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 |
|---|---|---|---|---|
| Genioplasty augmentation CPT 21120 | not published | not published | $2,418.72 – $2,418.72 | 1 |
| Geniop sldg augmentation CPT 21123 | not published | not published | $3,467.04 – $3,467.04 | 1 |
| Geniop sldg osteot 1 CPT 21121 | not published | not published | $2,992.02 – $2,992.02 | 1 |
| Geniop sldg osteot 2/> CPT 21122 | not published | not published | $2,419.43 – $2,419.43 | 1 |
| Genome re-evaluation CPT 81427 | not published | not published | $2,454.53 – $7,645.72 | 11 |
| Genome sequence analysis CPT 81425 | not published | not published | $5,282.76 – $16,456.50 | 11 |
| Genome sequence analysis CPT 81426 | not published | not published | $2,845.45 – $8,863.91 | 11 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $9.44 | $17.82 | $3.04 – $7.53 | 10 |
| Gentamicin peak therapeutic drug level CPT 80170 | $67.84 | $128.00 | $16.38 – $73.17 | 17 |
| G-esoph reflx tst w/electrod CPT 91035 | $1,352.03 | $2,551.00 | $281.08 – $721.31 | 4 |
| Gfrg autol fat lipo ea addl CPT 15774 | not published | not published | $639.47 – $639.47 | 1 |
| Ghs abscess perianal iandd CPT 46050 | not published | not published | $728.06 – $1,239.41 | 4 |
| Ghs abscess postoperative iandd complex CPT 10180 | not published | not published | $883.75 – $883.75 | 1 |
| Ghs acetylcholinesterase, rbc CPT 82482 | not published | not published | $9.81 – $34.22 | 17 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $56.18 | $106.00 | $17.11 – $72.00 | 17 |
| Ghs alpha thalasemia, 7 deletions CPT 81257 | $1,377.47 | $2,599.00 | $102.26 – $1,245.70 | 15 |
| Ghs analysis neurostim without reprogramming CPT 95970 | not published | not published | $125.16 – $225.08 | 4 |
| Ghs antibodies (torch) igm CPT 86694 | $92.75 | $175.00 | $14.39 – $64.93 | 17 |
| Ghs aspiration bladder - needle CPT 51100 | not published | not published | $222.08 – $330.62 | 4 |
| Ghs bladder cath - complex-foley CPT 51703 | $281.43 | $531.00 | $151.93 – $470.17 | 4 |
| Ghs bleeding time (ivy) CPT 85002 | not published | not published | $4.82 – $15.94 | 17 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | $964.60 | $1,820.00 | $487.40 – $941.43 | 4 |
| Ghs central line insert < age 5, failed CPT 36555 | not published | not published | $977.19 – $977.19 | 1 |
| Ghs change cysto/gastrost CPT 43762 | $489.72 | $924.00 | $236.16 – $804.11 | 4 |
| Ghs chemo >8 hrs CPT 96416 | not published | not published | $322.08 – $456.89 | 4 |
| Ghs chemo infusion >8 hrs CPT 96425 | not published | not published | $322.08 – $588.54 | 4 |
| Ghs chemo IV push, ea addtl CPT 96411 | not published | not published | $69.11 – $202.78 | 4 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $58.30 | $110.00 | $35.09 – $157.01 | 17 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | not published | not published | $232.93 – $989.76 | 4 |
| Ghs closed reduction ankle dislocation CPT 27840 | not published | not published | $232.93 – $1,333.06 | 4 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | not published | not published | $1,699.39 – $1,699.39 | 1 |
| Ghs closed tx radiocarpal disloc w manip CPT 25660 | not published | not published | $232.93 – $1,481.00 | 4 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | not published | not published | $1,951.65 – $1,951.65 | 1 |
| Ghs closure surg wound/dehiscence-13160 CPT 13160 | not published | not published | $2,925.77 – $2,925.77 | 1 |
| Ghs clsd red med malleolus fx without manip CPT 27760 | not published | not published | $232.93 – $1,212.06 | 4 |
| Ghs clsd red med malleolus fx w manip CPT 27762 | not published | not published | $1,725.83 – $1,725.83 | 1 |
| Ghs clsd tx frac distal tibia w/manipulation CPT 27825 | not published | not published | $1,966.72 – $1,966.72 | 1 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | not published | not published | $232.93 – $1,844.11 | 4 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | not published | not published | $232.93 – $1,165.74 | 4 |
| Ghs community re-entry 15 minutes CPT 97537 | not published | not published | $30.80 – $100.40 | 4 |
| Ghs conjunctiva foreign body-embed bil CPT 65210 | not published | not published | $248.75 – $542.47 | 4 |
| Ghs conjunctiva foreign body-superf bil CPT 65205 | not published | not published | $125.16 – $203.32 | 4 |
| Ghs corneal fb without slit lamp bilat CPT 65220 | not published | not published | $208.13 – $542.47 | 4 |
| Ghs corneal fb with slit lamp bilat CPT 65222 | not published | not published | $125.16 – $242.38 | 4 |
| Ghs cricothyroidotomy CPT 31605 | not published | not published | $225.49 – $664.09 | 4 |
| Ghs cutdown placement age 1 and over CPT 36425 | not published | not published | $146.14 – $542.47 | 4 |
| Ghs cutdown placement under 1 yr CPT 36420 | not published | not published | $125.16 – $191.50 | 4 |
| Ghs diphtheria toxoid ab igg CPT 86648 | $51.41 | $97.00 | $9.63 – $35.74 | 17 |
| Ghs dislocation elbow closed treatment CPT 24600 | not published | not published | $232.93 – $1,317.96 | 4 |
| Ghs ed peritoneal lavage w guidance if performed CPT 49084 | not published | not published | $390.94 – $1,274.55 | 4 |
| Ghs ed rmvl or bivalving cast CPT 29700 | not published | not published | $227.19 – $361.03 | 4 |
| Ghs ed therapeutic lp, drain csf w fluoro CPT 62329 | $1,724.09 | $3,253.00 | $672.45 – $1,162.72 | 4 |
| Ghs eeg cont rec w/video by tec min 8 chnls CPT 95700 | not published | not published | $151.93 – $758.71 | 4 |
| Ghs electrostagmgraphy CPT 92537 | not published | not published | $27.44 – $212.70 | 4 |
| Ghs elect torsion swing CPT 92546 | not published | not published | $49.98 – $212.70 | 4 |
| Ghs elect vertical elct CPT 92547 | not published | not published | $3.50 – $3.50 | 1 |
| Ghs epidermal shaving diameter >2.0 cm CPT 11303 | not published | not published | $387.95 – $560.99 | 4 |
| Ghs excision ingrown nail CPT 11765 | not published | not published | $387.95 – $607.58 | 4 |
| Ghs eye exam CPT 92002 | not published | not published | $125.14 – $267.48 | 4 |
| Ghs eyelid foreign body-embedded - bil CPT 67938 | not published | not published | $290.27 – $870.17 | 4 |
| Ghs fat & muscle CPT 89160 | not published | not published | $4.85 – $16.53 | 17 |
| Ghs fb removal foot - deep - left CPT 28192 | not published | not published | $1,748.18 – $1,748.18 | 1 |
| Ghs fb removal from muscle - complicated CPT 20525 | not published | not published | $1,745.42 – $1,745.42 | 1 |
| Ghs fb removal - incisional CPT 10121 | not published | not published | $991.92 – $991.92 | 1 |
| Ghs fb removal - non-incisional CPT 20520 | not published | not published | $737.61 – $737.61 | 1 |
| Ghs febrile agglutinns(mayo) CPT 86000 | $73.14 | $138.00 | $6.98 – $31.88 | 17 |
| Ghs fish cytogen CPT 88271 | $91.16 | $172.00 | $21.42 – $68.03 | 17 |
| Ghs fish hybrid in situ 100-300 CPT 88275 | $139.39 | $263.00 | $51.19 – $180.61 | 17 |
| Ghs flow volume loop CPT 94375 | $244.86 | $462.00 | $50.08 – $423.33 | 4 |
| Ghs gastric intub aspiration lavage CPT 43753 | not published | not published | $80.01 – $423.33 | 4 |
| Ghs hcv amplificaiton CPT 87521 | $175.43 | $331.00 | $35.09 – $157.01 | 17 |
| Ghs heavy metals bld (ars,lead,merc) CPT 82715 | not published | not published | $10.62 – $53.98 | 17 |
| Ghs hepatitis c virus (hcv riba) CPT 86804 | not published | not published | $15.49 – $69.66 | 17 |
| Ghs hgb stability-thal CPT 83068 | $56.18 | $106.00 | $9.47 – $37.78 | 17 |
| Ghs histoplasma antigen CPT 87385 | $106.00 | $200.00 | $13.25 – $54.30 | 17 |
| Ghs HIV antibody CPT 86703 | $53.53 | $101.00 | $13.71 – $61.38 | 17 |
| Ghs hla-dr/dq, multiple antigens CPT 86817 | not published | not published | $106.14 – $289.21 | 17 |
| Ghs i and d abscess/hematoma scrotum CPT 54700 | not published | not published | $782.37 – $782.37 | 1 |
| Ghs i and d perirectal abscess 46040 CPT 46040 | not published | not published | $1,932.81 – $1,932.81 | 1 |
| Ghs i and d pilonidal cyst complex CPT 10081 | not published | not published | $683.20 – $966.78 | 4 |
| Ghs i and d pilonidal cyst simple CPT 10080 | not published | not published | $645.03 – $956.48 | 4 |
| Ghs immun0electrophoresis CPT 86320 | not published | not published | $29.92 – $70.31 | 17 |
| Ghs incision thrombosed ext hemorrhoid CPT 46083 | not published | not published | $236.16 – $635.63 | 4 |
| Ghs indirect laryngoscopy/w fb removal CPT 31511 | not published | not published | $188.51 – $771.03 | 4 |
| Ghs inf midline insertion CPT 36140 | $1,038.80 | $1,960.00 | $1,564.40 – $1,564.40 | 1 |
| Ghs inhibitor screen CPT 85335 | $102.82 | $194.00 | $12.87 – $57.86 | 17 |
| Ghs init tx 1st degree burn CPT 16000 | not published | not published | $192.94 – $270.12 | 4 |
| Ghs inj neurolytic intercostal nerve CPT 64620 | not published | not published | $756.59 – $1,210.29 | 4 |
| Ghs inj neurolytic other perph nerve CPT 64640 | $1,290.02 | $2,434.00 | $487.18 – $1,210.29 | 4 |
| Ghs inj tendon origin/insertion CPT 20551 | $293.09 | $553.00 | $220.63 – $401.30 | 4 |
| Ghs inj transforaminal cerv ea add bil CPT 64480 | $729.81 | $1,377.00 | $415.00 – $415.00 | 1 |
| Ghs inj transforaminal cerv single bil CPT 64479 | $1,459.09 | $2,753.00 | $864.49 – $1,210.29 | 4 |
| Ghs insertion of needle - bone CPT 36680 | not published | not published | $213.54 – $542.47 | 4 |
| Ghs intermed repair 12.6 - 20.0 cm-12035 CPT 12035 | not published | not published | $387.95 – $1,378.42 | 4 |
| Ghs intermed repair 20.1 - 30.0 cm-12036 CPT 12036 | not published | not published | $594.39 – $1,517.89 | 4 |
| Ghs intermed repair over 30 cm - 12037 CPT 12037 | not published | not published | $1,721.47 – $1,721.47 | 1 |
| Ghs intro needle/intracath vein - 36000 CPT 36000 | $134.09 | $253.00 | $93.21 – $93.21 | 1 |
| Ghs irrigate corpora cavernosa for priapism CPT 54220 | not published | not published | $236.16 – $739.17 | 4 |
| Ghs IV inf sq injection, on-body injector CPT 96377 | not published | not published | $44.80 – $67.93 | 4 |
| Ghs IV thrombolytics - cerebral CPT 37195 | not published | not published | $322.08 – $3,528.02 | 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.