Aurora Hospitals CM Pricing
Note: Pharmacy and Supply pricing may vary based on exact item or dosage. Please call Customer Service line for further assistance.FacilityChargecodeCC DescriptionRevCPT1/1/24 FeeKENOSHA10000002ROOM CHARGE MED SURG121 2,010.00KENOSHA10000003ROOM CHARGE WOMEN’S HEALTH122 2,010.00KENOSHA10000004ROOM CHARGE PEDIATRICS123 2,010.00KENOSHA10000005ROOM CHARGE NURSERY LEVEL 1171 1,730.00KENOSHA10000006ROOM CHARGE NURSERY LEVEL 2172 2,120.00KENOSHA10000007ROOM CHARGE NURSERY LEVEL 3173 2,840.00KENOSHA10000008ROOM CHARGE ICU OR CCU200 2,920.00KENOSHA10000009LACTATION CONSULT EXTENDED230 215.00KENOSHA10000010LACTATION CONSULT LIMITED230 145.00KENOSHA10000013PHOTOTHERAPY, PER DAY231 360.00KENOSHA10000016NURSING L&D PER HOUR232 135.00KENOSHA10000019BREAST ASPIRATE CYST EA ADDL36019001410.00KENOSHA10000033ARTHROGRAM SHOULDER INJECT32023350880.00KENOSHA10000034ARTHROGRAM ELBOW INJECT32024220880.00KENOSHA10000035ARTHROGRAM WRIST INJECT32025246880.00KENOSHA10000036ARTHROGRAM HIP INJECT32027093880.00KENOSHA10000037ARTHROGRAM KNEE INJECT32027369880.00KENOSHA10000075HANDLING FEE3009900120.00KENOSHA10000080SELECTIVE CATH 1ST ORDER THORACIC360362152,140.00KENOSHA10000081SELECTIVE CATH 2ND ORDER THORACIC360362162,140.00KENOSHA10000082SELECTIVE CATH 3RD ORDER THORACIC360362172,140.00KENOSHA10000084SELECTIVE CATH 2&3 THORARIC ADDL360362181,070.00KENOSHA10000085SELECTIVE CATH 1ST ORDER ABD/PELVIC360362452,660.00KENOSHA10000086SELECTIVE CATH 2ND ABD/PELVIC/EXTREM360362462,660.00KENOSHA10000087SELECTIVE CATH 3RD ABD/PELVIC/EXTREM360362472,660.00KENOSHA10000088SELECTIVE CATH 2&3 ABD/PELVIC/EXTREM/ADDL360362481,330.00KENOSHA10000089SCLEROTHERAPY SINGLE VEIN36036470285.00KENOSHA10000090SCLEROTHERAPY MULTIPLE VEINS36036471425.00KENOSHA10000091ABLATION VARICOSE VEIN LASER 1ST360364788,110.00KENOSHA10000092CATH VENOUS BLOOD SAMPLING360365001,450.00KENOSHA10000093CATH UMBILICAL VEIN36036510660.00KENOSHA10000096INSERT CVL TUNNELED 5 YRS >/=360365582,860.00KENOSHA10000098INSERT CVL TUNNELED W/PORT 5 YRS >/=360365614,590.00KENOSHA10000100INSERT CVL DUAL TUNNELED WO PORT360365655,700.00KENOSHA10000101INSERT CVL DUAL TUNNELED W/PORT360365665,700.00KENOSHA10000102PICC LINE INSERTION <5 YRS360365681,750.00KENOSHA10000103PICC INSERTION360365692,070.00KENOSHA10000105INSERT PICC W/PORT 5 YRS >/=360365714,110.00KENOSHA10000106REPAIR CVL CATH360365751,160.00KENOSHA10000109REPLACE CVL NON TUNNELED COMPLETE360365802,140.00KENOSHA10000110REPLACE CVL TUNNELED COMPLETE360365814,280.00KENOSHA10000111REPLACE CVL TUNNELED W/PORT COMPLETE360365825,530.00KENOSHA10000113REPLACE PICC COMPLETE360365841,730.00KENOSHA10000115REMOVE CVL TUNNELED W/O PORT360365891,270.00KENOSHA10000116REMOVE CVL TUNNELED W/PORT360365902,070.00KENOSHA10000117BLOOD SPEC IMPLANTED DEVICE51036591160.00KENOSHA10000118REMOVE PERICATH OBSTRUCTIVE MATERIAL360365954,140.00KENOSHA10000120INJECT W FLUORO EVAL CENTRAL LINE36036598720.00KENOSHA10000121THROMBECTOMY VEIN(S)360371879,280.00KENOSHA10000122THROMBECTOMY VEIN(S) REPEAT360371889,280.00KENOSHA10000129PHLEBECTOMY 10-20 INCISIONS360377656,510.00KENOSHA10000130PHLEBECTOMY >20 INCISIONS360377667,540.00KENOSHA10000131PHLEBECTOMY <10 INCISIONS360377994,950.00KENOSHA10000134BONE MARROW BIOPSY360382211,120.00KENOSHA10000137INJECT RADIOACTIVE TRACER SENTINEL NODE36038792490.00KENOSHA10000139BX SALIVARY GLAND NEEDLE360424001,380.00KENOSHA10000142FB REMOVAL PHARYNGEAL45042809270.00KENOSHA10000143PEG TUBE PLACEMENT360432463,470.00KENOSHA10000145INTRO FEEDING TUBE36044500870.00KENOSHA10000149ANOSCOPY51046600305.00KENOSHA10000150LIVER BIOPSY360470002,000.00KENOSHA10000151PERCUTANEOUS CHOLECYSTOSTOMY360474905,040.00KENOSHA10000158BILIARY ENDOSCOPY WO STENT360475554,380.00KENOSHA10000159BILIARY ENDOSCOPY W STENT360475565,030.00KENOSHA10000165IMPLANT TISSUE MARKER PANCREAS360494116,460.00KENOSHA10000169PLACE INTERSTITIAL DVC ABD/PELV360494116,460.00KENOSHA10000172INSERT INTRAPERITONEAL CATH TUNNEL360494186,650.00KENOSHA10000173INSERT DIALYSIS CATH PERMANENT360494215,960.00KENOSHA10000174REMOVE PERITONEAL CATH W PORT360494224,550.00KENOSHA10000177INSERT GASTROSTOMY TUBE W S&I360494401,890.00KENOSHA10000178INSERT DUODENUM/J-TUBE W/S&I360494412,140.00KENOSHA10000180CONVERT TO G-J TUBE W/S&I360494461,730.00KENOSHA10000181CHANGE TUBE GASTRO/CECUM W/S&I360494501,270.00KENOSHA10000182CHANGE TUBE SM BOWEL W/S&I360494511,270.00KENOSHA10000183CHANGE G-J TUBE W/S&I360494521,020.00KENOSHA10000184CLEAR OBSTRUCTED GI TUBE W/S&I360494601,270.00KENOSHA10000185INJECTIONS GI TUBE EVAL W/S&I320494651,180.00KENOSHA10000187BX OMENTUM NEEDLE360499996,330.00KENOSHA10000190REMOVE URETERAL STENT-PERC S&I360503844,330.00KENOSHA10000191CHANGE URETERAL STENT S&I360503854,250.00KENOSHA10000194REMOVE NEPHROSTOMY TUBE/FLUORO360503891,160.00KENOSHA10000195ASPIRATE RENAL CYST/PELVIS360503902,070.00KENOSHA10000198CRYOABLATION RENAL TUMOR(S)3605059320,580.00KENOSHA10000199CHANGE URETEROSTOMY TUBE360506882,690.00KENOSHA10000202INSERT SUPRAPUBIC CATH360 3,590.00KENOSHA10000203INJECT CYSTOGRAM32051600725.00KENOSHA10000204INJECT URETHROGRAM RETROGRADE36051610855.00KENOSHA10000205BLADDER IRRIGATE OR INSTALLATION36051700520.00KENOSHA10000206STRAIGHT CATH51051701225.00KENOSHA10000207FOLEY CATH INSERTION51051702375.00KENOSHA10000208BLADDER CATH COMPLEX36051703625.00KENOSHA10000209CYSTOSTOMY TUBE CHANGE36051705405.00KENOSHA10000210BLADDER SCAN-RESIDUAL URINE40251798230.00KENOSHA10000211URINARY PROCEDURE MISC36053899305.00KENOSHA10000212CIRCUMCISION36054150230.00KENOSHA10000214PROSTATE, NEEDLE BIOPSIES360557002,300.00KENOSHA10000216HYSTEROSALPINGOGRAM INJECT360583401,270.00KENOSHA10000220TUBAL LIGATION POST PARTUM720586051,760.00KENOSHA10000221TUBAL LIGATION ADD-ON TO C-SECTION72058611655.00KENOSHA10000223AMNIOCENTESIS, DIAGNOSTIC40259000520.00KENOSHA10000226FETAL CONTRACTION STRESS TEST92059020905.00KENOSHA10000227FETAL NON STRESS TEST72059025525.00KENOSHA10000230D&C720 2,630.00KENOSHA10000231CERVICAL DILATOR INSERTION72059200730.00KENOSHA10000233VAGINAL DELIVERY ONLY450594094,490.00KENOSHA10000234VERSION, W/WO TOCOLYSIS720594121,470.00KENOSHA10000235DELIVERY PLACENTA720594141,220.00KENOSHA10000236AMNIOINFUSION72059899485.00KENOSHA10000237INTRAUTERINE PRESSURE MONITORING72059899435.00KENOSHA10000238BX THYROID NEEDLE360601001,440.00KENOSHA10000239UNLISTED PROCEDURE ENDOCRINE SYSTEM360606997,010.00KENOSHA10000251LUMBAR PUNCTURE DIAGNOSTIC360622701,100.00KENOSHA10000252EPIDURAL BLOOD OR CLOT PATCH360622731,900.00KENOSHA10000253INJECT FOR MYELOGRAM OR CT LUMBAR360622841,100.00KENOSHA10000254DISKECTOMY/PERCUTANEOUS LUMBAR360622876,670.00KENOSHA10000258EPIDURAL INJ 1ST LEVEL W/ IMAGING360 3,340.00KENOSHA10000259INJECT NERVE OCCIPITAL36064405980.00KENOSHA10000261NERVE BLOCK CELIAC PLEXUS360645302,460.00KENOSHA10000266FB CORNEA NO SLIT51665220435.00KENOSHA10000267FB CORNEA W/SLIT51665222435.00KENOSHA10000269FB REMOVAL EAR51669200150.00KENOSHA10000270REMOVE EAR WAX W/INSTRUMENT UNILAT51069210100.00KENOSHA10000272CISTERNOGRAM S&I320700151,750.00KENOSHA10000273XR EYE FOREIGN BODY32070030265.00KENOSHA10000274XR MANDIBLE PARTIAL32070100560.00KENOSHA10000275XR MANDIBLE COMPLETE32070110750.00KENOSHA10000276XR FACIAL BONES < 3 VIEW32070140520.00KENOSHA10000277XR FACIAL BONES COMPLETE32070150770.00KENOSHA10000278XR NASAL BONES32070160635.00KENOSHA10000280XR ORBITS MINIMUM 4 VIEWS32070200625.00KENOSHA10000281XR SINUSES < 3 VIEW32070210540.00KENOSHA10000282XR SINUSES COMPLETE32070220815.00KENOSHA10000283XR SKULL < 4 VIEW32070250535.00KENOSHA10000284XR SKULL COMPLETE32070260800.00KENOSHA10000290XR NECK SOFT TISSUES32070360535.00KENOSHA10000293CT HEAD W/O DYE350704502,800.00KENOSHA10000294CT HEAD W/DYE350704603,000.00KENOSHA10000295CT HEAD W/WO DYE350704704,400.00KENOSHA10000296CT ORBIT/SELLA/FOSSA/MASTOID/EAR W/O DYE350704802,800.00KENOSHA10000297CT ORBIT/SELLA/FOSSA/MASTOID/EAR W/DYE350704813,000.00KENOSHA10000298CT ORBIT/SELLA/FOSSA/MASTOID/EAR W/WO DYE350704824,400.00KENOSHA10000299CT MAXILLIOFACIAL W/O DYE350704862,800.00KENOSHA10000303CT MAXILLIOFACIAL W/DYE350704873,000.00KENOSHA10000304CT MAXILLIOFACL W/WO DYE350704884,400.00KENOSHA10000305CT NECK W/O DYE350704902,800.00KENOSHA10000306CT NECK W/DYE350704913,000.00KENOSHA10000307CT NECK W/WO DYE350704924,400.00KENOSHA10000308CT ANGIO HEAD350704963,720.00KENOSHA10000309CT ANGIO NECK350704983,720.00KENOSHA10000310MR ORBIT/FACE/NECK W/O DYE610705404,040.00KENOSHA10000311MR ORBIT/FACE/NECK W/DYE610705424,240.00KENOSHA10000312MR ORBIT/FACE/NECK W/WO DYE610705436,260.00KENOSHA10000313MRA HEAD W/O DYE610705444,040.00KENOSHA10000314MRA HEAD W/DYE610705454,240.00KENOSHA10000315MRA HEAD W/WO DYE610705466,260.00KENOSHA10000316MRA NECK W/O DYE610705474,040.00KENOSHA10000317MRA NECK W/DYE610705484,240.00KENOSHA10000318MRA NECK W/WO DYE610705496,260.00KENOSHA10000319MR BRAIN W/O DYE610705514,040.00KENOSHA10000320MR BRAIN W/DYE610705524,240.00KENOSHA10000321MR BRAIN W/WO DYE610705536,260.00KENOSHA10000324XR CHEST 1 VIEW32071045505.00KENOSHA10000325XR CHEST 2 VIEWS32071046600.00KENOSHA10000326XR CHEST 3 VIEWS32071047750.00KENOSHA10000328XR CHEST 4 + VIEWS32071048840.00KENOSHA10000331XR RIBS BILATERAL 3 VIEW32071110895.00KENOSHA10000332XR RIBS W/CHEST BILATERAL 4 VIEW320711111,040.00KENOSHA10000333XR STERNUM 2 VIEW32071120555.00KENOSHA10000334XR STERNOCLAVICULAR JOINT 3 VIEW32071130510.00KENOSHA10000335CT CHEST DX W/O DYE350712502,800.00KENOSHA10000336CT CHEST DX W/DYE350712603,000.00KENOSHA10000337CT CHEST DX W/WO DYE350712704,400.00KENOSHA10000338CT ANGIO CHEST350712753,720.00KENOSHA10000339MR CHEST W/O DYE610715504,040.00KENOSHA10000341MR CHEST W/WO DYE610715526,260.00KENOSHA10000343XR SPINE ANY LEVEL 1 VIEW32072020555.00KENOSHA10000344XR CERVICAL SPINE 2-3 VIEWS32072040670.00KENOSHA10000345XR CERVICAL SPINE 4-5 VIEWS32072050975.00KENOSHA10000346XR CERVICAL SPINE 6 VIEWS >320720521,110.00KENOSHA10000348XR THORACIC SPINE 2 VIEW32072070670.00KENOSHA10000349XR THORACIC SPINE 3 VIEW32072072770.00KENOSHA10000350XR THORACIC SPINE 4 VIEW32072074885.00KENOSHA10000351XR THORACOLUMBAR SPINE 2 VIEW32072080725.00KENOSHA10000353XR LUMBAR SPINE 2 OR 3 VIEW32072100725.00KENOSHA10000354XR LUMBAR SPINE 4 VIEW MIN320721101,020.00KENOSHA10000355XR L SPINE BENDING 6 VIEW OR >320721141,050.00KENOSHA10000356XR L SPINE BENDING VIEW 2 TO 332072120755.00KENOSHA10000357CT C SPINE W/O DYE350721252,800.00KENOSHA10000358CT C SPINE W/DYE350721263,000.00KENOSHA10000359CT C SPINE W/WO DYE350721274,400.00KENOSHA10000360CT T SPINE W/O DYE350721282,800.00KENOSHA10000361CT T SPINE W/DYE350721293,000.00KENOSHA10000362CT T SPINE W/WO DYE350721304,400.00KENOSHA10000363CT L SPINE W/O DYE350721312,800.00KENOSHA10000364CT L SPINE W/DYE350721323,000.00KENOSHA10000365CT L SPINE W/WO DYE350721334,400.00KENOSHA10000366MR C SPINE W/O DYE610721414,040.00KENOSHA10000367MR C SPINE W/DYE610721424,240.00KENOSHA10000368MR T SPINE WO DYE610721464,040.00KENOSHA10000369MR T SPINE W/DYE610721474,240.00KENOSHA10000370MR L SPINE WO DYE610721484,040.00KENOSHA10000371MR L SPINE W DYE610721494,240.00KENOSHA10000372MR C SPINE W/WO DYE610721566,260.00KENOSHA10000373MR T SPINE W/WO DYE610721576,260.00KENOSHA10000374MR L SPINE W/WO DYE610721586,260.00KENOSHA10000376XR PELVIS 1 OR 2 VIEW32072170515.00KENOSHA10000377XR PELVIS COMPLETE 3 VIEW MIN32072190690.00KENOSHA10000378CT ANGIO PELVIS350721913,720.00KENOSHA10000379CT PELVIS W/O DYE350721922,800.00KENOSHA10000380CT PELVIS W/DYE350721933,000.00KENOSHA10000381CT PELVIS W/WO DYE350721944,400.00KENOSHA10000382MR PELVIS W/O DYE610721954,040.00KENOSHA10000383MR PELVIS W/DYE610721964,240.00KENOSHA10000384MR PELVIS W/WO DYE610721976,260.00KENOSHA10000385XR SACROILIAC JOINTS < 3 VIEWS32072200485.00KENOSHA10000386XR SACROILIAC JOINTS 3 VIEW MIN32072202615.00KENOSHA10000387XR SACRUM & COCCYX 2 VIEW MIN32072220635.00KENOSHA10000388MYELOGRAM CERVICAL S&I320722402,400.00KENOSHA10000389MYELOGRAM THORACIC S&I320722552,400.00KENOSHA10000390MYELOGRAM LUMBAR S&I320722652,400.00KENOSHA10000393DISCOGRAM C/T EACH LEVEL S&I320722853,710.00KENOSHA10000395DISKOGRAM L/S EA LEVEL S&I320722953,710.00KENOSHA10000397XR SCAPULA COMPLETE32073010545.00KENOSHA10000400XR SHOULDER ARTHROGRAM S&I320730401,850.00KENOSHA10000401XR AC JOINTS BILATERAL32073050565.00KENOSHA10000410XR WRIST ARTHROGRAM S&I320731151,250.00KENOSHA10000413XR FINGER(S) 2 VIEW MINIMUM32073140520.00KENOSHA10000425XR HIP ARTHROGRAM S&I320735251,850.00KENOSHA10000432XR KNEES STANDING AP BILATERAL32073565485.00KENOSHA10000433XR KNEE ARTHROGRAM S&I320735801,850.00KENOSHA10000436XR ANKLE 2 VIEW32073600505.00KENOSHA10000437XR ANKLE COMPLETE32073610605.00KENOSHA10000442XR TOE(S) 2 VIEW MIN32073660505.00KENOSHA10000453XR ABDOMEN 1 VIEW32074018500.00KENOSHA10000454XR ABDOMEN 2 VIEWS32074019620.00KENOSHA10000455XR ABDOMEN 3 OR MORE VIEWS32074021745.00KENOSHA10000456XR ABDOMEN, ACUTE SERIES32074022865.00KENOSHA10000457CT ABDOMEN W/O DYE350741502,800.00KENOSHA10000458CT ABDOMEN W/DYE350741603,000.00KENOSHA10000459CT ABDOMEN W/WO DYE350741704,400.00KENOSHA10000460CT ANGIO ABDOMEN350741753,720.00KENOSHA10000461MR ABDOMEN W/O DYE610741814,040.00KENOSHA10000463MR ABDOMEN W/WO DYE610741836,260.00KENOSHA10000464XR ESOPHAGRAM32074220965.00KENOSHA10000465XR SWALLOWING FUNCTION W/VIDEO32074230835.00KENOSHA10000466XR UPPER GI W/O KUB320742401,250.00KENOSHA10000469XR UPPER GI W/CONTRAST W/O KUB320742461,350.00KENOSHA10000472XR SMALL BOWEL SERIES320742501,010.00KENOSHA10000476XR COLON BARIUM ENEMA32074270905.00KENOSHA10000477XR COLON DOUBLE CONTRAST320742801,180.00KENOSHA10000478ENEMA THERAPEUTIC AIR/CONTRAST32074283615.00KENOSHA10000479XR CHOLANGIOGRAM INTRAOP S&I320743001,220.00KENOSHA10000484ERCP BILE DUCT S&I32074328930.00KENOSHA10000485ERCP PANCREATIC DUCT S&I32074329930.00KENOSHA10000486ERCP BILE & PANCREAS DUCT S&I320743301,170.00KENOSHA10000487INSERT LONG FEEDING TUBE S&I32074340610.00KENOSHA10000488DILATION BILIARY DUCT W/WO STENT S&I320743632,130.00KENOSHA10000489XR IVP WITH OR W/O TOMOGRAM320744001,280.00KENOSHA10000492XR UROGRAPHY RETROGRADE320744201,770.00KENOSHA10000493XR UROGRAPHY ANTEGRADE S&I320744251,070.00KENOSHA10000494XR CYSTOGRAM 3 VIEW MIN S&I32074430975.00KENOSHA10000495XR URETHROGRAM RETROGRADE S&I32074450985.00KENOSHA10000496XR CYSTOGRAM VOIDING S&I320744551,320.00KENOSHA10000498DILATION NEPHROSTOMY/URETERS S&I320744852,640.00KENOSHA10000500XR HYSTEROSALPINGOGRAM S&I320747401,120.00KENOSHA10000502MR CARDIAC W/O DYE610755574,080.00KENOSHA10000503MR CARDIAC W/WO DYE610755616,320.00KENOSHA10000504MR HEART VELOCITY FLOW MAPPING610755654,010.00KENOSHA10000508CT HEART VESSEL W/CONTRAST350755743,220.00KENOSHA10000509ANGIO THORACIC S&I320756054,280.00KENOSHA10000510ANGIO ABDOMEN S&I320756254,960.00KENOSHA10000511ANGIO ABD/BILAT ILIOFEM S&I320756304,810.00KENOSHA10000512CHB TA ABD AORTA/ILIOFEMORAL350756353,720.00KENOSHA10000522ANGIO SPINAL SELECTIVE S&I320757055,460.00KENOSHA10000523ANGIO EXTREMITY UNILATERAL S&I320757104,420.00KENOSHA10000524ANGIO EXTREMITY BILATERAL S&I320757166,630.00KENOSHA10000527ANGIO VISCERAL SELECTIVE S&I320757265,480.00KENOSHA10000528ANGIO ADRENAL SELECTIVE S&I320757313,530.00KENOSHA10000529ANGIO PELVIC SELECTIVE S&I320757365,230.00KENOSHA10000530ANGIO PULMONARY SELECTIVE UNILAT S&I320757413,140.00KENOSHA10000531ANGIO PULMONARY SELECTIVE BILAT S&I320757434,710.00KENOSHA10000532ANGIO PULMONARY NON-SELECT S&I320757462,340.00KENOSHA10000533ANGIO SELECT EA ADD VESSEL S&I320757742,710.00KENOSHA10000535SHUNTOGRAM NONVASCULAR S&I32075809580.00KENOSHA10000536VENOGRAM EXTREMITY UNILAT S&I320758202,010.00KENOSHA10000537VENOGRAM EXTREMITY BILAT S&I320758223,010.00KENOSHA10000538VENOGRAM IVC S&I320758254,010.00KENOSHA10000539VENOGRAM SVC S&I320758274,010.00KENOSHA10000540VENOGRAM RENAL SELECTIVE BILAT S&I320758336,020.00KENOSHA10000541VENOGRAM ADRENAL SELECTIVE BILAT S&I320758427,530.00KENOSHA10000542VENOGRAM SINUS/JUGULAR S&I320758602,520.00KENOSHA10000543VENOGRAM LIVER W/EVAL S&I320758854,530.00KENOSHA10000544VENOGRAM LIVER W/O EVAL S&I320758873,010.00KENOSHA10000545VENOGRAM HEPATIC W HEMO S&I320758894,810.00KENOSHA10000546VENOGRAM HEPATIC WO HEMO S&I320758914,010.00KENOSHA10000547VENOUS BLOOD SAMPLING S&I320758935,900.00KENOSHA10000548TRANSCATHETER EMBOLIZATION S&I320758946,840.00KENOSHA10000550TRANSCATHETER ANGIOGRAPHY F/U320758981,070.00KENOSHA10000552REMOVE CVL DEVICE OBSTRUCTION S&I320759011,160.00KENOSHA10000553REMOVE CVL LUMEN OBSTRUCTION S&I32075902915.00KENOSHA10000570TRANSCATHETER BIOPSY S&I320759703,420.00KENOSHA10000574DRAIN CATH CHANGE W/CONTRAST S&I320759841,380.00KENOSHA10000575GUIDED DRAINAGE S&I320759892,390.00KENOSHA10000581FLUOROSCOPY UP TO 1 HR32076000880.00KENOSHA10000583XR FOREIGN BODY CHILD SINGLE VIEW32076010280.00KENOSHA10000584SINOGRAM S&I32076080800.00KENOSHA10000585RAD EXAM SURGICAL SPEC32076098720.00KENOSHA100005893D RENDERING WO POSTPROCESSING402763761,050.00KENOSHA100005903D RENDERING W/ POSTPROCESSING402763771,270.00KENOSHA10000591CT LIMITED OR LOCALIZED EXAM350763801,810.00KENOSHA10000594MR PROCEDURE MISCELLANEOUS610764982,650.00KENOSHA10000595XR PROCEDURE MISCELLANEOUS320764991,130.00KENOSHA10000602US, SOFT TISSUE HEAD/NECK40276536970.00KENOSHA10000603US CHEST40276604515.00KENOSHA10000605US ABDOMEN COMPLETE402767001,400.00KENOSHA10000606US ABDOMEN LTD402767051,060.00KENOSHA10000607US RETROPERITONEUM COMPLETE402767701,120.00KENOSHA10000608US RETROPERITONEUM LTD40276775845.00KENOSHA10000609US RENAL TRANSPLANT402767761,280.00KENOSHA10000610US SPINAL CORD40276800775.00KENOSHA10000611US OB < 14 WK SINGLE FETUS402768011,020.00KENOSHA10000612US OB <14 WK ADDL FETUS40276802510.00KENOSHA10000613US OB >/=14 WK SINGLE FETUS402768051,260.00KENOSHA10000614US OB >/=14 WK ADDL FETUS40276810630.00KENOSHA10000615US OB DETAILED SINGLE FETUS402768111,020.00KENOSHA10000616US OB DETAILED ADDL FETUS40276812510.00KENOSHA10000619US OB LIMITED40276815740.00KENOSHA10000620US OB FOLLOW UP EA FETUS40276816740.00KENOSHA10000621US OB TRANSVAGINAL40276817865.00KENOSHA10000622BPP W/NST402768181,380.00KENOSHA10000623BPP W/O NST402768191,120.00KENOSHA10000630US TRANSVAGINAL40276830950.00KENOSHA10000631US PELVIS COMPLETE402768561,470.00KENOSHA10000632US PELVIS LIMITED40276857950.00KENOSHA10000633US TESTICLES402768701,140.00KENOSHA10000634US PROSTATE VOLUME STUDY402768731,280.00KENOSHA10000636ULTRASOUND FOR VASCULAR ACCESS402769371,060.00KENOSHA10000637US GUIDED ABLATION MONITORING40276940805.00KENOSHA10000638US NEEDLE GUIDANCE S&I402769421,380.00KENOSHA10000640US GUIDANCE DX AMNIO S&I40276946720.00KENOSHA10000641US GUIDANCE RADIOTHERAPY40276965990.00KENOSHA10000642US GUIDANCE INTRAOPERATIVE40276998560.00KENOSHA10000643US MISCELLANEOUS40276999145.00KENOSHA10000644FLUORO GUIDANCE CVL32077001880.00KENOSHA10000645FLUORO GUIDANCE NEEDLE PLACEMENT32077002880.00KENOSHA10000647FLUORO GUIDANCE SPINE INJECTION32077003880.00KENOSHA10000648CT GUIDED STEREO LOCALIZATION350770111,620.00KENOSHA10000649CT GUIDED NEEDLE PLACEMENT S&I350770122,600.00KENOSHA10000650CT GUIDED TISSUE ABLATION350770132,170.00KENOSHA10000651CT GUIDED FIELD PLACEMENT350770142,890.00KENOSHA10000657GALACTOGRAM 1 DUCT S&I32077053580.00KENOSHA10000658GALACTOGRAM > 1 DUCT S&I32077054655.00KENOSHA10000662BONE AGE STUDY32077072560.00KENOSHA10000663BONE LENGTH STUDY32077073670.00KENOSHA10000665BONE SURVEY COMPLETE320770751,690.00KENOSHA10000666BONE SURVEY INFANT320770761,000.00KENOSHA10000667JOINT SURVEY 1 VIEW 2 OR >JOINTS32077077565.00KENOSHA10000668DXA AXIAL SKELETON32077080855.00KENOSHA10000669DXA APPENDICULAR SKELETON32077081515.00KENOSHA10000672DOSIMETRY BASIC CALCULATION33077300990.00KENOSHA10000678NM THYROID METS IMAGING WHOLE BODY341780183,320.00KENOSHA10000679NM THYROID METS UPTAKE34178020935.00KENOSHA10000680NM PARATHYROID IMAGING341780701,890.00KENOSHA10000681NM BONE MARROW IMAGING/LTD341781021,630.00KENOSHA10000687NM LYMPHOSCINTIGRAPHY341781952,610.00KENOSHA10000695NM GASTRIC EMPTYING STUDY341782642,430.00KENOSHA10000696NM GI BLEED STUDY341782782,170.00KENOSHA10000697NM BOWEL IMAGING341782901,860.00KENOSHA10000699NM BONE IMAGING/LTD341783001,810.00KENOSHA10000701NM BONE IMAGING/WHOLE BODY341783062,640.00KENOSHA10000702NM BONE IMAGING W FLOW341783152,780.00KENOSHA10000705NM VASCULAR FLOW IMAGING34178445970.00KENOSHA10000706NM MYO PERF SPECT SINGLE341784514,760.00KENOSHA10000707NM MYO PERF SPECT MULTIPLE341784527,150.00KENOSHA10000709NM MYO PERF PLANAR MULTIPLE341784545,750.00KENOSHA10000712NM GATED BLOOD POOL IMAGING REST341784722,510.00KENOSHA10000715NM GATED BLOOD POOL IMAGE SPECT341784943,000.00KENOSHA10000716NM PULMONARY PERFUSION341785802,070.00KENOSHA10000724NM BRAIN METABOLIC EVAL404786087,770.00KENOSHA10000727NM CISTERNOGRAPHY/PLANAR341786302,180.00KENOSHA10000731NM RENAL FUNCTION WO DRUG341787073,010.00KENOSHA10000732NM RENAL FUNCTION W DRUG341787083,260.00KENOSHA10000734NM TUMOR LOCALIZATION/LTD341788001,650.00KENOSHA10000735NM TUMOR LOCALIZATION/WB 1 DAY341788022,480.00KENOSHA10000736NM TUMOR LOCALIZATION/SPECT341788032,840.00KENOSHA10000737NM TUMOR LOCALIZATION/WB 2+ DAY341788043,320.00KENOSHA10000741NM INJECT NON-IMAGING PROBE STUDY34178808955.00KENOSHA10000743NM THERAPY ORAL ADMINISTRATION342790051,130.00KENOSHA10000744NM RADIOPHARMACEUTICAL THERAPY IV342791011,430.00KENOSHA10000745NM TX MONOCLONAL ANTIBODY342794032,420.00KENOSHA10000746NM THERAPY INTRA-ARTERIAL342794451,440.00KENOSHA10000747POC URINE DIPSTICK W/O MICRO3008100235.00KENOSHA10000749POC URINALYSIS AUTO W/O MICRO3078100350.00KENOSHA10000750URINALYSIS AUTO W/O MICRO3078100350.00KENOSHA10000751URINE MICROSCOPIC3078101540.00KENOSHA10000752URINE RBC MICROSCOPIC3078101540.00KENOSHA10000753MISC LAB30781025110.00KENOSHA10000754MISC LAB30781025150.00KENOSHA10000756URINE TIMED VOLUME, EACH3078105025.00KENOSHA10000757ACETAMINOPHIN30180143305.00KENOSHA10000759ACETONE SERUM QUANTITATIVE3018201090.00KENOSHA10000760ACETYLCHOLINESTERASE30182013305.00KENOSHA10000761ACYLCARNITINE QUANTITATIVE30182017435.00KENOSHA10000762NEWBORN FATTY ACID OXIDATION3018201725.00KENOSHA10000763ACTH30182024415.00KENOSHA10000764ALBUMIN, SERUM3018204075.00KENOSHA10000765ALBUMIN OTHER SOURCE EACH SPECIMEN3018204290.00KENOSHA10000766MICROALBUMIN URINE30182043120.00KENOSHA10000767MICROALBUMIN URINE 24 HR30182043120.00KENOSHA10000768MICROALBUMIN URINE TIMED30182043120.00KENOSHA10000769ALCOHOL SCREEN (ETHANOL)30082077220.00KENOSHA10000770ALDOLASE30182085125.00KENOSHA10000771ALDOSTERONE30182088275.00KENOSHA10000772ALDOSTERONE URINE30182088275.00KENOSHA10000774ALPHA-1 ANTITRYPSIN30182103195.00KENOSHA10000775ALPHA-1 ANTITRYPSIN PHENOTYPE30182104195.00KENOSHA10000776AFP, MATERNAL SCREEN30182105100.00KENOSHA10000777AFP, TUMOR MARKER30182105215.00KENOSHA10000783AMINO ACIDS QUANTITATIVE 6/>30182139425.00KENOSHA10000784AMMONIA30182140165.00KENOSHA10000787AMYLASE30182150130.00KENOSHA10000789AMYLASE, URINE30182150135.00KENOSHA10000791ANDROSTENEDIONE30182157215.00KENOSHA10000792ACE, CSF30182164185.00KENOSHA10000793ANGIOTENSIN CONVERTING ENZYME30182164175.00KENOSHA10000796ARSENIC30182175135.00KENOSHA10000797ARSENIC, URINE30182175135.00KENOSHA10000798VITAMIN C30182180135.00KENOSHA10000799BARBITURATES, GC/MS30180345170.00KENOSHA10000801BETA-2 MICROGLOBULIN30182232150.00KENOSHA10000803BILE ACIDS, TOTAL30182239185.00KENOSHA10000804BILIRUBIN TOTAL30182247110.00KENOSHA10000805BILIRUBIN DIRECT30182248110.00KENOSHA10000807NEWBORN BIOTINIDASE3018226125.00KENOSHA10000809OCCULT BLOOD, OTHER3018227135.00KENOSHA10000811OCCULT BLOOD, FECES3018227235.00KENOSHA10000813OCCULT BLOOD FECAL IMMUNOASSAY3018227490.00KENOSHA10000814CADMIUM30182300165.00KENOSHA10000815CADMIUM URINE30182300175.00KENOSHA10000816VITAMIN D, 25-OH30182306290.00KENOSHA10000817CALCITONIN30182308125.00KENOSHA10000818CALCIUM SERUM3018231095.00KENOSHA10000819CALCIUM IONIZED3018233080.00KENOSHA10000820POC CALCIUM IONIZED3018233080.00KENOSHA10000822CALCIUM URINE30182340115.00KENOSHA10000824CALCULI INFRARED SPECTROSCOPY30182365150.00KENOSHA10000825BICARBONATE URINE3018237480.00KENOSHA10000826CARBON DIOXIDE3018237490.00KENOSHA10000827CARBON MONOXIDE3018237565.00KENOSHA10000828POC CARBON MONOXIDE3018237565.00KENOSHA10000829CEA30182378275.00KENOSHA10000830CARNITINE FREE & TOTAL30182379300.00KENOSHA10000831CAROTENE30182380135.00KENOSHA10000832CATECHOLAMINES FRACT BLOOD30182384320.00KENOSHA10000833CATECHOLAMINES FRACT URINE30182384320.00KENOSHA10000834CERULOPLASMIN30182390165.00KENOSHA10000835IGF BINDING PROTEIN, CHEMILUM30182397240.00KENOSHA10000837CHLORIDE BLOOD3018243565.00KENOSHA10000838POC CHLORIDE3018243565.00KENOSHA10000839CHLORIDE URINE30182436105.00KENOSHA10000840CHLORIDE, OTHER SOURCE30182438105.00KENOSHA10000842CHOLESTEROL30182465100.00KENOSHA10000843CHOLINESTERASE SERUM30182480110.00KENOSHA10000849CHROMIUM30182495130.00KENOSHA10000850CITRATE30182507245.00KENOSHA10000853COPPER30182525170.00KENOSHA10000854COPPER TISSUE30182525170.00KENOSHA10000855COPPER URINE30182525170.00KENOSHA10000856CORTISOL, FREE30182530215.00KENOSHA10000857CORTISOL, SALIVARY30182533230.00KENOSHA10000858CORTISOL, TOTAL30182533230.00KENOSHA10000860CK TOTAL30182550120.00KENOSHA10000861CK ISOENZYMES30182552110.00KENOSHA10000863CK MB FRACTION30182553250.00KENOSHA10000865CREATININE BLOOD3018256575.00KENOSHA10000866POC CREATININE3018256575.00KENOSHA10000867CREATININE OTHER SOURCE3018257095.00KENOSHA10000868CREATININE URINE3018257095.00KENOSHA10000870CREATININE CLEARANCE30182575155.00KENOSHA10000872CRYOGLOBULIN QUALITATIVE3018259575.00KENOSHA10000873CYANIDE30182600170.00KENOSHA10000874VITAMIN B-1230182607195.00KENOSHA10000875VITAMIN B-12 BINDING CAPACITY30182608195.00KENOSHA10000876DHEA30182626265.00KENOSHA10000877DHEA SULFATE30182627265.00KENOSHA10000880VITAMIN D, 1, 25-DIHYDROXY30182652300.00KENOSHA10000881DISACCHARIDASES ACT TISSUE30182657415.00KENOSHA10000882THIOPURINE METHYLTRANSFERASE30184433415.00KENOSHA10000883LIPO ELECTROPHORETIC TEST30182664280.00KENOSHA10000884ERYTHROPOIETIN30182668165.00KENOSHA10000885ESTRADIOL30182670240.00KENOSHA10000887ESTRIOL30182677110.00KENOSHA10000889ETHYLENE GLYCOL30182693220.00KENOSHA10000890FAT, FECAL QUANTITATIVE30182710260.00KENOSHA10000891VERY LONG CHAIN FATTY ACIDS30182726345.00KENOSHA10000892FERRITIN30182728175.00KENOSHA10000893FETAL FIBRONECTIN30182731620.00KENOSHA10000894FOLIC ACID, SERUM30182746265.00KENOSHA10000895FOLIC ACID, RBC30182747235.00KENOSHA10000896NEWBORN GALACTOSE TRANSERASE3018277525.00KENOSHA10000897GAMMAGLOBULIN, IGA3018278475.00KENOSHA10000898GAMMAGLOBULIN, IGD3018278475.00KENOSHA10000899GAMMAGLOBULIN, IGG3018278475.00KENOSHA10000900GAMMAGLOBULIN, IGM3018278475.00KENOSHA10000901IMMUNOGLOBULIN IGE30182785210.00KENOSHA10000902IMMUNOGLOBULIN SUBCLASSES EA3018278750.00KENOSHA10000903PH BLOOD30182800100.00KENOSHA10000904BLOOD GASES30182803135.00KENOSHA10000906POC BLOOD GASES30182803135.00KENOSHA10000908BLOOD GAS PROFILE30082805215.00KENOSHA10000911GASES, O2 SATURATION30182810125.00KENOSHA10000913GASTRIN30182941100.00KENOSHA10000914GLUCAGON30182943210.00KENOSHA10000915GLUCOSE, BODY FLUID3018294595.00KENOSHA10000916GLUCOSE, BLOOD3018294755.00KENOSHA10000917POC GLUCOSE SERUM3018294755.00KENOSHA10000918GLUCOSE, POST GLUCOSE DOSE30182950105.00KENOSHA10000919GTT, 3 SPECIMENS30182951210.00KENOSHA10000920GTT, EACH ADDL SPECIMEN3018295270.00KENOSHA10000921G6PD, QUANTITATIVE30182955125.00KENOSHA10000923POC GLUCOSE – METER METHOD3018296225.00KENOSHA10000924GGT30182977145.00KENOSHA10000926FSH30183001265.00KENOSHA10000927LUTEINIZING HORMONE30183002275.00KENOSHA10000928HUMAN GROWTH HORMONE30183003155.00KENOSHA10000929HAPTOGLOBIN30183010135.00KENOSHA10000930H PYLORI BREATH TEST30183013420.00KENOSHA10000931H PYLORI BREATH DRUG ADMIN30183014105.00KENOSHA10000934HEMOGLOBIN ELECTROPH QUANT30183020225.00KENOSHA10000935HEMOGLOBIN ELECTROPHORESIS30183020225.00KENOSHA10000936NEWBORN HEMOGLOBINOPATHY3018302025.00KENOSHA10000938HEMOGLOBIN A1C30183036160.00KENOSHA10000939METHEMOGLOBIN QUANTITATIVE3018305060.00KENOSHA10000940POC METHEMOGLOBIN3018305060.00KENOSHA10000941HEMOGLOBIN PLASMA30183051115.00KENOSHA10000942HEMOSIDERIN QUALITATIVE3018307090.00KENOSHA10000944HISTAMINE30183088225.00KENOSHA10000945HISTAMINE, URINE30183088225.00KENOSHA10000946HOMOCYSTEINE30183090310.00KENOSHA10000948HYDROXYINDOLACETIC ACID, 530183497160.00KENOSHA10000949HYDROXYPROGESTERONE, 17D30183498220.00KENOSHA10000950NEWBORN OH-PROGESTRONE, 17D3018349825.00KENOSHA10000952ANNA BY IMMUNOBLOT30183516205.00KENOSHA10000953ANTI-GLIADIN IGA30186258165.00KENOSHA10000954ANTI-GLIADIN IGG30186258165.00KENOSHA10000958GLUTAMIC ACID DECARB, ELISA30286341260.00KENOSHA10000960GM1, IGG ANTIBODY30183516100.00KENOSHA10000961GM1, IGM ANTIBODY30183516100.00KENOSHA10000963MAG AB, IGM30183516135.00KENOSHA10000964MYELOPEROXIDASE AB30183516135.00KENOSHA10000965NEWBORN CYSTIC FIBROSIS3018351625.00KENOSHA10000967SERINE PROTEASE 330183516135.00KENOSHA10000968TISSUE TRANGLUTINASE AB30186364155.00KENOSHA10000969ANTI-SMOOTH MUSCLE ANTIBODY30086015195.00KENOSHA10000970BASEMENT MEMBRANE EPIDERMAL AB30183516125.00KENOSHA10000971POC PLACENTAL MICROGLOBULIN-130184112355.00KENOSHA10000974ACETYLCHOLINE RECEPTOR30183519230.00KENOSHA10000976PTH RELATED PEPTIDE30182542250.00KENOSHA10000978TSH RECEPTOR ANTIBODY30183520160.00KENOSHA10000979VOLTAGE-GATED CA CHANNEL AB30186596305.00KENOSHA10000981INHIBIN B30183520155.00KENOSHA10000982INTERLEUKIN 630183529155.00KENOSHA10000983PANCREATIC ELASTASE FECAL30182653225.00KENOSHA10000984TRYPTASE30183520280.00KENOSHA10000985INSULIN, TOTAL30183525125.00KENOSHA10000986INSULIN, FREE3018352790.00KENOSHA10000987IRON30183540130.00KENOSHA10000988IRON QUANTITATIVE TISSUE30183540160.00KENOSHA10000990IRON BINDING CAPACITY30183550140.00KENOSHA10000992LACTIC ACID30183605125.00KENOSHA10000993POC LACTIC ACID30183605125.00KENOSHA10000994LDH3018361590.00KENOSHA10000996LACTOFERRIN, FECAL QUAL30183630145.00KENOSHA10000997LEAD30183655110.00KENOSHA10001001LAMELLAR BODY COUNT30183664120.00KENOSHA10001003LIPASE30183690205.00KENOSHA10001004LIPOPROTEIN A30183695175.00KENOSHA10001007LIPOPROTEIN QUANT, NMR30183704265.00KENOSHA10001008HDL CHOLESTEROL30183718115.00KENOSHA10001009LDL CHOLESTEROL30183721130.00KENOSHA10001010MAGNESIUM SERUM30183735125.00KENOSHA10001012MAGNESIUM URINE3018373595.00KENOSHA10001013MANGANESE BLOOD30183785205.00KENOSHA10001015NEWBORN AMINO ACID SCREEN3018378925.00KENOSHA10001016MERCURY30183825160.00KENOSHA10001017MERCURY URINE30183825160.00KENOSHA10001018METANEPHRINES, PLASMA30183835305.00KENOSHA10001019METANEPHRINES, URINE30183835170.00KENOSHA10001023MYELIN BASIC PROTEIN, CSF30183873190.00KENOSHA10001024MYOGLOBIN30183874165.00KENOSHA10001025MYOGLOBIN, URINE30183874130.00KENOSHA10001027NATRIURETIC PEPTIDE30183880195.00KENOSHA10001029NEPHELOMETRY EACH ANALYTE30183883115.00KENOSHA100010495 NUCLEOTIDASE30183915120.00KENOSHA10001050OLIGOCLONAL BANDS30183916180.00KENOSHA10001052ORGANIC ACID, SINGLE QUANT30183921315.00KENOSHA10001053OPIATES, LC/MS30180361140.00KENOSHA10001054OSMOLALITY BLOOD3018393095.00KENOSHA10001055OSMOLALITY, URINE3018393595.00KENOSHA10001060PARATHYROID HORMONE30183970235.00KENOSHA10001061PH BODY FLUID3018398650.00KENOSHA10001062PH FECAL3018398640.00KENOSHA10001063PH URINE SRDP3018398670.00KENOSHA10001064ANTIPSYCHOTIC, 1-230180342230.00KENOSHA10001065NEWBORN PHENYLALANINE3018403025.00KENOSHA10001068ALKALINE PHOSPHATASE30184075125.00KENOSHA10001069ALKALINE PHOSPHATASE ISOENZYME30184080135.00KENOSHA10001071PHOSPHORUS3018410090.00KENOSHA10001072PHOSPHORUS URINE3018410590.00KENOSHA10001075PORPHOBILINOGEN URINE QUANT30184110125.00KENOSHA10001076PORPHYRINS URINE FRACTIONATED30184120215.00KENOSHA10001077PORPHYRINS FECES QUANT30184126265.00KENOSHA10001078POC POTASSIUM SERUM3018413270.00KENOSHA10001079POTASSIUM SERUM3018413270.00KENOSHA10001080POTASSIUM URINE30184133105.00KENOSHA10001082PREALBUMIN30184134195.00KENOSHA10001084PROGESTERONE30184144235.00KENOSHA10001085PROCALCITONIN (PCT)30184145315.00KENOSHA10001086PROLACTIN30184146290.00KENOSHA10001087PSA, TOTAL30184153175.00KENOSHA10001088PSA, FREE30184154175.00KENOSHA10001089PROTEIN, TOTAL3018415590.00KENOSHA10001090PROTEIN, TOTAL, URINE3018415690.00KENOSHA10001091PROTEIN, TOTAL, OTHER FLUID30184157110.00KENOSHA10001093PROTEIN ELECTROPHORESIS, SERUM30184165185.00KENOSHA10001094PROTEIN ELECTROPHORESIS, URINE30184166215.00KENOSHA10001095WESTERN BLOT IMMUNO PROBE EA30184182485.00KENOSHA10001096RBC PROTOPORPHYRIN, QUANT30184202110.00KENOSHA10001097PROIN
