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 |
|---|---|---|---|---|
| Adhesiolysis tube ovary 58740 CPT 58740 | not published | not published | $3,180.61 – $3,180.61 | 1 |
| Adh-sendout CPT 84588 | $109.71 | $207.00 | $33.94 – $152.28 | 17 |
| Adj gastric band via subq port CPT 43999 | not published | not published | $910.39 – $1,274.55 | 3 |
| Adjmt/revj ext fixj sys anes CPT 20693 | not published | not published | $1,617.51 – $1,617.51 | 1 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | not published | not published | $3,417.80 – $3,417.80 | 1 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | not published | not published | $69.11 – $96.75 | 4 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | not published | not published | $69.11 – $204.00 | 4 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $412.34 | $778.00 | $322.08 – $450.91 | 4 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | not published | not published | $322.08 – $450.91 | 4 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | not published | not published | $69.11 – $105.94 | 4 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | not published | not published | $69.11 – $243.07 | 4 |
| Administration immunization 1 vaccine CPT 90471 | not published | not published | $69.11 – $96.75 | 4 |
| Administration immunization each additional component CPT 90461 | not published | not published | $41.07 – $41.07 | 1 |
| Administration immunization each additional vaccine CPT 90472 | not published | not published | $41.07 – $41.07 | 1 |
| Administration immunization first component each vaccine CPT 90460 | not published | not published | $83.06 – $83.06 | 1 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | not published | not published | $69.11 – $96.75 | 4 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | not published | not published | $41.07 – $41.07 | 1 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | not published | not published | $72.90 – $72.90 | 1 |
| Administration vaccine hepatitis b HCPCS G0010 | $24.38 | $46.00 | $38.36 – $38.36 | 1 |
| Administration vaccine influenza virus HCPCS G0008 | $24.38 | $46.00 | $38.36 – $38.36 | 1 |
| Administration vaccine pneumococcal HCPCS G0009 | $24.38 | $46.00 | $38.36 – $38.36 | 1 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | not published | not published | $62.97 – $62.97 | 1 |
| Adrenal cortex & medulla img CPT 78075 | not published | not published | $120.72 – $2,938.37 | 2 |
| Adrenalectomy expl w/exc retro tumor 60545 CPT 60545 | not published | not published | $4,408.97 – $4,408.97 | 1 |
| Advance care planning each additional 30 min 99498 CPT 99498 | not published | not published | $198.29 – $198.29 | 1 |
| Aep hearing status deter i&r CPT 92651 | not published | not published | $295.83 – $423.33 | 4 |
| Aep neurodiagnostic i&r CPT 92653 | not published | not published | $283.90 – $423.33 | 4 |
| Aep thrshld est mlt freq i&r CPT 92652 | not published | not published | $302.38 – $423.33 | 4 |
| _afb id by dna probe rflx ast CPT 87149 | $36.57 | $69.00 | $20.05 – $89.70 | 17 |
| #afb mycobacteria suscep. #1 CPT 87190 | $35.51 | $67.00 | $4.77 – $17.18 | 17 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $336.02 | $634.00 | $115.36 – $518.22 | 17 |
| After cataract laser surgery CPT 66821 | not published | not published | $532.70 – $1,197.03 | 4 |
| Air conduction bilat CPT 92552 | not published | not published | $101.90 – $175.22 | 4 |
| Air injection into abdomen 49400 CPT 49400 | $292.03 | $551.00 | $495.05 – $495.05 | 1 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | $276.66 | $522.00 | $42.84 – $212.70 | 4 |
| Albumin body fluid quantitative each specimen CPT 82042 | $22.79 | $43.00 | $7.78 – $23.60 | 17 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $110.53 | $208.55 | $65.08 – $140.00 | 12 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $109.12 | $205.89 | $65.28 – $144.84 | 11 |
| Albumin ischemia modified CPT 82045 | not published | not published | $33.94 – $152.28 | 17 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $34.45 | $65.00 | $5.78 – $25.98 | 17 |
| Albumin serum plasma or whole blood CPT 82040 | $18.02 | $34.00 | $4.95 – $22.43 | 17 |
| Albuterol non-comp con HCPCS J7611 | $0.30 | $0.57 | $0.20 – $0.55 | 11 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $73.14 | $138.00 | $17.27 – $59.58 | 14 |
| Alkaline phosphatase CPT 84075 | $21.73 | $41.00 | $5.18 – $23.60 | 17 |
| Allergen alpha lactalbumin ige CPT 86008 | $29.15 | $55.00 | $17.93 – $73.19 | 14 |
| Allergen egg white ige CPT 86003 | $24.91 | $47.00 | $5.22 – $15.25 | 17 |
| Allergen specific ige qual multi scrn ea CPT 86005 | not published | not published | $7.97 – $35.40 | 17 |
| Allergy injections; 2 or more 95117 CPT 95117 | not published | not published | $33.25 – $62.72 | 4 |
| Allergy injection; single 95115 CPT 95115 | not published | not published | $28.59 – $62.72 | 4 |
| Allergy Skin Testing CPT 95004 | not published | not published | $21.69 – $1,383.07 | 4 |
| Allg patch or app # of tests 95044 CPT 95044 | not published | not published | $18.16 – $1,383.07 | 4 |
| Allgrft implnt knee w/scope CPT 29867 | not published | not published | $4,586.93 – $4,586.93 | 1 |
| All tstg perq&iq drugs/biol CPT 95018 | not published | not published | $38.11 – $67.76 | 4 |
| All tstg perq&iq w/venoms CPT 95017 | not published | not published | $23.78 – $33.29 | 4 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | not published | not published | $64.41 – $289.21 | 17 |
| Alpha-fetoprotein amniotic CPT 82106 | $61.48 | $116.00 | $17.00 – $75.56 | 17 |
| Alpha-fetoprotein tumor marker CPT 82105 | $66.25 | $125.00 | $16.77 – $75.56 | 17 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $149.45 | $281.99 | $97.27 – $279.01 | 11 |
| Alt/sgpt CPT 84460 | $19.08 | $36.00 | $5.30 – $23.60 | 17 |
| Aluminum - quest CPT 82108 | $83.21 | $157.00 | $25.48 – $114.51 | 17 |
| Alveoloplasty each quadrant CPT 41874 | not published | not published | $1,407.74 – $1,407.74 | 1 |
| Alys cplx sp/pn npgt w/prgrm CPT 95972 | not published | not published | $89.13 – $193.70 | 4 |
| Amantadine (symmetrel)-sendout CPT 80375 | not published | not published | $32.40 – $81.45 | 6 |
| Ambl bp mntr w/sw a/r CPT 93788 | not published | not published | $16.97 – $175.22 | 4 |
| Amino acid screen, urine CPT 82128 | not published | not published | $13.87 – $62.55 | 17 |
| Amino acid single qual CPT 82127 | not published | not published | $14.18 – $62.55 | 17 |
| Amino acids quant 2-5 CPT 82136 | not published | not published | $19.61 – $67.72 | 17 |
| Aminolevulinic acid delta CPT 82135 | $54.59 | $103.00 | $16.45 – $74.38 | 17 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $8.98 | $16.94 | $3.10 – $7.69 | 6 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $0.90 | $1.69 | $0.48 – $1.56 | 5 |
| Amitriptyline (elavil) -sendout CPT 80335 | $46.64 | $88.00 | $32.60 – $81.45 | 6 |
| Ammonia CPT 82140 | $60.95 | $115.00 | $14.57 – $64.93 | 17 |
| Amniocentesisdiagnostic 59000 CPT 59000 | not published | not published | $450.10 – $1,183.71 | 4 |
| Amniocentesis therapeutic CPT 59001 | not published | not published | $295.37 – $644.43 | 4 |
| Amniotic fluid scan CPT 82143 | not published | not published | $9.35 – $30.71 | 17 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | not published | not published | $2,327.45 – $2,327.45 | 1 |
| Amphetamine confirm urine -sendout CPT 80324 | $56.71 | $107.00 | $30.92 – $81.45 | 6 |
| Amphetamines 5 or more CPT 80326 | not published | not published | $30.92 – $30.92 | 1 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | $66.38 | $125.25 | $48.09 – $90.20 | 8 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $6.88 | $12.98 | $0.84 – $3.28 | 10 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $17.98 | $33.93 | $2.02 – $13.26 | 10 |
| Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 | not published | not published | $262.99 – $907.32 | 5 |
| Amp metatarsal w/toe single 28810 CPT 28810 | not published | not published | $1,583.65 – $1,583.65 | 1 |
| Amp thigh through femur re-amp 27596 CPT 27596 | not published | not published | $2,625.14 – $2,625.14 | 1 |
| Amputate hand at wrist CPT 25922 | not published | not published | $2,037.48 – $2,037.48 | 1 |
| Amputate metacarpal bone 26910 CPT 26910 | not published | not published | $2,589.22 – $2,589.22 | 1 |
| Amputate thigh through femur 27590 CPT 27590 | not published | not published | $2,912.65 – $2,912.65 | 1 |
| Amputation follow-up surgery CPT 24925 | not published | not published | $1,978.50 – $1,978.50 | 1 |
| Amputation follow-up surgery CPT 25907 | not published | not published | $2,102.90 – $2,102.90 | 1 |
| Amputation follow-up surgery CPT 25909 | not published | not published | $2,479.55 – $2,479.55 | 1 |
| Amputation follow-up surgery CPT 25929 | not published | not published | $2,132.37 – $2,132.37 | 1 |
| Amputation follow-up surgery CPT 25931 | not published | not published | $2,374.63 – $2,374.63 | 1 |
| Amputation follow-up surgery CPT 27594 | not published | not published | $1,842.32 – $1,842.32 | 1 |
| Amputation follow-up surgery CPT 27884 | not published | not published | $2,098.95 – $2,098.95 | 1 |
| Amputation leg thr tib/fib 27880 CPT 27880 | not published | not published | $3,333.65 – $3,333.65 | 1 |
| Amputation leg; tib/fib f/u 27886 CPT 27886 | not published | not published | $2,398.28 – $2,398.28 | 1 |
| Amputation of foot at ankle CPT 27889 | not published | not published | $2,363.55 – $2,363.55 | 1 |
| Amputation of lower leg CPT 27882 | not published | not published | $2,185.30 – $2,185.30 | 1 |
| Amputation of midtarsal 28800 CPT 28800 | not published | not published | $1,997.27 – $1,997.27 | 1 |
| Amputation thru metatarsal CPT 28805 | not published | not published | $2,691.98 – $2,691.98 | 1 |
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.