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 |
|---|---|---|---|---|
| Sugars multiple quant CPT 84379 | not published | not published | $11.53 – $51.92 | 17 |
| Sugars single quant CPT 84378 | $52.47 | $99.00 | $11.53 – $51.92 | 17 |
| Sulfonylurea screen qn-sendout CPT 80377 | $39.22 | $74.00 | $32.60 – $81.45 | 6 |
| Sup of prep of antigen # of vials 95144 CPT 95144 | not published | not published | $40.56 – $62.72 | 4 |
| Suprv interfacilty transport CPT 99485 | not published | not published | $205.69 – $205.69 | 1 |
| Suprv interfac trnsport addl CPT 99486 | not published | not published | $178.95 – $178.95 | 1 |
| Surg dx exam anorectal CPT 45990 | not published | not published | $392.10 – $392.10 | 1 |
| Surg ect salp-oophorectomy 59120 CPT 59120 | not published | not published | $2,836.44 – $2,836.44 | 1 |
| Surg ect without salp-oophorectomy 59121 CPT 59121 | not published | not published | $2,843.98 – $2,843.98 | 1 |
| Surgery for urethra pouch CPT 53240 | not published | not published | $1,563.32 – $1,563.32 | 1 |
| Surgery of pancreatic cyst CPT 48500 | not published | not published | $4,077.41 – $4,077.41 | 1 |
| Surgery to stop leg growth CPT 27475 | not published | not published | $2,395.93 – $2,395.93 | 1 |
| Surgery to stop leg growth CPT 27477 | not published | not published | $2,651.88 – $2,651.88 | 1 |
| Surgery to stop leg growth CPT 27479 | not published | not published | $2,882.88 – $2,882.88 | 1 |
| Surgery to stop leg growth CPT 27485 | not published | not published | $2,428.23 – $2,428.23 | 1 |
| Surgical exposure prostate 55860 CPT 55860 | not published | not published | $3,211.94 – $3,211.94 | 1 |
| Surgical opening esophagus CPT 43351 | not published | not published | $4,685.96 – $4,685.96 | 1 |
| Surgical opening esophagus CPT 43352 | not published | not published | $3,880.58 – $3,880.58 | 1 |
| Surgical opening of stomach CPT 43510 | not published | not published | $910.39 – $3,399.90 | 4 |
| Surgical opening of stomach 43500 CPT 43500 | not published | not published | $2,828.57 – $2,828.57 | 1 |
| Surgical opening of throat CPT 42955 | not published | not published | $2,894.93 – $2,894.93 | 1 |
| Surgical pathology level 1 gross examination only CPT 88300 | $42.40 | $80.00 | $14.41 – $33.29 | 11 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $75.26 | $142.00 | $24.95 – $55.08 | 11 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $96.99 | $183.00 | $39.71 – $72.63 | 11 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $503.50 | $950.00 | $33.88 – $112.85 | 12 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $193.45 | $365.00 | $77.15 – $489.02 | 12 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $434.60 | $820.00 | $82.47 – $1,110.52 | 11 |
| Surgical repair stomach bleedin ulcer 43501 CPT 43501 | not published | not published | $4,843.03 – $4,843.03 | 1 |
| Surgical repair stomach gastric lac 43502 CPT 43502 | not published | not published | $5,479.78 – $5,479.78 | 1 |
| Surgical revision intestine CPT 44680 | not published | not published | $3,843.80 – $3,843.80 | 1 |
| Surg tx anal fistula 2nd stage 46285 CPT 46285 | not published | not published | $1,931.99 – $1,931.99 | 1 |
| Susceptibility agar dilution per agent CPT 87181 | $24.38 | $46.00 | $4.75 – $21.25 | 17 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $14.84 | $28.00 | $4.75 – $21.25 | 17 |
| Susceptibility mic per plate CPT 87186 | not published | not published | $8.65 – $38.95 | 17 |
| Suscept studies macrobroth dilution ea CPT 87188 | $35.51 | $67.00 | $6.64 – $29.50 | 17 |
| Suspend bowel w/prosthesis CPT 44700 | not published | not published | $3,710.68 – $3,710.68 | 1 |
| Suspension of testis CPT 54620 | not published | not published | $1,104.08 – $1,104.08 | 1 |
| Suspension of uterus CPT 58410 | not published | not published | $2,949.27 – $2,949.27 | 1 |
| Suspension of uterus 58400 CPT 58400 | not published | not published | $1,596.55 – $1,596.55 | 1 |
| Sutr lg intestine 1/mult perf without colostomy 44604 CPT 44604 | not published | not published | $3,814.07 – $3,814.07 | 1 |
| Suture bile duct injury 47900 CPT 47900 | not published | not published | $4,932.93 – $4,932.93 | 1 |
| Svc venogram s&i CPT 75827 | $849.06 | $1,602.00 | $188.47 – $3,163.82 | 3 |
| Sweat collection by iontophoresis CPT 89230 | not published | not published | $2.91 – $72.63 | 11 |
| Sympathectomy cervical CPT 64802 | not published | not published | $2,451.32 – $2,451.32 | 1 |
| Sympathectomy digital artery CPT 64820 | not published | not published | $2,650.46 – $2,650.46 | 1 |
| Sympathectomy lumbar CPT 64818 | not published | not published | $2,266.94 – $2,266.94 | 1 |
| Sympathectomy supfc palmar CPT 64823 | not published | not published | $2,894.07 – $2,894.07 | 1 |
| Sympathectomy thoracolumbar CPT 64809 | not published | not published | $3,605.12 – $3,605.12 | 1 |
| Synch audio-only est high 40 CPT 98015 | not published | not published | $422.21 – $422.21 | 1 |
| Synch audio-only est low 20 CPT 98013 | not published | not published | $199.55 – $199.55 | 1 |
| Synch audio-only est mod 30 CPT 98014 | not published | not published | $289.71 – $289.71 | 1 |
| Synch audio-only est sf 10 CPT 98012 | not published | not published | $113.97 – $113.97 | 1 |
| Synch audio-only new high 60 CPT 98011 | not published | not published | $513.20 – $513.20 | 1 |
| Synch audio-only new low 30 CPT 98009 | not published | not published | $253.98 – $253.98 | 1 |
| Synch audio-only new mod 45 CPT 98010 | not published | not published | $393.21 – $393.21 | 1 |
| Synch audio-only new sf 15 CPT 98008 | not published | not published | $153.68 – $153.68 | 1 |
| Synthetic sentence id test CPT 92576 | not published | not published | $38.11 – $117.03 | 4 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $23.85 | $45.00 | $4.40 – $20.08 | 17 |
| T3 (triiodothyronine) free CPT 84481 | $57.77 | $109.00 | $16.94 – $55.55 | 17 |
| T3 (triiodothyronine) total CPT 84480 | $56.71 | $107.00 | $14.18 – $63.76 | 17 |
| T4 (thyroxine) free CPT 84439 | $45.05 | $85.00 | $9.02 – $40.12 | 17 |
| T4 (thyroxine) total CPT 84436 | $34.45 | $65.00 | $6.87 – $30.71 | 17 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $3.42 | $6.45 | $0.22 – $2.71 | 10 |
| Tacrolimus therapeutic drug level CPT 80197 | $93.81 | $177.00 | $13.73 – $61.38 | 17 |
| Tah rad debulk/lymph remove 58954 CPT 58954 | not published | not published | $7,911.89 – $7,911.89 | 1 |
| Tah rad dissect for debulk 58953 CPT 58953 | not published | not published | $7,290.51 – $7,290.51 | 1 |
| Tah w/mmk 58152 CPT 58152 | not published | not published | $4,515.46 – $4,515.46 | 1 |
| Tap block bilat cont infusion 64489 CPT 64489 | $885.10 | $1,670.00 | $788.90 – $788.90 | 1 |
| Tap block uni by cont infusion 64487 CPT 64487 | $638.65 | $1,205.00 | $563.94 – $563.94 | 1 |
| Target gsa panel hmtlmph neop CPT 81450 | $4,211.91 | $7,947.00 | $131.32 – $2,136.59 | 17 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $3,567.96 | $6,732.00 | $3,065.58 – $9,573.37 | 12 |
| Target gsa panel organ neop CPT 81445 | $2,655.83 | $5,011.00 | $131.32 – $1,970.16 | 17 |
| Tas congenital car anomal CPT 33741 | not published | not published | $2,552.89 – $2,552.89 | 1 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | not published | not published | $594.39 – $832.15 | 4 |
| Tavr perq femoral CPT 33361 | not published | not published | $4,905.77 – $4,905.77 | 1 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $1.50 | $2.84 | $0.47 – $1.22 | 11 |
| Tbp gene detc abnor alleles CPT 81344 | not published | not published | $137.00 – $448.57 | 14 |
| Tbs dxa cal w/i&r fx risk CPT 77089 | not published | not published | $93.44 – $141.31 | 2 |
| Tbs i&r fx rsk qhp CPT 77092 | not published | not published | $23.36 – $36.05 | 2 |
| Tbs techl calculation only CPT 77091 | $112.36 | $212.00 | $85.50 – $185.87 | 5 |
| Tbs techl prep&transmis data CPT 77090 | $112.36 | $212.00 | $7.80 – $185.87 | 5 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $200.87 | $379.00 | $100.00 – $336.41 | 17 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $200.87 | $379.00 | $61.98 – $278.59 | 17 |
| Tc-99m exametazime diag HCPCS A9521 | $3,200.67 | $6,039.00 | $2,380.20 – $5,332.16 | 2 |
| Tc-99m maa HCPCS A9540 | $368.35 | $695.00 | $48.32 – $93.33 | 2 |
| Tc-99m medronate HCPCS A9503 | $131.44 | $248.00 | $30.57 – $40.44 | 2 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $160.59 | $303.00 | $31.07 – $52.83 | 2 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $134.62 | $254.00 | $72.00 – $199.26 | 2 |
| Tc-99m sulfur colloid HCPCS A9541 | $548.02 | $1,034.00 | $415.19 – $831.77 | 2 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $438.31 | $827.00 | $203.64 – $265.29 | 2 |
| Tca peel dermal 15789 CPT 15789 | not published | not published | $594.39 – $1,987.83 | 4 |
| Tcd emboli detect w/inj CPT 93893 | not published | not published | $103.26 – $200.29 | 4 |
| Tcd emboli detect without inj CPT 93892 | not published | not published | $103.26 – $203.52 | 4 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $302.28 – $594.31 | 4 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $152.64 | $288.00 | $46.98 – $211.31 | 17 |
| T cells absolute cd 4 count CPT 86361 | $86.92 | $164.00 | $26.78 – $120.41 | 17 |
| T cells total count CPT 86359 | $121.90 | $230.00 | $37.73 – $168.81 | 17 |
| Tcranial magn stim tx deli CPT 90868 | not published | not published | $302.38 – $505.55 | 4 |
| Tcranial magn stim tx plan CPT 90867 | not published | not published | $302.38 – $784.18 | 4 |
| Tcran magn stim redetemine CPT 90869 | not published | not published | $302.38 – $715.46 | 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.