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 |
|---|---|---|---|---|
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $206.17 | $389.00 | $81.45 – $245.18 | 6 |
| Shunt subclavian to pulm art CPT 33750 | not published | not published | $4,567.65 – $4,567.65 | 1 |
| Shunt supr v/c p-art 1 lung CPT 33766 | not published | not published | $4,801.59 – $4,801.59 | 1 |
| Shunt supr v/c p-art bth lng CPT 33767 | not published | not published | $5,177.61 – $5,177.61 | 1 |
| Sialidase enzyme assay CPT 87905 | not published | not published | $12.22 – $54.30 | 17 |
| Sialography s&i CPT 70390 | not published | not published | $64.89 – $517.79 | 6 |
| Sialolithotomy 42330 CPT 42330 | not published | not published | $860.44 – $860.44 | 1 |
| Sickling rbc CPT 85660 | $27.03 | $51.00 | $5.51 – $24.81 | 17 |
| Sigmoidoscopy and biopsy CPT 45331 | not published | not published | $885.29 – $1,239.41 | 4 |
| Sigmoidoscopy flex decompression 45337 CPT 45337 | not published | not published | $448.38 – $1,239.41 | 4 |
| Sigmoidoscopy for bleeding CPT 45334 | not published | not published | $2,208.53 – $2,208.53 | 1 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | not published | not published | $885.29 – $1,239.41 | 4 |
| Sigmoidoscopy w/ablation CPT 45346 | not published | not published | $11,309.32 – $11,309.32 | 1 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | not published | not published | $1,123.55 – $1,123.55 | 1 |
| Sigmoidoscopy w/plcmt stent CPT 45347 | not published | not published | $595.76 – $595.76 | 1 |
| Sigmoidoscopy w/resection CPT 45349 | not published | not published | $757.41 – $757.41 | 1 |
| Sigmoidoscopy w/tumr remove CPT 45338 | not published | not published | $1,174.02 – $1,174.02 | 1 |
| Sigmoidoscopy w/ultrasound CPT 45341 | not published | not published | $483.26 – $1,239.41 | 4 |
| Sigmoidoscopy w/us guide bx CPT 45342 | not published | not published | $655.51 – $655.51 | 1 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | not published | not published | $885.29 – $1,261.67 | 4 |
| Signal avg ecg w or without ecg 93278 CPT 93278 | not published | not published | $41.62 – $80.75 | 4 |
| Sig w/tndsc balloon dilation CPT 45340 | not published | not published | $1,774.25 – $1,774.25 | 1 |
| Simple cystometrogram 51725 CPT 51725 | not published | not published | $236.16 – $330.62 | 4 |
| Single transfer toe-hand CPT 26553 | not published | not published | $11,824.66 – $11,824.66 | 1 |
| Sinus CT scan (with and without contrast) CPT 70488 | $1,007.53 | $1,901.00 | $172.86 – $724.00 | 6 |
| Sinus CT scan (with contrast) CPT 70487 | $867.61 | $1,637.00 | $172.86 – $724.00 | 6 |
| Sinus CT scan (without contrast) CPT 70486 | $858.60 | $1,620.00 | $103.26 – $724.00 | 6 |
| Sinus/juglr venogram s&i CPT 75860 | $1,691.23 | $3,191.00 | $189.72 – $6,438.74 | 3 |
| Sinusotomy maxillary sinus 31020 CPT 31020 | not published | not published | $1,768.28 – $1,768.28 | 1 |
| Sinusotomy sinus remove polyps 31032 CPT 31032 | not published | not published | $2,094.81 – $2,094.81 | 1 |
| Sinusotomy sphenoid w/wo bx 31050 CPT 31050 | not published | not published | $1,773.84 – $1,773.84 | 1 |
| Skeletal muscle relaxant 1/2 CPT 80369 | $106.53 | $201.00 | $32.60 – $81.45 | 6 |
| Skel musc relaxant 3 or more CPT 80370 | not published | not published | $35.06 – $35.06 | 1 |
| Skin and muscle repair face CPT 15845 | not published | not published | $3,697.10 – $3,697.10 | 1 |
| Skin Biopsy CPT 11102 | not published | not published | $192.94 – $356.63 | 4 |
| Skin full graft 20sq cm less 15200 CPT 15200 | not published | not published | $3,009.03 – $3,009.03 | 1 |
| Skin full graft add-on 15241 CPT 15241 | not published | not published | $671.47 – $671.47 | 1 |
| Skin pedicle flap arms/legs CPT 15572 | not published | not published | $3,224.32 – $3,224.32 | 1 |
| Skin pedicle flap trunk CPT 15570 | not published | not published | $3,319.44 – $3,319.44 | 1 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | not published | not published | $671.88 – $671.88 | 1 |
| Skin test unlisted antigen ea CPT 86486 | not published | not published | $6.98 – $33.29 | 11 |
| Skull base/brainstem surgery CPT 61575 | not published | not published | $7,869.96 – $7,869.96 | 1 |
| Skull base/brainstem surgery CPT 61576 | not published | not published | $13,222.92 – $13,222.92 | 1 |
| Slco1b1 gene com variants CPT 81328 | not published | not published | $174.81 – $573.69 | 14 |
| Sleep study attended CPT 95807 | not published | not published | $210.09 – $721.31 | 4 |
| Sleep Study (Polysomnography) CPT 95810 | not published | not published | $410.99 – $1,383.07 | 4 |
| Sleep study unattended CPT 95806 | not published | not published | $151.93 – $212.70 | 4 |
| Sleeve fing rolyan med HCPCS L3933 | $496.08 | $936.00 | $290.64 – $290.64 | 1 |
| Sleeve pneumonectomy CPT 32442 | not published | not published | $11,527.19 – $11,527.19 | 1 |
| Slitting of prepuce CPT 54000 | not published | not published | $536.22 – $536.22 | 1 |
| Slitting of prepuce CPT 54001 | not published | not published | $667.97 – $667.97 | 1 |
| Slp eval for nonspeech dev ea addl 30 mins CPT 92618 | not published | not published | $113.36 – $113.36 | 1 |
| Slp eval non-spch gen comm dev CPT 92605 | not published | not published | $311.98 – $311.98 | 1 |
| Slp pure tone screening CPT 92551 | not published | not published | $39.07 – $39.07 | 1 |
| Slp stdy unatnd w/anal CPT 95801 | not published | not published | $57.68 – $134.47 | 4 |
| Slp ther svc non-spch gen CPT 92606 | not published | not published | $277.27 – $277.27 | 1 |
| Small animal inoculation CPT 87003 | not published | not published | $16.84 – $75.56 | 17 |
| Small bowel endoscopy CPT 44360 | not published | not published | $557.41 – $557.41 | 1 |
| Small bowel endoscopy CPT 44364 | not published | not published | $784.16 – $784.16 | 1 |
| Small bowel endoscopy CPT 44366 | not published | not published | $918.81 – $918.81 | 1 |
| Small bowel endoscopy CPT 44369 | not published | not published | $940.63 – $940.63 | 1 |
| Small bowel endoscopy CPT 44376 | not published | not published | $1,080.73 – $1,080.73 | 1 |
| Small bowel endoscopy CPT 44378 | not published | not published | $1,460.63 – $1,460.63 | 1 |
| Small bowel endoscopy CPT 44382 | not published | not published | $910.39 – $1,274.55 | 4 |
| Small bowel endoscopy CPT 44384 | not published | not published | $585.35 – $585.35 | 1 |
| Small bowel endoscopy >2nd w/remove 44363 CPT 44363 | not published | not published | $735.48 – $735.48 | 1 |
| Small bowel endoscopy 44365 CPT 44365 | not published | not published | $693.97 – $693.97 | 1 |
| Small bowel endoscopy/biopsy CPT 44361 | not published | not published | $614.44 – $614.44 | 1 |
| Small bowel endoscopy/biopsy CPT 44377 | not published | not published | $1,140.26 – $1,140.26 | 1 |
| Small bowel endoscopy br/wa CPT 44380 | not published | not published | $798.00 – $1,274.55 | 4 |
| Small bowel endoscopy br/wa CPT 44381 | not published | not published | $3,622.76 – $3,622.76 | 1 |
| Small bowel endoscopy/stent 44370 CPT 44370 | not published | not published | $1,015.49 – $1,015.49 | 1 |
| Smallpox&monkeypox vac 0.5ml CPT 90611 | not published | not published | $0.01 – $922.32 | 9 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $33.92 | $64.00 | $5.39 – $23.60 | 17 |
| Smear gram stain CPT 87205 | $24.91 | $47.00 | $4.27 – $18.87 | 17 |
| Smear nasal eosinophil CPT 89190 | $25.44 | $48.00 | $5.79 – $21.25 | 17 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $35.51 | $67.00 | $5.99 – $27.15 | 17 |
| Smear wet mount CPT 87210 | $25.97 | $49.00 | $5.82 – $18.87 | 17 |
| Smn1 gene full gene sequence CPT 81336 | not published | not published | $301.35 – $985.67 | 14 |
| Smn1 gen nown famil seq vrnt CPT 81337 | not published | not published | $185.20 – $605.58 | 14 |
| Smpd1 gene common variants CPT 81330 | not published | not published | $47.00 – $154.64 | 14 |
| Snrpn/ube3a gene CPT 81331 | $282.49 | $533.00 | $51.07 – $255.47 | 15 |
| So cap design without jnts cf HCPCS L3671 | $2,094.56 | $3,952.00 | $1,227.36 – $1,227.36 | 1 |
| Sodium 24 hour urine CPT 84300 | $22.79 | $43.00 | $5.06 – $22.43 | 17 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $11.69 | $22.05 | $2.40 – $9.26 | 10 |
| Sodium serum/plasma/whole blood CPT 84295 | $15.90 | $30.00 | $4.81 – $21.25 | 17 |
| So gsap cl fr cpy nmbr&mcrst CPT 81463 | not published | not published | $1,681.64 – $4,641.32 | 2 |
| So gsap cll fr dna/dna&rna CPT 81462 | not published | not published | $1,494.79 – $4,125.61 | 2 |
| So gsap cll fr mcrstl ins CPT 81464 | not published | not published | $4,110.64 – $11,345.36 | 2 |
| So gsap dna cpy nmbr&mcrstl CPT 81458 | not published | not published | $1,307.94 – $3,609.91 | 2 |
| Somatosensory testing CPT 95927 | not published | not published | $92.28 – $423.33 | 4 |
| So neo gsap dna/dna&rna CPT 81459 | not published | not published | $3,736.94 – $10,313.95 | 2 |
| So neo gsap dna mcrstl ins CPT 81457 | not published | not published | $896.87 – $3,094.20 | 5 |
| Sp bone agrft morsel add-on CPT 20937 | not published | not published | $595.87 – $595.87 | 1 |
| Sp bone agrft struct add-on CPT 20938 | not published | not published | $651.93 – $651.93 | 1 |
| Sp bone algrft morsel add-on CPT 20930 | not published | not published | $439.92 – $439.92 | 1 |
| Special physics consult CPT 77370 | not published | not published | $128.92 – $399.13 | 4 |
| Special pump services CPT 99190 | not published | not published | $1,463.97 – $1,463.97 | 1 |
| Special pump services CPT 99191 | not published | not published | $1,024.11 – $1,024.11 | 1 |
| Special pump services CPT 99192 | not published | not published | $731.37 – $731.37 | 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.