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 |
|---|---|---|---|---|
| Prothrombin time substitution plasma fractions each CPT 85611 | $47.70 | $90.00 | $3.94 – $17.70 | 17 |
| Proton treatment complex CPT 77525 | not published | not published | $3,784.27 – $3,784.27 | 1 |
| Proton trmt intermediate CPT 77523 | not published | not published | $3,404.22 – $3,404.22 | 1 |
| Proton trmt simple w/comp CPT 77522 | not published | not published | $2,937.64 – $2,937.64 | 1 |
| Proton trmt simple without comp CPT 77520 | not published | not published | $561.71 – $2,940.06 | 4 |
| Protoporphyrin rbc screen CPT 84203 | not published | not published | $9.74 – $38.95 | 17 |
| Prpertl pel pack hemrrg trma 49013 CPT 49013 | not published | not published | $1,597.97 – $1,597.97 | 1 |
| Prp i/hern init block >5 yr CPT 49507 | not published | not published | $2,106.37 – $2,106.37 | 1 |
| Pr planning advance care 1st 30 minutes CPT 99497 | not published | not published | $89.82 – $227.80 | 4 |
| Prq av fstl crtj uxtr 1 acs CPT 36836 | not published | not published | $24,588.68 – $24,588.68 | 1 |
| Prq av fstl crt uxtr sep acs CPT 36837 | not published | not published | $34,982.96 – $34,982.96 | 1 |
| Prq card angio/athrect addl CPT 92925 | not published | not published | $17,728.00 – $17,728.00 | 1 |
| Prq cardiac angio addl art CPT 92921 | not published | not published | $17,728.00 – $17,728.00 | 1 |
| Prq card revasc chronic addl CPT 92944 | $10,706.53 | $20,201.00 | $18,835.00 – $18,835.00 | 1 |
| Prq card revasc mi 1 vsl CPT 92941 | $9,298.85 | $17,545.00 | $2,226.63 – $18,835.00 | 2 |
| Prq card stent/ath/angio CPT 92934 | not published | not published | $18,835.00 – $18,835.00 | 1 |
| Prq card stent w/angio addl CPT 92929 | not published | not published | $18,835.00 – $18,835.00 | 1 |
| Prq revasc byp graft 1 art and/or branches CPT 92937 | $9,087.91 | $17,147.00 | $1,984.72 – $18,835.00 | 2 |
| Prq revasc byp graft addl CPT 92938 | not published | not published | $18,835.00 – $18,835.00 | 1 |
| Prq skel fix clcnl fx w/mnpj CPT 28406 | not published | not published | $1,905.25 – $1,905.25 | 1 |
| Prq skel fix epcndylr hum fx CPT 24566 | not published | not published | $2,599.33 – $2,599.33 | 1 |
| Prq skel fix sprcndlr hum fx CPT 24538 | not published | not published | $2,693.84 – $2,693.84 | 1 |
| Prq skel fix talus fx w/mnpj CPT 28436 | not published | not published | $1,632.25 – $1,632.25 | 1 |
| Prq skel fix tarsl fx w/mnpj CPT 28456 | not published | not published | $1,161.93 – $1,161.93 | 1 |
| Prq tcat plmt ntrac st 1 les CPT 92928 | $9,087.91 | $17,147.00 | $1,987.10 – $18,835.00 | 2 |
| Prq trlml c athrc st angiop1 CPT 92933 | $14,313.71 | $27,007.00 | $2,222.34 – $18,835.00 | 2 |
| Prq trluml c angiop 1art&/br CPT 92920 | $8,923.61 | $16,837.00 | $1,790.20 – $17,728.00 | 2 |
| Prq trluml c athrc 1 art&/br CPT 92924 | $11,340.94 | $21,398.00 | $2,125.24 – $17,728.00 | 2 |
| Prq trluml revsc ch occ ant CPT 92943 | $21,413.06 | $40,402.00 | $2,225.95 – $18,835.00 | 2 |
| Pr removal drug delivery implant CPT 11982 | $960.89 | $1,813.00 | $387.48 – $574.01 | 4 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | not published | not published | $125.16 – $360.62 | 4 |
| Pr removal intrauterine device CPT 58301 | not published | not published | $295.37 – $413.52 | 4 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | not published | not published | $387.95 – $1,092.96 | 4 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | not published | not published | $192.94 – $392.99 | 4 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | not published | not published | $192.94 – $410.71 | 4 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | not published | not published | $192.94 – $320.93 | 4 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | not published | not published | $192.94 – $390.87 | 4 |
| Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child CPT 15100 | not published | not published | $3,103.36 – $3,103.36 | 1 |
| Pr subsequent hospital care e/m normal newborn per day CPT 99462 | not published | not published | $112.42 – $112.42 | 1 |
| Prtl exc bone olecrn process CPT 24147 | not published | not published | $2,255.34 – $2,255.34 | 1 |
| Prtl exc bone radial h/n CPT 24145 | not published | not published | $2,143.33 – $2,143.33 | 1 |
| Prtl exchange transfuse nb CPT 36456 | not published | not published | $392.88 – $594.31 | 4 |
| Prtl excision bone clavicle CPT 23180 | not published | not published | $2,398.76 – $2,398.76 | 1 |
| Prtl excision bone scapula CPT 23182 | not published | not published | $2,344.16 – $2,344.16 | 1 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $1,160.17 | $2,189.00 | $619.40 – $619.40 | 1 |
| PSA (Prostate) Test CPT 84153 | $69.96 | $132.00 | $18.39 – $82.63 | 17 |
| Psych/neuropsych test admin automated result 96146 CPT 96146 | not published | not published | $6.49 – $33.29 | 4 |
| Psychoanalysis CPT 90845 | not published | not published | $156.01 – $306.68 | 4 |
| Psychophysiological therapy CPT 90875 | not published | not published | $204.51 – $204.51 | 1 |
| Psychophysiological therapy CPT 90876 | not published | not published | $360.03 – $360.03 | 1 |
| Psychotherapy group therapy CPT 90853 | not published | not published | $86.05 – $125.75 | 4 |
| Psychotherapy patient individual therapy 30 minutes CPT 90832 | not published | not published | $156.01 – $218.41 | 4 |
| Psychotherapy patient individual therapy 45 minutes CPT 90834 | not published | not published | $156.01 – $284.51 | 4 |
| Psychotherapy patient individual therapy 60 minutes CPT 90837 | not published | not published | $156.01 – $426.53 | 4 |
| Psych test eval svc phys/qhp 1st hr CPT 96130 | not published | not published | $302.38 – $423.33 | 4 |
| Psych test eval svc phys/qhp ea addl hr CPT 96131 | not published | not published | $299.44 – $299.44 | 1 |
| Psycl/nrpsyc tech 1st CPT 96138 | not published | not published | $125.15 – $542.47 | 4 |
| Psy evaluation of records CPT 90885 | not published | not published | $165.34 – $165.34 | 1 |
| Psy/npsy phys/qhp 2> tst 1st 30 min CPT 96136 | not published | not published | $125.16 – $175.22 | 4 |
| Psy/npsy phys/qhp 2> tst ea l 30 min CPT 96137 | not published | not published | $144.67 – $144.67 | 1 |
| Psy/npsy tst admin tech 2> ea l 30 min CPT 96139 | not published | not published | $125.15 – $125.15 | 1 |
| Psytx complex interactive CPT 90785 | not published | not published | $46.72 – $46.72 | 1 |
| Psytx pt w/e&m 16-37 min CPT 90833 | not published | not published | $220.59 – $220.59 | 1 |
| Psytx pt w/e&m 38-52 min CPT 90836 | not published | not published | $280.02 – $280.02 | 1 |
| Psytx pt w/e&m 53+ min CPT 90838 | not published | not published | $369.14 – $369.14 | 1 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $77.38 | $146.00 | $13.77 – $63.72 | 4 |
| Pt application of modality >=1 area hot/cold packs CPT 97010 | not published | not published | $19.62 – $19.62 | 1 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $50.88 | $96.00 | $18.11 – $87.04 | 4 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $64.66 | $122.00 | $13.40 – $41.38 | 4 |
| Pt application of modality traction mechanical CPT 97012 | $59.36 | $112.00 | $13.77 – $53.24 | 4 |
| Pt/caregiver traing home inr CPT 93792 | not published | not published | $177.04 – $177.04 | 1 |
| Pten gene dup/delet variant CPT 81323 | not published | not published | $106.26 – $705.00 | 17 |
| Pten gene full sequence CPT 81321 | not published | not published | $600.00 – $1,976.06 | 17 |
| Pten gene known fam variant CPT 81322 | not published | not published | $46.60 – $192.41 | 17 |
| Pterygomaxillary fossa surg any appr 31040 CPT 31040 | not published | not published | $2,773.48 – $2,773.48 | 1 |
| Pt evaluation high complexity patient/family CPT 97163 | not published | not published | $95.13 – $267.07 | 4 |
| Pt evaluation low complexity patient/family CPT 97161 | not published | not published | $95.13 – $267.07 | 4 |
| Pt evaluation moderate complexity patient/family CPT 97162 | not published | not published | $95.13 – $267.07 | 4 |
| Pt-focused hlth risk assmt CPT 96160 | not published | not published | $15.13 – $40.50 | 4 |
| Pt init/spiromet rec/review/interp 94016 CPT 94016 | not published | not published | $22.61 – $85.65 | 4 |
| Pt prgrm for implt neurostim HCPCS L8681 | $2,908.01 | $5,486.81 | $1,710.36 – $1,710.36 | 1 |
| Pt re-evaluation patient/family CPT 97164 | not published | not published | $65.63 – $181.12 | 4 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | not published | not published | $39.75 – $144.13 | 4 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $51.94 | $98.00 | $27.97 – $94.79 | 4 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $58.30 | $110.00 | $28.76 – $87.52 | 4 |
| Pt wheelchair management each 15 minutes CPT 97542 | not published | not published | $29.87 – $102.71 | 4 |
| Pul art balloon repr percut CPT 92997 | not published | not published | $2,147.47 – $2,147.47 | 1 |
| Pul art balloon repr percut CPT 92998 | not published | not published | $1,060.29 – $1,060.29 | 1 |
| Pulm ds ipf mrna 190 gen alg CPT 81554 | not published | not published | $5,775.00 – $18,975.00 | 11 |
| Pulm endartercomy w/bypass 33916 CPT 33916 | not published | not published | $15,233.39 – $15,233.39 | 1 |
| Pulmonary decortication partial 32225 CPT 32225 | not published | not published | $3,592.51 – $3,592.51 | 1 |
| Pulmonary vent imaging CPT 78579 | $1,439.48 | $2,716.00 | $80.87 – $848.52 | 5 |
| Pulse ox continuous overnight monitoring CPT 94762 | $336.02 | $634.00 | $79.80 – $212.70 | 4 |
| Pulse ox multiple CPT 94761 | not published | not published | $15.81 – $15.81 | 1 |
| Pulse ox single CPT 94760 | not published | not published | $10.00 – $10.00 | 1 |
| Punc of shunt for asp or inj CPT 61070 | $782.81 | $1,477.00 | $210.19 – $941.43 | 4 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $68.37 | $129.00 | $115.22 – $175.22 | 4 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $665.15 | $1,255.00 | $387.95 – $543.13 | 4 |
| Puncture/clear windpipe 31612 CPT 31612 | not published | not published | $302.69 – $302.69 | 1 |
| Puncture spinal lumbar diagnostic CPT 62270 | $646.60 | $1,220.00 | $576.51 – $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.