 $212.50 45%
Basic metabolic panel (blood test) CPT 80048 HBC BASIC METABOLIC PANEL $116.88 $212.50 45%
Basic metabolic panel (blood test) inpatient CPT 80048 HBC BASIC METABOLIC PANEL $116.88 $212.50 45%
Basic metabolic panel (blood test) inpatient CPT 80048 HBC BASIC METABOLIC PANEL $116.88 $212.50 45%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HBC LIPID PANEL $119.49 $217.25 45%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HBC LIPID PANEL $119.49 $217.25 45%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HBC LIPID PANEL $119.49 $217.25 45%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HBC LIPID PANEL $119.49 $217.25 45%
Complete blood count (CBC) with differential CPT 85025 HBC CBC NB $86.76 $157.75 45%
Complete blood count (CBC) with differential CPT 85025 HBC CBC APPLTN $86.76 $157.75 45%
Complete blood count (CBC) with differential CPT 85025 HBC CBC KN $86.76 $157.75 45%
Complete blood count (CBC) with differential CPT 85025 HBC CBC MQ $86.76 $157.75 45%
Complete blood count (CBC) with differential CPT 85025 HBC CBC $86.76 $157.75 45%
Complete blood count (CBC) with differential CPT 85025 HBC CBC NB $86.76 $157.75 45%
Complete blood count (CBC) with differential CPT 85025 HBC CBC MQ $86.76 $157.75 45%
Complete blood count (CBC) with differential CPT 85025 HBC CBC KN $86.76 $157.75 45%
Complete blood count (CBC) with differential CPT 85025 HBC CBC APPLTN $86.76 $157.75 45%
Complete blood count (CBC) with differential CPT 85025 HBC CBC $86.76 $157.75 45%
Complete blood count (CBC) with differential inpatient CPT 85025 HBC CBC KN $86.76 $157.75 45%
Complete blood count (CBC) with differential inpatient CPT 85025 HBC CBC APPLTN $86.76 $157.75 45%
Complete blood count (CBC) with differential inpatient CPT 85025 HBC CBC $86.76 $157.75 45%
Complete blood count (CBC) with differential inpatient CPT 85025 HBC CBC NB $86.76 $157.75 45%
Complete blood count (CBC) with differential inpatient CPT 85025 HBC CBC MQ $86.76 $157.75 45%
Complete blood count (CBC) with differential inpatient CPT 85025 HBC CBC KN $86.76 $157.75 45%
Complete blood count (CBC) with differential inpatient CPT 85025 HBC CBC APPLTN $86.76 $157.75 45%
Complete blood count (CBC) with differential inpatient CPT 85025 HBC CBC $86.76 $157.75 45%
Complete blood count (CBC) with differential inpatient CPT 85025 HBC CBC NB $86.76 $157.75 45%
Complete blood count (CBC) with differential inpatient CPT 85025 HBC CBC MQ $86.76 $157.75 45%
Complete blood count (CBC), no differential CPT 85027 HBC PUBS CBC NO DIFF $17.60 $32.00 45%
Complete blood count (CBC), no differential CPT 85027 HBC PUBS CBC NO DIFF $17.60 $32.00 45%
Complete blood count (CBC), no differential CPT 85027 HBC CBC NO DIFF $70.26 $127.75 45%
Complete blood count (CBC), no differential CPT 85027 HBC CBC NO DIFF $70.26 $127.75 45%
Complete blood count (CBC), no differential CPT 85027 HBC CBC NO DIFF NB $73.70 $134.00 45%
Complete blood count (CBC), no differential CPT 85027 HBC CBC NO DIFF APPLTN $73.70 $134.00 45%
Complete blood count (CBC), no differential CPT 85027 HBC CBC NO DIFF KN $73.70 $134.00 45%
Complete blood count (CBC), no differential CPT 85027 HBC CBC NO DIFF MQ $73.70 $134.00 45%
Complete blood count (CBC), no differential CPT 85027 HBC CBC NO DIFF NB $73.70 $134.00 45%
Complete blood count (CBC), no differential CPT 85027 HBC CBC NO DIFF APPLTN $73.70 $134.00 45%
Complete blood count (CBC), no differential CPT 85027 HBC CBC NO DIFF KN $73.70 $134.00 45%
Complete blood count (CBC), no differential CPT 85027 HBC CBC NO DIFF MQ $73.70 $134.00 45%
Complete blood count (CBC), no differential inpatient CPT 85027 HBC PUBS CBC NO DIFF $17.60 $32.00 45%
Complete blood count (CBC), no differential inpatient CPT 85027 HBC PUBS CBC NO DIFF $17.60 $32.00 45%
Complete blood count (CBC), no differential inpatient CPT 85027 HBC CBC NO DIFF $70.26 $127.75 45%
Complete blood count (CBC), no differential inpatient CPT 85027 HBC CBC NO DIFF $70.26 $127.75 45%
Complete blood count (CBC), no differential inpatient CPT 85027 HBC CBC NO DIFF APPLTN $73.70 $134.00 45%
Complete blood count (CBC), no differential inpatient CPT 85027 HBC CBC NO DIFF KN $73.70 $134.00 45%
Complete blood count (CBC), no differential inpatient CPT 85027 HBC CBC NO DIFF NB $73.70 $134.00 45%
Complete blood count (CBC), no differential inpatient CPT 85027 HBC CBC NO DIFF KN $73.70 $134.00 45%
Complete blood count (CBC), no differential inpatient CPT 85027 HBC CBC NO DIFF MQ $73.70 $134.00 45%
Complete blood count (CBC), no differential inpatient CPT 85027 HBC CBC NO DIFF APPLTN $73.70 $134.00 45%
Complete blood count (CBC), no differential inpatient CPT 85027 HBC CBC NO DIFF MQ $73.70 $134.00 45%
Complete blood count (CBC), no differential inpatient CPT 85027 HBC CBC NO DIFF NB $73.70 $134.00 45%
Comprehensive metabolic panel (blood test) CPT 80053 HBC COMPREHENSIVE METABOLIC PANEL $161.98 $294.50 45%
Comprehensive metabolic panel (blood test) CPT 80053 HBC COMPREHENSIVE METABOLIC PANEL $161.98 $294.50 45%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HBC COMPREHENSIVE METABOLIC PANEL $161.98 $294.50 45%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HBC COMPREHENSIVE METABOLIC PANEL $161.98 $294.50 45%
Liver function blood test panel CPT 80076 HBC PUBS LIVER PANEL $21.31 $38.75 45%
Liver function blood test panel CPT 80076 HBC PUBS LIVER PANEL $21.31 $38.75 45%
Liver function blood test panel CPT 80076 HBC LIVER PANEL $115.09 $209.25 45%
Liver function blood test panel CPT 80076 HBC LIVER PANEL $115.09 $209.25 45%
Liver function blood test panel inpatient CPT 80076 HBC PUBS LIVER PANEL $21.31 $38.75 45%
Liver function blood test panel inpatient CPT 80076 HBC PUBS LIVER PANEL $21.31 $38.75 45%
Liver function blood test panel inpatient CPT 80076 HBC LIVER PANEL $115.09 $209.25 45%
Liver function blood test panel inpatient CPT 80076 HBC LIVER PANEL $115.09 $209.25 45%
PSA (prostate-specific antigen) blood test, total CPT 84153 HBC PROSTATE SPECIFIC ANTIGEN $59.95 $109.00 45%
PSA (prostate-specific antigen) blood test, total CPT 84153 HBC PROSTATE SPECIFIC ANTIGEN $59.95 $109.00 45%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HBC PROSTATE SPECIFIC ANTIGEN $59.95 $109.00 45%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HBC PROSTATE SPECIFIC ANTIGEN $59.95 $109.00 45%
Partial thromboplastin time (PTT) clotting test CPT 85730 HBC PARTIAL THROMBOPLASTIN TIME $64.90 $118.00 45%
Partial thromboplastin time (PTT) clotting test CPT 85730 HBC PARTIAL THROMBOPLASTIN TIME $64.90 $118.00 45%
Partial thromboplastin time (PTT) clotting test CPT 85730 HBC LUPUS ANTICOAGULANT LUPIRF $70.26 $127.75 45%
Partial thromboplastin time (PTT) clotting test CPT 85730 HBC LUPUS ANTICOAGULANT LUPIRF $70.26 $127.75 45%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HBC PARTIAL THROMBOPLASTIN TIME $64.90 $118.00 45%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HBC PARTIAL THROMBOPLASTIN TIME $64.90 $118.00 45%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HBC LUPUS ANTICOAGULANT LUPIRF $70.26 $127.75 45%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HBC LUPUS ANTICOAGULANT LUPIRF $70.26 $127.75 45%
Prothrombin time (PT/INR) clotting test CPT 85610 HBC PROTHROMBIN TIME APPLTN $45.51 $82.75 45%
Prothrombin time (PT/INR) clotting test CPT 85610 HBC PROTHROMBIN TIME $45.51 $82.75 45%
Prothrombin time (PT/INR) clotting test CPT 85610 HBC PROTHROMBIN TIME $45.51 $82.75 45%
Prothrombin time (PT/INR) clotting test CPT 85610 HBC PROTHROMBIN TIME APPLTN $45.51 $82.75 45%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HBC PROTHROMBIN TIME APPLTN $45.51 $82.75 45%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HBC PROTHROMBIN TIME $45.51 $82.75 45%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HBC PROTHROMBIN TIME APPLTN $45.51 $82.75 45%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HBC PROTHROMBIN TIME $45.51 $82.75 45%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HBC TSH NEO $26.40 $48.00 45%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HBC TSH NEO $26.40 $48.00 45%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HBC THYROID STIMULATING HORMONE TSH $124.44 $226.25 45%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HBC THYROID STIMULATING HORMONE TSH $124.44 $226.25 45%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HBC TSH NEO $26.40 $48.00 45%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HBC TSH NEO $26.40 $48.00 45%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HBC THYROID STIMULATING HORMONE TSH $124.44 $226.25 45%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HBC THYROID STIMULATING HORMONE TSH $124.44 $226.25 45%
Urinalysis with microscope exam, automated CPT 81001 HBC URINE MICRO MACRO $40.15 $73.00 45%
Urinalysis with microscope exam, automated CPT 81001 HBC URINE MICRO MACRO $40.15 $73.00 45%
Urinalysis with microscope exam, automated CPT 81001 HBC URINE MICRO MACRO MQ $54.18 $98.50 45%
Urinalysis with microscope exam, automated CPT 81001 HBC URINE MICRO MACRO MQ $54.18 $98.50 45%
Urinalysis with microscope exam, automated CPT 81001 HBC URINE MICRO MACRO NB $54.18 $98.50 45%
Urinalysis with microscope exam, automated CPT 81001 HBC URINE MICRO MACRO APPLTN $54.18 $98.50 45%
Urinalysis with microscope exam, automated CPT 81001 HBC URINE MICRO MACRO APPLTN $54.18 $98.50 45%
Urinalysis with microscope exam, automated CPT 81001 HBC URINE MICRO MACRO KN $54.18 $98.50 45%
Urinalysis with microscope exam, automated CPT 81001 HBC URINE MICRO MACRO KN $54.18 $98.50 45%
Urinalysis with microscope exam, automated CPT 81001 HBC URINE MICRO MACRO NB $54.18 $98.50 45%
Urinalysis with microscope exam, automated inpatient CPT 81001 HBC URINE MICRO MACRO $40.15 $73.00 45%
Urinalysis with microscope exam, automated inpatient CPT 81001 HBC URINE MICRO MACRO $40.15 $73.00 45%
Urinalysis with microscope exam, automated inpatient CPT 81001 HBC URINE MICRO MACRO APPLTN $54.18 $98.50 45%
Urinalysis with microscope exam, automated inpatient CPT 81001 HBC URINE MICRO MACRO KN $54.18 $98.50 45%
Urinalysis with microscope exam, automated inpatient CPT 81001 HBC URINE MICRO MACRO APPLTN $54.18 $98.50 45%
Urinalysis with microscope exam, automated inpatient CPT 81001 HBC URINE MICRO MACRO MQ $54.18 $98.50 45%
Urinalysis with microscope exam, automated inpatient CPT 81001 HBC URINE MICRO MACRO KN $54.18 $98.50 45%
Urinalysis with microscope exam, automated inpatient CPT 81001 HBC URINE MICRO MACRO MQ $54.18 $98.50 45%
Urinalysis with microscope exam, automated inpatient CPT 81001 HBC URINE MICRO MACRO NB $54.18 $98.50 45%
Urinalysis with microscope exam, automated inpatient CPT 81001 HBC URINE MICRO MACRO NB $54.18 $98.50 45%
Urinalysis with microscope exam, manual CPT 81000 CHG URINALYSIS, NONAUTO, W/SCOPE $25.85 $47.00 45%
Urinalysis without microscope exam, automated CPT 81003 HBC URINALYSIS MACRO $37.81 $68.75 45%
Urinalysis without microscope exam, automated CPT 81003 HBC SPECIFIC GRAVITY URINE $37.81 $68.75 45%
Urinalysis without microscope exam, automated CPT 81003 HBC URINALYSIS MACRO NB $37.81 $68.75 45%
Urinalysis without microscope exam, automated CPT 81003 HBC URINALYSIS MACRO MQ $37.81 $68.75 45%
Urinalysis without microscope exam, automated CPT 81003 HBC URINALYSIS MACRO KN $37.81 $68.75 45%
Urinalysis without microscope exam, automated CPT 81003 HBC URINALYSIS MACRO APPLTN $37.81 $68.75 45%
Urinalysis without microscope exam, automated CPT 81003 HBC POCT URINE MACROSCOPIC $37.81 $68.75 45%
Urinalysis without microscope exam, automated CPT 81003 HBC URINALYSIS MACRO APPLTN $37.81 $68.75 45%
Urinalysis without microscope exam, automated CPT 81003 HBC URINALYSIS MACRO KN $37.81 $68.75 45%
Urinalysis without microscope exam, automated CPT 81003 HBC URINALYSIS MACRO MQ $37.81 $68.75 45%
Urinalysis without microscope exam, automated CPT 81003 HBC URINALYSIS MACRO NB $37.81 $68.75 45%
Urinalysis without microscope exam, automated CPT 81003 HBC SPECIFIC GRAVITY URINE $37.81 $68.75 45%
Urinalysis without microscope exam, automated CPT 81003 HBC URINALYSIS MACRO $37.81 $68.75 45%
Urinalysis without microscope exam, automated CPT 81003 HBC POCT URINE MACROSCOPIC $37.81 $68.75 45%
Urinalysis without microscope exam, automated inpatient CPT 81003 HBC SPECIFIC GRAVITY URINE $37.81 $68.75 45%
Urinalysis without microscope exam, automated inpatient CPT 81003 HBC POCT URINE MACROSCOPIC $37.81 $68.75 45%
Urinalysis without microscope exam, automated inpatient CPT 81003 HBC URINALYSIS MACRO $37.81 $68.75 45%
Urinalysis without microscope exam, automated inpatient CPT 81003 HBC SPECIFIC GRAVITY URINE $37.81 $68.75 45%
Urinalysis without microscope exam, automated inpatient CPT 81003 HBC URINALYSIS MACRO NB $37.81 $68.75 45%
Urinalysis without microscope exam, automated inpatient CPT 81003 HBC URINALYSIS MACRO MQ $37.81 $68.75 45%
Urinalysis without microscope exam, automated inpatient CPT 81003 HBC URINALYSIS MACRO KN $37.81 $68.75 45%
Urinalysis without microscope exam, automated inpatient CPT 81003 HBC URINALYSIS MACRO APPLTN $37.81 $68.75 45%
Urinalysis without microscope exam, automated inpatient CPT 81003 HBC POCT URINE MACROSCOPIC $37.81 $68.75 45%
Urinalysis without microscope exam, automated inpatient CPT 81003 HBC URINALYSIS MACRO $37.81 $68.75 45%
Urinalysis without microscope exam, automated inpatient CPT 81003 HBC URINALYSIS MACRO APPLTN $37.81 $68.75 45%
Urinalysis without microscope exam, automated inpatient CPT 81003 HBC URINALYSIS MACRO KN $37.81 $68.75 45%
Urinalysis without microscope exam, automated inpatient CPT 81003 HBC URINALYSIS MACRO MQ $37.81 $68.75 45%
Urinalysis without microscope exam, automated inpatient CPT 81003 HBC URINALYSIS MACRO NB $37.81 $68.75 45%
Urinalysis without microscope exam, manual CPT 81002 CHG URINALYSIS NONAUTO W/O SCOPE $23.10 $42.00 45%
Urinalysis without microscope exam, manual CPT 81002 HBC POCT DIPSTICK MACROSCOPIC URINE $36.03 $65.50 45%
Urinalysis without microscope exam, manual CPT 81002 HBC POCT DIPSTICK KETONES URINE $36.03 $65.50 45%
Urinalysis without microscope exam, manual CPT 81002 HBC POCT DIPSTICK KETONES URINE $36.03 $65.50 45%
Urinalysis without microscope exam, manual CPT 81002 HBC POCT DIPSTICK MACROSCOPIC URINE $36.03 $65.50 45%
Urinalysis without microscope exam, manual inpatient CPT 81002 HBC POCT DIPSTICK KETONES URINE $36.03 $65.50 45%
Urinalysis without microscope exam, manual inpatient CPT 81002 HBC POCT DIPSTICK MACROSCOPIC URINE $36.03 $65.50 45%
Urinalysis without microscope exam, manual inpatient CPT 81002 HBC POCT DIPSTICK KETONES URINE $36.03 $65.50 45%
Urinalysis without microscope exam, manual inpatient CPT 81002 HBC POCT DIPSTICK MACROSCOPIC URINE $36.03 $65.50 45%

Surgery and procedures

ProcedureCash price List priceOff list
Left heart catheterization, diagnostic one side CPT 93452 HBC LEFT HEART CATHERIZATION W INJECTION FOR VENT SUP & INTERPRETATION $5,680.95 $10,329.00 45%
Left heart catheterization, diagnostic one side CPT 93452 HBC LEFT HEART CATHERIZATION W INJECTION FOR VENT SUP & INTERPRETATION $5,680.95 $10,329.00 45%
Left heart catheterization, diagnostic inpatient one side CPT 93452 HBC LEFT HEART CATHERIZATION W INJECTION FOR VENT SUP & INTERPRETATION $5,680.95 $10,329.00 45%
Left heart catheterization, diagnostic inpatient one side CPT 93452 HBC LEFT HEART CATHERIZATION W INJECTION FOR VENT SUP & INTERPRETATION $5,680.95 $10,329.00 45%
Lower-back epidural injection, with imaging guidance CPT 62323 HBC 62323 INJECTION EPIDURAL STEROID W IMAGING LUMBAR/SACRAL $1,360.70 $2,474.00 45%
Lower-back epidural injection, with imaging guidance CPT 62323 HBC 62323 INJECTION EPIDURAL STEROID W IMAGING LUMBAR/SACRAL $1,360.70 $2,474.00 45%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HBC 62323 INJECTION EPIDURAL STEROID W IMAGING LUMBAR/SACRAL $1,360.70 $2,474.00 45%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HBC 62323 INJECTION EPIDURAL STEROID W IMAGING LUMBAR/SACRAL $1,360.70 $2,474.00 45%
Lower-back epidural injection, without imaging guidance CPT 62322 HBC INJECTION THERAPEUTIC SUBS LUMBAR/SACRAL WO IMAGING $140.80 $256.00 45%
Lower-back epidural injection, without imaging guidance CPT 62322 HBC INJECTION THERAPEUTIC SUBS LUMBAR/SACRAL WO IMAGING $140.80 $256.00 45%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HBC INJECTION THERAPEUTIC SUBS LUMBAR/SACRAL WO IMAGING $140.80 $256.00 45%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HBC INJECTION THERAPEUTIC SUBS LUMBAR/SACRAL WO IMAGING $140.80 $256.00 45%

Doctor visits and therapy

ProcedureCash price List priceOff list
Family therapy with the patient, 50 minutes CPT 90847 HBC FAMILY PSYCHOTHERAPY W PATIENT PRESENT 50 MINS $63.66 $115.75 45%
Family therapy with the patient, 50 minutes CPT 90847 HBC FAMILY PSYCHOTHERAPY W PATIENT PRESENT 50 MINS $63.66 $115.75 45%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HBC FAMILY PSYCHOTHERAPY W PATIENT PRESENT 50 MINS $63.66 $115.75 45%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HBC FAMILY PSYCHOTHERAPY W PATIENT PRESENT 50 MINS $63.66 $115.75 45%
Family therapy without the patient, 50 minutes CPT 90846 HBC FAMILY PSYCHOTHERAPY WO PATIENT PRESENT 50 MINS $63.66 $115.75 45%
Family therapy without the patient, 50 minutes CPT 90846 HBC FAMILY PSYCHOTHERAPY WO PATIENT PRESENT 50 MINS $63.66 $115.75 45%
Family therapy without the patient, 50 minutes inpatient CPT 90846 HBC FAMILY PSYCHOTHERAPY WO PATIENT PRESENT 50 MINS $63.66 $115.75 45%
Family therapy without the patient, 50 minutes inpatient CPT 90846 HBC FAMILY PSYCHOTHERAPY WO PATIENT PRESENT 50 MINS $63.66 $115.75 45%
Group psychotherapy session CPT 90853 HBC GROUP PSYCHOTHERAPY $66.83 $121.50 45%
Group psychotherapy session CPT 90853 HBC GROUP PSYCHOTHERAPY $66.83 $121.50 45%
Group psychotherapy session inpatient CPT 90853 HBC GROUP PSYCHOTHERAPY $66.83 $121.50 45%
Group psychotherapy session inpatient CPT 90853 HBC GROUP PSYCHOTHERAPY $66.83 $121.50 45%
New patient office visit, about 30 minutes CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES $269.50 $490.00 45%
New patient office visit, about 30 minutes CPT 99203 OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES $269.50 $490.00 45%
New patient office visit, about 45 minutes CPT 99204 OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES $403.70 $734.00 45%
New patient office visit, about 45 minutes CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES $403.70 $734.00 45%
New patient office visit, about 60 minutes CPT 99205 OFFICE/OUTPATIENT NEW HIGH MDM 60-74 MINUTES $533.50 $970.00 45%
New patient office visit, about 60 minutes CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES $533.50 $970.00 45%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HBC OT THERAPEUTIC EXERCISE EACH 15 MINUTES $93.09 $169.25 45%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HBC OT THERAPEUTIC EXERCISE EACH 15 MINUTES $93.09 $169.25 45%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HBC PT THERAPEUTIC EXERCISE EACH 15 MINUTES $93.09 $169.25 45%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HBC PT THERAPEUTIC EXERCISE EACH 15 MINUTES $93.09 $169.25 45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HBC PT THERAPEUTIC EXERCISE EACH 15 MINUTES $93.09 $169.25 45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HBC OT THERAPEUTIC EXERCISE EACH 15 MINUTES $93.09 $169.25 45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HBC PT THERAPEUTIC EXERCISE EACH 15 MINUTES $93.09 $169.25 45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HBC OT THERAPEUTIC EXERCISE EACH 15 MINUTES $93.09 $169.25 45%
Psychotherapy session, 30 minutes CPT 90832 HBC PSYCHOTHERAPY W PATIENT 30 MINUTES $38.09 $69.25 45%
Psychotherapy session, 30 minutes CPT 90832 HBC PSYCHOTHERAPY W PATIENT 30 MINUTES $38.09 $69.25 45%
Psychotherapy session, 30 minutes inpatient CPT 90832 HBC PSYCHOTHERAPY W PATIENT 30 MINUTES $38.09 $69.25 45%
Psychotherapy session, 30 minutes inpatient CPT 90832 HBC PSYCHOTHERAPY W PATIENT 30 MINUTES $38.09 $69.25 45%
Psychotherapy session, 45 minutes CPT 90834 HBC PSYCHOTHERAPY W PATIENT 45 MINUTES $57.20 $104.00 45%
Psychotherapy session, 45 minutes CPT 90834 HBC PSYCHOTHERAPY W PATIENT 45 MINUTES $57.20 $104.00 45%
Psychotherapy session, 45 minutes inpatient CPT 90834 HBC PSYCHOTHERAPY W PATIENT 45 MINUTES $57.20 $104.00 45%
Psychotherapy session, 45 minutes inpatient CPT 90834 HBC PSYCHOTHERAPY W PATIENT 45 MINUTES $57.20 $104.00 45%
Psychotherapy session, 60 minutes CPT 90837 HBC PSYCHOTHERAPY W PATIENT 60 MINUTES $76.31 $138.75 45%
Psychotherapy session, 60 minutes CPT 90837 HBC PSYCHOTHERAPY W PATIENT 60 MINUTES $76.31 $138.75 45%
Psychotherapy session, 60 minutes inpatient CPT 90837 HBC PSYCHOTHERAPY W PATIENT 60 MINUTES $76.31 $138.75 45%
Psychotherapy session, 60 minutes inpatient CPT 90837 HBC PSYCHOTHERAPY W PATIENT 60 MINUTES $76.31 $138.75 45%
Specialist consultation, low complexity or 30+ minutes CPT 99243 PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES $300.85 $547.00 45%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES $416.90 $758.00 45%

Dental

ProcedureCash price List priceOff list
Porcelain crown CDT D2740 PR CROWN PORCELAIN/CERAMIC SUBS $1,079.10 $1,962.00 45%
Porcelain crown inpatient CDT D2740 PR CROWN PORCELAIN/CERAMIC SUBS $1,079.10 $1,962.00 45%

Source file: https://7pgcgohua4yc5gik.public.blob.vercel-storage.com/390812532-1750482022_Childrens-Hospital-of-Wisconsin_standardcharges.csv