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 |
|---|---|---|---|---|
| L/s ratio fetal lung CPT 83661 | not published | not published | $21.99 – $99.15 | 17 |
| Lumbar diskogram s&i CPT 72295 | $1,023.96 | $1,932.00 | $148.11 – $3,947.38 | 3 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $5,701.60 – $5,701.60 | 1 |
| Lung function test (mbc/mvv) CPT 94200 | $85.33 | $161.00 | $18.73 – $80.75 | 4 |
| Lung Function Test (Spirometry) CPT 94010 | $365.17 | $689.00 | $28.39 – $212.70 | 4 |
| Lung perfusion imaging CPT 78580 | $1,315.46 | $2,482.00 | $124.96 – $848.52 | 5 |
| Lung transplant double CPT 32853 | not published | not published | $16,587.87 – $16,587.87 | 1 |
| Lung transplant single CPT 32851 | not published | not published | $11,906.57 – $11,906.57 | 1 |
| Lung transplant with bypass CPT 32852 | not published | not published | $13,025.64 – $13,025.64 | 1 |
| Lung transplant with bypass CPT 32854 | not published | not published | $17,639.88 – $17,639.88 | 1 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $5,333.34 – $5,333.34 | 1 |
| Lutetium lu 177 vipivotide HCPCS A9607 | $576.64 | $1,088.00 | $739.87 – $739.87 | 1 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $23.78 – $189.75 | 4 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $20.05 – $89.70 | 17 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $2,544.72 – $2,544.72 | 1 |
| Lymphatics/lymph node imaging CPT 78195 | not published | not published | $200.45 – $1,101.15 | 5 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $36.56 – $253.78 | 17 |
| Lymphocyte transformation mitogen CPT 86353 | not published | not published | $49.03 – $219.56 | 17 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $86.54 – $445.35 | 17 |
| Lymphocytotoxicity assay CPT 86806 | not published | not published | $47.59 – $213.66 | 17 |
| Lymph vessel x-ray arm/leg CPT 75801 | $894.64 | $1,688.00 | $146.25 – $1,218.65 | 6 |
| Lymph vessel x-ray arms/legs CPT 75803 | $991.63 | $1,871.00 | $200.76 – $3,163.82 | 3 |
| Lymph vessel x-ray trunk CPT 75805 | $2,313.45 | $4,365.00 | $139.04 – $6,438.74 | 3 |
| Lymph vessel x-ray trunk CPT 75807 | $1,691.23 | $3,191.00 | $201.45 – $6,438.74 | 3 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $494.49 – $979.42 | 4 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $521.64 – $521.64 | 1 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $933.13 – $933.13 | 1 |
| Macro exam dissect molec study ea CPT 88387 | not published | not published | $8.56 – $30.22 | 8 |
| Macroscopic exam arthropod CPT 87168 | $30.74 | $58.00 | $4.27 – $18.87 | 17 |
| Macroscopic exam parasite CPT 87169 | $36.04 | $68.00 | $4.31 – $18.87 | 17 |
| Magnesium CPT 83735 | $39.75 | $75.00 | $6.70 – $29.50 | 17 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $8.55 | $16.14 | $0.60 – $1.49 | 10 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $234.71 – $836.00 | 6 |
| Malaria antibody CPT 86750 | not published | not published | $13.19 – $59.03 | 17 |
| Male sling procedure CPT 53440 | not published | not published | $2,761.62 – $2,761.62 | 1 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $10,898.09 – $10,898.09 | 1 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $1,220.12 – $1,220.12 | 1 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $1,513.22 – $1,513.22 | 1 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $52.47 | $99.00 | $93.30 – $175.22 | 4 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $104.94 | $198.00 | $83.98 – $175.22 | 4 |
| Manipulation of hip joint CPT 27275 | not published | not published | $661.11 – $661.11 | 1 |
| Manipulation of spine CPT 22505 | not published | not published | $464.24 – $464.24 | 1 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $232.93 – $360.36 | 4 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $3.50 | $6.60 | $2.77 – $6.60 | 6 |
| Manual diff wbc count b-coat CPT 85009 | not published | not published | $5.07 – $16.53 | 17 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | not published | not published | $286.86 – $286.86 | 1 |
| Mapping io sentinel lymph node CPT 38900 | not published | not published | $496.13 – $496.13 | 1 |
| Map tachycard site(s) CPT 93609 | $3,842.50 | $7,250.00 | $355.37 – $13,407.00 | 2 |
| Marsupialization liver lesion 47300 CPT 47300 | not published | not published | $4,082.60 – $4,082.60 | 1 |
| Mastectomy partial CPT 19301 | not published | not published | $2,341.06 – $2,341.06 | 1 |
| Mast mod rad CPT 19307 | not published | not published | $4,288.79 – $4,288.79 | 1 |
| Mastoidectomy CPT 69501 | not published | not published | $2,696.19 – $2,696.19 | 1 |
| Mastoidectomy complete 69502 CPT 69502 | not published | not published | $3,568.38 – $3,568.38 | 1 |
| Mastoids complete CPT 70130 | not published | not published | $58.79 – $245.18 | 6 |
| Mastoid surgery revision CPT 69603 | not published | not published | $4,672.94 – $4,672.94 | 1 |
| Mastopexy CPT 19316 | not published | not published | $2,801.34 – $2,801.34 | 1 |
| Mast radical CPT 19305 | not published | not published | $4,046.27 – $4,046.27 | 1 |
| Mast rad urban type CPT 19306 | not published | not published | $4,296.59 – $4,296.59 | 1 |
| Mast simple complete CPT 19303 | not published | not published | $3,621.08 – $3,621.08 | 1 |
| M.avium-intra dna amp prob CPT 87561 | not published | not published | $35.09 – $157.01 | 17 |
| M.avium-intra dna dir prob CPT 87560 | not published | not published | $27.29 – $89.70 | 17 |
| M.avium-intra dna quant CPT 87562 | not published | not published | $42.84 – $192.41 | 17 |
| Maxillofacial fixation CPT 21100 | not published | not published | $3,751.63 – $3,751.63 | 1 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $63.60 | $120.00 | $14.46 – $64.93 | 17 |
| Mayo aathr protein s free CPT 85306 | $95.93 | $181.00 | $15.32 – $67.14 | 17 |
| Mayo activated protein c resistance assay CPT 85307 | $85.86 | $162.00 | $15.32 – $67.14 | 17 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | not published | not published | $38.57 – $125.86 | 14 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $37.63 | $71.00 | $21.49 – $21.49 | 1 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $73.14 | $138.00 | $32.60 – $81.45 | 6 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $51.94 | $98.00 | $14.78 – $66.10 | 17 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $73.14 | $138.00 | $32.60 – $81.45 | 6 |
| Mayo alpha 1 antitrypsin CPT 82103 | $51.94 | $98.00 | $13.44 – $60.20 | 17 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $58.30 | $110.00 | $15.08 – $67.28 | 17 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | not published | not published | $30.92 – $30.92 | 1 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | not published | not published | $30.99 – $81.45 | 6 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $1,264.05 | $2,385.00 | $121.63 – $422.97 | 17 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $258.11 | $487.00 | $91.66 – $411.96 | 17 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $199.28 | $376.00 | $137.00 – $448.57 | 14 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $1,931.32 | $3,644.00 | $1,218.00 – $3,803.38 | 12 |
| Mayo androstenedione CPT 82157 | $94.87 | $179.00 | $29.28 – $131.03 | 17 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $54.06 | $102.00 | $14.60 – $66.10 | 17 |
| Mayo antithrombin iii antigen CPT 85301 | $66.78 | $126.00 | $10.81 – $48.40 | 17 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $32.33 | $61.00 | $9.63 – $35.37 | 17 |
| Mayo avwpr vw factor activity CPT 85397 | $93.28 | $176.00 | $30.86 – $102.71 | 17 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | not published | not published | $35.09 – $115.68 | 6 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | $54.59 | $103.00 | $22.78 – $81.45 | 6 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $41.87 | $79.00 | $9.63 – $27.32 | 17 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $265.00 | $500.00 | $144.84 – $650.43 | 17 |
| Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative CPT 81208 | not published | not published | $214.62 – $722.43 | 17 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $31.80 | $60.00 | $9.63 – $30.32 | 17 |
| Mayo bnzu sedative hypnotics definitive urine CPT 80368 | not published | not published | $32.60 – $81.45 | 6 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $38.69 | $73.00 | $9.63 – $31.00 | 17 |
| Mayo brcmg brucella antibody igm CPT 86622 | not published | not published | $8.93 – $27.32 | 17 |
| Mayo c1 esterase inhibitor CPT 83883 | $51.41 | $97.00 | $13.60 – $61.38 | 17 |
| Mayo cannabinoids natural definitive assay thc confirmation urine CPT 80349 | $74.73 | $141.00 | $32.60 – $81.45 | 6 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $71.55 | $135.00 | $16.87 – $67.72 | 17 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $66.25 | $125.00 | $26.78 – $120.41 | 17 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | not published | not published | $122.22 – $548.90 | 17 |
| Mayo ceruloplasmin CPT 82390 | $43.99 | $83.00 | $10.74 – $48.40 | 17 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $73.67 | $139.00 | $14.12 – $63.76 | 17 |
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.