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 |
|---|---|---|---|---|
| Excise tendon forearm/wrist CPT 25109 | not published | not published | $1,966.42 – $1,966.42 | 1 |
| Excise wrist tendon sheath CPT 25118 | not published | not published | $1,390.62 – $1,390.62 | 1 |
| Excision addl breast lesion 19126 CPT 19126 | not published | not published | $140.73 – $580.54 | 2 |
| Excision aural polyp CPT 69540 | not published | not published | $763.90 – $763.90 | 1 |
| Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm CPT 11441 | not published | not published | $603.96 – $956.48 | 4 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | not published | not published | $630.11 – $630.11 | 1 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | not published | not published | $595.31 – $956.48 | 4 |
| Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 | not published | not published | $1,122.13 – $1,122.13 | 1 |
| Excision breast lesion CPT 19125 | not published | not published | $526.43 – $1,956.65 | 2 |
| Excision coa w/graft CPT 33845 | not published | not published | $4,823.41 – $4,823.41 | 1 |
| Excision floor mouth lesion 41116 CPT 41116 | not published | not published | $1,236.68 – $1,236.68 | 1 |
| Excision graft abdomen CPT 35907 | not published | not published | $7,002.03 – $7,002.03 | 1 |
| Excision graft extremity CPT 35903 | not published | not published | $2,073.25 – $2,073.25 | 1 |
| Excision graft neck CPT 35901 | not published | not published | $1,732.96 – $1,732.96 | 1 |
| Excision graft thorax 35905 CPT 35905 | not published | not published | $6,159.72 – $6,159.72 | 1 |
| Excision gum each quadrant CPT 41820 | not published | not published | $882.48 – $882.48 | 1 |
| Excision hand/finger tendon CPT 26415 | not published | not published | $2,741.55 – $2,741.55 | 1 |
| Excision lesion mouth roof CPT 42106 | not published | not published | $1,022.09 – $1,022.09 | 1 |
| Excision lesion mouth roof CPT 42107 | not published | not published | $1,719.31 – $1,719.31 | 1 |
| Excision nasal polyp(s) simple 30110 CPT 30110 | not published | not published | $839.96 – $839.96 | 1 |
| Excision of anal lesion(s) CPT 46922 | not published | not published | $964.76 – $964.76 | 1 |
| Excision of bile duct cyst CPT 47715 | not published | not published | $4,792.08 – $4,792.08 | 1 |
| Excision of bile duct tumor CPT 47711 | not published | not published | $5,602.57 – $5,602.57 | 1 |
| Excision of bile duct tumor CPT 47712 | not published | not published | $7,160.89 – $7,160.89 | 1 |
| Excision of bowel lesion(s) CPT 44111 | not published | not published | $3,563.01 – $3,563.01 | 1 |
| Excision of brain tumor CPT 61545 | not published | not published | $11,346.10 – $11,346.10 | 1 |
| Excision of esophagus lesion CPT 43100 | not published | not published | $2,299.84 – $2,299.84 | 1 |
| Excision of esophagus lesion CPT 43101 | not published | not published | $3,689.42 – $3,689.42 | 1 |
| Excision of gum flap CPT 41821 | not published | not published | $200.52 – $200.52 | 1 |
| Excision of gum lesion CPT 41822 | not published | not published | $1,093.30 – $1,093.30 | 1 |
| Excision of gum lesion CPT 41823 | not published | not published | $1,596.18 – $1,596.18 | 1 |
| Excision of gum lesion CPT 41826 | not published | not published | $1,179.31 – $1,179.31 | 1 |
| Excision of gum lesion CPT 41827 | not published | not published | $1,646.83 – $1,646.83 | 1 |
| Excision of gum lesion CPT 41828 | not published | not published | $1,150.93 – $1,150.93 | 1 |
| Excision of gum lesion 41825 CPT 41825 | not published | not published | $791.62 – $791.62 | 1 |
| Excision of lesion of mesentery 44820 CPT 44820 | not published | not published | $3,031.11 – $3,031.11 | 1 |
| Excision of lingual tonsil CPT 42870 | not published | not published | $2,242.89 – $2,242.89 | 1 |
| Excision of meckels diverticulum 44800 CPT 44800 | not published | not published | $2,754.12 – $2,754.12 | 1 |
| Excision of mouth lesion complex 40816 CPT 40816 | not published | not published | $1,499.98 – $1,499.98 | 1 |
| Excision of neck cyst CPT 42815 | not published | not published | $2,066.53 – $2,066.53 | 1 |
| Excision of neck cyst confined 42810 CPT 42810 | not published | not published | $1,431.91 – $1,431.91 | 1 |
| Excision of penis lesion(s) 54060 CPT 54060 | not published | not published | $649.54 – $649.54 | 1 |
| Excision of rectal lesion CPT 45160 | not published | not published | $3,679.46 – $3,679.46 | 1 |
| Excision of rectal prolapse CPT 45135 | not published | not published | $4,933.52 – $4,933.52 | 1 |
| Excision of rectal stricture CPT 45150 | not published | not published | $1,432.62 – $1,432.62 | 1 |
| Excision of salivary cyst CPT 42408 | not published | not published | $1,670.18 – $1,670.18 | 1 |
| Excision of skull/sutures CPT 61558 | not published | not published | $6,148.27 – $6,148.27 | 1 |
| Excision of skull/sutures CPT 61559 | not published | not published | $7,567.46 – $7,567.46 | 1 |
| Excision of skull tumor CPT 61563 | not published | not published | $6,800.27 – $6,800.27 | 1 |
| Excision of skull tumor CPT 61564 | not published | not published | $8,252.74 – $8,252.74 | 1 |
| Excision of stomach lesion CPT 43610 | not published | not published | $3,529.29 – $3,529.29 | 1 |
| Excision of stomach lesion CPT 43611 | not published | not published | $4,411.02 – $4,411.02 | 1 |
| Excision of tongue lesion CPT 41112 | not published | not published | $1,248.17 – $1,248.17 | 1 |
| Excision of tongue lesion CPT 41114 | not published | not published | $2,362.99 – $2,362.99 | 1 |
| Excision of tongue lesion w/closure 41113 CPT 41113 | not published | not published | $1,365.48 – $1,365.48 | 1 |
| Excision of tonsil tags CPT 42860 | not published | not published | $696.06 – $696.06 | 1 |
| Excision of umbilicus 49250 CPT 49250 | not published | not published | $2,123.56 – $2,123.56 | 1 |
| Excision of uvula CPT 42140 | not published | not published | $939.10 – $939.10 | 1 |
| Excision of vaginal septum 57130 CPT 57130 | not published | not published | $639.10 – $639.10 | 1 |
| Excision olecranon bursa CPT 24105 | not published | not published | $1,272.45 – $1,272.45 | 1 |
| Excision perinephric cyst CPT 50290 | not published | not published | $3,296.50 – $3,296.50 | 1 |
| Excision radial head CPT 24130 | not published | not published | $1,848.14 – $1,848.14 | 1 |
| Excision tongue lesion without closure 41110 CPT 41110 | not published | not published | $788.71 – $788.71 | 1 |
| Excision tumor soft tissue back/flank subcutaneous >= 3 cm CPT 21931 | not published | not published | $1,692.60 – $1,692.60 | 1 |
| Excis partial tal calc CPT 28120 | not published | not published | $2,476.65 – $2,476.65 | 1 |
| Excis uppr jaw cyst w/repair CPT 21049 | not published | not published | $4,453.73 – $4,453.73 | 1 |
| Exc leg/ankle tum dep 5 cm/ > 27634 CPT 27634 | not published | not published | $2,489.74 – $2,489.74 | 1 |
| Exc leg/ankle tum subfasc<5cm 27619 CPT 27619 | not published | not published | $1,713.41 – $1,713.41 | 1 |
| Exc les conjunctiva <1 cm CPT 68110 | not published | not published | $817.17 – $817.17 | 1 |
| Exc les conjunctiva >1 cm CPT 68115 | not published | not published | $1,129.52 – $1,129.52 | 1 |
| Exc les conjunctiva adj scl CPT 68130 | not published | not published | $1,957.69 – $1,957.69 | 1 |
| Exc les/mucos/sub/ves mouth/no rpr 40810 CPT 40810 | not published | not published | $768.12 – $768.12 | 1 |
| Excl laa open any method 33267 CPT 33267 | not published | not published | $3,816.80 – $3,816.80 | 1 |
| Excl laa opn oth px any meth 33268 CPT 33268 | not published | not published | $475.46 – $475.46 | 1 |
| Excl laa thrscp any method CPT 33269 | not published | not published | $3,020.37 – $3,020.37 | 1 |
| Exc malig feenl <0.5cm 11640 CPT 11640 | not published | not published | $683.20 – $956.48 | 4 |
| Exc malig feenl 1.1-2 11642 CPT 11642 | not published | not published | $683.20 – $978.42 | 4 |
| Exc malig feenl 3.1-4.0 11644 CPT 11644 | not published | not published | $1,424.97 – $1,424.97 | 1 |
| Exc malig feenl >4cm 11646 CPT 11646 | not published | not published | $1,863.73 – $1,863.73 | 1 |
| Exc malig snhfg 0.5cm or less 11620 CPT 11620 | not published | not published | $697.51 – $697.51 | 1 |
| Exc malig snhfg 0.6-1.0 cm 11621 CPT 11621 | not published | not published | $683.20 – $956.48 | 4 |
| Exc malig snhfg 2.1-3 cm 11623 CPT 11623 | not published | not published | $1,083.90 – $1,083.90 | 1 |
| Exc malig tal <0.5cm 11600 CPT 11600 | not published | not published | $683.20 – $956.48 | 4 |
| Exc malig tal 0.6-1.0cm 11601 CPT 11601 | not published | not published | $683.20 – $956.48 | 4 |
| Exc mal+marg tal 1.1-2 cm 11602 CPT 11602 | not published | not published | $387.95 – $891.92 | 4 |
| Exc mal+marg tal 2.1-3 cm 11603 CPT 11603 | not published | not published | $683.20 – $1,019.67 | 4 |
| Exc mal+marg tal 3.1-4 cm 11604 CPT 11604 | not published | not published | $683.20 – $1,134.26 | 4 |
| Exc mandible 21025 CPT 21025 | not published | not published | $3,286.35 – $3,286.35 | 1 |
| Exc neck tum deep < 5 cm CPT 21556 | not published | not published | $1,926.36 – $1,926.36 | 1 |
| Exc neck tum deep 5 cm/> CPT 21554 | not published | not published | $2,646.29 – $2,646.29 | 1 |
| Exc of facial bones/osteomy/abcess 21026 CPT 21026 | not published | not published | $2,279.07 – $2,279.07 | 1 |
| Exc of rectal prlpse 45130 CPT 45130 | not published | not published | $3,970.14 – $3,970.14 | 1 |
| Exc of residual cervix 57540 CPT 57540 | not published | not published | $2,829.80 – $2,829.80 | 1 |
| Exc of residual cervix via aginal approach 57550 CPT 57550 | not published | not published | $1,473.72 – $1,473.72 | 1 |
| Exc/pilonidal cyst/sinus/simple 11770 CPT 11770 | not published | not published | $993.34 – $993.34 | 1 |
| Exc prtl bn phlnx toe CPT 28124 | not published | not published | $1,768.47 – $1,768.47 | 1 |
| Exc rect tum transanal full CPT 45172 | not published | not published | $2,946.44 – $2,946.44 | 1 |
| Exc rect tum transanal part CPT 45171 | not published | not published | $2,183.02 – $2,183.02 | 1 |
| Exc sac pr ulc prim str ostc CPT 15933 | not published | not published | $3,072.03 – $3,072.03 | 1 |
| Exc sac pr ulc skn flp ostc CPT 15935 | not published | not published | $3,956.08 – $3,956.08 | 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.