Midwest Orthopedic Specialty Hospital
10101 S. 27th St, Franklin, WI · Ascension · · NPI 1861635971
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Chromosome analys amniotic CPT 88269 | $288.85 | $545.00 | $173.66 – $746.03 | 17 |
| Chromosome analysis 100 CPT 88249 | not published | not published | $173.17 – $776.73 | 17 |
| Chromosome analysis 15-20 cell count CPT 88262 | $433.01 | $817.00 | $125.49 – $559.52 | 17 |
| Chromosome analysis 20-25 CPT 88245 | not published | not published | $173.17 – $668.13 | 17 |
| Chromosome analysis 45 CPT 88263 | not published | not published | $150.29 – $674.03 | 17 |
| Chromosome analysis 5 CPT 88261 | not published | not published | $264.34 – $793.26 | 17 |
| Chromosome analysis 50-100 CPT 88248 | not published | not published | $173.17 – $776.73 | 17 |
| Chromosome analys placenta CPT 88267 | $611.09 | $1,153.00 | $188.57 – $807.44 | 17 |
| Chromosome banding study CPT 88283 | $81.62 | $154.00 | $68.60 – $308.09 | 17 |
| Chromosome count additional CPT 88285 | not published | not published | $26.91 – $85.01 | 17 |
| Chromosome karyotype study CPT 88280 | $93.28 | $176.00 | $33.47 – $112.13 | 17 |
| Chromosome study additional CPT 88289 | not published | not published | $34.43 – $154.63 | 17 |
| Chronic urticaria - sendout CPT 86343 | $52.47 | $99.00 | $12.46 – $55.48 | 17 |
| Chylomicron screen, bf - sendout CPT 82664 | $111.30 | $210.00 | $56.85 – $154.63 | 17 |
| Ciliary transsleral therapy CPT 66710 | not published | not published | $1,603.15 – $1,603.15 | 1 |
| Cine/video x-rays CPT 76120 | not published | not published | $66.07 – $245.18 | 6 |
| Cine/video x-rays add-on CPT 76125 | not published | not published | $48.47 – $204.00 | 2 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $4.66 | $8.80 | $1.02 – $2.77 | 10 |
| Circum 28 days or older CPT 54161 | not published | not published | $721.27 – $721.27 | 1 |
| Circumcise/surg/28 days or < 54160 CPT 54160 | not published | not published | $648.13 – $907.38 | 4 |
| Circumcision (newborn) CPT 54150 | not published | not published | $558.46 – $558.46 | 1 |
| C-kit mutation liquid tumor - sendout CPT 81272 | $1,105.05 | $2,085.00 | $329.51 – $841.25 | 17 |
| Claviculectomy partial CPT 23120 | not published | not published | $2,110.88 – $2,110.88 | 1 |
| Claviculectomy total CPT 23125 | not published | not published | $2,568.52 – $2,568.52 | 1 |
| Clean out mastoid cavity CPT 69222 | not published | not published | $494.49 – $803.11 | 4 |
| Clearance of airways CPT 31720 | $116.60 | $220.00 | $190.57 – $276.50 | 4 |
| Clearance of tear duct CPT 68530 | not published | not published | $290.27 – $1,550.67 | 4 |
| C-lens fitg corneosclrl lens CPT 92313 | not published | not published | $125.16 – $316.57 | 4 |
| C-lens fitg tech aphakia 1 CPT 92315 | not published | not published | $125.16 – $234.19 | 4 |
| C-lens fitg tech aphakia ou CPT 92316 | not published | not published | $125.16 – $294.78 | 4 |
| C-lens fitg tech corneosclrl CPT 92317 | not published | not published | $38.11 – $246.98 | 4 |
| Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 | $17.14 | $32.34 | $2.62 – $6.50 | 6 |
| Clitoroplasty intersex state CPT 56805 | not published | not published | $4,197.41 – $4,197.41 | 1 |
| Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 | $22.16 | $41.82 | $2.90 – $27.62 | 5 |
| Close bronchial fistula 32815 CPT 32815 | not published | not published | $10,127.55 – $10,127.55 | 1 |
| Closed carpo/metacarpal disl thumb w/manip CPT 26641 | not published | not published | $232.93 – $1,328.03 | 4 |
| Closed carpo/metacarpal fx disl thumb w/manip CPT 26645 | not published | not published | $1,523.00 – $1,523.00 | 1 |
| Closed treatment of femoral fracture proximal end neck; wi CPT 27232 | not published | not published | $2,747.22 – $2,747.22 | 1 |
| Closed tx/acetabululm without manip 27220 CPT 27220 | not published | not published | $232.93 – $1,921.99 | 4 |
| Closed tx humerus fx with manip 23605 CPT 23605 | not published | not published | $1,682.23 – $1,682.23 | 1 |
| Closed tx humerus fx without manip 23600 CPT 23600 | not published | not published | $232.93 – $1,184.24 | 4 |
| Closed tx humerus fx w/manip 24505 CPT 24505 | not published | not published | $1,809.46 – $1,809.46 | 1 |
| Closed tx metatarsophalangeal jnt disl without anes CPT 28630 | not published | not published | $232.93 – $572.11 | 4 |
| Closed tx nose/jaw fx CPT 21345 | not published | not published | $2,977.32 – $2,977.32 | 1 |
| Closed tx orbit without manipulj CPT 21400 | not published | not published | $494.49 – $702.32 | 4 |
| Closed tx orbit w/manipulj CPT 21401 | not published | not published | $1,615.87 – $1,615.87 | 1 |
| Closed tx post hip arthroplasty disloc w/anes 27266 CPT 27266 | not published | not published | $2,106.41 – $2,106.41 | 1 |
| Closed tx septal&nose fx CPT 21337 | not published | not published | $1,479.65 – $1,479.65 | 1 |
| Closed tx sesamoid fx 28530 CPT 28530 | not published | not published | $232.93 – $425.93 | 4 |
| Closed tx/talus fracture without manip 28430 CPT 28430 | not published | not published | $232.93 – $864.28 | 4 |
| Closed tx vert fx w/manj CPT 22315 | not published | not published | $3,180.87 – $3,180.87 | 1 |
| Close lac/mouth vest/2.5 cm or < 40830 CPT 40830 | not published | not published | $225.49 – $987.78 | 4 |
| Close mastoid fistula CPT 69700 | not published | not published | $2,518.46 – $2,518.46 | 1 |
| Close median sternotomy separation 21750 CPT 21750 | not published | not published | $2,464.22 – $2,464.22 | 1 |
| Close tear duct opening CPT 68760 | not published | not published | $290.27 – $730.15 | 4 |
| Close tear duct opening CPT 68761 | not published | not published | $290.27 – $533.43 | 4 |
| Close tear system fistula CPT 68770 | not published | not published | $2,296.75 – $2,296.75 | 1 |
| Clostridium toxin a w/optic CPT 87803 | not published | not published | $16.00 – $54.30 | 17 |
| Clos txnose fx without stablz 21315 CPT 21315 | not published | not published | $1,011.58 – $1,011.58 | 1 |
| Closure enterostomy lg/sm intestine 44620 CPT 44620 | not published | not published | $3,140.73 – $3,140.73 | 1 |
| Closure enterostomy lg/sm intestine anast 44626 CPT 44626 | not published | not published | $5,790.41 – $5,790.41 | 1 |
| Closure enterostomy lg/sm intestine oth/thn 44625 CPT 44625 | not published | not published | $3,688.60 – $3,688.60 | 1 |
| Closure intestinal cutaneous fistula 44640 CPT 44640 | not published | not published | $5,069.85 – $5,069.85 | 1 |
| Closure laceration vestibule mouth > 2.5 cm cmplx CPT 40831 | not published | not published | $494.49 – $1,258.13 | 4 |
| Closure of eyelid by suture CPT 67875 | not published | not published | $621.38 – $1,316.66 | 4 |
| Closure of salivary fistula CPT 42600 | not published | not published | $1,770.07 – $1,770.07 | 1 |
| Closure of windpipe lesion 31820 CPT 31820 | not published | not published | $1,584.50 – $1,584.50 | 1 |
| Closure paravalvlr leak pq CPT 33999 | not published | not published | $600.34 – $840.48 | 3 |
| Clot factor fletcher fact CPT 85292 | not published | not published | $18.93 – $85.01 | 17 |
| Clot factor viii reltd antgn CPT 85244 | not published | not published | $20.42 – $92.08 | 17 |
| Clot factor wght kininogen CPT 85293 | not published | not published | $18.93 – $85.01 | 17 |
| Clot factor xii hageman CPT 85280 | $115.54 | $218.00 | $19.35 – $87.35 | 17 |
| Clot factor xiii fibrin scrn CPT 85291 | $59.89 | $113.00 | $9.11 – $40.12 | 17 |
| Clot factor xiii fibrin stab CPT 85290 | $25.97 | $49.00 | $16.34 – $73.17 | 17 |
| Clotting assay whole blood CPT 85396 | not published | not published | $26.13 – $70.76 | 8 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | not published | not published | $232.93 – $1,130.30 | 4 |
| Clsd tx bimalleol ank fx without manip 27808 CPT 27808 | not published | not published | $232.93 – $1,213.56 | 4 |
| Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 | not published | not published | $232.93 – $1,227.47 | 4 |
| Clsd tx clav dislc without manip 23520 CPT 23520 | not published | not published | $808.96 – $808.96 | 1 |
| Clsd tx clavicle dislocation without manip 23540 CPT 23540 | not published | not published | $232.93 – $820.64 | 4 |
| Clsd tx clavicle fracture w/manip 23505 CPT 23505 | not published | not published | $1,279.95 – $1,279.95 | 1 |
| Clsd tx/clavicular fx without manip 23500 CPT 23500 | not published | not published | $232.93 – $795.24 | 4 |
| Clsd tx coccygeal fracture 27200 CPT 27200 | not published | not published | $232.93 – $655.73 | 4 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | not published | not published | $232.93 – $669.61 | 4 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | not published | not published | $232.93 – $1,529.78 | 4 |
| Clsd tx/dis tib/wt bear no manip 27824 CPT 27824 | not published | not published | $232.93 – $1,138.10 | 4 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | not published | not published | $232.93 – $489.75 | 4 |
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | not published | not published | $2,807.65 – $2,807.65 | 1 |
| Clsd tx finger tendon w/wo perq pin 26432 CPT 26432 | not published | not published | $1,796.74 – $1,796.74 | 1 |
| Clsd tx fracture of radius 25500 CPT 25500 | not published | not published | $232.93 – $988.97 | 4 |
| Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 | not published | not published | $232.93 – $528.88 | 4 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | not published | not published | $232.93 – $589.41 | 4 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | not published | not published | $232.93 – $1,191.14 | 4 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | not published | not published | $1,991.67 – $1,991.67 | 1 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | not published | not published | $232.93 – $1,006.06 | 4 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | not published | not published | $1,886.75 – $1,886.75 | 1 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | not published | not published | $232.93 – $974.35 | 4 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | not published | not published | $232.93 – $1,452.69 | 4 |
| Clsd tx humeral fract without manip 24530 CPT 24530 | not published | not published | $232.93 – $1,379.69 | 4 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | not published | not published | $232.93 – $1,297.93 | 4 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.