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 |
|---|---|---|---|---|
| Hba1/hba2 full gene sequence CPT 81259 | not published | not published | $600.00 – $1,967.79 | 14 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $390.61 | $737.00 | $202.40 – $663.41 | 14 |
| Hba1/hba2 gene fam vrnt CPT 81258 | not published | not published | $375.25 – $1,230.02 | 14 |
| Hbb full gene sequence CPT 81364 | $475.94 | $898.00 | $324.58 – $1,064.76 | 14 |
| Hbb gene com variants CPT 81361 | not published | not published | $174.81 – $573.69 | 14 |
| Hbb gene dup/del variants CPT 81363 | not published | not published | $202.40 – $663.41 | 14 |
| Hbb gene known fam variant CPT 81362 | not published | not published | $375.25 – $1,230.02 | 14 |
| Hb glycosylated a1c home dev CPT 83037 | not published | not published | $9.71 – $43.68 | 17 |
| Hc ea ha check monaural CPT 92594 | not published | not published | $66.33 – $66.33 | 1 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | not published | not published | $118.78 – $401.74 | 6 |
| Hcg free betachain test CPT 84704 | $52.47 | $99.00 | $15.29 – $67.28 | 17 |
| Hcg qualitative CPT 84703 | $48.76 | $92.00 | $7.52 – $34.22 | 17 |
| Hcg quantitative CPT 84702 | $69.96 | $132.00 | $15.05 – $67.28 | 17 |
| Hc hearing aid chck binaurl CPT 92593 | not published | not published | $114.99 – $114.99 | 1 |
| Hc hearing aid chck monarl CPT 92592 | not published | not published | $70.58 – $70.58 | 1 |
| Hc hearing aid exam both ears CPT 92591 | not published | not published | $224.03 – $224.03 | 1 |
| Hc hearing aid exam one ear CPT 92590 | not published | not published | $175.41 – $175.41 | 1 |
| Hc metata joint dislocation anes CPT 28635 | not published | not published | $640.78 – $640.78 | 1 |
| Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks CPT 17311 | not published | not published | $594.39 – $2,386.72 | 4 |
| Hc mohs micrographic h/n/h/f/g each addl stage CPT 17312 | not published | not published | $1,400.28 – $1,400.28 | 1 |
| Hc mohs trunk/arm/leg 1st stage 5 blocks CPT 17313 | not published | not published | $594.39 – $2,231.62 | 4 |
| Hc mohs trunk/arm/leg ea addl block any stage CPT 17315 | not published | not published | $288.18 – $288.18 | 1 |
| Hc mohs trunk/arm/leg ea stage after 1st stage CPT 17314 | not published | not published | $1,344.74 – $1,344.74 | 1 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | not published | not published | $162.87 – $1,101.15 | 5 |
| Hc nm fusion spect CT unlisted CPT 78999 | not published | not published | $390.18 – $848.52 | 4 |
| Hc nm kidney imaging with flow CPT 78701 | not published | not published | $80.87 – $848.52 | 5 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | not published | not published | $155.46 – $1,101.15 | 5 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | $2,783.56 | $5,252.00 | $241.53 – $3,756.00 | 3 |
| Hc transcatheter placement and sbsq removal cepd perq CPT 33370 | not published | not published | $486.77 – $486.77 | 1 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | not published | not published | $342.24 – $943.18 | 4 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | not published | not published | $668.58 – $943.18 | 4 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | not published | not published | $673.70 – $947.99 | 4 |
| Hdr rdncl skn surf brachytx CPT 77767 | not published | not published | $185.23 – $357.50 | 4 |
| Hdr rdncl skn surf brachytx CPT 77768 | not published | not published | $245.71 – $357.50 | 4 |
| Head CT scan (with and without contrast) CPT 70470 | $862.84 | $1,628.00 | $172.86 – $724.00 | 6 |
| Head CT scan (with contrast) CPT 70460 | $850.12 | $1,604.00 | $172.86 – $724.00 | 6 |
| Head CT scan (without contrast) CPT 70450 | $841.64 | $1,588.00 | $103.26 – $724.00 | 6 |
| Hearing loss dup/del analys CPT 81431 | not published | not published | $679.57 – $2,228.67 | 14 |
| Hearing loss sequence analys CPT 81430 | not published | not published | $1,706.25 – $5,328.50 | 11 |
| Heart first pass add-on CPT 78496 | not published | not published | $68.00 – $68.00 | 1 |
| Heart first pass multiple CPT 78483 | not published | not published | $243.74 – $1,101.15 | 5 |
| Heart image spect CPT 78494 | not published | not published | $197.82 – $848.52 | 5 |
| Heart infarct image CPT 78466 | not published | not published | $119.27 – $848.52 | 5 |
| Heart infarct image (ef) CPT 78468 | not published | not published | $134.03 – $1,101.15 | 5 |
| Heart revascularize (tmr) CPT 33140 | not published | not published | $5,688.92 – $5,688.92 | 1 |
| Heart tmr w/other procedure 33141 CPT 33141 | not published | not published | $472.44 – $472.44 | 1 |
| Heavy metal qual any number CPT 83015 | not published | not published | $20.94 – $85.01 | 17 |
| Heinz bodies direct CPT 85441 | not published | not published | $4.20 – $18.87 | 17 |
| Heinz bodies induced CPT 85445 | not published | not published | $6.82 – $30.71 | 17 |
| Helicobacter pylori antibody igm CPT 86677 | $60.95 | $115.00 | $9.63 – $39.60 | 17 |
| Hemagglutination inhibition CPT 86280 | not published | not published | $8.19 – $36.60 | 17 |
| Hematocrit CPT 85014 | $14.84 | $28.00 | $2.37 – $10.63 | 17 |
| Hematopoietic nuclear tx CPT 79403 | not published | not published | $217.63 – $561.65 | 5 |
| Hemicrt intrclry algrft prtl CPT 20933 | not published | not published | $2,379.03 – $2,379.03 | 1 |
| Hemiepiphyseal arrest CPT 24470 | not published | not published | $2,066.98 – $2,066.98 | 1 |
| Hemodialysis access study CPT 90940 | not published | not published | $77.66 – $77.66 | 1 |
| Hemodialysis one evaluation CPT 90935 | not published | not published | $241.64 – $951.22 | 4 |
| Hemodialysis repeated eval CPT 90937 | not published | not published | $346.73 – $346.73 | 1 |
| Hemoglobin CPT 85018 | $14.84 | $28.00 | $2.37 – $10.63 | 17 |
| Hemoglobin copper sulfate CPT 83026 | not published | not published | $3.91 – $10.63 | 17 |
| Hemoglobin fetal qualitative CPT 83033 | not published | not published | $8.00 – $27.15 | 17 |
| Hemoglobin f (fetal) chemical CPT 83030 | not published | not published | $10.74 – $36.60 | 17 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $22.79 | $43.00 | $4.85 – $19.27 | 17 |
| Hemoglobin-oxygen affinity CPT 82820 | not published | not published | $13.34 – $44.85 | 17 |
| Hemoglobin plasma CPT 83051 | $42.93 | $81.00 | $5.75 – $17.18 | 17 |
| Hemoglobin thermolabile CPT 83065 | not published | not published | $9.00 – $30.71 | 17 |
| Hemoglobin urine CPT 83069 | not published | not published | $3.95 – $17.70 | 17 |
| Hemolysin acid CPT 85475 | not published | not published | $8.87 – $40.12 | 17 |
| Hemolysins/agglutinins auto CPT 86940 | not published | not published | $8.77 – $36.60 | 17 |
| Hemolysins and agglutinins incubated CPT 86941 | not published | not published | $12.11 – $54.30 | 17 |
| Hemoperfusion CPT 90997 | not published | not published | $311.98 – $311.98 | 1 |
| Hemophilus influenza antibdy CPT 86684 | not published | not published | $15.84 – $70.83 | 17 |
| Hemorrhoidectomy intern transanal deater 2+ 46948 CPT 46948 | not published | not published | $1,598.94 – $1,598.94 | 1 |
| Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 | not published | not published | $885.29 – $1,239.41 | 4 |
| Hemorrhoidopexy stapling 46947 CPT 46947 | not published | not published | $1,381.59 – $1,381.59 | 1 |
| Heparin assay CPT 85520 | $90.63 | $171.00 | $13.09 – $52.51 | 17 |
| Heparin bolus from bag HCPCS J1644 | $9.84 | $18.57 | $0.14 – $0.61 | 11 |
| Heparin neutralization CPT 85525 | $38.69 | $73.00 | $11.84 – $53.13 | 17 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $0.27 | $0.51 | $0.02 – $0.06 | 10 |
| Heparin-protamine tolerance CPT 85530 | not published | not published | $13.09 – $63.76 | 17 |
| Hepatectomy removal of liver 47120 CPT 47120 | not published | not published | $8,394.29 – $8,394.29 | 1 |
| Hepatitis a antibody igm CPT 86709 | $47.17 | $89.00 | $11.26 – $50.75 | 17 |
| Hepatitis b core antibody igm CPT 86705 | $49.82 | $94.00 | $11.77 – $53.13 | 17 |
| Hepatitis b core antibody total CPT 86704 | $48.76 | $92.00 | $12.05 – $54.30 | 17 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | not published | not published | $143.22 – $514.29 | 13 |
| Hepatitis b surface ag quan CPT 87467 | not published | not published | $18.81 – $51.92 | 5 |
| Hepatitis b surface antibody CPT 86706 | $46.64 | $88.00 | $10.74 – $48.40 | 17 |
| Hepatitis b vaccine 40 mcg/ml inj-adult CPT 90747 | not published | not published | $161.86 – $474.76 | 10 |
| Hepatitis c antibody CPT 86803 | $59.89 | $113.00 | $14.27 – $63.76 | 17 |
| Hepatitis c rna dir probe CPT 87520 | not published | not published | $31.22 – $89.70 | 17 |
| Hepatitis d quantification CPT 87523 | $136.21 | $257.00 | $42.84 – $140.97 | 6 |
| Hepatitis g dna amp probe CPT 87526 | not published | not published | $39.26 – $157.01 | 17 |
| Hepatitis g dna dir probe CPT 87525 | not published | not published | $29.80 – $89.70 | 17 |
| Hepatitis g dna quant CPT 87527 | not published | not published | $41.76 – $187.68 | 17 |
| Hepatobiliary system imaging CPT 78226 | not published | not published | $124.96 – $848.52 | 5 |
| Hep b vac 3ag 10mcg 3 dos im CPT 90759 | not published | not published | $90.79 – $238.14 | 7 |
| Hepb vacc 3 dose immunsup im CPT 90740 | not published | not published | $168.28 – $638.06 | 10 |
| Hereditary colon ca dsordrs CPT 81435 | not published | not published | $614.14 – $2,625.31 | 14 |
| Hereditary colon ca dsordrs CPT 81436 | not published | not published | $614.14 – $2,748.79 | 13 |
| Hered neuroend tum-rlt do 5+ CPT 81437 | not published | not published | $460.88 – $1,980.78 | 12 |
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.