Ascension SE Wisconsin Hospital - Franklin Campus

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  • HCPCS 86618

    Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria)

  • HCPCS 86644

    Analysis for antibody (IgM) to Cytomegalovirus (CMV)

  • HCPCS 86694

    Analysis for antibody to Herpes simplex virus

  • HCPCS 86695

    Analysis for antibody to Herpes simplex virus, type 1

  • HCPCS 86701

    Analysis for antibody to HIV -1 virus

  • HCPCS 86803

    Confirmation test for Hepatitis C antibody

  • HCPCS 86318

    Covid-19 antibody test

  • HCPCS 86225

    Deoxyribonucleic acid (DNA) antibody; native or double stranded

  • HCPCS 99214

    Established patient office or other outpatient visit, typically 25 minutes

  • HCPCS 99214

    Established patient office or other outpatient visit, typically 25 minutes

    $223.66
    Cash Price
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  • HCPCS 99215

    Established patient office or other outpatient, visit typically 40 minutes

  • HCPCS 99215

    Established patient office or other outpatient, visit typically 40 minutes

    $259.17
    Cash Price
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  • HCPCS 99395

    Established patient periodic preventive medicine examination age 18-39 years

  • HCPCS 99396

    Established patient periodic preventive medicine examination age 40-64 years

  • HCPCS 86704

    Hepatitis B core antibody (IgM) measurement

  • HCPCS 86706

    Hepatitis B surface antibody measurement

  • HCPCS 86317

    Immunoassay for infectious agent antibody

  • HCPCS 86334

    Immunofixation electrophoresis; serum

  • HCPCS 99381

    Initial visit for an infant

  • HCPCS 99392

    Initial visit for new patients 1-4 years old

  • HCPCS 99382

    Initial visit for new patients 1-4 years old

  • HCPCS 99387

    Initial visit for new patients 65 and older years old

  • HCPCS 86140

    Measurement C-reactive protein

  • HCPCS 86003

    Measurement of antibody (IgE) to allergic substance

  • HCPCS 86161

    Measurement of Complement (Immune System Proteins)

  • HCPCS 86708

    Measurement of Hepatitis A antibody (IgM)

  • HCPCS 86376

    Microsomal Antibodies Measurement

  • HCPCS 99394

    New preventative visit in new patients 12-17 years old

  • HCPCS 99384

    New preventative visit in new patients 12-17 years old

  • HCPCS 99383

    New preventative visit in new patients 5-11 years old

  • HCPCS 99393

    New preventative visit in new patients 5-11 years old

  • HCPCS 99422

    Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes

  • HCPCS 99421

    Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes

  • HCPCS 99211

    Outpatient visit of established patient not requiring a physician

  • HCPCS 99211

    Outpatient visit of established patient not requiring a physician

    $82.15
    Cash Price
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  • HCPCS 99391

    Periodic primary re-evaluation for an established infant patient

  • HCPCS 99397

    Periodic primary re-evaluation for an established patient 65 and older

  • HCPCS 99442

    Physician telephone patient service, 11-20 minutes of medical discussion

  • HCPCS 99443

    Physician telephone patient service, 21-30 minutes of medical discussion

  • HCPCS 99441

    Physician telephone patient service, 5-10 minutes of medical discussion

  • HCPCS 86431

    Rheumatoid factor level

  • HCPCS 86255

    Screening test for antibody to noninfectious agent

  • HCPCS 86308

    Screening test for mononucleosis (mono)

  • HCPCS 86592

    Syphilis Detection Test

  • HCPCS 86361

    T cell count and ratio

  • HCPCS 86360

    T cells; absolute CD4 and CD8 count, including ratio

  • HCPCS 86359

    T cells count, total

  • HCPCS 86800

    Thyroglobulin (thyroid protein) antibody measurement

  • HCPCS 86580

    Tuberculosis Test

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