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 |
|---|---|---|---|---|
| Perq p-art revsc 1 nm nt bi CPT 33901 | $15,217.89 | $28,713.00 | $2,500.22 – $2,500.22 | 1 |
| Perq p-art revsc 1 nm nt uni CPT 33900 | $30,435.78 | $57,426.00 | $1,901.85 – $1,901.85 | 1 |
| Perq p-art revsc each addl CPT 33904 | $15,217.89 | $28,713.00 | $954.54 – $954.54 | 1 |
| Perq plmt bile duct stent CPT 47538 | not published | not published | $16,289.32 – $16,289.32 | 1 |
| Perq plmt bile duct stent CPT 47539 | not published | not published | $17,807.21 – $17,807.21 | 1 |
| Perq plmt bile duct stent CPT 47540 | not published | not published | $18,519.00 – $18,519.00 | 1 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | not published | not published | $236.16 – $1,193.94 | 4 |
| Perq skel fix rad/uln dislc CPT 25671 | not published | not published | $1,922.89 – $1,922.89 | 1 |
| Perq skel fix ulnar styld fx CPT 25651 | not published | not published | $1,756.76 – $1,756.76 | 1 |
| Perq transcath closure each CPT 93592 | not published | not published | $1,431.50 – $1,431.50 | 1 |
| Perq transcath closure pda CPT 93582 | not published | not published | $2,195.62 – $2,195.62 | 1 |
| Perq transcath cls aortic CPT 93591 | not published | not published | $3,250.37 – $3,250.37 | 1 |
| Perq transcath cls mitral CPT 93590 | not published | not published | $3,916.43 – $3,916.43 | 1 |
| Perq transcath septal reduxn CPT 93583 | not published | not published | $2,481.25 – $2,481.25 | 1 |
| Perq trluml angp nt/recr coa CPT 33897 | not published | not published | $2,105.21 – $2,105.21 | 1 |
| Perq tx big toe fracture w/manip 28496 CPT 28496 | not published | not published | $1,615.76 – $1,615.76 | 1 |
| Perq tx malar fracture CPT 21355 | not published | not published | $1,568.39 – $1,568.39 | 1 |
| Perq tx mndblr fx xtrnl fixj CPT 21452 | not published | not published | $2,200.03 – $2,200.03 | 1 |
| Perq tx nasoethmoid fx CPT 21340 | not published | not published | $2,776.13 – $2,776.13 | 1 |
| Pertussis ag if CPT 87265 | not published | not published | $11.98 – $54.30 | 17 |
| Pet CT skull-mid thgh initial CPT 78815 | $2,729.50 | $5,150.00 | $407.96 – $3,756.00 | 3 |
| Pet CT whole body initial CPT 78816 | not published | not published | $411.86 – $3,756.00 | 3 |
| Pet fdg brain metoblic eval sb CPT 78608 | $2,783.56 | $5,252.00 | $245.78 – $3,756.00 | 3 |
| Pet image full body CPT 78813 | not published | not published | $334.48 – $3,756.00 | 3 |
| Pet image ltd area CPT 78811 | not published | not published | $262.75 – $3,756.00 | 3 |
| Pet image skull-thigh CPT 78812 | not published | not published | $321.57 – $3,756.00 | 3 |
| Pet image w/ct lmtd CPT 78814 | not published | not published | $370.53 – $3,756.00 | 3 |
| Pet scan brain perf study CPT 78609 | not published | not published | $255.51 – $3,756.00 | 2 |
| Ph1 assmt&mgmt nqhp 11-20 CPT 98967 | not published | not published | $23.20 – $89.73 | 4 |
| Ph1 assmt&mgmt nqhp 21-30 CPT 98968 | not published | not published | $32.21 – $132.50 | 4 |
| Ph1 assmt&mgmt nqhp 5-10 CPT 98966 | not published | not published | $12.53 – $46.27 | 4 |
| Phalangectomy ea toe 28150 CPT 28150 | not published | not published | $1,582.08 – $1,582.08 | 1 |
| Ph body fluid CPT 83986 | $21.20 | $40.00 | $3.58 – $16.53 | 17 |
| Phencyclidine (pcp) CPT 83992 | $61.48 | $116.00 | $24.33 – $91.91 | 10 |
| Phenobarbital therapeutic drug level CPT 80184 | $59.89 | $113.00 | $15.30 – $51.92 | 17 |
| Phentolaine mesylate inj HCPCS J2760 | $595.62 | $1,123.82 | $472.00 – $1,119.72 | 11 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $7.84 | $14.80 | $0.03 – $0.03 | 1 |
| Phenytoin total therapeutic drug level CPT 80185 | $59.89 | $113.00 | $13.25 – $59.03 | 17 |
| Phlebotomy therapeutic CPT 99195 | not published | not published | $125.16 – $324.05 | 4 |
| Phleb veins 1 extrm 10-20 stab CPT 37765 | $2,086.08 | $3,936.00 | $2,372.47 – $2,372.47 | 1 |
| Phleb veins 1 extrm >20 stab CPT 37766 | $2,362.21 | $4,457.00 | $2,818.76 – $2,818.76 | 1 |
| Phosphorus CPT 84100 | $19.08 | $36.00 | $4.74 – $21.25 | 17 |
| Phosphorus 24 hour urine CPT 84105 | $24.38 | $46.00 | $5.78 – $23.60 | 17 |
| Photchmtx tar&uvb/ptrltm&uvb CPT 96910 | not published | not published | $57.68 – $234.53 | 4 |
| Photochemotherapy puva CPT 96912 | not published | not published | $57.68 – $299.68 | 4 |
| Photochemotherapy uv-a or b CPT 96913 | not published | not published | $387.95 – $543.13 | 4 |
| Photodynamic tx addl 15 min CPT 96571 | not published | not published | $90.24 – $90.24 | 1 |
| Photodynmc tx 30 min add-on CPT 96570 | not published | not published | $188.50 – $188.50 | 1 |
| Photo patch test CPT 95052 | not published | not published | $21.62 – $80.75 | 4 |
| Photopheresis CPT 36522 | not published | not published | $5,074.33 – $5,074.33 | 1 |
| Photosensitivity tests CPT 95056 | not published | not published | $125.16 – $175.22 | 4 |
| Phys blood bank serv authrj CPT 86079 | $82.15 | $155.00 | $24.95 – $188.16 | 11 |
| Phys blood bank serv reactj CPT 86078 | $258.64 | $488.00 | $53.33 – $232.95 | 11 |
| Phys blood bank serv xmatch CPT 86077 | $45.05 | $85.00 | $23.78 – $190.51 | 11 |
| Physician standby services CPT 99360 | not published | not published | $164.81 – $164.81 | 1 |
| Phys review of motion tests CPT 96004 | not published | not published | $390.39 – $390.39 | 1 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $11.25 | $21.23 | $2.71 – $8.40 | 10 |
| Pierce earlobes 69090 CPT 69090 | not published | not published | $112.76 – $112.76 | 1 |
| Pik3ca gene trgt seq alys CPT 81309 | not published | not published | $274.83 – $893.58 | 14 |
| Pinch graft 1/mlt c> sm ulcer tip/oth area 2cm 15050 CPT 15050 | not published | not published | $594.39 – $2,034.83 | 4 |
| Pin finger dislocation CPT 26776 | not published | not published | $1,611.14 – $1,611.14 | 1 |
| Pin finger fracture each CPT 26756 | not published | not published | $1,521.24 – $1,521.24 | 1 |
| Pin hand dislocation CPT 26676 | not published | not published | $1,820.24 – $1,820.24 | 1 |
| Pin knuckle dislocation CPT 26706 | not published | not published | $1,602.04 – $1,602.04 | 1 |
| Pinworm exam CPT 87172 | $23.32 | $44.00 | $4.27 – $18.87 | 17 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $9.28 | $17.51 | $1.40 – $5.78 | 10 |
| Pituitary evaluation panel CPT 80418 | not published | not published | $579.48 – $2,715.01 | 17 |
| Place breast cath for rad CPT 19297 | not published | not published | $339.99 – $339.99 | 1 |
| Place breast rad tube/caths CPT 19298 | not published | not published | $3,758.12 – $3,758.12 | 1 |
| Place cath intracranial art CPT 36228 | not published | not published | $4,398.60 – $4,398.60 | 1 |
| Place cath xtrnl carotid CPT 36227 | $1,087.03 | $2,051.00 | $905.01 – $905.01 | 1 |
| Place cecostomy tube perc CPT 49442 | not published | not published | $3,512.47 – $3,512.47 | 1 |
| Place duod/jej tube perc CPT 49441 | not published | not published | $4,238.96 – $4,238.96 | 1 |
| Place gastrostomy tube open 43832 CPT 43832 | not published | not published | $3,746.49 – $3,746.49 | 1 |
| Place gastrostomy tube perc CPT 49440 | not published | not published | $3,770.55 – $3,770.55 | 1 |
| Placement bile duct support CPT 47801 | not published | not published | $3,640.44 – $3,640.44 | 1 |
| Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides) CPT 19281 | not published | not published | $228.79 – $867.97 | 2 |
| Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left CPT 19282 | not published | not published | $162.02 – $607.02 | 2 |
| Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) CPT 19285 | not published | not published | $346.44 – $1,863.43 | 5 |
| Placement nephrostomy catheter (both sides) CPT 50432 | not published | not published | $3,062.93 – $3,062.93 | 1 |
| Placement of drain pancreas CPT 48001 | not published | not published | $8,245.31 – $8,245.31 | 1 |
| Placement of seton CPT 46020 | not published | not published | $999.94 – $999.94 | 1 |
| Placement stent(s) intravascular transcatheter artery initial CPT 37236 | $10,265.57 | $19,369.00 | $14,898.93 – $14,898.93 | 1 |
| Place ndl musc/tis for right CPT 20555 | not published | not published | $1,196.43 – $1,196.43 | 1 |
| Place needles h&n for right CPT 41019 | not published | not published | $1,742.25 – $1,742.25 | 1 |
| Place needles pelvic for right CPT 55920 | not published | not published | $1,652.95 – $1,652.95 | 1 |
| Place non-slctv cath thoracic arta CPT 36221 | $2,487.82 | $4,694.00 | $3,960.44 – $3,960.44 | 1 |
| Placental lactogen CPT 83632 | not published | not published | $20.22 – $90.91 | 17 |
| Place po breast cath for rad CPT 19296 | not published | not published | $14,311.15 – $14,311.15 | 1 |
| Place right device/marker pros CPT 55876 | $3,177.35 | $5,995.00 | $493.67 – $493.67 | 1 |
| Place slctv cath carotd art uni CPT 36224 | $4,127.11 | $7,787.00 | $6,553.42 – $6,553.42 | 1 |
| Place slctv cath carotid/inom art excrn uni CPT 36222 | not published | not published | $4,747.84 – $4,747.84 | 1 |
| Place slctv cath carotid/inom art intcrn uni CPT 36223 | $4,127.11 | $7,787.00 | $5,557.18 – $5,557.18 | 1 |
| Place slctv cath subclavian art CPT 36225 | not published | not published | $5,430.10 – $5,430.10 | 1 |
| Place slctv cath vertebral art uni CPT 36226 | $4,127.11 | $7,787.00 | $6,651.93 – $6,651.93 | 1 |
| Plasma volume multiple CPT 78111 | not published | not published | $37.33 – $2,938.37 | 2 |
| Plasma volume single CPT 78110 | not published | not published | $32.46 – $2,938.37 | 2 |
| Platelet aggregation each agent teg CPT 85576 | $69.96 | $132.00 | $24.91 – $62.96 | 17 |
| Platelet automated CPT 85049 | $25.97 | $49.00 | $4.48 – $20.08 | 17 |
| Platelet deplete of harvest CPT 38213 | not published | not published | $45.84 – $594.31 | 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.