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 |
|---|---|---|---|---|
| Ghs lac repair mouth.ant tong 2.5cm/less CPT 41250 | not published | not published | $387.48 – $990.65 | 4 |
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | not published | not published | $387.95 – $853.54 | 4 |
| Ghs layer closure 2.5 cm or less - 12041 CPT 12041 | not published | not published | $387.95 – $854.13 | 4 |
| Ghs layer closure 2.5cm or less - 12051 CPT 12051 | not published | not published | $387.95 – $932.05 | 4 |
| Ghs layer closure 2.6 - 5.0 cm - 12052 CPT 12052 | not published | not published | $387.95 – $1,061.86 | 4 |
| Ghs layer closure 2.6 - 7.5 cm - 12042 CPT 12042 | not published | not published | $387.95 – $1,041.45 | 4 |
| Ghs layer closure 5.1 - 7.5 cm - 12053 CPT 12053 | not published | not published | $387.95 – $1,246.12 | 4 |
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | not published | not published | $387.95 – $1,122.39 | 4 |
| Ghs layer closure 7.6 - 12.5 cm - 12044 CPT 12044 | not published | not published | $594.39 – $1,295.99 | 4 |
| Ghs layer closure 7.6 - 12.5 cm - 12054 CPT 12054 | not published | not published | $387.95 – $1,301.66 | 4 |
| Ghs layered repair 12.6 - 20.0 cm -12045 CPT 12045 | not published | not published | $594.39 – $1,452.65 | 4 |
| Ghs layered repair 12.6 - 20.0 cm -12055 CPT 12055 | not published | not published | $387.95 – $1,690.10 | 4 |
| Ghs layered repair 20.1 - 30.0 cm -12046 CPT 12046 | not published | not published | $594.39 – $1,708.00 | 4 |
| Ghs layered repair 20.1 - 30.0 cm -12056 CPT 12056 | not published | not published | $387.95 – $1,988.02 | 4 |
| Ghs layered repair over 30.0 cm -12047 CPT 12047 | not published | not published | $1,862.24 – $1,862.24 | 1 |
| Ghs layered repair over 3.0 cm -12057 CPT 12057 | not published | not published | $387.95 – $2,028.75 | 4 |
| Ghs leukocyte alkaline phos (mayo) CPT 85540 | not published | not published | $8.60 – $38.95 | 17 |
| Ghs low level laser therapy CPT 97039 | not published | not published | $40.83 – $40.83 | 1 |
| Ghs mbp CPT 83873 | $61.48 | $116.00 | $17.20 – $76.73 | 17 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | not published | not published | $253.98 – $253.98 | 1 |
| Ghs moderate sedation < 5 yr, 30 min, other CPT 99155 | not published | not published | $308.31 – $308.31 | 1 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | not published | not published | $69.54 – $252.04 | 2 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $175.43 | $331.00 | $35.60 – $35.60 | 1 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | not published | not published | $55.56 – $191.25 | 2 |
| Ghs musc test done w/n test comp CPT 95886 | $403.86 | $762.00 | $146.57 – $146.57 | 1 |
| Ghs musc tst done w/nerv tst lim CPT 95885 | $266.59 | $503.00 | $63.78 – $63.78 | 1 |
| Ghs musc tst done w/n tst non ext CPT 95887 | $222.60 | $420.00 | $127.64 – $127.64 | 1 |
| Ghs myocardial strain img spckl track CPT 93356 | not published | not published | $131.82 – $131.82 | 1 |
| Ghs nailbed repair/nail removal CPT 11760 | not published | not published | $594.39 – $832.15 | 4 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | $518.87 | $979.00 | $555.43 – $1,210.29 | 4 |
| Ghs nerve blk intercostal, single level CPT 64420 | $1,037.74 | $1,958.00 | $413.62 – $941.43 | 4 |
| Ghs nerve block axillary nerve CPT 64417 | not published | not published | $488.15 – $1,210.29 | 4 |
| Ghs nerve block brachial plexus CPT 64415 | not published | not published | $446.78 – $1,210.29 | 4 |
| Ghs nerve block celiac plexus CPT 64530 | not published | not published | $703.40 – $1,210.29 | 4 |
| Ghs nerve block interscaline CPT 64510 | $1,137.38 | $2,146.00 | $470.50 – $1,210.29 | 4 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $1,404.50 | $2,650.00 | $685.95 – $1,210.29 | 4 |
| Ghs nerve block sciatic nerve CPT 64445 | not published | not published | $502.13 – $941.43 | 4 |
| Ghs nerve block suprascapular CPT 64418 | $1,596.89 | $3,013.00 | $531.56 – $941.43 | 4 |
| Ghs ng placement w fluoro guidance CPT 43752 | $456.33 | $861.00 | $151.33 – $542.47 | 4 |
| Ghs o2 saturation CPT 82810 | $45.05 | $85.00 | $9.77 – $38.95 | 17 |
| Ghs o2 uptake rest & exercise CPT 94680 | not published | not published | $42.84 – $212.70 | 4 |
| Ghs o2 uptake rest & indirect CPT 94690 | not published | not published | $12.72 – $80.75 | 4 |
| Ghs ob unlisted IV or art inj or infusion CPT 96379 | not published | not published | $44.80 – $62.72 | 3 |
| Ghs opcc repair cvp without subq port CPT 36575 | $614.80 | $1,160.00 | $600.34 – $840.48 | 4 |
| Ghs opcc repair cvp w subq port CPT 36576 | $1,612.79 | $3,043.00 | $1,405.17 – $1,405.17 | 1 |
| Ghs optokenetic CPT 92544 | not published | not published | $7.68 – $212.70 | 4 |
| Ghs oscillating trac CPT 92545 | not published | not published | $6.49 – $423.33 | 4 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | not published | not published | $24.57 – $104.65 | 4 |
| Ghs osteopathic manipulative tx, 3-4 regions CPT 98926 | not published | not published | $24.57 – $152.08 | 4 |
| Ghs ot dds rom CPT 95851 | not published | not published | $22.62 – $60.89 | 4 |
| Ghs ot group caregiver training CPT 97552 | not published | not published | $21.17 – $71.77 | 4 |
| Ghs ot prosthetic training/15 min CPT 97761 | $60.95 | $115.00 | $39.19 – $109.72 | 4 |
| Ghs ot sensory integrative tech/15min CPT 97533 | not published | not published | $58.35 – $97.34 | 4 |
| Ghs ot work hardening-additional hours CPT 97546 | not published | not published | $175.41 – $175.41 | 1 |
| Ghs pacing - transcutaneous CPT 92953 | not published | not published | $37.54 – $889.59 | 4 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $663.56 | $1,252.00 | $347.64 – $347.64 | 1 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $643.42 | $1,214.00 | $320.41 – $320.41 | 1 |
| Ghs path - pap (papanicolau) smear - vagina CPT 88141 | not published | not published | $23.10 – $108.78 | 9 |
| Ghs peritonsillar abscess i andd CPT 42700 | not published | not published | $225.49 – $700.79 | 4 |
| Ghs phenylketonurid CPT 84030 | $10.07 | $19.00 | $5.50 – $24.81 | 17 |
| Ghs picc line insert < 5 CPT 36568 | $1,943.51 | $3,667.00 | $1,099.01 – $1,099.01 | 1 |
| Ghs plngl fx pm cl CPT 26725 | not published | not published | $232.93 – $1,224.11 | 4 |
| Ghs plt ct-manual CPT 85032 | $36.57 | $69.00 | $4.31 – $18.87 | 17 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | not published | not published | $426.19 – $1,383.07 | 4 |
| Ghs pos nystagmus CPT 92542 | not published | not published | $8.84 – $175.22 | 4 |
| Ghs ppd (tb intradermal) CPT 86580 | $16.96 | $32.00 | $8.14 – $33.29 | 11 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $38.16 | $72.00 | $9.66 – $43.68 | 17 |
| Ghs protein, misc fluid CPT 84160 | not published | not published | $5.61 – $18.84 | 17 |
| Ghs protoporphyrins fract CPT 84202 | $46.64 | $88.00 | $14.35 – $64.93 | 17 |
| Ghs pr without cont pulse ox CPT 94625 | not published | not published | $57.68 – $221.82 | 4 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | $45.05 | $85.00 | $12.25 – $55.48 | 17 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | not published | not published | $438.63 – $438.63 | 1 |
| Ghs quinidine CPT 80194 | $51.41 | $97.00 | $14.60 – $66.10 | 17 |
| Ghs refill of implantable pump CPT 95990 | not published | not published | $301.04 – $450.91 | 4 |
| Ghs removal intranasal foreign body CPT 30300 | not published | not published | $125.16 – $676.96 | 4 |
| Ghs removal pharyngeal foreign body CPT 42809 | not published | not published | $387.48 – $746.30 | 4 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | not published | not published | $2,037.40 – $2,037.40 | 1 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | not published | not published | $1,782.72 – $1,782.72 | 1 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | not published | not published | $9.63 – $37.34 | 17 |
| Ghs reticulocyte count CPT 85044 | $25.44 | $48.00 | $4.31 – $18.87 | 17 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | not published | not published | $13.91 – $54.30 | 17 |
| Ghs sedimentation rate CPT 85651 | $22.79 | $43.00 | $4.27 – $15.35 | 17 |
| Ghs semen analysis fert CPT 89320 | not published | not published | $12.31 – $54.30 | 17 |
| Ghs semen analysis, post-vas CPT 89300 | $30.74 | $58.00 | $9.84 – $40.12 | 17 |
| Ghs sensitivity (per antimicro) CPT 87184 | $33.92 | $64.00 | $7.48 – $30.71 | 17 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | not published | not published | $387.95 – $580.54 | 4 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | not published | not published | $387.95 – $737.35 | 4 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | not published | not published | $387.95 – $687.89 | 4 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | not published | not published | $387.95 – $555.43 | 4 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | not published | not published | $192.94 – $480.42 | 4 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | not published | not published | $192.94 – $460.24 | 4 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | not published | not published | $192.94 – $581.88 | 4 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | not published | not published | $192.94 – $802.14 | 4 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | not published | not published | $192.94 – $630.18 | 4 |
| Ghs sleep study unattended CPT 95800 | not published | not published | $151.93 – $212.70 | 4 |
| Ghs somatosensory testing lower extremit CPT 95926 | $925.91 | $1,747.00 | $92.28 – $423.33 | 4 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $1,290.02 | $2,434.00 | $154.73 – $721.31 | 4 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $103.88 | $196.00 | $46.07 – $175.75 | 4 |
| Ghs sphenopalatine ganglion block CPT 64505 | not published | not published | $286.64 – $401.30 | 4 |
| Ghs spont nystagmus CPT 92541 | not published | not published | $10.00 – $175.22 | 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.