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 |
|---|---|---|---|---|
| Unlisted procedure liver CPT 47399 | not published | not published | $683.20 – $956.48 | 3 |
| Unlisted procedure microbiology CPT 87999 | not published | not published | not published | 0 |
| Unlisted procedure orbit CPT 67599 | not published | not published | $290.27 – $406.38 | 3 |
| Unlisted procedure pancreas CPT 48999 | not published | not published | $683.20 – $956.48 | 3 |
| Unlisted procedure rectum CPT 45999 | not published | not published | $885.29 – $1,239.41 | 3 |
| Unlisted procedure spine CPT 22899 | not published | not published | $232.93 – $326.10 | 3 |
| Unlisted procedure urinary 58750 CPT 58750 | not published | not published | $3,445.18 – $3,445.18 | 1 |
| Unlisted psychiatric service/proc 90899 CPT 90899 | not published | not published | $28.93 – $40.50 | 3 |
| Unlisted px abdomen muscskel CPT 22999 | not published | not published | $232.93 – $326.10 | 3 |
| Unlisted px accessory sinus CPT 31299 | not published | not published | $225.49 – $315.69 | 3 |
| Unlisted px arthroscopy CPT 29999 | not published | not published | $232.93 – $326.10 | 3 |
| Unlisted px biliary tract CPT 47999 | not published | not published | $910.39 – $1,274.55 | 3 |
| Unlisted px casting/strpg CPT 29799 | not published | not published | $153.22 – $214.51 | 3 |
| Unlisted px conjunctiva CPT 68399 | not published | not published | $290.27 – $406.38 | 3 |
| Unlisted px exc pressure ulc CPT 15999 | not published | not published | $683.20 – $956.48 | 3 |
| Unlisted px external ear CPT 69399 | not published | not published | $225.49 – $315.69 | 3 |
| Unlisted px extraocular musc CPT 67399 | not published | not published | $290.27 – $406.38 | 3 |
| Unlisted px foot/toes CPT 28899 | not published | not published | $232.93 – $326.10 | 3 |
| Unlisted px forearm/wrist CPT 25999 | not published | not published | $232.93 – $326.10 | 3 |
| Unlisted px hands/fingers CPT 26989 | not published | not published | $232.93 – $326.10 | 3 |
| Unlisted px inner ear CPT 69949 | not published | not published | $225.49 – $315.69 | 3 |
| Unlisted px lacrimal system CPT 68899 | not published | not published | $290.27 – $406.38 | 3 |
| Unlisted px leg/ankle CPT 27899 | not published | not published | $232.93 – $326.10 | 3 |
| Unlisted px male genital sys CPT 55899 | not published | not published | $236.16 – $330.62 | 3 |
| Unlisted px med radj physics CPT 77399 | not published | not published | $128.92 – $180.49 | 3 |
| Unlisted px middle ear CPT 69799 | not published | not published | $225.49 – $315.69 | 3 |
| Unlisted px neck/thorax CPT 21899 | not published | not published | $225.49 – $315.69 | 3 |
| Unlisted px palate uvula CPT 42299 | not published | not published | $225.49 – $315.69 | 3 |
| Unlisted px pelvis/hip joint CPT 27299 | not published | not published | $232.93 – $27,040.00 | 4 |
| Unlisted px salivry glnd/dux CPT 42699 | not published | not published | $225.49 – $315.69 | 3 |
| Unlisted px small intestine CPT 44799 | not published | not published | $910.39 – $1,274.55 | 3 |
| Unlisted px temporal bone CPT 69979 | not published | not published | $225.49 – $315.69 | 3 |
| Unlisted px ther rad tx plng CPT 77299 | not published | not published | $128.92 – $180.49 | 3 |
| Unlisted px tongue flr mouth CPT 41599 | not published | not published | $225.49 – $315.69 | 3 |
| Unlisted px vestibule mouth CPT 40899 | not published | not published | $225.49 – $315.69 | 3 |
| Unlisted reprod med lab proc CPT 89398 | not published | not published | $16.15 – $72.63 | 6 |
| Unlisted resp px dx nuc med CPT 78599 | not published | not published | $390.18 – $848.52 | 4 |
| Unlisted spec derm svc/px CPT 96999 | not published | not published | $192.94 – $270.12 | 3 |
| Unlisted surgical path px CPT 88399 | not published | not published | $16.15 – $72.63 | 6 |
| Unlisted transfusion med px CPT 86999 | $225.78 | $426.00 | $21.46 – $33.29 | 6 |
| Unlisted ultrasound procedure CPT 76999 | not published | not published | $85.50 – $182.03 | 4 |
| Unlisted urinalysis px CPT 81099 | not published | not published | not published | 0 |
| Unlisted vasc endoscopy px CPT 37501 | not published | not published | $600.34 – $840.48 | 3 |
| Unlstd hematop ret/endo lymp CPT 78199 | not published | not published | $390.18 – $848.52 | 4 |
| Upgrade pm system CPT 33214 | $9,284.54 | $17,518.00 | $1,764.55 – $22,160.00 | 2 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $1,441.07 | $2,719.00 | $346.78 – $836.00 | 6 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $1,391.25 | $2,625.00 | $304.91 – $836.00 | 6 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $1,337.19 | $2,523.00 | $234.71 – $836.00 | 6 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | not published | not published | $910.39 – $1,274.55 | 4 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | not published | not published | $910.39 – $1,438.70 | 4 |
| Upper ext harvest for cabg1 seg 35600 CPT 35600 | not published | not published | $918.59 – $918.59 | 1 |
| Uppr gi scope w/submuc inj CPT 43236 | not published | not published | $910.39 – $1,402.96 | 4 |
| Urachal cyst/sinus excision 51500 CPT 51500 | not published | not published | $2,340.24 – $2,340.24 | 1 |
| Urea nitrogen CPT 84520 | $19.08 | $36.00 | $3.95 – $17.70 | 17 |
| Urea nitrogen 24 hour urine CPT 84540 | $21.20 | $40.00 | $5.56 – $21.25 | 17 |
| Urea nitrogen clearance CPT 84545 | not published | not published | $7.20 – $29.50 | 17 |
| Urea nitrogen semi-quant CPT 84525 | $38.69 | $73.00 | $5.13 – $16.53 | 17 |
| Ureteral embolization/occl CPT 50705 | not published | not published | $6,171.73 – $6,171.73 | 1 |
| Ureteral reflux study CPT 78740 | not published | not published | $94.29 – $848.52 | 5 |
| Ureter endoscopy CPT 50970 | not published | not published | $1,369.43 – $1,369.43 | 1 |
| Ureter endoscopy & biopsy CPT 50955 | not published | not published | $1,552.95 – $1,552.95 | 1 |
| Ureter endoscopy & biopsy CPT 50974 | not published | not published | $1,741.84 – $1,741.84 | 1 |
| Ureter endoscopy & catheter CPT 50972 | not published | not published | $1,327.28 – $1,327.28 | 1 |
| Ureter endoscopy & treatment CPT 50957 | not published | not published | $1,568.50 – $1,568.50 | 1 |
| Ureter endoscopy & treatment CPT 50961 | not published | not published | $1,413.04 – $1,413.04 | 1 |
| Ureter endoscopy & treatment CPT 50976 | not published | not published | $1,715.05 – $1,715.05 | 1 |
| Ureter endoscopy & treatment CPT 50980 | not published | not published | $1,303.41 – $1,303.41 | 1 |
| Ureteroneocystostomy 50780 CPT 50780 | not published | not published | $4,051.64 – $4,051.64 | 1 |
| Ureteroureterostomy 50760 CPT 50760 | not published | not published | $4,114.86 – $4,114.86 | 1 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | not published | not published | $56.34 – $517.79 | 6 |
| Urethrlys transvag with scope CPT 53500 | not published | not published | $2,743.08 – $2,743.08 | 1 |
| Urethrocystography void s&i CPT 74455 | not published | not published | $56.34 – $517.79 | 6 |
| Uric acid blood CPT 84550 | $21.20 | $40.00 | $4.52 – $20.08 | 17 |
| Uric acid urine CPT 84560 | $23.32 | $44.00 | $5.08 – $21.25 | 17 |
| Urinalysis glass test CPT 81020 | not published | not published | $4.70 – $16.53 | 17 |
| Urinalysis microscopic only CPT 81015 | $11.66 | $22.00 | $3.05 – $14.18 | 17 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | not published | not published | $2.17 – $9.45 | 17 |
| Urinalysis (with microscopy) CPT 81001 | $22.26 | $42.00 | $3.17 – $14.18 | 17 |
| Urinalysis (without microscopy) CPT 81003 | $9.01 | $17.00 | $2.25 – $10.56 | 17 |
| Urinary bldr retent nuc study CPT 78730 | not published | not published | $26.32 – $26.32 | 1 |
| Urinary reflex study CPT 51792 | not published | not published | $57.68 – $204.33 | 4 |
| Urine Culture Test CPT 87086 | $39.22 | $74.00 | $8.07 – $36.60 | 17 |
| Urine flow measurement 51736 CPT 51736 | not published | not published | $24.99 – $175.22 | 4 |
| Urine pregnancy test CPT 81025 | $39.75 | $75.00 | $8.61 – $28.32 | 18 |
| Urine screen for bacteria CPT 81007 | not published | not published | $4.25 – $70.45 | 17 |
| Urine shunt to intestine CPT 50815 | not published | not published | $4,493.90 – $4,493.90 | 1 |
| Urography, antegrade CPT 74425 | $201.40 | $380.00 | $60.06 – $828.27 | 6 |
| Urography inf drip &/or bolus CPT 74410 | not published | not published | $82.73 – $401.74 | 6 |
| Use 1st target lesion CPT 76982 | not published | not published | $101.71 – $519.00 | 6 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | not published | not published | $198.83 – $484.40 | 7 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | not published | not published | $180.88 – $475.18 | 7 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | not published | not published | $191.75 – $467.14 | 7 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | not published | not published | $107.97 – $285.53 | 7 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | not published | not published | $80.63 – $213.08 | 7 |
| Vaccine dtap < 7 years im CPT 90700 | not published | not published | $58.91 – $98.39 | 3 |
| Vaccine dtap-hep b-ipv im CPT 90723 | not published | not published | $203.92 – $334.68 | 3 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | not published | not published | $208.65 – $252.73 | 2 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | not published | not published | $535.00 – $617.41 | 2 |
| Vaccine dtap-ipv/hib im CPT 90698 | not published | not published | $222.73 – $410.13 | 3 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | not published | not published | $60.29 – $104.46 | 3 |
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.