Hospital Milwaukee-Waukesha, WI

Ascension Sacred Heart Rehabilitation Hospital

Listed in its price file as “Sacred Heart Rehabilitation Institute, Inc.”.

Ascension Sacred Heart Rehabilitation Hospital in Mequon, WI publishes cash prices for 267 common procedures listed here, from its own machine-readable price file updated Jan 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Wisconsin median for 4 of 4 procedures. Select a procedure to compare it with other hospitals nearby.

13111 N Port Washington Rd Fl 2 Mequon WI 53097 Collected Sep 23, 2026 Source price file Check a bill from this hospital

Some prices here are not compared

Ascension Sacred Heart Rehabilitation Hospital is an inpatient rehabilitation hospital. Its price file also lists scans, lab tests and procedures, but these are generally provided to its own inpatients, not booked by outside patients, so they are not compared with other hospitals here. Only its physical, occupational and speech therapy prices are compared.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W/WO CONTRAST	$1,797.76	$3,392.00	$109.28–$846.98	—	47%
Abdominal X-ray, 2 views CPT 74019 HC X-RAY EXAM ABDOMEN 2 VIEWS	$208.29	$393.00	$18.36–$245.18	—	47%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC PBB UPR/L XTREMITY ART 2 LEVELS	$233.20	$440.00	$18.95–$302.48	—	47%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC PBB UPR/L XTREMITY ART 2 LEVELS	$233.20	$440.00	$18.95–$302.48	—	47%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC UPR/L XTR NON-INVAS ART STUDY 2 LEVELS LIMITED	$378.95	$715.00	$18.95–$302.48	—	47%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC UPR/L XTR NON-INVAS ART STUDY 2 LEVELS LIMITED	$378.95	$715.00	$18.95–$302.48	—	47%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC PBB UPR/L XTREMITY ART 2 LEVELS	$233.20	$440.00	$18.95–$302.48	—	47%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC UPR/L XTR NON-INVAS ART STUDY 2 LEVELS LIMITED	$378.95	$715.00	$18.95–$302.48	—	47%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXTREMITY WO CONTRAST	$1,102.40	$2,080.00	$78.03–$577.54	—	47%
Breast ultrasound, complete, one breast CPT 76641 HC ULTRASOUND BREAST COMPLETE	$303.69	$573.00	$57.56–$350.08	—	47%
Breast ultrasound, limited (one breast or one area) CPT 76642 HC ULTRASOUND BREAST LIMITED	$318.00	$600.00	$53.58–$287.90	—	47%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CTA ABDOMEN PELVIS W/WO CONTRAST	$3,741.80	$7,060.00	$171.05–$1,254.27	—	47%
CT angiography (CTA) of the head CPT 70496 HC STROKE CT ANGIOGRAPHY HEAD AI	$1,348.32	$2,544.00	$137.10–$951.77	—	47%
CT angiography (CTA) of the neck CPT 70498 HC CTA NECK W/WO CONTRAST	$1,756.42	$3,314.00	$137.10–$947.18	—	47%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CTA CHEST W/WO CONTRAST	$2,079.72	$3,924.00	$142.22–$968.22	—	47%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABDOMEN PELVIS WO CONTRAST	$1,981.67	$3,739.00	$136.53–$647.29	—	47%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABDOMEN PELVIS CONTRAST 1/> REGIONS	$2,848.22	$5,374.00	$157.01–$1,139.54	—	47%
CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W CONTRAST	$1,476.58	$2,786.00	$99.60–$744.74	—	47%
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN WO CONTRAST	$1,175.01	$2,217.00	$93.18–$484.11	—	47%
CT scan of the head without and with contrast CPT 70470 HC CT HEAD W/WO CONTRAST	$1,531.70	$2,890.00	$99.60–$618.64	—	47%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE WO CONTRAST	$1,395.49	$2,633.00	$78.03–$579.82	—	47%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST	$1,281.54	$2,418.00	$90.90–$729.23	—	47%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC 93880 CAROTID DUPLEX BILATERAL STUDY	$466.93	$881.00	$61.57–$713.47	—	47%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC 93880 CAROTID DUPLEX BILATERAL STUDY	$466.93	$881.00	$61.57–$713.47	—	47%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC 93880 CAROTID DUPLEX BILATERAL STUDY	$466.93	$881.00	$61.57–$713.47	—	47%
Chest CT scan without and with contrast CPT 71270 HC CT THORAX W/WO CONTRAST	$1,511.56	$2,852.00	$97.72–$888.15	—	47%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DXA BONE DENSITY AXIAL	$307.40	$580.00	$15.54–$245.18	—	47%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC DXA BONE DENSITY/PERIPHERAL	$313.23	$591.00	$16.08–$182.03	—	47%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC US OB DETAILED EXAM SINGLE FETUS	$375.77	$709.00	$140.28–$595.60	—	47%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT THORAX W CONTRAST	$1,257.69	$2,373.00	$91.44–$741.12	—	47%
Diagnostic mammogram, both breasts both sides CPT 77066 HC DX MAMMO INCL CAD BI	$145.75	$275.00	$78.03–$263.00	—	47%
Diagnostic mammogram, one breast CPT 77065 HC DX MAMMO INCL CAD UNI	$116.07	$219.00	$63.26–$205.70	—	47%
Duplex ultrasound of the leg arteries, both legs CPT 93925 HC PBB LOWER EXTREMITY STUDY	$570.81	$1,077.00	$60.30–$906.50	—	47%
Duplex ultrasound of the leg arteries, both legs CPT 93925 HC PBB LOWER EXTREMITY STUDY	$570.81	$1,077.00	$60.30–$906.50	—	47%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 HC PBB LOWER EXTREMITY STUDY	$570.81	$1,077.00	$60.30–$906.50	—	47%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC PBB TTE W/DOPPLER COMPLETE	$495.02	$934.00	$112.74–$746.96	—	47%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC PBB TTE W/DOPPLER COMPLETE	$495.02	$934.00	$112.74–$746.96	—	47%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC PBB TTE W/DOPPLER COMPLETE	$495.02	$934.00	$112.74–$746.96	—	47%
Elbow X-ray, 2 views CPT 73070 HC X-RAY EXAM OF ELBOW 2 VIEWS	$237.44	$448.00	$13.23–$182.03	—	47%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT SELLA WO CONTRAST	$1,162.29	$2,193.00	$100.72–$753.95	—	47%
Facial bones X-ray, complete, 3 or more views CPT 70150 HC X-RAY EXAM OF FACIAL BONES 3/>VIEWS	$281.96	$532.00	$20.64–$245.18	—	47%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC HEPATOBILIARY IMAGING W OR WO GB	$1,162.29	$2,193.00	$57.03–$1,105.23	—	47%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC HEPATOBILIARY IMAGING W OR WO GB	$1,162.29	$2,193.00	$57.03–$1,105.23	—	47%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC HEPATOBILIARY IMAGING W OR WO GB	$1,162.29	$2,193.00	$57.03–$1,105.23	—	47%
Hand X-ray, 2 views CPT 73120 HC X-RAY EXAM OF HAND 2 VIEWS	$246.98	$466.00	$13.23–$245.18	—	47%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC X-RAY EXAM OF HEEL 2 VIEWS	$180.73	$341.00	$12.68–$182.03	—	47%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC PBB SLEEP STUDY UNATT&RESP EFFT	$314.82	$594.00	$71.81–$540.21	—	47%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC PBB SLEEP STUDY UNATT&RESP EFFT	$314.82	$594.00	$71.81–$540.21	—	47%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC PBB SLEEP STUDY UNATT&RESP EFFT	$314.82	$594.00	$71.81–$540.21	—	47%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC PBB POLYSOMNOGRAPHY W/CPAP	$1,501.49	$2,833.00	$200.84–$2,388.00	—	47%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC PBB POLYSOMNOGRAPHY W/CPAP	$1,501.49	$2,833.00	$200.84–$2,388.00	—	47%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC PBB POLYSOMNOGRAPHY W/CPAP	$1,501.49	$2,833.00	$200.84–$2,388.00	—	47%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT LOWER EXTREMITY WO CONTRAST	$1,195.15	$2,255.00	$78.03–$578.68	—	47%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG	$169.60	$320.00	$14.94–$245.18	—	47%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG	$169.60	$320.00	$14.94–$245.18	—	47%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG	$169.60	$320.00	$14.94–$245.18	—	47%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI JOINT LOWER EXTREMITY WO CONTRAST	$3,579.09	$6,753.00	$106.40–$763.70	—	47%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI JOINT LOWER EXTREMITY WO CONTRAST	$3,579.09	$6,753.00	$106.40–$763.70	—	47%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI JOINT LOWER EXTREMITY WO CONTRAST	$3,579.09	$6,753.00	$106.40–$763.70	—	47%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI JOINT LOWER EXTREMITY W/WO CONTRAST	$6,520.06	$12,302.00	$168.54–$1,518.09	—	47%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI JOINT LOWER EXTREMITY W/WO CONTRAST	$6,520.06	$12,302.00	$168.54–$1,518.09	—	47%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI JOINT LOWER EXTREMITY W/WO CONTRAST	$6,520.06	$12,302.00	$168.54–$1,518.09	—	47%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN WO CONTRAST	$1,895.81	$3,577.00	$114.56–$1,073.78	—	47%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN WO CONTRAST	$1,895.81	$3,577.00	$114.56–$1,073.78	—	47%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN WO CONTRAST	$1,895.81	$3,577.00	$114.56–$1,073.78	—	47%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN W/WO CONTRAST	$2,007.64	$3,788.00	$171.96–$1,634.00	—	47%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN W/WO CONTRAST	$2,007.64	$3,788.00	$171.96–$1,634.00	—	47%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI ABDOMEN W/WO CONTRAST	$2,007.64	$3,788.00	$171.96–$1,634.00	—	47%
MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE WO CONTRAST	$2,158.16	$4,072.00	$116.26–$719.71	—	47%
MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE WO CONTRAST	$2,158.16	$4,072.00	$116.26–$719.71	—	47%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI LUMBAR SPINE WO CONTRAST	$2,158.16	$4,072.00	$116.26–$719.71	—	47%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI THORACIC SPINE WO CONTRAST	$2,100.39	$3,963.00	$116.26–$724.30	—	47%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI THORACIC SPINE WO CONTRAST	$2,100.39	$3,963.00	$116.26–$724.30	—	47%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI THORACIC SPINE WO CONTRAST	$2,100.39	$3,963.00	$116.26–$724.30	—	47%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERVICAL SPINE WO CONTRAST	$2,071.77	$3,909.00	$116.26–$723.16	—	47%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERVICAL SPINE WO CONTRAST	$2,071.77	$3,909.00	$116.26–$723.16	—	47%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI CERVICAL SPINE WO CONTRAST	$2,071.77	$3,909.00	$116.26–$723.16	—	47%
MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS W/WO CONTRAST	$2,685.51	$5,067.00	$171.96–$1,630.55	—	47%
MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS W/WO CONTRAST	$2,685.51	$5,067.00	$171.96–$1,630.55	—	47%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIS W/WO CONTRAST	$2,685.51	$5,067.00	$171.96–$1,630.55	—	47%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS WO CONTRAST	$2,288.54	$4,318.00	$114.56–$1,207.91	—	47%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS WO CONTRAST	$2,288.54	$4,318.00	$114.56–$1,207.91	—	47%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS WO CONTRAST	$2,288.54	$4,318.00	$114.56–$1,207.91	—	47%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI JOINT UPPER EXTREMITY WO CONTRAST	$4,368.26	$8,242.00	$106.95–$762.56	—	47%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI JOINT UPPER EXTREMITY WO CONTRAST	$4,368.26	$8,242.00	$106.95–$762.56	—	47%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI JOINT UPPER EXTREMITY WO CONTRAST	$4,368.26	$8,242.00	$106.95–$762.56	—	47%
Neck soft tissue CT scan with contrast CPT 70491 HC CT SOFT TISSUE NECK W CONTRAST	$1,470.75	$2,775.00	$108.68–$762.06	—	47%
Neck soft tissue CT scan without contrast CPT 70490 HC CT SOFT TISSUE NECK WO CONTRAST	$1,138.44	$2,148.00	$100.72–$624.44	—	47%
Neck soft tissue X-ray CPT 70360 HC X-RAY EXAM OF NECK	$196.10	$370.00	$14.38–$182.03	—	47%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC MYOCARDIAL SPECT MULTIPLE STUDIES	$2,828.08	$5,336.00	$125.05–$2,938.37	—	47%
Pelvic CT scan without contrast CPT 72192 HC CT PELVIS WO CONTRAST	$1,113.53	$2,101.00	$85.22–$471.41	—	47%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US NON-OB PELVIC LTD /FOLLOW UP	$352.45	$665.00	$39.02–$245.18	—	47%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US NON-OB PELVIC COMPLETE	$462.16	$872.00	$54.16–$357.88	—	47%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB 14 WKS / > SINGLE FETUS	$445.20	$840.00	$78.56–$462.40	—	47%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US OB < 14WKS SINGLE FETUS	$436.72	$824.00	$78.01–$403.27	—	47%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC 76815 US,PREGNANT UTERUS,LIMITED, 1/> FETUSES	$398.03	$751.00	$51.31–$275.14	—	47%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC 76815 US,PREGNANT UTERUS,LIMITED, 1/> FETUSES	$398.03	$751.00	$51.31–$275.14	—	47%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC 76815 US,PREGNANT UTERUS,LIMITED, 1/> FETUSES	$398.03	$751.00	$51.31–$275.14	—	47%
Rib X-ray, one side, 2 views CPT 71100 HC X-RAY EXAM RIBS UNI 2 VIEWS	$250.16	$472.00	$17.78–$182.03	—	47%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC X-RAY EXAM UNILAT RIBS/CHEST	$286.73	$541.00	$21.22–$245.18	—	47%
Screening mammogram, both breasts both sides CPT 77067 HC SCREEN MAMMO BI INCL CAD	$115.01	$217.00	$59.82–$151.23	—	47%
Sinus X-ray, complete, 3 or more views CPT 70220 HC X-RAY EXAM OF SINUSES 3/> VIEWS	$396.44	$748.00	$17.24–$182.03	—	47%
Skull X-ray, fewer than 4 views CPT 70250 HC X-RAY EXAM OF SKULL < 4 VIEWS	$199.28	$376.00	$14.38–$245.18	—	47%
Sleep study in a lab (polysomnography) CPT 95810 HC PBB POLYSOMNOGRAPHY 4 OR MORE	$1,370.58	$2,586.00	$193.44–$2,388.00	—	47%
Sleep study in a lab (polysomnography) CPT 95810 HC PBB POLYSOMNOGRAPHY 4 OR MORE	$1,370.58	$2,586.00	$193.44–$2,388.00	—	47%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC PBB POLYSOMNOGRAPHY 4 OR MORE	$1,370.58	$2,586.00	$193.44–$2,388.00	—	47%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC PBB STRESS TTE COMPLETE	$448.38	$846.00	$135.29–$844.57	—	47%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC PBB STRESS TTE COMPLETE	$448.38	$846.00	$135.29–$844.57	—	47%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC PBB STRESS TTE COMPLETE	$448.38	$846.00	$135.29–$844.57	—	47%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC X-RAY EXAM OF FEMUR 2/> VIEWS	$69.96	$132.00	$14.38–$104.35	—	47%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC X-RAY EXAM OF FEMUR 2/> VIEWS	$69.96	$132.00	$14.38–$104.35	—	47%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC X-RAY EXAM OF FEMUR 2/> VIEWS	$69.96	$132.00	$14.38–$104.35	—	47%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT THORACIC SPINE WO CONTRAST	$1,230.13	$2,321.00	$78.03–$582.13	—	47%
Toe X-ray, 2 or more views CPT 73660 HC X-RAY EXAM OF TOE(S) 2 VIEWS	$160.59	$303.00	$10.40–$182.03	—	47%
Transvaginal pelvic ultrasound CPT 76830 HC US NON-OB TRANSVAGINAL	$388.49	$733.00	$54.71–$396.84	—	47%
Transvaginal ultrasound during pregnancy CPT 76817 HC US OB TRANSVAGINAL EXAM	$376.83	$711.00	$59.26–$317.61	—	47%
Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMINAL COMPLETE	$586.71	$1,107.00	$63.26–$399.79	—	47%
Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM & TESTICLES	$445.73	$841.00	$50.18–$245.18	—	47%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US EXAM OF SOFT TISSUES HEAD AND NECK	$173.31	$327.00	$44.47–$303.84	—	47%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US EXAM OF SOFT TISSUES HEAD AND NECK	$173.31	$327.00	$44.47–$303.84	—	47%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US EXAM OF SOFT TISSUES HEAD AND NECK	$173.31	$327.00	$44.47–$303.84	—	47%
Upper arm X-ray (humerus), 2 views CPT 73060 HC X-RAY EXAM OF HUMERUS	$253.34	$478.00	$13.23–$182.03	—	47%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC 93971TC EXTREMITY STUDY	$299.45	$565.00	$34.31–$435.64	—	47%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC 93971TC EXTREMITY STUDY	$299.45	$565.00	$34.31–$435.64	—	47%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC 93971TC EXTREMITY STUDY	$299.45	$565.00	$34.31–$435.64	—	47%
Wrist X-ray, 2 views CPT 73100 HC X-RAY EXAM OF WRIST 2 VIEWS	$242.21	$457.00	$13.23–$182.03	—	47%
X-ray of the ankle, 2 views CPT 73600 HC X-RAY EXAM OF ANKLE 2 VIEWS	$348.21	$657.00	$13.23–$182.03	—	47%
X-ray of the finger(s), 2 or more views CPT 73140 HC X-RAY EXAM OF FINGER(S)	$196.63	$371.00	$10.95–$182.03	—	47%
X-ray of the nasal bones, 3 or more views CPT 70160 HC X-RAY EXAM OF NASAL BONES	$243.27	$459.00	$13.80–$182.03	—	47%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC X-RAY EXAM OF PELVIS 1 OR 2 VIEWS	$178.08	$336.00	$13.80–$245.18	—	47%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC ALANINE AMINO (ALT) (SGPT)	$53.00	$100.00	$5.57–$24.19	—	47%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC ALANINE AMINO (ALT) (SGPT)	$53.00	$100.00	$5.57–$24.19	—	47%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC ALANINE AMINO (ALT) (SGPT)	$53.00	$100.00	$5.57–$24.19	—	47%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC TRANSFERASE (AST) (SGOT)	$51.94	$98.00	$5.44–$23.62	—	47%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC TRANSFERASE (AST) (SGOT)	$51.94	$98.00	$5.44–$23.62	—	47%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC TRANSFERASE (AST) (SGOT)	$51.94	$98.00	$5.44–$23.62	—	47%
Albumin blood test CPT 82040 HC ASSAY OF SERUM ALBUMIN	$41.34	$78.00	$5.20–$22.58	—	47%
Albumin blood test CPT 82040 HC ASSAY OF SERUM ALBUMIN	$41.34	$78.00	$5.20–$22.58	—	47%
Albumin blood test inpatient CPT 82040 HC ASSAY OF SERUM ALBUMIN	$41.34	$78.00	$5.20–$22.58	—	47%
Aldosterone blood test CPT 82088 HC ASSAY OF ALDOSTERONE	$209.35	$395.00	$42.79–$185.96	—	47%
Aldosterone blood test CPT 82088 HC ASSAY OF ALDOSTERONE	$209.35	$395.00	$42.79–$185.96	—	47%
Aldosterone blood test inpatient CPT 82088 HC ASSAY OF ALDOSTERONE	$209.35	$395.00	$42.79–$185.96	—	47%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ASSAY ALKALINE PHOSPHATASE	$53.53	$101.00	$5.44–$23.62	—	47%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ASSAY ALKALINE PHOSPHATASE	$53.53	$101.00	$5.44–$23.62	—	47%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ASSAY ALKALINE PHOSPHATASE	$53.53	$101.00	$5.44–$23.62	—	47%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN SERUM	$109.71	$207.00	$17.61–$76.55	—	47%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN SERUM	$109.71	$207.00	$17.61–$76.55	—	47%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN SERUM	$109.71	$207.00	$17.61–$76.55	—	47%
Amylase blood test CPT 82150 HC ASSAY OF AMYLASE	$53.53	$101.00	$6.80–$29.58	—	47%
Amylase blood test CPT 82150 HC ASSAY OF AMYLASE	$53.53	$101.00	$6.80–$29.58	—	47%
Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE	$53.53	$101.00	$6.80–$29.58	—	47%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CCP ANTIBODY	$88.51	$167.00	$13.60–$59.06	—	47%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CCP ANTIBODY	$88.51	$167.00	$13.60–$59.06	—	47%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CCP ANTIBODY	$88.51	$167.00	$13.60–$59.06	—	47%
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL	$16.43	$31.00	$5.27–$22.88	—	47%
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL	$16.43	$31.00	$5.27–$22.88	—	47%
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL	$16.43	$31.00	$5.27–$22.88	—	47%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC SURGICAL PATHOLOGY GROSS EXAM LVL IV	$525.76	$992.00	$37.48–$239.93	—	47%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC SURGICAL PATHOLOGY GROSS EXAM LVL IV	$525.76	$992.00	$37.48–$239.93	—	47%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC SURGICAL PATHOLOGY GROSS EXAM LVL IV	$525.76	$992.00	$37.48–$239.93	—	47%
Blood glucose (sugar) test CPT 82947 HC ASSAY GLUCOSE BLOOD QUANTITATIVE	$15.90	$30.00	$4.13–$17.92	—	47%
Blood glucose (sugar) test CPT 82947 HC ASSAY GLUCOSE BLOOD QUANTITATIVE	$15.90	$30.00	$4.13–$17.92	—	47%
Blood glucose (sugar) test inpatient CPT 82947 HC ASSAY GLUCOSE BLOOD QUANTITATIVE	$15.90	$30.00	$4.13–$17.92	—	47%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC CHORIONIC GONADOTROPIN ASSAY	$78.97	$149.00	$7.90–$34.30	—	47%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC CHORIONIC GONADOTROPIN ASSAY	$78.97	$149.00	$7.90–$34.30	—	47%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC CHORIONIC GONADOTROPIN ASSAY	$78.97	$149.00	$7.90–$34.30	—	47%
C-peptide blood test CPT 84681 HC ASSAY OF C-PEPTIDE	$43.46	$82.00	$12.36–$80.43	—	47%
C-peptide blood test CPT 84681 HC ASSAY OF C-PEPTIDE	$43.46	$82.00	$12.36–$80.43	—	47%
C-peptide blood test inpatient CPT 84681 HC ASSAY OF C-PEPTIDE	$43.46	$82.00	$12.36–$80.43	—	47%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA-ZOSTER ANTIBODY	$47.17	$89.00	$13.52–$56.18	—	47%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA-ZOSTER ANTIBODY	$47.17	$89.00	$13.52–$56.18	—	47%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA-ZOSTER ANTIBODY	$47.17	$89.00	$13.52–$56.18	—	47%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHYLAMYDIA TRACHOMATIS DNA AMP PROBE	$198.75	$375.00	$36.84–$160.13	—	47%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHYLAMYDIA TRACHOMATIS DNA AMP PROBE	$198.75	$375.00	$36.84–$160.13	—	47%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHYLAMYDIA TRACHOMATIS DNA AMP PROBE	$198.75	$375.00	$36.84–$160.13	—	47%
Cortisol blood test, total CPT 82533 HC TOTAL CORTISOL	$63.07	$119.00	$17.12–$74.40	—	47%
Cortisol blood test, total CPT 82533 HC TOTAL CORTISOL	$63.07	$119.00	$17.12–$74.40	—	47%
Cortisol blood test, total inpatient CPT 82533 HC TOTAL CORTISOL	$63.07	$119.00	$17.12–$74.40	—	47%
Cytomegalovirus (CMV) antibody test CPT 86644 HC CMV ANTIBODY	$104.94	$198.00	$15.11–$65.69	—	47%
Cytomegalovirus (CMV) antibody test CPT 86644 HC CMV ANTIBODY	$104.94	$198.00	$15.11–$65.69	—	47%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC CMV ANTIBODY	$104.94	$198.00	$15.11–$65.69	—	47%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRESUMPTIVE CHEM ANALYZER	$68.37	$129.00	$65.25–$116.67	—	47%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRESUMPTIVE CHEM ANALYZER	$68.37	$129.00	$65.25–$116.67	—	47%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRESUMPTIVE CHEM ANALYZER	$68.37	$129.00	$65.25–$116.67	—	47%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EPSTEIN-BARR CAPSID VCA	$118.72	$224.00	$19.05–$82.81	—	47%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EPSTEIN-BARR CAPSID VCA	$118.72	$224.00	$19.05–$82.81	—	47%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EPSTEIN-BARR CAPSID VCA	$118.72	$224.00	$19.05–$82.81	—	47%
Fecal calprotectin (stool inflammation test) CPT 83993 HC ASSAY FOR CALPROTECTIN FECAL	$704.37	$1,329.00	$20.61–$89.58	—	47%
Fecal calprotectin (stool inflammation test) CPT 83993 HC ASSAY FOR CALPROTECTIN FECAL	$704.37	$1,329.00	$20.61–$89.58	—	47%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC ASSAY FOR CALPROTECTIN FECAL	$704.37	$1,329.00	$20.61–$89.58	—	47%
Fibrinogen blood test CPT 85384 HC FIBRINOGEN ACTIVITY	$28.62	$54.00	$10.21–$38.76	—	47%
Fibrinogen blood test CPT 85384 HC FIBRINOGEN ACTIVITY	$28.62	$54.00	$10.21–$38.76	—	47%
Fibrinogen blood test inpatient CPT 85384 HC FIBRINOGEN ACTIVITY	$28.62	$54.00	$10.21–$38.76	—	47%
Free T3 thyroid hormone test CPT 84481 HC FREE ASSAY (FT-3)	$102.29	$193.00	$17.79–$73.37	—	47%
Free T3 thyroid hormone test CPT 84481 HC FREE ASSAY (FT-3)	$102.29	$193.00	$17.79–$73.37	—	47%
Free T3 thyroid hormone test inpatient CPT 84481 HC FREE ASSAY (FT-3)	$102.29	$193.00	$17.79–$73.37	—	47%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE	$91.69	$173.00	$9.47–$41.14	—	47%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE	$91.69	$173.00	$9.47–$41.14	—	47%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE	$91.69	$173.00	$9.47–$41.14	—	47%
Free testosterone test CPT 84402 HC ASSAY OF FREE TESTOSTERONE	$156.88	$296.00	$26.74–$116.21	—	47%
Free testosterone test CPT 84402 HC ASSAY OF FREE TESTOSTERONE	$156.88	$296.00	$26.74–$116.21	—	47%
Free testosterone test inpatient CPT 84402 HC ASSAY OF FREE TESTOSTERONE	$156.88	$296.00	$26.74–$116.21	—	47%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC ASSAY OF GGT	$36.04	$68.00	$7.56–$32.86	—	47%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC ASSAY OF GGT	$36.04	$68.00	$7.56–$32.86	—	47%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC ASSAY OF GGT	$36.04	$68.00	$7.56–$32.86	—	47%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC NESSERIA GONORRHOEAE DNA AMPLIFIED PROBE	$198.75	$375.00	$36.84–$160.13	—	47%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC NESSERIA GONORRHOEAE DNA AMPLIFIED PROBE	$198.75	$375.00	$36.84–$160.13	—	47%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC NESSERIA GONORRHOEAE DNA AMPLIFIED PROBE	$198.75	$375.00	$36.84–$160.13	—	47%
H. pylori antibody blood test CPT 86677 HC HELICOBACTER PYLORI ANTIBODY	$48.23	$91.00	$13.78–$63.05	—	47%
H. pylori antibody blood test CPT 86677 HC HELICOBACTER PYLORI ANTIBODY	$48.23	$91.00	$13.78–$63.05	—	47%
H. pylori antibody blood test inpatient CPT 86677 HC HELICOBACTER PYLORI ANTIBODY	$48.23	$91.00	$13.78–$63.05	—	47%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1 QUANTIFICATION&REVERSE TRANSCRIPT	$619.04	$1,168.00	$89.36–$388.33	—	47%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1 QUANTIFICATION&REVERSE TRANSCRIPT	$619.04	$1,168.00	$89.36–$388.33	—	47%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV-1 QUANTIFICATION&REVERSE TRANSCRIPT	$619.04	$1,168.00	$89.36–$388.33	—	47%
HIV-1 and HIV-2 antibody test CPT 86703 HC HIV-1/HIV-2 1 RESULT ANTIBODY	$110.77	$209.00	$14.40–$62.54	—	47%
HIV-1 and HIV-2 antibody test CPT 86703 HC HIV-1/HIV-2 1 RESULT ANTIBODY	$110.77	$209.00	$14.40–$62.54	—	47%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC HIV-1/HIV-2 1 RESULT ANTIBODY	$110.77	$209.00	$14.40–$62.54	—	47%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC HPV HIGH-RISK TYPES	$226.31	$427.00	$36.84–$160.13	—	47%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC HPV HIGH-RISK TYPES	$226.31	$427.00	$36.84–$160.13	—	47%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC HPV HIGH-RISK TYPES	$226.31	$427.00	$36.84–$160.13	—	47%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST	$38.16	$72.00	$10.20–$44.29	—	47%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST	$38.16	$72.00	$10.20–$44.29	—	47%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST	$38.16	$72.00	$10.20–$44.29	—	47%
Hepatitis B core antibody test (total) CPT 86704 HC HEP B CORE ANTIBODY TOTAL	$78.44	$148.00	$12.65–$54.97	—	47%
Hepatitis B core antibody test (total) CPT 86704 HC HEP B CORE ANTIBODY TOTAL	$78.44	$148.00	$12.65–$54.97	—	47%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEP B CORE ANTIBODY TOTAL	$78.44	$148.00	$12.65–$54.97	—	47%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEP B SURFACE ANTIBODY	$46.64	$88.00	$11.28–$49.01	—	47%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEP B SURFACE ANTIBODY	$46.64	$88.00	$11.28–$49.01	—	47%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEP B SURFACE ANTIBODY	$46.64	$88.00	$11.28–$49.01	—	47%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC HEPATITIS B SURFACE AG EIA	$85.33	$161.00	$10.85–$47.13	—	47%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC HEPATITIS B SURFACE AG EIA	$85.33	$161.00	$10.85–$47.13	—	47%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC HEPATITIS B SURFACE AG EIA	$85.33	$161.00	$10.85–$47.13	—	47%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY TEST	$133.56	$252.00	$14.98–$65.12	—	47%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY TEST	$133.56	$252.00	$14.98–$65.12	—	47%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY TEST	$133.56	$252.00	$14.98–$65.12	—	47%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC HEPATITIS C REVERSE TRANSCRIPTION	$296.27	$559.00	$44.98–$195.47	—	47%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC HEPATITIS C REVERSE TRANSCRIPTION	$296.27	$559.00	$44.98–$195.47	—	47%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC HEPATITIS C REVERSE TRANSCRIPTION	$296.27	$559.00	$44.98–$195.47	—	47%
Herpes blood test, HSV-1 antibody CPT 86695 HC HERPES SIMPLEX TYPE 1 TEST	$100.17	$189.00	$13.85–$60.20	—	47%
Herpes blood test, HSV-1 antibody CPT 86695 HC HERPES SIMPLEX TYPE 1 TEST	$100.17	$189.00	$13.85–$60.20	—	47%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HERPES SIMPLEX TYPE 1 TEST	$100.17	$189.00	$13.85–$60.20	—	47%
Herpes blood test, HSV-2 antibody CPT 86696 HC HERPES SIMPLEX TYPE 2 TEST	$137.27	$259.00	$20.32–$88.34	—	47%
Herpes blood test, HSV-2 antibody CPT 86696 HC HERPES SIMPLEX TYPE 2 TEST	$137.27	$259.00	$20.32–$88.34	—	47%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HERPES SIMPLEX TYPE 2 TEST	$137.27	$259.00	$20.32–$88.34	—	47%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY	$25.97	$49.00	$13.60–$30.66	—	47%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY	$25.97	$49.00	$13.60–$30.66	—	47%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY	$25.97	$49.00	$13.60–$30.66	—	47%
Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTINE	$147.87	$279.00	$18.82–$76.98	—	47%
Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTINE	$147.87	$279.00	$18.82–$76.98	—	47%
Homocysteine blood test inpatient CPT 83090 HC ASSAY OF HOMOCYSTINE	$147.87	$279.00	$18.82–$76.98	—	47%
Insulin blood test CPT 83525 HC ASSAY OF INSULIN TOTAL	$73.67	$139.00	$12.00–$52.16	—	47%
Insulin blood test CPT 83525 HC ASSAY OF INSULIN TOTAL	$73.67	$139.00	$12.00–$52.16	—	47%
Insulin blood test inpatient CPT 83525 HC ASSAY OF INSULIN TOTAL	$73.67	$139.00	$12.00–$52.16	—	47%
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL	$72.08	$136.00	$9.11–$39.63	—	47%
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL	$72.08	$136.00	$9.11–$39.63	—	47%
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL	$72.08	$136.00	$9.11–$39.63	—	47%
Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTIC ACID	$71.55	$135.00	$12.15–$48.74	—	47%
Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTIC ACID	$71.55	$135.00	$12.15–$48.74	—	47%
Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTIC ACID	$71.55	$135.00	$12.15–$48.74	—	47%
Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE	$58.30	$110.00	$7.23–$31.42	—	47%
Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE	$58.30	$110.00	$7.23–$31.42	—	47%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE	$58.30	$110.00	$7.23–$31.42	—	47%
Lyme disease antibody test CPT 86618 HC LYME DISEASE ANTIBODY	$116.60	$220.00	$17.88–$77.72	—	47%
Lyme disease antibody test CPT 86618 HC LYME DISEASE ANTIBODY	$116.60	$220.00	$17.88–$77.72	—	47%
Lyme disease antibody test inpatient CPT 86618 HC LYME DISEASE ANTIBODY	$116.60	$220.00	$17.88–$77.72	—	47%
Measles (rubeola) antibody test CPT 86765 HC RUBEOLA ANTIBODY	$84.27	$159.00	$13.52–$58.79	—	47%
Measles (rubeola) antibody test CPT 86765 HC RUBEOLA ANTIBODY	$84.27	$159.00	$13.52–$58.79	—	47%
Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA ANTIBODY	$84.27	$159.00	$13.52–$58.79	—	47%
Mumps immunity blood test CPT 86735 HC MUMPS ANTIBODY	$110.77	$209.00	$13.70–$59.53	—	47%
Mumps immunity blood test CPT 86735 HC MUMPS ANTIBODY	$110.77	$209.00	$13.70–$59.53	—	47%
Mumps immunity blood test inpatient CPT 86735 HC MUMPS ANTIBODY	$110.77	$209.00	$13.70–$59.53	—	47%
Obstetric blood test panel CPT 80055 HC PBB OBSTETRIC PANEL	$100.17	$189.00	$50.20–$184.71	—	47%
Obstetric blood test panel CPT 80055 HC PBB OBSTETRIC PANEL	$100.17	$189.00	$50.20–$184.71	—	47%
Obstetric blood test panel inpatient CPT 80055 HC PBB OBSTETRIC PANEL	$100.17	$189.00	$50.20–$184.71	—	47%
Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTOPATHOLOGY C/V AUTOMATED FLUID REDO	$125.61	$237.00	$27.94–$115.78	—	47%
Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTOPATHOLOGY C/V AUTOMATED FLUID REDO	$125.61	$237.00	$27.94–$115.78	—	47%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTOPATHOLOGY C/V AUTOMATED FLUID REDO	$125.61	$237.00	$27.94–$115.78	—	47%
Prolactin blood test CPT 84146 HC ASSAY OF PROLACTIN	$82.68	$156.00	$20.35–$88.44	—	47%
Prolactin blood test CPT 84146 HC ASSAY OF PROLACTIN	$82.68	$156.00	$20.35–$88.44	—	47%
Prolactin blood test inpatient CPT 84146 HC ASSAY OF PROLACTIN	$82.68	$156.00	$20.35–$88.44	—	47%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC DRUG TEST PRESUMPTIVE DIRECT OPT OBS - POC	$73.14	$138.00	$13.23–$67.74	—	47%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC DRUG TEST PRESUMPTIVE DIRECT OPT OBS - POC	$73.14	$138.00	$13.23–$67.74	—	47%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC DRUG TEST PRESUMPTIVE DIRECT OPT OBS - POC	$73.14	$138.00	$13.23–$67.74	—	47%
Rapid flu test (influenza antigen) CPT 87804 HC INFLUENZA ASSAY W/OPTIC	$98.58	$186.00	$14.00–$54.71	—	47%
Rapid flu test (influenza antigen) CPT 87804 HC INFLUENZA ASSAY W/OPTIC	$98.58	$186.00	$14.00–$54.71	—	47%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC INFLUENZA ASSAY W/OPTIC	$98.58	$186.00	$14.00–$54.71	—	47%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC STREP A ASSAY W/OPTIC	$83.74	$158.00	$17.36–$54.71	—	47%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC STREP A ASSAY W/OPTIC	$83.74	$158.00	$17.36–$54.71	—	47%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC STREP A ASSAY W/OPTIC	$83.74	$158.00	$17.36–$54.71	—	47%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR QUANTITATIVE	$48.23	$91.00	$5.95–$25.90	—	47%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR QUANTITATIVE	$48.23	$91.00	$5.95–$25.90	—	47%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR QUANTITATIVE	$48.23	$91.00	$5.95–$25.90	—	47%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA ANTIBODY	$115.54	$218.00	$15.11–$65.69	—	47%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA ANTIBODY	$115.54	$218.00	$15.11–$65.69	—	47%
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA ANTIBODY	$115.54	$218.00	$15.11–$65.69	—	47%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 HC PBB SEMEN ANAL VOL/COUNT/MOT	$34.98	$66.00	$12.93–$54.97	—	47%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 HC PBB SEMEN ANAL VOL/COUNT/MOT	$34.98	$66.00	$12.93–$54.97	—	47%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 HC PBB SEMEN ANAL VOL/COUNT/MOT	$34.98	$66.00	$12.93–$54.97	—	47%
Sodium blood test CPT 84295 HC ASSAY OF SERUM SODIUM	$36.04	$68.00	$5.05–$21.98	—	47%
Sodium blood test CPT 84295 HC ASSAY OF SERUM SODIUM	$36.04	$68.00	$5.05–$21.98	—	47%
Sodium blood test inpatient CPT 84295 HC ASSAY OF SERUM SODIUM	$36.04	$68.00	$5.05–$21.98	—	47%
Stool ova and parasites exam CPT 87177 HC OVA AND PARASITES SMEARS	$95.40	$180.00	$9.35–$40.60	—	47%
Stool ova and parasites exam CPT 87177 HC OVA AND PARASITES SMEARS	$95.40	$180.00	$9.35–$40.60	—	47%
Stool ova and parasites exam inpatient CPT 87177 HC OVA AND PARASITES SMEARS	$95.40	$180.00	$9.35–$40.60	—	47%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC TREPONEMA PALLIDUM	$54.06	$102.00	$13.90–$57.32	—	47%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC TREPONEMA PALLIDUM	$54.06	$102.00	$13.90–$57.32	—	47%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC TREPONEMA PALLIDUM	$54.06	$102.00	$13.90–$57.32	—	47%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREPONEMAL QUALITATIVE	$33.39	$63.00	$4.48–$19.50	—	47%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREPONEMAL QUALITATIVE	$33.39	$63.00	$4.48–$19.50	—	47%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREPONEMAL QUALITATIVE	$33.39	$63.00	$4.48–$19.50	—	47%
Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TOTAL TESTOSTERONE	$24.38	$46.00	$27.10–$43.88	—	47%
Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TOTAL TESTOSTERONE	$24.38	$46.00	$27.10–$43.88	—	47%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TOTAL TESTOSTERONE	$24.38	$46.00	$27.10–$43.88	—	47%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODY EACH	$43.99	$83.00	$15.28–$66.40	—	47%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODY EACH	$43.99	$83.00	$15.28–$66.40	—	47%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODY EACH	$43.99	$83.00	$15.28–$66.40	—	47%
Total IgE blood test CPT 82785 HC ASSAY OF IGE	$133.56	$252.00	$17.28–$75.14	—	47%
Total IgE blood test CPT 82785 HC ASSAY OF IGE	$133.56	$252.00	$17.28–$75.14	—	47%
Total IgE blood test inpatient CPT 82785 HC ASSAY OF IGE	$133.56	$252.00	$17.28–$75.14	—	47%
Trichomonas test (NAAT) CPT 87661 HC TRICHOMONAS VAGINALIS AMPLIFIED	$181.79	$343.00	$36.84–$160.13	—	47%
Trichomonas test (NAAT) CPT 87661 HC TRICHOMONAS VAGINALIS AMPLIFIED	$219.95	$415.00	$36.84–$160.13	—	47%
Trichomonas test (NAAT) inpatient CPT 87661 HC TRICHOMONAS VAGINALIS AMPLIFIED	$219.95	$415.00	$36.84–$160.13	—	47%
Triglycerides blood test CPT 84478 HC ASSAY OF TRIGLYCERIDES	$46.64	$88.00	$6.03–$26.23	—	47%
Triglycerides blood test CPT 84478 HC ASSAY OF TRIGLYCERIDES	$46.64	$88.00	$6.03–$26.23	—	47%
Triglycerides blood test inpatient CPT 84478 HC ASSAY OF TRIGLYCERIDES	$46.64	$88.00	$6.03–$26.23	—	47%
Uric acid blood test CPT 84550 HC ASSAY OF BLOOD/URIC ACID	$46.64	$88.00	$4.75–$20.64	—	47%
Uric acid blood test CPT 84550 HC ASSAY OF BLOOD/URIC ACID	$46.64	$88.00	$4.75–$20.64	—	47%
Uric acid blood test inpatient CPT 84550 HC ASSAY OF BLOOD/URIC ACID	$46.64	$88.00	$4.75–$20.64	—	47%
Urinalysis with microscope exam, manual CPT 81000 HC URINALYSIS NONAUTOMATED W/SCOPE	$14.84	$28.00	$4.22–$14.47	—	47%
Urinalysis with microscope exam, manual CPT 81000 HC URINALYSIS NONAUTOMATED W/SCOPE	$14.84	$28.00	$4.22–$14.47	—	47%
Urinalysis with microscope exam, manual inpatient CPT 81000 HC URINALYSIS NONAUTOMATED W/SCOPE	$14.84	$28.00	$4.22–$14.47	—	47%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC VITAMIN D 25 HYDROXY	$184.97	$349.00	$31.08–$135.11	—	47%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC VITAMIN D 25 HYDROXY	$184.97	$349.00	$31.08–$135.11	—	47%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC VITAMIN D 25 HYDROXY	$184.97	$349.00	$31.08–$135.11	—	47%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC VIT D 1 25-DIHYDROXY	$214.65	$405.00	$40.43–$175.67	—	47%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC VIT D 1 25-DIHYDROXY	$214.65	$405.00	$40.43–$175.67	—	47%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC VIT D 1 25-DIHYDROXY	$214.65	$405.00	$40.43–$175.67	—	47%
Zinc blood test CPT 84630 HC ASSAY OF ZINC	$110.77	$209.00	$11.96–$49.28	—	47%
Zinc blood test CPT 84630 HC ASSAY OF ZINC	$110.77	$209.00	$11.96–$49.28	—	47%
Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC	$110.77	$209.00	$11.96–$49.28	—	47%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Balloon dilation of the maxillary sinus opening, one side CPT 31295 HC PBB NASAL/SINUS NDSC SURG W/DILATION MAXILLARY	$4,437.16	$8,372.00	$250.89–$7,504.19	—	47%
Balloon dilation of the maxillary sinus opening, one side CPT 31295 HC PBB NASAL/SINUS NDSC SURG W/DILATION MAXILLARY	$4,437.16	$8,372.00	$250.89–$7,504.19	—	47%
Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295 HC PBB NASAL/SINUS NDSC SURG W/DILATION MAXILLARY	$4,437.16	$8,372.00	$250.89–$7,504.19	—	47%
Cardiac catheterization with coronary angiogram CPT 93458 HC PBB L HRT ARTERY/VENTRICLE ANGIO	$1,881.50	$3,550.00	$446.32–$3,410.65	—	47%
Cardiac catheterization with coronary angiogram CPT 93458 HC PBB L HRT ARTERY/VENTRICLE ANGIO	$1,881.50	$3,550.00	$446.32–$3,410.65	—	47%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 HC PBB L HRT ARTERY/VENTRICLE ANGIO	$1,881.50	$3,550.00	$446.32–$3,410.65	—	47%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC PBB CARDIOVERSION ELECTRIC EXT	$237.44	$448.00	$174.11	—	47%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC PBB CARDIOVERSION ELECTRIC EXT	$237.44	$448.00	$174.11	—	47%
Cervical biopsy CPT 57500 HC 57500 BIOPSY OF CERVIX	$119.78	$226.00	$118.54–$145.04	—	47%
Cervical biopsy CPT 57500 HC 57500 BIOPSY OF CERVIX	$119.78	$226.00	$118.54–$145.04	—	47%
Cervical biopsy inpatient CPT 57500 HC 57500 BIOPSY OF CERVIX	$119.78	$226.00	$118.54–$145.04	—	47%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC PBB CIRCUMCISION W/REGIONL BLOCK	$154.76	$292.00	$152.29	—	47%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC PBB CIRCUMCISION W/REGIONL BLOCK	$154.76	$292.00	$152.29	—	47%
Circumcision, surgical, older than a newborn CPT 54160 HC PBB CIRCUMCISION NEONATE	$185.50	$350.00	$231.63	—	47%
Circumcision, surgical, older than a newborn inpatient CPT 54160 HC PBB CIRCUMCISION NEONATE	$185.50	$350.00	$231.63	—	47%
Colonoscopy with polyp removal CPT 45385 HC PBB LESION REMOVAL COLONOSCOPY	$2,205.33	$4,161.00	$400.74–$1,765.38	—	47%
Colonoscopy with polyp removal CPT 45385 HC PBB LESION REMOVAL COLONOSCOPY	$2,205.33	$4,161.00	$400.74–$1,765.38	—	47%
Colonoscopy with polyp removal inpatient CPT 45385 HC PBB LESION REMOVAL COLONOSCOPY	$2,205.33	$4,161.00	$400.74–$1,765.38	—	47%
Colonoscopy with tissue sample CPT 45380 HC PBB COLONOSCOPY AND BIOPSY	$2,205.33	$4,161.00	$316.47–$1,692.15	—	47%
Colonoscopy with tissue sample CPT 45380 HC PBB COLONOSCOPY AND BIOPSY	$2,205.33	$4,161.00	$316.47–$1,692.15	—	47%
Colonoscopy with tissue sample inpatient CPT 45380 HC PBB COLONOSCOPY AND BIOPSY	$2,205.33	$4,161.00	$316.47–$1,692.15	—	47%
Colonoscopy, diagnostic CPT 45378 HC PBB DIAGNOSTIC COLONOSCOPY	$2,031.49	$3,833.00	$290.63–$1,330.60	—	47%
Colonoscopy, diagnostic CPT 45378 HC PBB DIAGNOSTIC COLONOSCOPY	$2,031.49	$3,833.00	$290.63–$1,330.60	—	47%
Colonoscopy, diagnostic inpatient CPT 45378 HC PBB DIAGNOSTIC COLONOSCOPY	$2,031.49	$3,833.00	$290.63–$1,330.60	—	47%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 HC PBB BX OF CERVIX W/SCOPE LEEP	$310.58	$586.00	$251.26–$295.30	—	47%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 HC PBB BX OF CERVIX W/SCOPE LEEP	$310.58	$586.00	$251.26–$295.30	—	47%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 HC PBB BX OF CERVIX W/SCOPE LEEP	$310.58	$586.00	$251.26–$295.30	—	47%
Cystoscopy with ureteral stent placement CPT 52332 HC PBB CYSTOSCOPY AND TREATMENT	$775.39	$1,463.00	$244.31	—	47%
Cystoscopy with ureteral stent placement inpatient CPT 52332 HC PBB CYSTOSCOPY AND TREATMENT	$775.39	$1,463.00	$244.31	—	47%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC 17000 DESTROY BENIGN/PRE	$54.06	$102.00	$88.76	—	47%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC 17000 DESTROY BENIGN/PRE	$54.06	$102.00	$88.76	—	47%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 HC 69433 CREATE EARDRUM OPE	$157.94	$298.00	$214.28	—	47%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 HC 69433 CREATE EARDRUM OPE	$157.94	$298.00	$214.28	—	47%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HC 69209 REMOVAL IMPACTED CERUMEN IRRGTN	$27.03	$51.00	$24.80–$44.09	—	47%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HC 69209 REMOVAL IMPACTED CERUMEN IRRGTN	$27.03	$51.00	$24.80–$44.09	—	47%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC 69209 REMOVAL IMPACTED CERUMEN IRRGTN	$27.03	$51.00	$24.80–$44.09	—	47%
Earwax removal with instruments, one ear CPT 69210 HC 69210 REMOVE IMPACTED EA	$37.10	$70.00	$51.92	—	47%
Earwax removal with instruments, one ear inpatient CPT 69210 HC 69210 REMOVE IMPACTED EA	$37.10	$70.00	$51.92	—	47%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC PBB NJX INTERLAMINAR CRV/THRC	$287.26	$542.00	$171.05	—	47%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC PBB NJX INTERLAMINAR CRV/THRC	$287.26	$542.00	$171.05	—	47%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC PBB INJ PARAVERT F JNT L/S 1 LEV	$314.82	$594.00	$144.28	—	47%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC PBB INJ PARAVERT F JNT L/S 1 LEV	$314.82	$594.00	$144.28	—	47%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC PBB DIAGNOSTIC SIGMOIDOSCOPY	$984.21	$1,857.00	$88.88–$695.44	—	47%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC PBB DIAGNOSTIC SIGMOIDOSCOPY	$984.21	$1,857.00	$88.88–$695.44	—	47%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HC PBB DIAGNOSTIC SIGMOIDOSCOPY	$984.21	$1,857.00	$88.88–$695.44	—	47%
Hemorrhoid banding (rubber band ligation) CPT 46221 HC 46221 LIGATION OF HEMORR	$632.82	$1,194.00	$309.76–$1,089.04	—	47%
Hemorrhoid banding (rubber band ligation) CPT 46221 HC 46221 LIGATION OF HEMORR	$632.82	$1,194.00	$309.76–$1,089.04	—	47%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC 46221 LIGATION OF HEMORR	$632.82	$1,194.00	$309.76–$1,089.04	—	47%
Hemorrhoidectomy (internal and external), one area CPT 46255 HC PBB REMOVE INT/EXT HEM 1 GROUP	$348.21	$657.00	$564.89	—	47%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HC PBB REMOVE INT/EXT HEM 1 GROUP	$348.21	$657.00	$564.89	—	47%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC PBB CATHETER FOR HYSTEROGRAPHY	$215.71	$407.00	$90.98	—	47%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC PBB CATHETER FOR HYSTEROGRAPHY	$215.71	$407.00	$90.98	—	47%
Hysteroscopy with endometrial ablation CPT 58563 HC PBB HYSTEROSCOPY ABLATION	$3,525.56	$6,652.00	$386.92–$5,833.70	—	47%
Hysteroscopy with endometrial ablation CPT 58563 HC PBB HYSTEROSCOPY ABLATION	$3,525.56	$6,652.00	$386.92–$5,833.70	—	47%
Hysteroscopy with endometrial ablation inpatient CPT 58563 HC PBB HYSTEROSCOPY ABLATION	$3,525.56	$6,652.00	$386.92–$5,833.70	—	47%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC 20550 INJECT TENDON/LIGA	$46.64	$88.00	$61.98	—	47%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC 20550 INJECT TENDON/LIGA	$46.64	$88.00	$61.98	—	47%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC 11981 INSERT DRUG IMPLAN	$111.30	$210.00	$97.75	—	47%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC 11981 INSERT DRUG IMPLAN	$111.30	$210.00	$97.75	—	47%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC 20605 DRAIN/INJECT, JOIN	$41.34	$78.00	$58.50	—	47%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC INJECT/ASP MEDIUM JOINT	$461.10	$870.00	$58.50–$206.03	—	47%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC INJECT/ASP MEDIUM JOINT	$461.10	$870.00	$58.50–$206.03	—	47%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC 20605 DRAIN/INJECT, JOIN	$41.34	$78.00	$58.50	—	47%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC INJECT/ASP MEDIUM JOINT	$461.10	$870.00	$58.50–$206.03	—	47%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC INJECT/ASP SMALL JOINT	$212.53	$401.00	$56.44–$198.85	—	47%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC INJECT/ASP SMALL JOINT	$212.53	$401.00	$56.44–$198.85	—	47%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC INJECT/ASP SMALL JOINT	$212.53	$401.00	$56.44–$198.85	—	47%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC 12031 LAYER CLOSURE OF W	$178.61	$337.00	$243.42	—	47%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC 12031 LAYER CLOSURE OF W	$178.61	$337.00	$243.42	—	47%
Left heart catheterization, diagnostic one side CPT 93452 HC PBB LEFT HRT CATH W/VENTRCLGRPHY	$1,490.89	$2,813.00	$359.09–$2,806.62	—	47%
Left heart catheterization, diagnostic one side CPT 93452 HC PBB LEFT HRT CATH W/VENTRCLGRPHY	$1,490.89	$2,813.00	$359.09–$2,806.62	—	47%
Left heart catheterization, diagnostic inpatient one side CPT 93452 HC PBB LEFT HRT CATH W/VENTRCLGRPHY	$1,490.89	$2,813.00	$359.09–$2,806.62	—	47%
Lower-back epidural injection, with imaging guidance CPT 62323 HC PBB NJX INTERLAMINAR LMBR/SAC	$298.92	$564.00	$158.39	—	47%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC PBB NJX INTERLAMINAR LMBR/SAC	$298.92	$564.00	$158.39	—	47%
Lower-back epidural injection, without imaging guidance CPT 62322 HC PBB NJX INTERLAMINAR LMBR/SAC	$139.92	$264.00	$128.13	—	47%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC PBB NJX INTERLAMINAR LMBR/SAC	$139.92	$264.00	$128.13	—	47%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC PBB INJ FORAMEN EPIDURAL L/S	$450.50	$850.00	$177.84–$782.10	—	47%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC PBB INJ FORAMEN EPIDURAL L/S	$450.50	$850.00	$177.84–$782.10	—	47%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC PBB INJ FORAMEN EPIDURAL L/S	$450.50	$850.00	$177.84–$782.10	—	47%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 HC PBB MOHS 1 STAGE H/N/HF/G	$669.92	$1,264.00	$569.23	—	47%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals inpatient CPT 17311 HC PBB MOHS 1 STAGE H/N/HF/G	$669.92	$1,264.00	$569.23	—	47%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC 11400 REMOVAL OF SKIN LE	$92.22	$174.00	$135.56	—	47%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC 11400 REMOVAL OF SKIN LE	$92.22	$174.00	$135.56	—	47%
Nail removal (partial or complete), one nail CPT 11730 HC 11730 REMOVAL OF NAIL PL	$83.74	$158.00	$86.38	—	47%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC 11730 REMOVAL OF NAIL PL	$83.74	$158.00	$86.38	—	47%
Occipital nerve block (injection for headaches) CPT 64405 HC 64405 INJECTION FOR NERV	$76.85	$145.00	$80.56	—	47%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC 64405 INJECTION FOR NERV	$76.85	$145.00	$80.56	—	47%
Paracentesis with imaging guidance CPT 49083 HC PBB ABD PARACENTESIS W/IMAGING	$575.58	$1,086.00	$169.56–$1,034.34	—	47%
Paracentesis with imaging guidance CPT 49083 HC PBB ABD PARACENTESIS W/IMAGING	$575.58	$1,086.00	$169.56–$1,034.34	—	47%
Paracentesis with imaging guidance inpatient CPT 49083 HC PBB ABD PARACENTESIS W/IMAGING	$575.58	$1,086.00	$169.56–$1,034.34	—	47%
Prostate biopsy CPT 55700 HC 55700 BIOPSY OF PROSTATE	$272.95	$515.00	$204.71	—	47%
Prostate biopsy inpatient CPT 55700 HC 55700 BIOPSY OF PROSTATE	$272.95	$515.00	$204.71	—	47%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC PBB DESTROY LUMB/SAC FACET JNT	$507.21	$957.00	$308.33	—	47%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC PBB DESTROY LUMB/SAC FACET JNT	$507.21	$957.00	$308.33	—	47%
Removal of a foreign object under the skin, simple CPT 10120 HC 10120 REMOVE FOREIGN BODY SIMPLE	$95.40	$180.00	$169.13	—	47%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC 10120 REMOVE FOREIGN BODY SIMPLE	$95.40	$180.00	$169.13	—	47%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC PBB COLORECTAL SCREEN NOT HIH	$1,903.76	$3,592.00	$290.80–$1,309.79	—	47%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC PBB COLORECTAL SCREEN NOT HIH	$1,903.76	$3,592.00	$290.80–$1,309.79	—	47%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 HC PBB COLORECTAL SCREEN NOT HIH	$1,903.76	$3,592.00	$290.80–$1,309.79	—	47%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC PBB COLONOSCOPY,FLEX DIAG	$1,951.46	$3,682.00	$290.63–$1,308.84	—	47%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC PBB COLONOSCOPY,FLEX DIAG	$1,951.46	$3,682.00	$290.63–$1,308.84	—	47%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 HC PBB COLONOSCOPY,FLEX DIAG	$1,951.46	$3,682.00	$290.63–$1,308.84	—	47%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 HC PBB FRAGMENTING OF KIDNEY STONE	$754.72	$1,424.00	$909.26	—	47%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 HC PBB FRAGMENTING OF KIDNEY STONE	$754.72	$1,424.00	$909.26	—	47%
Short arm cast (elbow to hand) CPT 29075 HC 29075 APPLICATION OF FOR	$54.59	$103.00	$98.87	—	47%
Short arm cast (elbow to hand) inpatient CPT 29075 HC 29075 APPLICATION OF FOR	$54.59	$103.00	$98.87	—	47%
Short arm splint (forearm and hand) CPT 29125 HC 29125 APPLY FOREARM SPLI	$56.18	$106.00	$64.00	—	47%
Short arm splint (forearm and hand) inpatient CPT 29125 HC 29125 APPLY FOREARM SPLI	$56.18	$106.00	$64.00	—	47%
Short leg cast (below the knee) CPT 29405 HC 29405 APPLY SHORT LEG CA	$77.91	$147.00	$93.13	—	47%
Short leg cast (below the knee) inpatient CPT 29405 HC 29405 APPLY SHORT LEG CA	$77.91	$147.00	$93.13	—	47%
Short leg splint (calf to foot) CPT 29515 HC 29515 APPLICATION LOWER	$47.17	$89.00	$78.52	—	47%
Short leg splint (calf to foot) inpatient CPT 29515 HC 29515 APPLICATION LOWER	$47.17	$89.00	$78.52	—	47%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC 12001 REPAIR SUPERFICIAL	$95.40	$180.00	$69.53	—	47%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC 12001 REPAIR SUPERFICIAL	$95.40	$180.00	$69.53	—	47%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 HC 11600 REMOVAL OF SKIN LE	$157.41	$297.00	$195.84	—	47%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 HC 11600 REMOVAL OF SKIN LE	$157.41	$297.00	$195.84	—	47%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC PBB SPINAL FLUID TAP DIAGNOSTIC	$177.55	$335.00	$96.88	—	47%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC PBB SPINAL FLUID TAP DIAGNOSTIC	$177.55	$335.00	$96.88	—	47%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC 12002 REPAIR SUPERFICIAL	$90.10	$170.00	$91.00	—	47%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC 12002 REPAIR SUPERFICIAL	$90.10	$170.00	$91.00	—	47%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC 12011 REPAIR SUPERFICIAL	$107.06	$202.00	$85.51	—	47%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC 12011 REPAIR SUPERFICIAL	$107.06	$202.00	$85.51	—	47%
Thoracentesis with imaging guidance CPT 32555 HC PBB THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$917.43	$1,731.00	$1,022.54–$1,242.22	—	47%
Trigger finger release surgery CPT 26055 HC 26055 INCISE FINGER TEND	$555.97	$1,049.00	$472.60	—	47%
Trigger finger release surgery inpatient CPT 26055 HC 26055 INCISE FINGER TEND	$555.97	$1,049.00	$472.60	—	47%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC PBB ESOPH ENDOSCOPY DILATION	$357.75	$675.00	$242.06	—	47%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC PBB ESOPH ENDOSCOPY DILATION	$357.75	$675.00	$242.06	—	47%
Upper endoscopy (EGD) with biopsy CPT 43239 HC PBB UPPER GI ENDOSCOPY BIOPSY	$2,318.75	$4,375.00	$218.45–$1,484.73	—	47%
Upper endoscopy (EGD) with biopsy CPT 43239 HC PBB UPPER GI ENDOSCOPY BIOPSY	$2,318.75	$4,375.00	$218.45–$1,484.73	—	47%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC PBB UPPER GI ENDOSCOPY BIOPSY	$2,318.75	$4,375.00	$218.45–$1,484.73	—	47%
Upper endoscopy (EGD) with injection into the lining CPT 43236 HC PBB UPPR GI SCOPE W/SUBMUC INJ	$770.62	$1,454.00	$218.09–$1,361.59	—	47%
Upper endoscopy (EGD) with injection into the lining CPT 43236 HC PBB UPPR GI SCOPE W/SUBMUC INJ	$770.62	$1,454.00	$218.09–$1,361.59	—	47%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 HC PBB UPPR GI SCOPE W/SUBMUC INJ	$770.62	$1,454.00	$218.09–$1,361.59	—	47%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HC PBB OPERATIVE UPPER GI ENDOSCOPY	$259.17	$489.00	$309.30	—	47%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 HC PBB OPERATIVE UPPER GI ENDOSCOPY	$259.17	$489.00	$309.30	—	47%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HC PBB UPPR GI ENDOSCOPY/GUIDE WIRE	$2,318.75	$4,375.00	$262.09–$1,546.73	—	47%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HC PBB UPPR GI ENDOSCOPY/GUIDE WIRE	$2,318.75	$4,375.00	$262.09–$1,546.73	—	47%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 HC PBB UPPR GI ENDOSCOPY/GUIDE WIRE	$2,318.75	$4,375.00	$262.09–$1,546.73	—	47%
Upper endoscopy (EGD), diagnostic CPT 43235 HC PBB UPPR GI ENDOSCOPY DIAGNOSIS	$2,184.66	$4,122.00	$193.51–$1,112.21	—	47%
Upper endoscopy (EGD), diagnostic CPT 43235 HC PBB UPPR GI ENDOSCOPY DIAGNOSIS	$2,184.66	$4,122.00	$193.51–$1,112.21	—	47%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC PBB UPPR GI ENDOSCOPY DIAGNOSIS	$2,184.66	$4,122.00	$193.51–$1,112.21	—	47%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 HC 55250 REMOVAL OF SPERM D	$411.28	$776.00	$367.20	—	47%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 HC 55250 REMOVAL OF SPERM D	$411.28	$776.00	$367.20	—	47%
Vein ablation, radiofrequency, first vein CPT 36475 HC PBB ENDOVENOUS RF 1ST VEIN	$3,429.10	$6,470.00	$419.53–$5,407.33	—	47%
Vein ablation, radiofrequency, first vein CPT 36475 HC PBB ENDOVENOUS RF 1ST VEIN	$3,429.10	$6,470.00	$419.53–$5,407.33	—	47%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 HC PBB ENDOVENOUS RF 1ST VEIN	$3,429.10	$6,470.00	$419.53–$5,407.33	—	47%
Wart removal, up to 14 warts CPT 17110 HC 17110 DESTROY BENIGN LES	$90.63	$171.00	$108.90	—	47%
Wart removal, up to 14 warts inpatient CPT 17110 HC 17110 DESTROY BENIGN LES	$90.63	$171.00	$108.90	—	47%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC 11042 DEBRIDE SKIN/TISSU	$86.92	$164.00	$95.39	—	47%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC 11042 DEBRIDE SKIN/TISSU	$86.92	$164.00	$95.39	—	47%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC PBB BLOOD TRANSFUSION SERVICE	$112.36	$212.00	$63.29–$137.15	—	47%
Blood transfusion (giving blood or blood components) CPT 36430 HC PBB BLOOD TRANSFUSION SERVICE	$112.36	$212.00	$63.29–$137.15	—	47%
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION SERVICE	$739.35	$1,395.00	$120.37–$137.15	—	47%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC PBB BLOOD TRANSFUSION SERVICE	$112.36	$212.00	$63.29–$137.15	—	47%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC 94640 AIRWAY INHALATION TREATMENT	$37.10	$70.00	$14.42–$62.53	—	47%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC 94640 AIRWAY INHALATION TREATMENT	$37.10	$70.00	$14.42–$62.53	—	47%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC 94640 AIRWAY INHALATION TREATMENT	$37.10	$70.00	$14.42–$62.53	—	47%
Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO INFUSION INITIAL UP TO 1 HR	$340.79	$643.00	$211.68–$512.30	—	47%
Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO INFUSION INITIAL UP TO 1 HR	$340.79	$643.00	$211.68–$512.30	—	47%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO INFUSION INITIAL UP TO 1 HR	$340.79	$643.00	$211.68–$512.30	—	47%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC PBB EEG AWAKE AND DROWSY	$721.33	$1,361.00	$91.95–$1,305.87	—	47%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC PBB EEG AWAKE AND DROWSY	$721.33	$1,361.00	$91.95–$1,305.87	—	47%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC PBB EEG AWAKE AND DROWSY	$721.33	$1,361.00	$91.95–$1,305.87	—	47%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC PBB ELECTROCARDIOGRAM TRACING	$45.58	$86.00	$10.03–$29.56	—	47%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC PBB ELECTROCARDIOGRAM TRACING	$45.58	$86.00	$10.03–$29.56	—	47%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC PBB ELECTROCARDIOGRAM TRACING	$45.58	$86.00	$10.03–$29.56	—	47%
Electroconvulsive therapy (ECT), one session CPT 90870 HC 90870 ELECTROCONVULSIVE	$121.37	$229.00	$173.74	—	47%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 HC 90870 ELECTROCONVULSIVE	$121.37	$229.00	$173.74	—	47%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC 93017 CARDIOVASCULAR STRESS TEST	$217.30	$410.00	$57.83–$123.75	—	47%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC 93017 CARDIOVASCULAR STRESS TEST	$217.30	$410.00	$57.83–$123.75	—	47%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC 93017 CARDIOVASCULAR STRESS TEST	$217.30	$410.00	$57.83–$123.75	—	47%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC 96360IV HYDRATION 31 MIN-1 HR	$133.03	$251.00	$53.21–$181.30	—	47%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC 96360IV HYDRATION 31 MIN-1 HR	$133.03	$251.00	$53.21–$181.30	—	47%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC 96360IV HYDRATION 31 MIN-1 HR	$133.03	$251.00	$53.21–$181.30	—	47%
IV infusion of a medicine, first hour CPT 96365 HC 96365 THER/PROPH/DG IV I	$162.18	$306.00	$103.67–$250.68	—	47%
IV infusion of a medicine, first hour CPT 96365 HC 96365 THER/PROPH/DG IV I	$162.18	$306.00	$103.67–$250.68	—	47%
IV infusion of a medicine, first hour inpatient CPT 96365 HC 96365 THER/PROPH/DG IV I	$162.18	$306.00	$103.67–$250.68	—	47%
IV push of a medicine, first drug CPT 96374 HC 96374 THER/PROPH/DG IV PUSH	$128.79	$243.00	$60.54–$179.78	—	47%
IV push of a medicine, first drug CPT 96374 HC 96374 THER/PROPH/DG IV PUSH	$128.79	$243.00	$60.54–$179.78	—	47%
IV push of a medicine, first drug inpatient CPT 96374 HC 96374 THER/PROPH/DG IV PUSH	$128.79	$243.00	$60.54–$179.78	—	47%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJ SC/IM THER/PROPH/DIAG	$54.59	$103.00	$23.10–$80.62	—	47%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJ SC/IM THER/PROPH/DIAG	$54.59	$103.00	$23.10–$80.62	—	47%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJ SC/IM THER/PROPH/DIAG	$54.59	$103.00	$23.10–$80.62	—	47%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 HC 95910 MOTOR & SENSE 7-8	$187.09	$353.00	$117.30–$350.43	—	47%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 HC 95910 MOTOR & SENSE 7-8	$187.09	$353.00	$117.30–$350.43	—	47%
Neuromuscular re-education, 15 minutes CPT 97112 HC PBB NEUROMUSCULAR REEDUCATION	$68.90	$130.00	$43.05–$108.74	28% below	47%
Neuromuscular re-education, 15 minutes CPT 97112 HC PBB NEUROMUSCULAR REEDUCATION	$68.90	$130.00	$43.05–$108.74	28% below	47%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC PBB NEUROMUSCULAR REEDUCATION	$68.90	$130.00	$43.05–$108.74	—	47%
New patient office visit, about 60 minutes CPT 99205 HC PBB OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES	$151.58	$286.00	$209.02	—	47%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC PBB MANUAL THERAPY	$61.48	$116.00	$34.40–$96.69	37% below	47%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC PBB MANUAL THERAPY	$61.48	$116.00	$34.40–$96.69	37% below	47%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC PBB MANUAL THERAPY	$61.48	$116.00	$34.40–$96.69	—	47%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC 97110 THERAPEUTIC EXERCI	$66.78	$126.00	$37.41–$104.21	31% below	47%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC 97110 THERAPEUTIC EXERCI	$66.78	$126.00	$37.41–$104.21	31% below	47%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC 97110 THERAPEUTIC EXERCI	$66.78	$126.00	$37.41–$104.21	—	47%
Preventive checkup, returning patient aged 65 or older CPT 99397 HC 99397 PREVENTIVE VISIT,EST,65 & OVER	$50.88	$96.00	$86.74	—	47%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC BEHAV CHNG SMOKING 3-10 MIN	$30.74	$58.00	$19.11–$36.68	—	47%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC BEHAV CHNG SMOKING 3-10 MIN	$30.74	$58.00	$19.11–$36.68	—	47%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC BEHAV CHNG SMOKING 3-10 MIN	$30.74	$58.00	$19.11–$36.68	—	47%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC PBB OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MI	$58.30	$110.00	$86.74–$106.79	—	47%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC PBB OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MI	$58.30	$110.00	$86.74–$106.79	—	47%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC PBB OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MI	$58.30	$110.00	$86.74–$106.79	—	47%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC PBB OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MI	$75.26	$142.00	$122.48	—	47%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC PBB OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MIN	$58.30	$110.00	$53.91–$107.67	—	47%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC PBB OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MIN	$58.30	$110.00	$53.91–$107.67	—	47%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC PBB OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MIN	$58.30	$110.00	$53.91–$107.67	—	47%
Spirometry (breathing test) CPT 94010 HC 94010TC BREATHING CAPACI	$85.86	$162.00	$13.26–$126.21	—	47%
Spirometry (breathing test) CPT 94010 HC 94010TC BREATHING CAPACI	$85.86	$162.00	$13.26–$126.21	—	47%
Spirometry (breathing test) inpatient CPT 94010 HC 94010TC BREATHING CAPACI	$85.86	$162.00	$13.26–$126.21	—	47%
Spirometry before and after a bronchodilator CPT 94060 HC 94060 TC EVAL OF BRONCHOSPASM	$121.37	$229.00	$16.69–$210.94	—	47%
Spirometry before and after a bronchodilator CPT 94060 HC 94060 TC EVAL OF BRONCHOSPASM	$121.37	$229.00	$16.69–$210.94	—	47%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC 94060 TC EVAL OF BRONCHOSPASM	$121.37	$229.00	$16.69–$210.94	—	47%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC 97530 THERAPEUTIC ACTIVI	$70.49	$133.00	$48.01–$112.53	22% below	47%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC 97530 THERAPEUTIC ACTIVI	$70.49	$133.00	$48.01–$112.53	22% below	47%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC 97530 THERAPEUTIC ACTIVI	$70.49	$133.00	$48.01–$112.53	—	47%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC 99195 PHLEBOTOMY	$175.96	$332.00	$156.52–$314.52	—	47%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC 99195 PHLEBOTOMY	$175.96	$332.00	$156.52–$314.52	—	47%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC 99195 PHLEBOTOMY	$175.96	$332.00	$156.52–$314.52	—	47%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 HC PBB CARDIOVASCULAR STRESS TEST	$438.84	$828.00	$242.65–$255.19	—	47%
Visual field test, extended CPT 92083 HC PBB VISUAL FIELD EXAMINATION(S)	$95.93	$181.00	$44.30–$125.87	—	47%
Visual field test, extended inpatient CPT 92083 HC PBB VISUAL FIELD EXAMINATION(S)	$95.93	$181.00	$44.30–$125.87	—	47%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 HC 90653 IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR	$51.94	$98.00	$49.00	—	47%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 HC 90696 KINRIX DTAP-IPV (C	$64.13	$121.00	$74.20–$76.79	—	47%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 HC 90700 VAC-STAP ACELLULAR PERTUS	$39.22	$74.00	$34.87–$58.38	—	47%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HC PBB DTAP-HEPB-IPV VACCINE IM	$106.53	$201.00	$117.56–$187.79	—	47%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 HC RIV3 VACCINE NO PRESERV IM	$51.94	$98.00	$49.00	—	47%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 HC 90656 INFLUENZA	$19.61	$37.00	$21.07–$36.88	—	47%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACC TS2024-25(6MOS UP)/PF SYRINGE 1	$46.48	$87.69	$21.07–$59.69	—	47%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACC TS2024-25(6MOS UP)/PF SYRINGE 1	$46.48	$87.69	$21.07–$59.69	—	47%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC PBB 9VHPV VACCINE 3 DOSE IM	$204.58	$386.00	$369.13	—	47%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HC 90636 TWINRIX VACCINE	$133.56	$252.00	$151.44–$213.39	—	47%
Hepatitis A vaccine, adult dose CPT 90632 HC 90632 HEP A VACCINE, ADU	$87.98	$166.00	$98.52–$155.83	—	47%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HC 90632 HEP A VACCINE, ADU	$87.98	$166.00	$98.52–$155.83	—	47%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HC 90633 HEP A VACCINE ADOL	$63.60	$120.00	$46.12–$119.04	—	47%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HC 90746 HEP B VACCINE, ADU	$112.36	$212.00	$83.11–$211.30	—	47%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HC 90746 HEP B VACCINE, ADU	$112.36	$212.00	$83.11–$211.30	—	47%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HC 90647 PEDVAX (HIB 3 DOSE	$41.34	$78.00	$36.70–$60.29	—	47%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HC 90648 HIB PRP-T 4 DOSE A	$39.75	$75.00	$15.43–$42.52	—	47%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 HC 90662 HD FLUZONE	$46.64	$88.00	$80.43	—	47%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACC TS2024-25(65YR UP)/PF 180MCG/0.5 ML SYRIN	$133.15	$251.23	$100.19–$220.36	—	47%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACC TS2024-25(65YR UP)/PF 180MCG/0.5 ML SYRIN	$133.15	$251.23	$100.19–$220.36	—	47%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 HC 90738 JAPANESE ENCEPH VACC, INACTIVATED, IM	$232.14	$438.00	$212.29–$335.35	—	47%
MMR vaccine (measles, mumps and rubella), live CPT 90707 HC 90707 MMR VACCINE, SC	$72.61	$137.00	$112.62–$114.24	—	47%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 HC 90710 MMR/VARICELLA	$195.04	$368.00	$218.94–$333.79	—	47%
Meningococcal B vaccine (Trumenba) CPT 90621 HC 90621 MENB-FHBP RECOMBNT LIPOPROTEIN VACC 2/3 D	$159.53	$301.00	$228.31–$247.88	—	47%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 HC 90670 PNEUMOCOCCAL VAC,	$234.26	$442.00	$296.69–$425.68	—	47%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HC PBB PNEUMOCOCCAL VACCINE	$94.34	$178.00	$140.50–$153.49	—	47%
Polio vaccine, inactivated (IPV) CPT 90713 HC 90713 POLIOVIRUS, IPV, S	$41.34	$78.00	$51.17–$53.68	—	47%
Rabies vaccine, one dose CPT 90675 HC 90675 RABIES VACCINE	$383.72	$724.00	$408.50–$700.28	—	47%
Rabies vaccine, one dose inpatient CPT 90675 HC 90675 RABIES VACCINE	$383.72	$724.00	$408.50–$700.28	—	47%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 HC 90681 ROTAVIRUS, 2 DOSE	$129.85	$245.00	$166.49–$241.63	—	47%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 HC 90714 TD PRESERVATIVE FR	$36.57	$69.00	$44.52–$67.92	—	47%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 HC 90714 TD PRESERVATIVE FR	$36.57	$69.00	$44.52–$67.92	—	47%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC 90715 TDAP VACCINE >7 IM	$36.57	$69.00	$43.12–$63.74	—	47%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 HC 90691 TYPHOID INJECTION	$113.95	$215.00	$167.51–$194.95	—	47%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADMIN	$38.69	$73.00	$32.96–$52.82	—	47%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADMIN	$38.69	$73.00	$32.96–$52.82	—	47%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZATION ADMIN	$38.69	$73.00	$32.96–$52.82	—	47%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZATION ADMIN EACH ADD	$18.55	$35.00	$23.60	—	47%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC IMMUNIZATION ADMIN EACH ADD	$18.55	$35.00	$23.60	—	47%

Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More

Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More

List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More

Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More

Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.

Off list How much lower the cash price is than the list price.

No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More

At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More

Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://healthcare.ascension.org/-/media/project/ascension/healthcare/price-transparency-files/wi-csv/390902199_sacred-heart-rehabilitation-institute-inc_standardcharges.csv