Aspirus Divine Savior Hospital

2817 New Pinery Road, Portage, WI 53901 · (608) 742-4131

Acute Care HospitalsVoluntary non-profit - PrivateCMS rating 3/5Madison, WI metro Website ↗

Price file

Prices published

File dated 2026-04-01

2,524 price rows for 68 procedures

Published prices

cash · negotiated range · list

Basic metabolic panel (blood test)

CPT 80048 · lowest of 2 lines · metro median $92

$92

cash

$8 to $63

27 negotiated rates

$142

list

CT scan of the abdomen and pelvis, with contrast

CPT 74177 · lowest of 3 lines · metro median $3,468

$584

cash

$64 to $2,542

63 negotiated rates

$898

list

CT scan of the head, no contrast

CPT 70450 · lowest of 3 lines · metro median $1,235

$274

cash

$36 to $1,473

55 negotiated rates

$421

list

CT scan of the pelvis, with contrast

CPT 72193 · lowest of 3 lines · metro median $1,557

$460

cash

$51 to $1,473

30 negotiated rates

$707

list

Cataract surgery with lens implant

CPT 66984 · lowest of 2 lines · metro median $3,118

$4,623

cash

$104 to $16,812

37 negotiated rates

$7,113

list

Cesarean delivery with prenatal and postpartum care

CPT 59510 · metro median $5,793

$5,793

cash

$1,149 to $8,840

16 negotiated rates

$8,912

list

Cesarean section hospital stay, no complications

MS-DRG 788

—

cash

$7,564 to $21,882

33 negotiated rates

—

list

Chlamydia test (DNA)

CPT 87491 · lowest of 3 lines · metro median $31

$213

cash

$30 to $263

27 negotiated rates

$327

list

Colonoscopy (diagnostic)

CPT 45378 · lowest of 3 lines · metro median $1,806

$1,806

cash

$80 to $6,775

51 negotiated rates

$2,778

list

Colonoscopy with biopsy

CPT 45380 · lowest of 3 lines · metro median $2,092

$2,092

cash

$117 to $8,718

55 negotiated rates

$3,219

list

Colonoscopy with polyp removal

CPT 45385 · lowest of 3 lines · metro median $2,173

$2,425

cash

$98 to $8,718

54 negotiated rates

$3,730

list

Complete blood count (CBC) with differential

CPT 85025 · lowest of 2 lines · metro median $80

$80

cash

$8 to $58

28 negotiated rates

$123

list

Comprehensive metabolic panel (blood test)

CPT 80053 · lowest of 2 lines · metro median $134

$114

cash

$11 to $79

27 negotiated rates

$175

list

Diagnostic mammogram (both breasts)

CPT 77066 · lowest of 3 lines · metro median $448

$235

cash

$38 to $671

19 negotiated rates

$361

list

Electrocardiogram (ECG) with interpretation

CPT 93000 · metro median $154

$154

cash

$7 to $148

12 negotiated rates

$237

list

Established patient office visit (about 40 minutes)

CPT 99215 · lowest of 3 lines · metro median $175

$315

cash

$108 to $441

37 negotiated rates

$484

list

Family psychotherapy with the patient

CPT 90847 · lowest of 3 lines · metro median $234

$190

cash

$172 to $1,473

13 negotiated rates

$292

list

Family psychotherapy without the patient

CPT 90846 · lowest of 3 lines · metro median $222

$183

cash

$172 to $1,473

13 negotiated rates

$281

list

Gallbladder removal (laparoscopic)

CPT 47562 · lowest of 3 lines · metro median $4,053

$4,053

cash

$226 to $44,042

33 negotiated rates

$6,236

list

Gonorrhea test (DNA)

CPT 87591 · lowest of 3 lines · metro median $74

$213

cash

$30 to $263

27 negotiated rates

$327

list

Group psychotherapy

CPT 90853 · lowest of 2 lines · metro median $84

$31

cash

$99 to $1,473

13 negotiated rates

$48

list

Hip or knee replacement, no major complications

MS-DRG 470

—

cash

$14,408 to $44,021

33 negotiated rates

—

list

Hospital stay for digestive disorders, no complications

MS-DRG 392

—

cash

$6,299 to $17,792

33 negotiated rates

—

list

Hysterectomy for non-cancer reasons, no complications

MS-DRG 743

—

cash

$9,553 to $28,315

33 negotiated rates

—

list

Inguinal hernia repair (age 5 and up)

CPT 49505 · lowest of 3 lines · metro median $2,706

$2,706

cash

$221 to $26,083

28 negotiated rates

$4,163

list

Knee arthroscopy with meniscus repair

CPT 29881 · lowest of 2 lines · metro median $2,852

$2,852

cash

$72 to $23,837

32 negotiated rates

$4,387

list

Laser treatment after cataract surgery (YAG)

CPT 66821 · lowest of 3 lines · metro median $1,066

$1,175

cash

$534 to $4,007

17 negotiated rates

$1,808

list

Left heart catheterization

CPT 93452 · lowest of 2 lines · metro median $4,282

$4,159

cash

$3,149 to $23,617

13 negotiated rates

$6,399

list

Lipid panel (cholesterol test)

CPT 80061 · lowest of 3 lines · metro median $107

$107

cash

$13 to $100

27 negotiated rates

$165

list

Liver function panel

CPT 80076 · lowest of 2 lines · metro median $93

$102

cash

$8 to $61

27 negotiated rates

$157

list

MRI of the brain, with and without contrast

CPT 70553 · lowest of 3 lines · metro median $2,726

$970

cash

$99 to $6,069

43 negotiated rates

$1,493

list

MRI of the knee or other lower joint, no contrast

CPT 73721 · lowest of 3 lines · metro median $1,695

$574

cash

$54 to $3,438

50 negotiated rates

$883

list

MRI of the lower back (lumbar spine), no contrast

CPT 72148 · lowest of 3 lines · metro median $2,119

$629

cash

$52 to $3,893

45 negotiated rates

$968

list

MRI of the neck (cervical spine), no contrast

CPT 72141 · lowest of 3 lines · metro median $2,087

$626

cash

$61 to $4,064

42 negotiated rates

$963

list

Neck (cervical) spinal fusion, no complications

MS-DRG 473

—

cash

$18,023 to $55,715

33 negotiated rates

—

list

Nerve block injection, lower back, with imaging guidance

CPT 64483 · lowest of 3 lines · metro median $1,722

$680

cash

$105 to $6,443

41 negotiated rates

$1,046

list

New patient office visit (about 30 minutes)

CPT 99203 · lowest of 3 lines · metro median $205

$205

cash

$64 to $300

44 negotiated rates

$315

list

New patient office visit (about 45 minutes)

CPT 99204 · lowest of 3 lines · metro median $351

$351

cash

$111 to $514

45 negotiated rates

$540

list

New patient office visit (about 60 minutes)

CPT 99205 · lowest of 3 lines · metro median $459

$459

cash

$146 to $631

26 negotiated rates

$706

list

PSA test (prostate)

CPT 84153 · lowest of 2 lines · metro median $118

$118

cash

$18 to $138

27 negotiated rates

$182

list

Partial thromboplastin time (blood clotting test)

CPT 85730 · lowest of 3 lines · metro median $51

$65

cash

$6 to $45

27 negotiated rates

$100

list

Physical therapy, therapeutic exercise (15 minutes)

CPT 97110 · lowest of 2 lines · metro median $97

$97

cash

$21 to $240

35 negotiated rates

$149

list

Pregnancy ultrasound (after first trimester)

CPT 76805 · lowest of 4 lines · metro median $603

$286

cash

$44 to $1,473

42 negotiated rates

$440

list

Preventive visit, new patient age 18 to 39

CPT 99385 · metro median $157

$277

cash

$87 to $362

20 negotiated rates

$426

list

Preventive visit, new patient age 40 to 64

CPT 99386 · lowest of 2 lines · metro median $157

$336

cash

$100 to $472

18 negotiated rates

$517

list

Prostate biopsy

CPT 55700 · lowest of 3 lines · metro median $949

$949

cash

—

$1,460

list

Prostate removal (laparoscopic)

CPT 55866 · metro median $6,440

$6,440

cash

$9,072 to $77,438

17 negotiated rates

$9,908

list

Prothrombin time (blood clotting test)

CPT 85610 · lowest of 4 lines · metro median $26

$46

cash

$4 to $32

27 negotiated rates

$71

list

Psychotherapy, 30 minutes

CPT 90832 · lowest of 3 lines · metro median $119

$77

cash

$172 to $1,473

13 negotiated rates

$119

list

Psychotherapy, 45 minutes

CPT 90834 · lowest of 3 lines · metro median $151

$102

cash

$172 to $1,473

13 negotiated rates

$157

list

Psychotherapy, 60 minutes

CPT 90837 · lowest of 3 lines · metro median $235

$153

cash

$172 to $1,473

13 negotiated rates

$235

list

Removal of a breast lump (biopsy by excision)

CPT 19120 · lowest of 2 lines · metro median $2,153

$2,153

cash

$306 to $28,524

20 negotiated rates

$3,312

list

Screening mammogram (both breasts)

CPT 77067 · lowest of 4 lines · metro median $194

$125

cash

$29 to $554

46 negotiated rates

$192

list

Shoulder arthroscopy with decompression

CPT 29826 · lowest of 2 lines · metro median $878

$2,618

cash

$155 to $7,560

9 negotiated rates

$4,027

list

Sleep study (overnight, attended)

CPT 95810 · lowest of 3 lines · metro median $3,409

$3,409

cash

$834 to $6,256

13 negotiated rates

$5,244

list

Spinal injection, lower back, no imaging guidance

CPT 62322 · lowest of 3 lines · metro median $1,588

$825

cash

$71 to $6,443

19 negotiated rates

$1,269

list

Spinal injection, lower back, with imaging guidance

CPT 62323 · lowest of 3 lines · metro median $1,100

$550

cash

$89 to $5,142

31 negotiated rates

$846

list

TSH test (thyroid)

CPT 84443 · lowest of 3 lines · metro median $112

$112

cash

$17 to $126

28 negotiated rates

$173

list

Tonsils and adenoids removal (under age 12)

CPT 42820 · metro median $1,286

$1,548

cash

$131 to $43,126

18 negotiated rates

$2,381

list

Transvaginal ultrasound

CPT 76830 · lowest of 4 lines · metro median $458

$238

cash

$30 to $1,473

51 negotiated rates

$366

list

Ultrasound of the abdomen (complete)

CPT 76700 · lowest of 4 lines · metro median $690

$356

cash

$35 to $1,473

33 negotiated rates

$548

list

Upper endoscopy (EGD)

CPT 43235 · lowest of 3 lines · metro median $1,218

$1,370

cash

$96 to $6,607

25 negotiated rates

$2,107

list

Upper endoscopy with biopsy

CPT 43239 · lowest of 3 lines · metro median $1,414

$1,581

cash

$62 to $6,607

52 negotiated rates

$2,432

list

Urinalysis with microscope

CPT 81001 · lowest of 2 lines · metro median $37

$40

cash

$3 to $24

27 negotiated rates

$62

list

Vaginal delivery after a previous cesarean

CPT 59610 · metro median $5,545

$5,545

cash

$8,840 to $8,840

4 negotiated rates

$8,530

list

Vaginal delivery hospital stay, no complications

MS-DRG 807

—

cash

$5,556 to $15,387

33 negotiated rates

—

list

Vaginal delivery with prenatal and postpartum care

CPT 59400 · metro median $4,891

$4,891

cash

$1,149 to $8,840

20 negotiated rates

$7,524

list

X-ray of the lower spine (4 or more views)

CPT 72110 · lowest of 4 lines · metro median $358

$112

cash

$12 to $1,473

33 negotiated rates

$173

list

Source files

The machine-readable files this hospital lists in its cms-hpt.txt. Every price above comes from one of them.

https://www.aspirus.org/Uploads/Public/Documents/PriceEstimate/TransparencyFY27/390806250_1124083894_aspirus-divine-savior-hospital_standardcharges.json
Aspirus Divine Savior Hospital · parsed · json v3.0.0 · file dated 2026-04-01 · 197.9 MB · 2524 price rows read · read Nov 2026
https://www.aspirus.org/Uploads/Public/Documents/PriceEstimate/TransparencyFY27/390806429_1639187412_aspirus-langlade-hospital_standardcharges.json
Aspirus Langlade Hospital · unmatched · json v3.0.0 · file dated 2026-04-01 · 160 MB · read Oct 2026
https://www.aspirus.org/Uploads/Public/Documents/PriceEstimate/TransparencyFY27/391138241_1598375271_aspirus-plover-hospital_standardcharges.json
Aspirus Plover Hospital · unmatched · json v3.0.0 · file dated 2026-04-01 · 147.3 MB · read Oct 2026
https://www.aspirus.org/Uploads/Public/Documents/PriceEstimate/TransparencyFY27/383236977_1497750830_aspirus-iron-river-hospital_standardcharges.json
Aspirus Iron River Hospital · unmatched · json v3.0.0 · file dated 2026-04-01 · 151.6 MB · read Oct 2026
https://www.aspirus.org/Uploads/Public/Documents/PriceEstimate/TransparencyFY27/381443361_1326115569_aspirus-keweenaw-hospital_standardcharges.json
Aspirus Keweenaw Hospital · unmatched · json v3.0.0 · file dated 2026-04-01 · 150.3 MB · read Oct 2026
https://www.aspirus.org/Uploads/Public/Documents/PriceEstimate/TransparencyFY27/410714079_1801835970_aspirus-st-lukes-hospital_standardcharges.json
Aspirus St. Luke's Hospital · unmatched · json v3.0.0 · file dated 2026-04-01 · 188.6 MB · read Oct 2026