Lab & pathology prices at Childrens Hospital of Wisconsin Fox Valley

Neenah, WI · every code in this section with a posted price and a Medicare benchmark.

281 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
17-Hydroxypregnenolone (84143) $109.73 $199.50 4.8×
Acth (82024) $265.10 $482 6.9×
Acylcarnitines Quant (82017) $351.31 $638.75 20.8×
Albumin serum (82040) $19.66 $35.75 4.0×
Aldolase (82085)
range across 2 matching MRF lines
$65.04–$68.20 $118.25–$124 varies
Aldosterone urine (82088) $230.45 $419 5.7×
Allergen specific ige (86003) $44 $80 8.4×
Alpha-1-antitrypsin total (82103) $63.66 $115.75 4.7×
Alt (sgpt) (84460) $19.39 $35.25 3.7×
Amino Acids 6/> Amino Acids Quantitative Ea Spe (82139) $658.21 $1,196.75 39.0×
Amino Acids Multiple Qualitative Each Specimen (82128) $141.76 $257.75 10.2×
Ammonia (82140) $84.29 $153.25 5.8×
Amylase urine (82150) $61.19 $111.25 9.4×
Ana Titer (86039)
range across 2 matching MRF lines
$45.38–$61.33 $82.50–$111.50 varies
Androstenedione (82157) $142.31 $258.75 4.9×
Antibody Borrelia Burgdorferi Confirmatory Tst (86617) $149.05 $271 9.6×
Antibody Cytomegalovirus Cmv Igm (86645) $111.10 $202 6.6×
Antibody Epstein-Barr Eb Virus Early Antigen Ea (86663) $70.54 $128.25 5.4×
Antibody Epstein-Barr Eb Virus Nuclear Ag Ebna (86664) $121.55 $221 7.9×
Antibody Epstein-Barr Eb Virus Viral Capsid Vca (86665) $144.10 $262 7.9×
Antibody Protozoa Nes (86753) $33.55 $61 2.7×
Antinuclear antibodies (86038) $110.96 $201.75 9.2×
Antistreptolysin O Screen (86063) $32.73 $59.50 5.7×
Assay Blood Carbon Dioxide (82374) $19.66 $35.75 4.0×
Assay of blood/uric acid (84550) $19.66 $35.75 4.3×
Assay of calcium in urine (82340) $38.78 $70.50 6.4×
Assay of corticosterone (82528) $109.18 $198.50 4.8×
Assay of g6pd enzyme (82955) $94.60 $172 9.8×
Assay of gammaglobulin igm (82784)
range across 5 matching MRF lines
$82.09–$153.86 $149.25–$279.75 varies
Assay of lactic acid (83605) $49.36 $89.75 4.3×
Assay of metanephrines (83835) $93.09 $169.25 5.5×
Assay of pyruvate (84210) $147.68 $268.50 10.2×
Assay of serum potassium (84132) $19.66 $35.75 4.1×
Assay of Tyrosine (84510) $16.78 $30.50 1.6×
Assay of urea nitrogen (84520) $19.66 $35.75 5.0×
Assay of urine vma (84585) $74.53 $135.50 4.8×
Assay spec xcp ur&breath ia (82077) $68.20 $124 3.9×
B cells total count (86355) $68.06 $123.75 1.8×
Bartonella antibody (86611) $154.14 $280.25 15.1×
Beta 2 glycoprotein i antibody each (86146) $92.40 $168 3.6×
Beta hydroxybutyrate (82010)
range across 2 matching MRF lines
$32.86–$67.38 $59.75–$122.50 varies
Bilirubin direct (82248) $19.66 $35.75 3.9×
Bilirubin total (82247) $19.66 $35.75 3.9×
Biotinidase (82261) $69.03 $125.50 4.1×
Blood count reticulocyte automated (85045)
range across 2 matching MRF lines
$42.21–$50.60 $76.75–$92 varies
Blood Count Smear Mcrscp W/Mnl Difrntl Wbc Count (85007) $29.56 $53.75 7.8×
Blood gas (82803)
range across 2 matching MRF lines
$76.86–$113.58 $139.75–$206.50 varies
Blood gases w/02 saturation (82805) $95.15 $173 1.2×
Blood Occult Fecal Hgb Deter Ia Qual Feces 1-3 (82274) $99.55 $181 6.3×
Blood typing serologic abo (86900) $15.40 $28 5.2×
Body fluid cell count (89050) $39.60 $72 8.4×
C diff amplified probe (87493) $282.84 $514.25 7.6×
C-Peptide (84681) $52.94 $96.25 2.5×
C-reactive protein (86140) $82.09 $149.25 15.8×
Calcium ionized (82330) $75.21 $136.75 5.5×
Calcium total (82310) $19.66 $35.75 3.8×
Cardiolipin ab iga (86147) $48.26 $87.75 1.9×
Carnitine Quantitative Each Specimen (82379) $77.41 $140.75 4.6×
Cell count csf (89051) $64.63 $117.50 11.5×
Ceruloplasmin (82390) $58.99 $107.25 5.5×
Chemiluminescent assay (82397) $69.03 $125.50 4.9×
Chloride Serum (82435) $19.66 $35.75 4.3×
Cholesterol total (82465) $18.98 $34.50 4.4×
Chorionic gonadotropin test (84702) $135.30 $246 9.0×
Chromosome Analysis 15-20 (88262) $1,124.61 $2,044.75 9.0×
Chylmd Trach, Dna, Amp Probe - Chlamydia Dna Pcr (87491)
range across 2 matching MRF lines
$111.51–$172.29 $202.75–$313.25 varies
Clostridium Difficile (87324) $76.31 $138.75 6.4×
Clotting Funct Activity (85397) $343.75 $625 11.1×
Cns DNA amp probe type 12-25 (87483) $669.21 $1,216.75 1.6×
Collagen crosslinks (82523) $58.16 $105.75 3.1×
Column Chromotography Quant (82542) $409.06 $743.75 17.0×
Compatibility test antiglob (86922) $83.46 $151.75 0.5×
Complement Antigen Each Component (86160) $108.63 $197.50 9.1×
Coombs direct (86880)
range across 3 matching MRF lines
$28.60–$39.19 $52–$71.25 varies
Cortisol saliva (82533)
range across 2 matching MRF lines
$154.96–$162.53 $281.75–$295.50 varies
Creatine kinase total (82550) $19.66 $35.75 3.0×
Creatinine blood (82565) $19.66 $35.75 3.8×
Creatinine Urine (82570)
range across 3 matching MRF lines
$26.95–$36.58 $49–$66.50 varies
Crossmatch electronic (86923) $314.74 $572.25 1.9×
Crossmatch immediate spin (86920) $77.55 $141 0.5×
Crp High Sensitivity (86141) $62.43 $113.50 4.8×
Cul Bact Aerobic Addl Meths Definitive Ea Isol (87077)
range across 2 matching MRF lines
$47.03–$66.83 $85.50–$121.50 varies
Cul Bact Anaerobic Addl Meths Definitive Ea Isol (87076) $53.49 $97.25 6.6×
Cul Typ ID Bld Pthgn 6+ Trgt (87154) $485.65 $883 2.2×
Culture afb (87116) $106.84 $194.25 9.9×
Culture Anaerobic (87075) $148.78 $270.50 15.7×
Culture blood (87040) $185.08 $336.50 17.9×
Culture csf (87070) $52.94 $96.25 6.1×
Culture fungus (87102) $130.08 $236.50 15.5×
Culture fungus blood (87103) $128.29 $233.25 6.3×
Culture screen only (87081) $55 $100 8.3×
Culture stool (87045) $49.91 $90.75 5.3×
Culture Typing Immunologic Oth/Thn Immunofluores (87147) $29.15 $53 5.6×
Culture urine (87086) $52.25 $95 6.5×
Cytogenom Const Microarray Copy Number&Snp Var (81229) $3,560.15 $6,473 3.1×
Cytomegalovirus igg (86644) $54.86 $99.75 3.8×
Deoxycortisol (82634) $136.68 $248.50 4.7×
Desoxycorticosterone (82633) $172.98 $314.50 5.6×
Detect Agent Nos Dna Amp (87798)
range across 3 matching MRF lines
$190.71–$486.61 $346.75–$884.75 varies
Dhea (82626) $122.79 $223.25 4.9×
Dhea-S (82627) $108.08 $196.50 4.9×
Digoxin (80162) $125.40 $228 9.4×
Dna Antibody Native/Double Stranded (86225) $38.91 $70.75 2.8×
Dna/Rna Amplified Probe (87150) $170.36 $309.75 4.9×
Drug assay acetaminophen (80143) $68.20 $124 3.7×
Drug assay adalimumab (80145) $92.13 $167.50 2.4×
Drug Assay Infliximab (80230) $91.44 $166.25 2.4×
Drug Assay Vedolizumab (80280) $87.86 $159.75 2.3×
Drug Test Prsmv Chem Anlyzr (80307) $169.13 $307.50 2.7×
Drug Test Prsmv Instrmnt (80306) $47.58 $86.50 2.8×
Ehrlichia antibody (86666)
range across 2 matching MRF lines
$33.55–$40.84 $61–$74.25 varies
Electrolyte panel (80051) $78.10 $142 11.1×
Enterovirus PCR (87498) $160.05 $291 4.6×
Estradiol serum (82670) $132.41 $240.75 4.7×
Exam Synovial Fluid Crystals (89060) $26.95 $49 3.7×
Factor ix activity (85250) $110.69 $201.25 5.8×
Factor viii assay (85240) $150.98 $274.50 8.4×
Fatty acids free (82725) $65.04 $118.25 3.5×
Ferritin (82728) $72.33 $131.50 5.3×
Fibrin Dgradj Products D-Dimer Ultrasensitive (85380) $47.99 $87.25 4.7×
Fibrinogen activity (85384) $63.94 $116.25 6.6×
Flow cytometry first marker (88184) $327.94 $596.25 0.9×
Fluorescent antibody screen (86255) $70.26 $127.75 5.8×
Folic Acid Serum (82746) $91.71 $166.75 6.2×
Follicle Stimulating Hormone (83001) $105.05 $191 5.7×
Galactose (82760) $57.75 $105 5.2×
Gammaglobulin ige (82785) $95.29 $173.25 5.8×
Gases blood ph only (82800) $83.46 $151.75 7.6×
Gastrointestinal pathogen panel by PCR (12 to 25 targets) (87507) $669.21 $1,216.75 1.6×
Gentamicin (80170) $119.90 $218 7.3×
Ggt (82977) $48.68 $88.50 6.8×
Glucose body fluid (82945)
range across 3 matching MRF lines
$17.46–$46.61 $31.75–$84.75 varies
Glucose Serum (82947)
range across 2 matching MRF lines
$12.10–$19.39 $22–$35.25 varies
Gonadotropin Chorionic Qualitative (84703) $112.75 $205 15.0×
Growth hormone (83003) $54.86 $99.75 3.3×
Haptoglobin (83010) $106.70 $194 8.5×
Helicobacter Pylori Stool (87338) $175.31 $318.75 12.2×
Hematocrit (85014) $12.65 $23 5.3×
Hemoglobin (85018) $17.33 $31.50 7.3×
Hemoglobin a1c (83036) $59.95 $109 6.2×
Hemoglobin Chromotography (83021) $61.46 $111.75 3.4×
Hemoglobin electrophoresis (83020) $21.45 $39 1.7×
Hemoglobin Methemoglobin Quantitative (83050) $61.88 $112.50 7.5×
Hep a ab igm (86709) $88.41 $160.75 7.9×
Heparin assay (85520) $61.33 $111.50 4.7×
Hepatitis a antibody total (86708) $60.78 $110.50 4.9×
Hepatitis b core ab total (86704) $116.88 $212.50 9.7×
Hepatitis B Surface Antigen (87340)
range across 2 matching MRF lines
$25.16–$33.96 $45.75–$61.75 varies
Hepatitis C Antibody (86803) $157.85 $287 11.1×
Heterophile Antibody Screen (86308) $42.21 $76.75 8.1×
Hiv-1 Ag W/Hiv-1 & Hiv-2 Ab (87389) $113.99 $207.25 4.7×
Homocysteine (83090) $206.25 $375 11.5×
Homovanillic acid urine (83150) $77.83 $141.50 3.5×
Hsv Dna Amp Probe (87529) $339.08 $616.50 9.7×
Hydroxyprogesterone 17-d (83498) $49.36 $89.75 1.8×
Iaad ia shiga-like toxin (87427) $58.30 $106 4.9×
Iadna Borrelia Burgdorferi Amplified Probe Tq (87476) $203.78 $370.50 5.8×
Iadna chlamydia pneumoniae amplified probe tq (87486) $168.99 $307.25 4.8×
Iadna Cytomegalovirus Amplified Probe Tq (87496) $293.70 $534 8.4×
Iadna Cytomegalovirus Quantification (87497) $190.85 $347 4.5×
Iadna Dna/Rna Rsv Amplified Probe Technique (87634) $150.98 $274.50 2.2×
Iadna mycoplsm pneumoniae amplified probe tq (87581) $170.50 $310 4.9×
Iadna Neisseria Gonorrhoeae Amplified Probe Tq (87591) $180.95 $329 5.2×
Iadna Respiratry Probe & Rev Trnscr 3-5 Targets (87631) $577.78 $1,050.50 4.1×
Immunoassay Analyte Quant Radioimmunoassay (83519) $138.05 $251 7.5×
Immunoassay nonantibody (83516) $58.85 $107 5.1×
Immunohistochemistry (88342) $301.13 $547.50 1.8×
Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique Facility (87650) $51.01 $92.75 2.5×
Influenza assay w/optic (87804) $113.44 $206.25 6.9×
Influenza DNA amp probe (87502) $226.60 $412 2.4×
Inhibin b (83520)
range across 6 matching MRF lines
$74.94–$286 $136.25–$520 varies
Insulin antibodies (86337) $103.95 $189 4.9×
Insulin total (83525) $115.91 $210.75 10.1×
Iron (83540) $68.06 $123.75 10.5×
Iron Binding Capacity (83550) $76.04 $138.25 8.7×
Islet cell antibody (86341) $82.09 $149.25 3.5×
Lactate (ld) (ldh) enzyme (83615) $19.66 $35.75 3.3×
Lead (83655)
range across 2 matching MRF lines
$85.66–$94.19 $155.75–$171.25 varies
Level V Surg Pathology Gross&Microscopic Exam (88307) $144.93 $263.50 0.4×
Lipase (83690) $81.68 $148.50 11.9×
Lithium (80178) $26.81 $48.75 4.1×
Luteinizing Hormone (Lh) (83002)
range across 2 matching MRF lines
$47.71–$105.05 $86.75–$191 varies
Lyme disease antibody (86618)
range across 3 matching MRF lines
$82.78–$83.60 $150.50–$152 varies
Magnesium Urine (83735) $61.46 $111.75 9.2×
Mass Spectrometry Quant (83789) $88.55 $161 3.7×
Methylmalonic acid serum (83921) $203.09 $369.25 9.6×
Microsomal Antibodies Each (86376)
range across 2 matching MRF lines
$66.96–$116.46 $121.75–$211.75 varies
Mycophenolic Acid (80180) $100.10 $182 5.5×
Mycoplasma antibody (86738)
range across 2 matching MRF lines
$77–$90.75 $140–$165 varies
Myoglobin urine (83874) $81.40 $148 6.3×
Natriuretic peptide (83880) $142.59 $259.25 3.6×
Nk cells total count (86357) $61.74 $112.25 1.6×
Nuclear antigen antibody (86235) $82.50 $150 4.6×
Occult Blood Other Sources (82271) $29.15 $53 5.5×
Organic Acids Qualitative Each Specimen (83919) $186.45 $339 11.3×
Organic acids urine (83918) $79.75 $145 3.4×
Osmolality serum (83930) $53.21 $96.75 8.0×
Osmolality Urine (83935) $53.21 $96.75 7.8×
Osteocalcin (83937) $145.61 $264.75 4.9×
Ova and parasites smears (87177) $83.05 $151 9.3×
Ph urine (81003) $9.90 $18 4.4×
Phenobarbital Level (80184) $78.51 $142.75 5.1×
Phenylalanine (84030) $26.54 $48.25 4.8×
Phenytoin (Dilantin) (80185) $52.39 $95.25 4.0×
Phosphatase alkaline (84075) $19.66 $35.75 3.8×
Phosphorus Serum (84100) $19.66 $35.75 4.1×
Phosphorus urine (84105) $25.16 $45.75 4.4×
Platelet Aggregation (85576) $67.38 $122.50 2.7×
Platelet count automated (85049) $24.48 $44.50 5.5×
Potassium Urine (84133) $38.36 $69.75 8.1×
Prealbumin (84134) $125.26 $227.75 8.6×
Pregnenolone (84140) $152.35 $277 7.4×
Procalcitonin (Pct) (84145) $164.18 $298.50 6.0×
Progesterone (84144) $90.48 $164.50 4.3×
Prolactin (84146) $153.45 $279 7.9×
Protein body fluid (84157)
range across 2 matching MRF lines
$38.78–$52.39 $70.50–$95.25 varies
Protein total serum (84155) $19.39 $35.25 5.3×
Protein Total Urine (84156) $38.78 $70.50 10.6×
Pth Intact (83970) $215.88 $392.50 5.2×
Quantiferon tb gold plus (86480) $115.50 $210 1.9×
Quantitative assay drug (80299) $363.41 $660.75 19.5×
Rbc antibody identification (86870) $131.45 $239 0.4×
Rbc antibody screen (86850) $49.50 $90 5.1×
Resp virus 12-25 targets (87633) $178.20 $324 0.4×
Rh (86901) $21.59 $39.25 7.2×
Rheumatoid factor quant (86431) $58.99 $107.25 10.4×
Ristocetin cofactor (85245) $106.15 $193 4.6×
Rsv Assay W/Optic (87807) $143 $260 10.9×
Russell Viper Venom Time Diluted (85613) $88.96 $161.75 9.3×
Salicylate Level (80179) $68.20 $124 3.7×
Sars-Cov-2 Covid-19 Amp Prb (87635)
range across 2 matching MRF lines
$121.55–$276.24 $221–$502.25 varies
Sars-cov-2 COVID-19 antibody (86769) $76.73 $139.50 1.8×
Sedimentation Rate, Automated (85652) $29.56 $53.75 10.9×
Sensitivity mic (87186) $64.35 $117 7.4×
Sex Hormone Binding Globulin (84270) $105.19 $191.25 4.8×
Sickling of rbc reduction (85660) $31.21 $56.75 5.7×
Smear acid fast (87206)
range across 2 matching MRF lines
$43.31–$48.26 $78.75–$87.75 varies
Smear complex stain (87209) $82.09 $149.25 4.6×
Smear gram stain (87205) $43.31 $78.75 10.1×
Sodium Serum (84295) $22.41 $40.75 4.7×
Sodium Urine (84300) $38.91 $70.75 7.7×
Somatomedin (84305) $200.61 $364.75 9.4×
Specimen infect agnt concntj (87015)
range across 2 matching MRF lines
$25.16–$33.96 $45.75–$61.75 varies
Spectrophotometry (84311) $40.15 $73 5.0×
Stool cultr aerobic bact ea (87046) $46.20 $84 4.9×
Strep a assay w/optic (87880) $50.33 $91.50 3.0×
Strep a DNA amp probe (87651) $161.29 $293.25 4.6×
Surg path level iii (88304) $110.83 $201.50 2.2×
Surgical pathology level IV (88305) $126.36 $229.75 2.5×
Susceptbilty Stdy Antimicrbial Agnt Agar Dilutj (87181) $28.60 $52 6.0×
T3 Free (84481) $71.91 $130.75 4.2×
T4 Free (84439) $73.70 $134 8.2×
T4 total (84436) $47.99 $87.25 7.0×
Tb ag response t-cell susp (86481) $364.24 $662.25 3.6×
Testosterone total (84403) $91.85 $167 3.6×
Testosterone, Free (84402) $71.64 $130.25 2.8×
Thrombin Time (85670) $113.99 $207.25 19.8×
Thyroglobulin Antibody (86800) $56.10 $102 3.5×
Thyroid Stimulating Immunoglobulin (84445) $112.89 $205.25 2.2×
Tiss Trnsgltmnase Ea Ig Clas (86364) $53.76 $97.75 4.7×
Tissue Culture Lymphocyte (88230) $314.74 $572.25 2.7×
Topiramate (80201) $68.20 $124 5.7×
Transferase Aspartate Amino Ast Sgot (84450) $19.39 $35.25 3.7×
Transferrin (84466) $68.75 $125 5.4×
Triglycerides (84478) $19.66 $35.75 3.4×
Troponin Quant (84484) $145.89 $265.25 11.7×
Urine Bacteria Culture (87088) $25.16 $45.75 3.1×
Urine Pregnancy Test (81025) $31.08 $56.50 3.6×
Urnls Dip Stick/Tablet Reagent Auto Microscopy (81001) $33.96 $61.75 10.7×
Valproic acid (80164) $113.99 $207.25 8.4×
Vancomycin (80202) $132.28 $240.50 9.8×
Viral Culture (87252) $119.90 $218 4.6×
Virus inoculation, shell via (87254) $90.48 $164.50 4.6×
Vit D 1 25-Dihydroxy (82652) $314.88 $572.50 8.2×
Vitamin A (84590) $91.85 $167 7.9×
Vitamin b-12 (82607) $70.81 $128.75 4.7×
Vitamin B6 (84207) $136.40 $248 4.9×
Vitamin D 25-Hydroxy (82306)
range across 2 matching MRF lines
$110.69–$194.56 $201.25–$353.75 varies
Vitamin E (84446) $63.11 $114.75 4.5×
Von willebrand factor ag (85246) $206.53 $375.50 9.0×
Zinc (84630) $96.25 $175 8.5×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.