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 |
|---|---|---|---|---|
| Esoph imped funct test > 1hr CPT 91038 | not published | not published | $193.97 – $721.31 | 4 |
| Esoph optical endomicroscopy CPT 43206 | not published | not published | $1,196.36 – $1,196.36 | 1 |
| Esoph scope w/sclerosis inj CPT 43204 | not published | not published | $524.33 – $524.33 | 1 |
| Esoph scope w/submucous inj CPT 43201 | not published | not published | $1,003.11 – $1,003.11 | 1 |
| Esphg dstl 2/3 w/laps moblj 43287 CPT 43287 | not published | not published | $12,983.79 – $12,983.79 | 1 |
| Esphg thrsc moblj CPT 43288 | not published | not published | $13,586.18 – $13,586.18 | 1 |
| Esphg tot w/laps moblj CPT 43286 | not published | not published | $11,393.91 – $11,393.91 | 1 |
| Esphg tot w/thrcm CPT 43112 | not published | not published | $9,745.63 – $9,745.63 | 1 |
| Esrd home pt serv p mo 12-19 CPT 90965 | not published | not published | $1,507.39 – $1,507.39 | 1 |
| Esrd home pt serv p mo 20+ CPT 90966 | not published | not published | $791.42 – $791.42 | 1 |
| Esrd home pt serv p mo 2-11 CPT 90964 | not published | not published | $1,583.58 – $1,583.58 | 1 |
| Esrd home pt serv p mo <2yrs CPT 90963 | not published | not published | $1,812.57 – $1,812.57 | 1 |
| Esrd serv 1 visit p mo 20+ CPT 90962 | not published | not published | $611.35 – $611.35 | 1 |
| Esrd serv 1 visit p mo <2yrs CPT 90953 | not published | not published | $1,597.35 – $1,597.35 | 1 |
| Esrd serv 1 vst p mo 12-19 CPT 90959 | not published | not published | $985.22 – $985.22 | 1 |
| Esrd serv 2-3 vsts p mo <2yr CPT 90952 | not published | not published | $2,396.25 – $2,396.25 | 1 |
| Esrd serv 4 visits p mo <2yr CPT 90951 | not published | not published | $3,134.49 – $3,134.49 | 1 |
| Esrd serv 4 vsts p mo 2-11 CPT 90954 | not published | not published | $2,716.09 – $2,716.09 | 1 |
| Esrd srv 1 visit p mo 2-11 CPT 90956 | not published | not published | $1,060.70 – $1,060.70 | 1 |
| Esrd srv 2-3 vsts p mo 12-19 CPT 90958 | not published | not published | $1,451.09 – $1,451.09 | 1 |
| Esrd srv 2-3 vsts p mo 20+ CPT 90961 | not published | not published | $793.25 – $793.25 | 1 |
| Esrd srv 2-3 vsts p mo 2-11 CPT 90955 | not published | not published | $1,521.91 – $1,521.91 | 1 |
| Esrd srv 4 visits p mo 20+ CPT 90960 | not published | not published | $943.67 – $943.67 | 1 |
| Esrd srv 4 vsts p mo 12-19 CPT 90957 | not published | not published | $2,148.26 – $2,148.26 | 1 |
| Esrd svc pr day pt 12-19 CPT 90969 | not published | not published | $50.66 – $50.66 | 1 |
| Esrd svc pr day pt <2 CPT 90967 | not published | not published | $60.32 – $60.32 | 1 |
| Esrd svc pr day pt 20+ CPT 90970 | not published | not published | $25.87 – $25.87 | 1 |
| Esrd svc pr day pt 2-11 CPT 90968 | not published | not published | $51.88 – $51.88 | 1 |
| Essure 58565 CPT 58565 | not published | not published | $6,726.98 – $6,726.98 | 1 |
| Establish access to aorta CPT 36160 | not published | not published | $1,788.09 – $1,788.09 | 1 |
| Establish access to artery CPT 36100 | not published | not published | $1,755.04 – $1,755.04 | 1 |
| Establish brain cavity shunt CPT 62223 | not published | not published | $3,749.40 – $3,749.40 | 1 |
| Establish brain cavity shunt CPT 62180 | not published | not published | $5,676.87 – $5,676.87 | 1 |
| Establish brain cavity shunt CPT 62190 | not published | not published | $3,143.83 – $3,143.83 | 1 |
| Establish brain cavity shunt CPT 62192 | not published | not published | $3,468.49 – $3,468.49 | 1 |
| Establish brain cavity shunt CPT 62200 | not published | not published | $4,893.91 – $4,893.91 | 1 |
| Establish brain cavity shunt CPT 62220 | not published | not published | $3,663.31 – $3,663.31 | 1 |
| Established Patient Office Visit (level 1) CPT 99211 | $113.42 | $214.00 | $22.35 – $52.91 | 2 |
| Established Patient Office Visit (level 2) CPT 99212 | $192.39 | $363.00 | $53.91 – $115.90 | 2 |
| Established Patient Office Visit (level 3) CPT 99213 | $230.02 | $434.00 | $86.74 – $193.80 | 2 |
| Established Patient Office Visit (level 4) CPT 99214 | $308.46 | $582.00 | $122.48 – $285.95 | 2 |
| Established Patient Office Visit (level 5) CPT 99215 | $342.38 | $646.00 | $385.16 – $385.16 | 1 |
| Estim aid bone healg invasiv CPT 20975 | not published | not published | $635.11 – $635.11 | 1 |
| Estradiol total CPT 82670 | $90.63 | $171.00 | $27.94 – $125.13 | 17 |
| Estrogens total-sendout CPT 82672 | not published | not published | $21.70 – $97.98 | 17 |
| Ethmoidectomy extranasal total 31205 CPT 31205 | not published | not published | $3,286.02 – $3,286.02 | 1 |
| Ethylene glycol -sendout CPT 82693 | $70.49 | $133.00 | $9.35 – $35.02 | 17 |
| Euglobulin lysis CPT 85360 | $39.75 | $75.00 | $8.41 – $37.78 | 17 |
| Evacuate mole of uterus CPT 59870 | not published | not published | $1,689.62 – $1,689.62 | 1 |
| Eval aud funcj ea addl 15 CPT 92627 | not published | not published | $73.47 – $73.47 | 1 |
| Eval aud rehab status/first hr 92626 CPT 92626 | not published | not published | $151.93 – $299.64 | 4 |
| Eval/fit voice prosthesis iii, st CPT 92607 | not published | not published | $117.54 – $420.51 | 4 |
| Evaluation cervical mucus CPT 89330 | not published | not published | $9.22 – $26.19 | 17 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $126.14 | $238.00 | $98.11 – $289.21 | 17 |
| Evaluation heart device CPT 93640 | $1,145.86 | $2,162.00 | $631.45 – $13,407.00 | 2 |
| Evaluation of speech fluency 92521 CPT 92521 | not published | not published | $127.16 – $369.92 | 4 |
| Evaluation psychiatric diagnostic CPT 90791 | not published | not published | $156.01 – $440.50 | 4 |
| Evasc prlng admn rx agnt 1st CPT 61650 | $1,094.98 | $2,066.00 | $1,918.56 – $1,918.56 | 1 |
| Evasc prlng admn rx agnt add CPT 61651 | $546.43 | $1,031.00 | $816.68 – $816.68 | 1 |
| Evasc repair of iliac artery; endograft 34718 CPT 34718 | not published | not published | $4,459.48 – $4,459.48 | 1 |
| Evasc rpr a-ao ndgft 34701 CPT 34701 | not published | not published | $4,446.08 – $4,446.08 | 1 |
| Evasc rpr a-ao ndgft rpt 34702 CPT 34702 | not published | not published | $6,649.64 – $6,649.64 | 1 |
| Evasc rpr a-biiliac ndgft rptr CPT 34706 | not published | not published | $8,299.61 – $8,299.61 | 1 |
| Evasc rpr a-iliac ndgft 34717 CPT 34717 | not published | not published | $1,597.45 – $1,597.45 | 1 |
| Evasc rpr a-unilac ndgft 34703 CPT 34703 | not published | not published | $4,987.05 – $4,987.05 | 1 |
| Evasc rpr a-unilac ndgft rpt CPT 34704 | not published | not published | $8,309.77 – $8,309.77 | 1 |
| Evasc rpr ilio-iliac ndgft CPT 34707 | not published | not published | $4,145.50 – $4,145.50 | 1 |
| Evasc rpr ilio-iliac rpt CPT 34708 | not published | not published | $6,675.71 – $6,675.71 | 1 |
| Evasc st rpr thrc/aa acrs br CPT 33894 | not published | not published | $3,555.92 – $3,555.92 | 1 |
| Evasc st rpr thrc/aa x crsg CPT 33895 | not published | not published | $2,829.17 – $2,829.17 | 1 |
| Event monitor CPT 93270 | not published | not published | $29.78 – $50.69 | 4 |
| Evoked auditory tst complete CPT 92588 | not published | not published | $12.31 – $423.33 | 4 |
| Evoked oa emissions ltd CPT 92587 | not published | not published | $10.00 – $423.33 | 4 |
| Evoked potentials auditory screening automated analysis CPT 92650 | not published | not published | $92.96 – $92.96 | 1 |
| Evoked potentials upper limbs CPT 95925 | $925.91 | $1,747.00 | $94.62 – $423.33 | 4 |
| Evoked potential visual not glaucoma CPT 95930 | $814.61 | $1,537.00 | $61.95 – $423.33 | 4 |
| Evok oa screening qual CPT 92558 | not published | not published | $32.10 – $32.10 | 1 |
| Ewho w/joint(s) cf HCPCS L3764 | $1,820.55 | $3,435.00 | $1,066.77 – $1,066.77 | 1 |
| Exam of vagina w/scope 57420 CPT 57420 | not published | not published | $295.37 – $424.18 | 4 |
| Exam pelvic add-on CPT 99459 | not published | not published | $58.39 – $58.39 | 1 |
| Exam plvc w/anes othr thn lcl CPT 57410 | not published | not published | $391.13 – $391.13 | 1 |
| Ex arm/elbow tum deep < 5 cm CPT 24076 | not published | not published | $1,965.60 – $1,965.60 | 1 |
| Ex arm/elbow tum deep 5 cm/> CPT 24073 | not published | not published | $2,502.12 – $2,502.12 | 1 |
| Exc 1st&/crv rib w/sympth CPT 21616 | not published | not published | $2,718.46 – $2,718.46 | 1 |
| Exc abd les sc 3 cm/> CPT 22903 | not published | not published | $1,579.47 – $1,579.47 | 1 |
| Exc abdl tum deep < 5 cm CPT 22900 | not published | not published | $2,033.56 – $2,033.56 | 1 |
| Exc abdl tum deep 5 cm/> CPT 22901 | not published | not published | $2,392.09 – $2,392.09 | 1 |
| Exc arm/elbo les sc >=3cm 24071 CPT 24071 | not published | not published | $1,463.50 – $1,463.50 | 1 |
| Exc arm/elbo les sc <3cm 24075 CPT 24075 | not published | not published | $1,772.61 – $1,772.61 | 1 |
| Exc aurl glomus tum extended CPT 69554 | not published | not published | $8,938.91 – $8,938.91 | 1 |
| Exc aurl glomus tum trnscanl CPT 69550 | not published | not published | $3,828.17 – $3,828.17 | 1 |
| Exc aurl glomus tum trnsmstd CPT 69552 | not published | not published | $5,743.38 – $5,743.38 | 1 |
| Exc back les sbq <3 cm 21930 CPT 21930 | not published | not published | $1,705.43 – $1,705.43 | 1 |
| Exc back tum deep 5 cm/> CPT 21933 | not published | not published | $2,656.10 – $2,656.10 | 1 |
| Exc bartholins gland/cyst CPT 56740 | not published | not published | $1,085.65 – $1,085.65 | 1 |
| Exc benign feenlm 3.1-4.0cm 11444 CPT 11444 | not published | not published | $1,013.14 – $1,013.14 | 1 |
| Exc benign feenlm >4.0cm 11446 CPT 11446 | not published | not published | $1,409.53 – $1,409.53 | 1 |
| Exc benign snhfg 3.1-4.0cm 11424 CPT 11424 | not published | not published | $837.94 – $837.94 | 1 |
| Exc benign tal 0.5 < cm 11400 CPT 11400 | not published | not published | $445.32 – $956.48 | 4 |
| Exc ben+marg excep skin tag feenlm <0.5cm 11440 CPT 11440 | not published | not published | $485.80 – $956.48 | 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.