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 |
|---|---|---|---|---|
| Infect ag if ea plyvlnt antsrm CPT 87300 | $49.82 | $94.00 | $11.98 – $54.30 | 17 |
| Infect ag if hep delta agent CPT 87380 | not published | not published | $18.36 – $73.17 | 17 |
| Infect ag if influenza a CPT 87276 | $50.88 | $96.00 | $16.07 – $54.30 | 17 |
| Infect ag if influenza b CPT 87275 | $50.88 | $96.00 | $12.25 – $54.30 | 17 |
| Infect ag if legionella pneumophila CPT 87278 | $75.79 | $143.00 | $15.60 – $54.30 | 17 |
| Infect ag if nos ea CPT 87299 | not published | not published | $16.10 – $54.30 | 17 |
| Infect ag if pneumocystis carinii CPT 87281 | $82.68 | $156.00 | $11.98 – $54.30 | 17 |
| Infect ag if varicella zoster CPT 87290 | $42.93 | $81.00 | $13.42 – $54.30 | 17 |
| Infect ag na chlamydia trachomatis qnt CPT 87492 | not published | not published | $53.47 – $157.01 | 17 |
| Infect ag na hep b amp CPT 87516 | not published | not published | $35.09 – $157.01 | 17 |
| Infect ag na herpes simplex quant CPT 87530 | not published | not published | $42.84 – $192.41 | 17 |
| Infect ag na hpv high-risk types CPT 87624 | $113.42 | $214.00 | $35.09 – $157.01 | 18 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $198.75 | $375.00 | $95.80 – $382.47 | 17 |
| Infect ag na influenza revr/amp ea type CPT 87501 | not published | not published | $51.31 – $230.18 | 17 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | not published | not published | $51.31 – $167.95 | 5 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $448.91 | $847.00 | $416.78 – $1,871.00 | 17 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | $536.36 | $1,012.00 | $488.66 – $2,193.27 | 17 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | $122.43 | $231.00 | $26.07 – $116.85 | 17 |
| Infectious agent antigen immunoassay direct optical observation sars-cov-2 CPT 87811 | not published | not published | $41.38 – $134.93 | 11 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $78.44 | $148.00 | $11.98 – $54.30 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | not published | not published | $13.42 – $54.30 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $42.40 | $80.00 | $13.82 – $54.30 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $42.40 | $80.00 | $11.98 – $54.30 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $74.20 | $140.00 | $14.38 – $64.93 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $44.52 | $84.00 | $10.33 – $46.02 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $34.45 | $65.00 | $10.33 – $46.02 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $64.66 | $122.00 | $24.08 – $108.61 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $71.55 | $135.00 | $11.98 – $54.30 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $56.18 | $106.00 | $11.98 – $54.30 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $45.58 | $86.00 | $11.98 – $54.30 | 17 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $143.10 | $270.00 | $35.09 – $157.01 | 17 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $113.42 | $214.00 | $35.09 – $157.01 | 17 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $109.71 | $207.00 | $37.27 – $157.01 | 17 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $776.45 | $1,465.00 | $416.78 – $2,541.48 | 16 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $126.67 | $239.00 | $35.09 – $157.01 | 17 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $109.71 | $207.00 | $35.09 – $157.01 | 17 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $152.11 | $287.00 | $41.68 – $157.01 | 17 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $113.42 | $214.00 | $35.09 – $157.01 | 17 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $109.18 | $206.00 | $51.31 – $166.70 | 12 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $222.60 | $420.00 | $142.63 – $463.82 | 11 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | not published | not published | $142.63 – $463.82 | 11 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $143.10 | $270.00 | $35.09 – $157.01 | 17 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $143.10 | $270.00 | $35.09 – $157.01 | 17 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | not published | not published | $76.77 – $264.86 | 5 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | not published | not published | $416.78 – $1,871.00 | 17 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $289.91 | $547.00 | $128.29 – $576.05 | 17 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | not published | not published | $262.99 – $957.34 | 17 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $197.69 | $373.00 | $42.84 – $192.41 | 17 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $136.21 | $257.00 | $42.84 – $192.41 | 17 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $190.80 | $360.00 | $42.84 – $192.41 | 17 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $297.33 | $561.00 | $85.10 – $382.47 | 17 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $233.20 | $440.00 | $142.63 – $576.05 | 17 |
| Influenza dna amp prob addl CPT 87503 | not published | not published | $29.22 – $93.25 | 17 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | not published | not published | $102.70 – $271.56 | 7 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $35.51 – $86.92 | 7 |
| Inf lwr xtr fscl pln blk uni w/wo image CPT 64474 | not published | not published | $776.40 – $776.40 | 1 |
| Infratemporal approach/skull CPT 61591 | not published | not published | $11,247.14 – $11,247.14 | 1 |
| Infratemporal approach/skull CPT 61590 | not published | not published | $11,072.43 – $11,072.43 | 1 |
| Inf thrc fascial pln blk bi w/wo image CPT 64469 | not published | not published | $1,203.00 – $1,203.00 | 1 |
| Inf thrc fascial pln blk uni w/wo image CPT 64467 | not published | not published | $785.87 – $785.87 | 1 |
| Infuse radioactive materials CPT 77750 | not published | not published | $255.36 – $374.64 | 4 |
| Ingest challenge ea addl 60 min CPT 95079 | not published | not published | $277.41 – $277.41 | 1 |
| Ingest challenge ini 120 min CPT 95076 | not published | not published | $388.11 – $721.31 | 4 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | not published | not published | $145.18 – $276.50 | 4 |
| Initial hosp neonate 28 d/less than not critically ill 99477 CPT 99477 | not published | not published | $960.29 – $960.29 | 1 |
| Initial nursing facility care/day 35 minutes CPT 99305 | not published | not published | $348.72 – $348.72 | 1 |
| Initial nursing facility care/day 45 minutes CPT 99306 | not published | not published | $445.00 – $445.00 | 1 |
| Initial nursing facility care/day low severity 99304 CPT 99304 | not published | not published | $244.93 – $244.93 | 1 |
| Initiation & management bipap/cpap initial day CPT 94660 | $213.06 | $402.00 | $197.50 – $276.50 | 4 |
| Init nb em per day non-fac CPT 99461 | not published | not published | $264.08 – $264.08 | 1 |
| Init pm e/m new pat 65+ yrs CPT 99387 | not published | not published | $105.67 – $442.18 | 2 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $464.28 | $876.00 | $518.10 – $518.10 | 1 |
| Inj disk cerv-thor ea lev CPT 62291 | not published | not published | $1,214.38 – $1,214.38 | 1 |
| Inj dupuytren cord w/enzyme CPT 20527 | not published | not published | $286.64 – $401.30 | 4 |
| Inj dx for sinogram CPT 20501 | $311.64 | $588.00 | $428.47 – $428.47 | 1 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | $1,724.09 | $3,253.00 | $672.45 – $941.43 | 4 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | not published | not published | $682.07 – $682.07 | 1 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | not published | not published | $279.38 – $401.30 | 4 |
| Injection during cath supravalvular aortography CPT 93567 | $495.55 | $935.00 | $460.22 – $460.22 | 1 |
| Injection epidural blood patch or clot CPT 62273 | $756.31 | $1,427.00 | $641.19 – $941.43 | 4 |
| Injection eye drug CPT 67028 | not published | not published | $322.08 – $450.91 | 4 |
| Injection for arthrography wrist (both sides) CPT 25246 | not published | not published | $588.52 – $588.52 | 1 |
| Injection for bladder x-ray CPT 51600 | $456.33 | $861.00 | $663.49 – $663.49 | 1 |
| Injection for hip x-ray CPT 27095 | not published | not published | $879.76 – $879.76 | 1 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $341.32 | $644.00 | $473.56 – $473.56 | 1 |
| Injection for spleen x-ray CPT 38200 | not published | not published | $432.75 – $432.75 | 1 |
| Injection for tear sac x-ray CPT 68850 | not published | not published | $221.97 – $221.97 | 1 |
| Injection for ureter x-ray CPT 50684 | not published | not published | $385.83 – $385.83 | 1 |
| Injection for ureter x-ray CPT 50690 | not published | not published | $359.87 – $359.87 | 1 |
| Injection into brain canal CPT 61026 | not published | not published | $376.95 – $941.43 | 4 |
| Injection into brain canal CPT 61055 | $657.20 | $1,240.00 | $286.64 – $439.84 | 4 |
| Injection into hemorrhoid(s) CPT 46500 | not published | not published | $703.63 – $1,239.41 | 4 |
| Injection into spinal artery CPT 62294 | not published | not published | $864.49 – $2,918.39 | 4 |
| Injection into vocal cord CPT 31513 | not published | not published | $377.06 – $527.88 | 4 |
| Injection intraop add-on CPT 48400 | not published | not published | $390.53 – $390.53 | 1 |
| Injection jaw joint x-ray CPT 21116 | not published | not published | $530.59 – $530.59 | 1 |
| Injection of sinus tract CPT 20500 | $1,015.48 | $1,916.00 | $379.23 – $379.23 | 1 |
| Injection px peyronie ds CPT 54200 | not published | not published | $236.16 – $388.40 | 4 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | not published | not published | $144.24 – $546.25 | 4 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $1,596.89 | $3,013.00 | $453.31 – $941.43 | 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.