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 |
|---|---|---|---|---|
| Pvb thoracic 2nd+ inj site CPT 64462 | not published | not published | $307.73 – $307.73 | 1 |
| Pvb thoracic cont infusion CPT 64463 | not published | not published | $602.17 – $941.43 | 4 |
| Pvb thoracic single inj site CPT 64461 | not published | not published | $544.62 – $941.43 | 4 |
| Pyelotomy w/drg pyelostomy CPT 50125 | not published | not published | $3,771.74 – $3,771.74 | 1 |
| Pyelotomy w/exploration CPT 50120 | not published | not published | $3,484.23 – $3,484.23 | 1 |
| Pyelotomy w/removal calculus CPT 50130 | not published | not published | $3,791.62 – $3,791.62 | 1 |
| Pyloroplasty 43800 CPT 43800 | not published | not published | $3,346.33 – $3,346.33 | 1 |
| Pyruvate CPT 84210 | $40.81 | $77.00 | $14.48 – $48.40 | 17 |
| Pyruvate kinase CPT 84220 | $87.45 | $165.00 | $9.44 – $42.50 | 17 |
| Quan puplmtry phy/qhp uni/bi CPT 95919 | not published | not published | $17.44 – $175.22 | 4 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $1,986.44 | $3,748.00 | $142.11 – $1,101.15 | 5 |
| Quant diff pulm perf w/imaging CPT 78597 | $1,584.17 | $2,989.00 | $121.96 – $848.52 | 5 |
| Quest t3 uptake CPT 84479 | not published | not published | $6.47 – $29.50 | 17 |
| Rabies ig heat-treated human im/subq 90376 CPT 90376 | not published | not published | $347.32 – $1,545.98 | 9 |
| Rabies ig ht&sol human im/sc CPT 90377 | not published | not published | $241.15 – $1,218.05 | 13 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | not published | not published | $289.91 – $1,145.12 | 13 |
| Rabies vaccine id CPT 90676 | not published | not published | $264.47 – $436.38 | 4 |
| Radial keratotomy CPT 65771 | not published | not published | $2,288.65 – $2,288.65 | 1 |
| Radiation handling CPT 77790 | not published | not published | $20.08 – $20.08 | 1 |
| Radiation physics consult CPT 77336 | not published | not published | $128.92 – $261.06 | 4 |
| Radiation therapy dose plan CPT 77300 | not published | not published | $109.43 – $180.49 | 4 |
| Radiation therapy management CPT 77431 | not published | not published | $343.79 – $343.79 | 1 |
| Radiation treatment aid(s) CPT 77332 | not published | not published | $96.46 – $180.49 | 4 |
| Radiation treatment aid(s) CPT 77333 | not published | not published | $31.40 – $180.49 | 4 |
| Radiation treatment aid(s) CPT 77334 | not published | not published | $218.14 – $497.64 | 4 |
| Radiation treatment delivery CPT 77401 | not published | not published | $80.97 – $148.86 | 4 |
| Radiation treatment delivery CPT 77402 | not published | not published | $106.33 – $477.58 | 4 |
| Radiation treatment delivery CPT 77412 | not published | not published | $255.36 – $922.63 | 4 |
| Radiation tx management x5 CPT 77427 | not published | not published | $625.76 – $625.76 | 1 |
| Radical abdominal hysterectomy 58210 CPT 58210 | not published | not published | $6,619.11 – $6,619.11 | 1 |
| Radical rescj tumor clavicle CPT 23200 | not published | not published | $5,380.34 – $5,380.34 | 1 |
| Radical rescj tumor prox hum CPT 23220 | not published | not published | $7,040.26 – $7,040.26 | 1 |
| Radical rescj tumor scapula CPT 23210 | not published | not published | $6,436.23 – $6,436.23 | 1 |
| Radical resection of elbow CPT 24149 | not published | not published | $4,278.98 – $4,278.98 | 1 |
| Radical resection sternum 21630 CPT 21630 | not published | not published | $4,369.62 – $4,369.62 | 1 |
| Radic resect abd tumor<5cm 22904 CPT 22904 | not published | not published | $3,784.16 – $3,784.16 | 1 |
| Radic resect shoulder tumor 5cm/> 23078 CPT 23078 | not published | not published | $5,196.71 – $5,196.71 | 1 |
| Radiology port images(s) CPT 77417 | not published | not published | $36.12 – $36.12 | 1 |
| Radiotherapy dose plan imrt CPT 77301 | not published | not published | $1,403.32 – $1,403.32 | 1 |
| Radium ra223 dichl ther/uci HCPCS A9606 | $388.49 | $733.00 | $525.82 – $525.82 | 1 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $1,685.93 | $3,181.00 | $143.35 – $2,938.37 | 2 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $2,036.79 | $3,843.00 | $177.09 – $2,938.37 | 2 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | $3,734.91 | $7,047.00 | $300.22 – $2,938.37 | 2 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $1,828.50 | $3,450.00 | $177.19 – $2,938.37 | 2 |
| Radphm lcl tumor plr sgl day CPT 78800 | $863.90 | $1,630.00 | $114.09 – $848.52 | 5 |
| Radphm quant measure sgl area add-on CPT 78835 | not published | not published | $77.21 – $77.21 | 1 |
| Rad rescj tum dstl/shft hum CPT 24150 | not published | not published | $5,650.61 – $5,650.61 | 1 |
| Rad rescj tum shoulder<5 cm CPT 23077 | not published | not published | $4,144.18 – $4,144.18 | 1 |
| Rad rescj tum tiss a/e 5 cm+ CPT 24079 | not published | not published | $4,788.84 – $4,788.84 | 1 |
| Rad rescj tum tiss a/e <5cm CPT 24077 | not published | not published | $3,746.19 – $3,746.19 | 1 |
| Rad resec soft tis tum/ft/toe/<3cm 28046 CPT 28046 | not published | not published | $2,687.39 – $2,687.39 | 1 |
| Rad resect abd tumor 5 cm/> CPT 22905 | not published | not published | $4,795.25 – $4,795.25 | 1 |
| Rad resect hand tumor < 3 cm CPT 26117 | not published | not published | $2,733.12 – $2,733.12 | 1 |
| Rad resect hand tumor 3 cm/> CPT 26118 | not published | not published | $3,829.14 – $3,829.14 | 1 |
| Rad resection tum radial h/n CPT 24152 | not published | not published | $4,888.54 – $4,888.54 | 1 |
| Rad resect tumor/neck/ant thor/<5cm21557 CPT 21557 | not published | not published | $3,480.46 – $3,480.46 | 1 |
| Range of motion measurements CPT 95852 | not published | not published | $19.14 – $53.65 | 4 |
| Rapid desensitization CPT 95180 | not published | not published | $387.48 – $542.47 | 4 |
| Rapid Strep Test CPT 87880 | $45.58 | $86.00 | $16.53 – $54.30 | 17 |
| Rbc count only automated CPT 85041 | $4.77 | $9.00 | $3.02 – $12.97 | 17 |
| Rbc depletion of harvest CPT 38212 | not published | not published | $181.39 – $594.31 | 4 |
| Rbc mechanical fragility CPT 85547 | not published | not published | $8.60 – $38.95 | 17 |
| Rbc osmotic fragility CPT 85555 | not published | not published | $7.47 – $29.50 | 17 |
| Rbc serum pretx incubj drugs CPT 86975 | not published | not published | $36.67 – $542.47 | 11 |
| Rcm img acquisj&i&r 1st les CPT 96931 | not published | not published | $523.36 – $523.36 | 1 |
| Rcm img acquisj&i&r ea addl CPT 96934 | not published | not published | $268.36 – $268.36 | 1 |
| Rcm img acquisj only 1st les CPT 96932 | not published | not published | $338.74 – $338.74 | 1 |
| Rcm img acquisj only ea addl CPT 96935 | not published | not published | $113.53 – $113.53 | 1 |
| Rcm i&r only 1st lesion CPT 96933 | not published | not published | $147.59 – $147.59 | 1 |
| Rcm i&r only ea addl lesion CPT 96936 | not published | not published | $140.42 – $140.42 | 1 |
| Rcnst bfrnt sp orb rm&lw fhd CPT 21175 | not published | not published | $7,996.30 – $7,996.30 | 1 |
| Rcnstj forehead w/autograft CPT 21180 | not published | not published | $5,666.95 – $5,666.95 | 1 |
| Rcnstj forehead with grafts CPT 21179 | not published | not published | $5,388.92 – $5,388.92 | 1 |
| Rcnstj mdfc lefort i 1 w/grf CPT 21145 | not published | not published | $5,783.40 – $5,783.40 | 1 |
| Rcnstj mdfc lefort i 2 w/grf CPT 21146 | not published | not published | $5,685.56 – $5,685.56 | 1 |
| Rcnstj mdfc lefort iii w/i CPT 21155 | not published | not published | $8,003.20 – $8,003.20 | 1 |
| Rcnstj mdfc lefort iii without i CPT 21154 | not published | not published | $7,630.80 – $7,630.80 | 1 |
| Rcnstj mdfc lefrtii w/b1 grf CPT 21151 | not published | not published | $7,507.04 – $7,507.04 | 1 |
| Rcnst mdfc lfrtiii advm w/i CPT 21160 | not published | not published | $11,720.48 – $11,720.48 | 1 |
| Rcnst mdfc lfrtiii advm wo i CPT 21159 | not published | not published | $9,195.46 – $9,195.46 | 1 |
| Rdctj forehead cntrg only CPT 21137 | not published | not published | $2,744.76 – $2,744.76 | 1 |
| Rdctj forehead cntrg&prostc CPT 21138 | not published | not published | $3,289.64 – $3,289.64 | 1 |
| Rdctj forehead cntrg&setback CPT 21139 | not published | not published | $3,490.09 – $3,490.09 | 1 |
| Realignment of knee CPT 27457 | not published | not published | $3,425.22 – $3,425.22 | 1 |
| Realignment of knee CPT 27455 | not published | not published | $3,414.14 – $3,414.14 | 1 |
| Realignment of tendons CPT 26437 | not published | not published | $2,245.16 – $2,245.16 | 1 |
| Realignment of thigh bone CPT 27454 | not published | not published | $4,717.52 – $4,717.52 | 1 |
| Rebuild eardrum structures CPT 69632 | not published | not published | $3,955.18 – $3,955.18 | 1 |
| Rebuild eardrum structures CPT 69633 | not published | not published | $3,837.72 – $3,837.72 | 1 |
| Rebuild eardrum structures CPT 69636 | not published | not published | $5,080.78 – $5,080.78 | 1 |
| Rebuild outer ear canal CPT 69310 | not published | not published | $4,006.21 – $4,006.21 | 1 |
| Rebuild outer ear canal CPT 69320 | not published | not published | $5,667.77 – $5,667.77 | 1 |
| Rechanneling of artery CPT 35361 | not published | not published | $5,621.22 – $5,621.22 | 1 |
| Rechanneling of artery CPT 35306 | not published | not published | $1,664.89 – $1,664.89 | 1 |
| Rechanneling of artery CPT 35311 | not published | not published | $5,321.40 – $5,321.40 | 1 |
| Rechanneling of artery CPT 35363 | not published | not published | $6,415.12 – $6,415.12 | 1 |
| Rechanneling of artery 35305 CPT 35305 | not published | not published | $4,500.17 – $4,500.17 | 1 |
| Rechanneling of artery 35341 CPT 35341 | not published | not published | $5,001.45 – $5,001.45 | 1 |
| Rechanneling w/graft tibioperoneal trunk artery 35304 CPT 35304 | not published | not published | $4,695.36 – $4,695.36 | 1 |
| Rechanneling w/wo patch graft abd aorta 35331 CPT 35331 | not published | not published | $5,305.33 – $5,305.33 | 1 |
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.