Assay of lap enzyme at Midwest Orthopedic Specialty Hospital
10101 S. 27th St, Franklin, WI · Ascension · · NPI 1861635971
not published by hospital
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
not published by hospital
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$9.81 with MEDICARE REPLACEMENT vs $41.33 with WPS — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| MEDICARE REPLACEMENT | 1205_MEDICARE REPLACEMENT OUTPATIENT 20250101 | $9.81 | — |
| VETERANS ADMINISTRATION | 1208_VETERAN ADMINISTRATION OUTPATIENT 20250101 | $9.81 | — |
| VETERANS ADMINISTRATION | 1323_VETERAN ADMINISTRATION INPATIENT 20251001 | $9.81 | — |
| MEDICARE REPLACEMENT | 1321_MEDICARE REPLACEMENT INPATIENT 20251001 | $9.81 | — |
| SEHN | 1171_SEHN 20241001 | $10.30 | — |
| CENTIVO NW3 | 1255_CENTIVO NW3 20250101 | $11.38 | — |
| CENTIVO NW2 | 1254_CENTIVO NW2 20250101 | $11.97 | — |
| CENTIVO NW1 | 1253_CENTIVO NW1 20250101 | $12.56 | — |
| UNITED BEHAVIORAL HEALTH | 605_UNITED HEALTH CARE BEHAVIORAL 20171024 | $12.73 | — |
| UNITED HEALTH CARE | 1282_UNITED HEALTH CARE 20250701 | $12.73 | — |
| UNITED HEALTH CARE | 1283_UNITED HEALTH CARE MWWI 20250701 | $12.73 | — |
| ANTHEM BLUE CONNECTION | 1277_ANTHEM BLUE CONNECTION 20250701 | $13.73 | — |
| SMART HEALTH | 1206_SMARTHEALTH OUTPATIENT 20250101 | $13.73 | — |
| SMART HEALTH | 1317_SMARTHEALTH INPATIENT 20251001 | $13.73 | — |
| ANTHEM PATHWAYS | 1242_ANTHEM PATHWAYS 20250101 | $13.93 | — |
| NETWORK HEALTH | 1289_NETWORK HEALTH PLAN 20250701 | $15.16 | — |
| ANTHEM HMO POS | 1275_ANTHEM HMO POS 20250701 | $15.21 | — |
| CCHP | 1280_CCHP 20250701 | $18.86 | — |
| ALLIANCE | 1166_ALLIANCE 20241001 | $21.22 | — |
| ANTHEM PPO | 1276_ANTHEM PPO 20250701 | $23.05 | — |
| WPS | 1272_WISCONSIN PHYSICIAN SERVICES PPO 20250701 | $41.33 | — |
Visitor-reported prices
Comments
Assay of lap enzyme at other Wisconsin hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Milwaukee | $68.37 | $9.81 – $40.13 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | $68.37 | $9.81 – $40.13 |
| SSM Health St. Clare Hospital - Baraboo | Baraboo | $39.60 | $7.36 – $91.07 |
| SSM Health St. Mary's Hospital - Janesville | Janesville | $48.40 | $7.36 – $72.86 |
| SSM Health St. Mary's Hospital - Madison | Madison | $33.55 | $7.36 – $74.51 |
| UnityPoint Health - Meriter Hospital | Madison | not published | $5.89 – $14.26 |
| Orthopaedic Hospital of Wisconsin, LLC | Glendale | not published | $9.52 – $16.42 |
| SSM Health Monroe Hospital | Monroe | not published | $9.81 – $17.17 |