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 |
|---|---|---|---|---|
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | not published | not published | $26.05 – $88.40 | 3 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | not published | not published | $80.69 – $277.79 | 10 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | not published | not published | $219.57 – $431.09 | 3 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | not published | not published | $69.83 – $129.84 | 3 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | not published | not published | $48.03 – $116.35 | 2 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $84.92 – $235.06 | 7 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | not published | not published | $80.93 – $235.06 | 10 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | not published | not published | $174.89 – $504.32 | 10 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | not published | not published | $34.38 – $95.34 | 10 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | not published | not published | $608.82 – $1,050.79 | 2 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | not published | not published | $173.46 – $547.14 | 3 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | $111.37 | $210.13 | $80.43 – $250.59 | 11 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | not published | not published | $102.69 – $271.56 | 7 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | not published | not published | $26.89 – $65.94 | 7 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | not published | not published | $27.49 – $67.41 | 7 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | not published | not published | $23.55 – $62.98 | 5 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | not published | not published | $82.43 – $232.23 | 5 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | not published | not published | $47.61 – $65.27 | 4 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | $42.15 | $79.52 | $24.75 – $67.41 | 7 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | not published | not published | $11.78 – $31.51 | 5 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | not published | not published | $30.91 – $83.69 | 6 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | not published | not published | $80.43 – $220.36 | 5 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | not published | not published | $45.32 – $119.99 | 7 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | not published | not published | $13.44 – $32.97 | 7 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | not published | not published | $424.35 – $764.33 | 2 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | not published | not published | $410.24 – $649.92 | 2 |
| Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 | not published | not published | $340.25 – $587.46 | 2 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | not published | not published | $306.16 – $537.50 | 3 |
| Vaccine mmr live subcutaneous CPT 90707 | not published | not published | $166.36 – $315.95 | 3 |
| Vaccine mmrv live subcutaneous CPT 90710 | not published | not published | $442.07 – $950.20 | 3 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $132.74 | $250.45 | $105.19 – $399.95 | 11 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | $277.39 | $523.37 | $219.82 – $773.48 | 11 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | not published | not published | $283.12 – $782.93 | 10 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | not published | not published | $326.27 – $893.50 | 10 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | not published | not published | $88.32 – $152.81 | 3 |
| Vaccine rabies im CPT 90675 | not published | not published | $317.67 – $1,413.92 | 13 |
| Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 | not published | not published | $607.46 – $1,007.72 | 2 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 | not published | not published | $1,775.47 – $2,202.29 | 2 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im CPT 90381 | not published | not published | $1,101.14 – $1,775.47 | 2 |
| Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im CPT 90679 | not published | not published | $582.12 – $1,004.30 | 2 |
| Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 | not published | not published | $193.91 – $473.94 | 3 |
| Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 | not published | not published | $195.41 – $337.57 | 3 |
| Vaccine tdap >=7 years im CPT 90715 | not published | not published | $43.12 – $161.89 | 10 |
| Vaccine td preservative free >= 7 years im CPT 90714 | $52.98 | $99.97 | $31.95 – $95.62 | 11 |
| Vaccine typhoid vicps im CPT 90691 | not published | not published | $194.95 – $500.69 | 3 |
| Vaccine varicella live subcutaneous CPT 90716 | not published | not published | $243.13 – $625.13 | 3 |
| Vaccine yellow fever live subcutaneous CPT 90717 | not published | not published | $281.52 – $765.09 | 3 |
| Vaccinia vrs vac 0.3 ml perq CPT 90622 | not published | not published | $0.01 – $0.03 | 9 |
| Vag hys/<250g/rmv tube/rpr entero 58263 CPT 58263 | not published | not published | $3,576.10 – $3,576.10 | 1 |
| Vag hyst incl t/o complex CPT 58291 | not published | not published | $4,492.67 – $4,492.67 | 1 |
| Vag hyst including t/o CPT 58262 | not published | not published | $3,332.08 – $3,332.08 | 1 |
| Vag hyst t/o & repair compl CPT 58292 | not published | not published | $4,744.30 – $4,744.30 | 1 |
| Vag hyst w/enterocele compl 58294 CPT 58294 | not published | not published | $4,408.15 – $4,408.15 | 1 |
| Vag hyst w/enterocele repair CPT 58270 | not published | not published | $3,184.90 – $3,184.90 | 1 |
| Vaginal bx CPT 58999 | not published | not published | $195.34 – $273.48 | 3 |
| Vaginal delivery after cesarean delivery 59612 CPT 59612 | not published | not published | $3,277.81 – $3,277.81 | 1 |
| Vaginal Delivery (full care) CPT 59400 | not published | not published | $7,480.78 – $7,480.78 | 1 |
| Vaginal hysterectomy CPT 58260 | not published | not published | $2,985.90 – $2,985.90 | 1 |
| Vaginectomy partial w/nodes CPT 57109 | not published | not published | $6,208.59 – $6,208.59 | 1 |
| Vagnc compl rmvl paravag tis CPT 57111 | not published | not published | $5,831.30 – $5,831.30 | 1 |
| Vagnc compl rmvl vag wall CPT 57110 | not published | not published | $3,232.94 – $3,232.94 | 1 |
| Vagotomy pfrmd w/prtl dstl gstrct 43635 CPT 43635 | not published | not published | $403.47 – $403.47 | 1 |
| Vagotomy & pylorus repair CPT 43641 | not published | not published | $4,292.97 – $4,292.97 | 1 |
| Vagotomy & pylorus repair 43640 CPT 43640 | not published | not published | $4,245.00 – $4,245.00 | 1 |
| Valproic acid total therapeutic drug level CPT 80164 | $61.48 | $116.00 | $13.54 – $61.38 | 17 |
| Valvuloplasty aortic CPT 92986 | $10,128.83 | $19,111.00 | $4,377.13 – $4,377.13 | 1 |
| Valvuloplasty aortic valve CPT 33390 | not published | not published | $6,897.03 – $6,897.03 | 1 |
| Valvuloplasty aortic valve CPT 33391 | not published | not published | $8,172.80 – $8,172.80 | 1 |
| Valvuloplasty mitral CPT 92987 | $9,916.83 | $18,711.00 | $4,517.21 – $4,517.21 | 1 |
| Valvuloplasty pulmonary CPT 92990 | not published | not published | $3,562.04 – $3,562.04 | 1 |
| Valvuloplasty/tv without ring insert 33463 CPT 33463 | not published | not published | $11,186.68 – $11,186.68 | 1 |
| Valvuloplasty/tv w/ring insertion 33464 CPT 33464 | not published | not published | $8,834.73 – $8,834.73 | 1 |
| Vancomycin peak therapeutic drug level CPT 80202 | $68.90 | $130.00 | $13.54 – $61.38 | 17 |
| Vanomycin dna amp probe CPT 87500 | not published | not published | $35.09 – $157.01 | 17 |
| Varicella zoster antibody igg CPT 86787 | $51.94 | $98.00 | $9.63 – $30.27 | 17 |
| Varicella-zoster immue globin im CPT 90396 | not published | not published | $397.87 – $7,455.66 | 3 |
| Vasc graft into carpal bone CPT 25430 | not published | not published | $2,648.82 – $2,648.82 | 1 |
| Vasectomy CPT 55250 | not published | not published | $1,390.36 – $1,390.36 | 1 |
| Vbac delivery 59610 CPT 59610 | not published | not published | $7,847.77 – $7,847.77 | 1 |
| Vbac/include postpartum care 59614 CPT 59614 | not published | not published | $4,078.08 – $4,078.08 | 1 |
| Veeg cont 2-12 hrs CPT 95713 | not published | not published | $515.22 – $1,766.81 | 4 |
| Veeg ea 12-26hr cont mntr CPT 95716 | not published | not published | $987.91 – $3,567.01 | 4 |
| Veeg intrmnt 2-12 hrs CPT 95712 | not published | not published | $302.38 – $1,355.00 | 4 |
| Veeg unmon 12-26 hrs CPT 95714 | not published | not published | $515.22 – $949.21 | 4 |
| Veeg unmon 2-12 hrs CPT 95711 | not published | not published | $302.38 – $644.47 | 4 |
| Vein bypass grft fem-popliteal 35583 CPT 35583 | not published | not published | $5,305.51 – $5,305.51 | 1 |
| Vein byp fem-tibial peroneal 35585 CPT 35585 | not published | not published | $6,150.25 – $6,150.25 | 1 |
| Vein byp pop-tibl peroneal CPT 35587 | not published | not published | $5,007.11 – $5,007.11 | 1 |
| Vein gft fem a/p tib/pero/dis art 35566 CPT 35566 | not published | not published | $6,123.47 – $6,123.47 | 1 |
| Vein x-ray adrenal gland CPT 75840 | $1,691.23 | $3,191.00 | $195.86 – $6,438.74 | 3 |
| Vein x-ray adrenal glands CPT 75842 | $2,913.94 | $5,498.00 | $204.00 – $10,733.33 | 3 |
| Vein x-ray eye socket CPT 75880 | not published | not published | $123.54 – $1,218.65 | 6 |
| Vein x-ray kidney CPT 75831 | $1,691.23 | $3,191.00 | $186.85 – $6,438.74 | 3 |
| Vein x-ray liver CPT 75891 | $1,921.78 | $3,626.00 | $190.68 – $6,438.74 | 3 |
| Vein x-ray liver w/hemodynam CPT 75885 | $1,691.23 | $3,191.00 | $204.00 – $6,438.74 | 3 |
| Vein x-ray liver w/hemodynam CPT 75889 | $1,691.23 | $3,191.00 | $188.30 – $6,438.74 | 3 |
| Vein x-ray liver without hemodyn CPT 75887 | $1,691.23 | $3,191.00 | $204.00 – $6,438.74 | 3 |
| Vein x-ray skull CPT 75870 | not published | not published | $195.86 – $6,438.74 | 3 |
| Vein x-ray skull epidural CPT 75872 | not published | not published | $181.92 – $1,218.65 | 6 |
| Vein x-ray spleen/liver CPT 75810 | not published | not published | $195.37 – $6,438.74 | 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.