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 |
|---|---|---|---|---|
| Cryoablate prostate CPT 55873 | not published | not published | $25,561.24 – $25,561.24 | 1 |
| Cryocautery of cervix 57511 CPT 57511 | not published | not published | $295.37 – $523.02 | 4 |
| Cryofibrinogen qualitative - sendout CPT 82585 | $30.21 | $57.00 | $10.62 – $33.23 | 17 |
| Cryopreservation embryo(s) CPT 89258 | not published | not published | $82.47 – $1,110.52 | 6 |
| Cryopreservation oocyte(s) CPT 89337 | not published | not published | $166.39 – $268.42 | 6 |
| Cryopreservation sperm CPT 89259 | not published | not published | $53.33 – $232.95 | 6 |
| Cryopreserve stem cells CPT 38207 | not published | not published | $171.39 – $594.31 | 4 |
| Cryopreserve testicular tiss CPT 89335 | not published | not published | $51.88 – $82.47 | 6 |
| Cryosurg ablate fa each CPT 19105 | not published | not published | $7,735.20 – $7,735.20 | 1 |
| Cryosurgery penis lesion(s) 54056 CPT 54056 | not published | not published | $192.94 – $513.99 | 4 |
| Cryotherapy of acne 17340 CPT 17340 | not published | not published | $57.68 – $186.28 | 4 |
| Cryptococcus abs qn - sendout CPT 86641 | not published | not published | $9.63 – $33.86 | 17 |
| Cryptosporidium antigen CPT 87272 | $74.73 | $141.00 | $11.98 – $54.30 | 17 |
| Crystal identification light microscopy CPT 89060 | $31.80 | $60.00 | $7.33 – $31.88 | 17 |
| C-Section Delivery (full care) CPT 59510 | not published | not published | $8,280.97 – $8,280.97 | 1 |
| C-section delivery incl p/p care 59515 CPT 59515 | not published | not published | $4,514.49 – $4,514.49 | 1 |
| Csf leakage imaging CPT 78650 | not published | not published | $102.29 – $2,938.37 | 2 |
| Csf shunt reprogram 62252 CPT 62252 | not published | not published | $139.88 – $407.71 | 4 |
| Csf ventriculography CPT 78635 | not published | not published | $104.64 – $1,101.15 | 5 |
| CT 3d report other modality w/workstation CPT 76377 | $455.80 | $860.00 | $80.97 – $724.00 | 2 |
| Cta abdomen without & /or w/contrast CPT 74175 | $885.10 | $1,670.00 | $172.86 – $724.00 | 6 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $885.10 | $1,670.00 | $172.86 – $724.00 | 6 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $1,007.53 | $1,901.00 | $172.86 – $724.00 | 6 |
| Cta neck without &/or w/contrast CPT 70498 | $885.10 | $1,670.00 | $172.86 – $724.00 | 6 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $1,292.67 | $2,439.00 | $346.78 – $828.27 | 6 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $885.10 | $1,670.00 | $172.86 – $724.00 | 6 |
| CT Angiogram of the Head CPT 70496 | $845.35 | $1,595.00 | $172.86 – $724.00 | 6 |
| CT angio hrt w/3d image CPT 75574 | not published | not published | $346.78 – $724.00 | 6 |
| CT angio pelvis CPT 72191 | $1,007.53 | $1,901.00 | $172.86 – $724.00 | 6 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $885.10 | $1,670.00 | $172.86 – $724.00 | 6 |
| CT bone density axial CPT 77078 | not published | not published | $42.23 – $724.00 | 6 |
| CT colonography dx CPT 74261 | not published | not published | $103.26 – $724.00 | 6 |
| CT colonography dx w/dye CPT 74262 | not published | not published | $172.86 – $724.00 | 6 |
| CT colonography screening CPT 74263 | not published | not published | $234.71 – $1,486.98 | 6 |
| CT guidance for needle placement CPT 77012 | $683.70 | $1,290.00 | $195.51 – $724.00 | 2 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $650.84 | $1,228.00 | $199.20 – $204.00 | 2 |
| CT guid cryo ablat intramuscular CPT 20999 | not published | not published | $232.93 – $326.10 | 3 |
| CT guid parench tis ablat CPT 77013 | $744.65 | $1,405.00 | $667.47 – $724.00 | 2 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | not published | not published | $85.50 – $724.00 | 6 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | not published | not published | $346.78 – $724.00 | 6 |
| CT hrt w/3d image CPT 75572 | not published | not published | $295.80 – $724.00 | 6 |
| CT limited or localized follow-up study CPT 76380 | $516.22 | $974.00 | $85.50 – $724.00 | 6 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $867.61 | $1,637.00 | $172.86 – $724.00 | 6 |
| CT lower extremity without contrast (both sides) CPT 73700 | $841.64 | $1,588.00 | $103.26 – $724.00 | 6 |
| CT lwr extremity w/o&w/dye CPT 73702 | $1,007.53 | $1,901.00 | $172.86 – $724.00 | 6 |
| CT neck soft tissue w/contrast CPT 70491 | $850.12 | $1,604.00 | $172.86 – $724.00 | 6 |
| CT neck soft tissue without contrast CPT 70490 | $841.64 | $1,588.00 | $103.26 – $724.00 | 6 |
| CT neck soft tissue without & w/contrast CPT 70492 | $876.09 | $1,653.00 | $172.86 – $724.00 | 6 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $876.62 | $1,654.00 | $172.86 – $724.00 | 6 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $867.61 | $1,637.00 | $172.86 – $724.00 | 6 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $858.60 | $1,620.00 | $103.26 – $724.00 | 6 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | not published | not published | $225.49 – $1,267.68 | 4 |
| CT scan for therapy guide CPT 77014 | not published | not published | $149.18 – $724.00 | 2 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $1,274.65 | $2,405.00 | $343.48 – $828.27 | 6 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $1,274.65 | $2,405.00 | $312.23 – $828.27 | 6 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $1,212.11 | $2,287.00 | $234.71 – $724.00 | 6 |
| CT thoracic spine w/contrast CPT 72129 | $894.64 | $1,688.00 | $172.86 – $724.00 | 6 |
| CT thoracic spine without contrast CPT 72128 | $841.64 | $1,588.00 | $103.26 – $724.00 | 6 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $595.72 | $1,124.00 | $103.26 – $182.03 | 5 |
| CT t-spine w /wo contrast CPT 72130 | $947.64 | $1,788.00 | $172.86 – $724.00 | 6 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $867.61 | $1,637.00 | $199.03 – $828.27 | 6 |
| CT upper extremity without contrast (both sides) CPT 73200 | $850.12 | $1,604.00 | $103.26 – $724.00 | 6 |
| CT uppr extremity w/o&w/dye CPT 73202 | $885.10 | $1,670.00 | $172.86 – $724.00 | 6 |
| Cultr oocyte/embryo <4 days CPT 89250 | not published | not published | $82.47 – $3,456.31 | 11 |
| Cultr oocyte/embryo <4 days CPT 89251 | not published | not published | $82.47 – $3,594.45 | 11 |
| Cult skin graft fnhfg 15155 CPT 15155 | not published | not published | $2,621.56 – $2,621.56 | 1 |
| Cult skin grft t/arm/leg CPT 15150 | not published | not published | $2,490.93 – $2,490.93 | 1 |
| Culture aerobic additional method definitive id each CPT 87077 | $30.74 | $58.00 | $8.08 – $36.60 | 17 |
| Culture afb any source CPT 87116 | $67.84 | $128.00 | $10.80 – $48.40 | 17 |
| Culture anaerobic additional method definitive id each CPT 87076 | $38.69 | $73.00 | $8.08 – $36.60 | 17 |
| Culture anaerobic except blood CPT 87075 | $62.54 | $118.00 | $9.47 – $42.50 | 17 |
| Culture bact stool aero addl path ea CPT 87046 | $36.04 | $68.00 | $9.44 – $42.50 | 17 |
| Culture body fluid CPT 87070 | $54.06 | $102.00 | $8.62 – $38.95 | 17 |
| Culture fungi definitive id mold CPT 87107 | $38.16 | $72.00 | $10.32 – $46.02 | 17 |
| Culture fungi definitive id yeast CPT 87106 | $39.22 | $74.00 | $10.32 – $46.02 | 17 |
| Culture fungi other (except blood) CPT 87102 | $64.66 | $122.00 | $8.41 – $37.78 | 17 |
| Culture fungi skin/hair/nail CPT 87101 | $47.70 | $90.00 | $7.71 – $34.22 | 17 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $79.50 | $150.00 | $14.61 – $49.58 | 17 |
| Culture mycoplasma any source CPT 87109 | $81.62 | $154.00 | $15.39 – $46.82 | 17 |
| Culture quantitative aerobic other source CPT 87071 | $46.64 | $88.00 | $9.89 – $42.50 | 17 |
| Culture screening strep group a CPT 87081 | $36.04 | $68.00 | $6.63 – $29.50 | 17 |
| Culture typing added method CPT 87158 | not published | not published | $7.74 – $23.60 | 17 |
| Culture typing immunologic CPT 87147 | $20.67 | $39.00 | $5.18 – $23.60 | 17 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | not published | not published | $218.06 – $715.15 | 11 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $130.38 | $246.00 | $35.09 – $157.01 | 17 |
| Culture urine each isolate CPT 87088 | $36.57 | $69.00 | $8.09 – $36.60 | 17 |
| Culture virus isolation CPT 87250 | not published | not published | $19.56 – $87.35 | 17 |
| Curette/treat cornea CPT 65435 | not published | not published | $289.56 – $1,316.66 | 4 |
| Curette/treat cornea CPT 65436 | not published | not published | $1,413.37 – $1,413.37 | 1 |
| Cv line/pic reposition CPT 36597 | $1,228.54 | $2,318.00 | $464.31 – $464.31 | 1 |
| Cv stress test i&r only 93018 CPT 93018 | not published | not published | $48.86 – $48.86 | 1 |
| Cv stress test/supervision only 93016 CPT 93016 | not published | not published | $73.64 – $73.64 | 1 |
| Cyanocobalamin unsat binding capacity CPT 82608 | $46.64 | $88.00 | $14.32 – $63.76 | 17 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $4.75 | $8.96 | $1.56 – $3.96 | 10 |
| Cyclic citrullinated peptide antibody CPT 86200 | $56.18 | $106.00 | $12.95 – $57.86 | 17 |
| Cyclosporine 2 hour CPT 80158 | $89.04 | $168.00 | $18.05 – $81.45 | 17 |
| Cyp2c19 gene com variants CPT 81225 | not published | not published | $291.36 – $959.69 | 17 |
| Cyp2c9 gene com variants CPT 81227 | not published | not published | $174.81 – $576.05 | 17 |
| Cyp2d6 gene com variants CPT 81226 | not published | not published | $450.91 – $1,486.16 | 17 |
| Cyp3a4 gene common variants CPT 81230 | not published | not published | $174.81 – $573.69 | 14 |
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.