Orthopaedic Hospital of Wisconsin, LLC
475 W River Woods Pkwy, Glendale, WI · Ascension · · NPI 1669584983
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 |
|---|---|---|---|---|
| Ghs layered repair 20.1 - 30.0 cm -12046 CPT 12046 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs layered repair 20.1 - 30.0 cm -12056 CPT 12056 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs layered repair over 30.0 cm -12047 CPT 12047 | not published | not published | $1,549.00 – $16,897.00 | 6 |
| Ghs layered repair over 3.0 cm -12057 CPT 12057 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs leukocyte alkaline phos (mayo) CPT 85540 | not published | not published | $8.34 – $15.41 | 5 |
| Ghs mbp CPT 83873 | not published | not published | $16.68 – $30.82 | 5 |
| Ghs nailbed repair/nail removal CPT 11760 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs nerve blk intercostal, single level CPT 64420 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs nerve block axillary nerve CPT 64417 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs nerve block brachial plexus CPT 64415 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs nerve block celiac plexus CPT 64530 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs nerve block interscaline CPT 64510 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs nerve block sciatic nerve CPT 64445 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs nerve block suprascapular CPT 64418 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs ng placement w fluoro guidance CPT 43752 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs o2 saturation CPT 82810 | not published | not published | $9.48 – $15.64 | 5 |
| Ghs opcc repair cvp without subq port CPT 36575 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs opcc repair cvp w subq port CPT 36576 | not published | not published | $1,104.00 – $16,897.00 | 6 |
| Ghs pacing - transcutaneous CPT 92953 | not published | not published | $1,898.00 – $16,897.00 | 6 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | not published | not published | $949.00 – $16,897.00 | 6 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | not published | not published | $949.00 – $16,897.00 | 6 |
| Ghs path - pap (papanicolau) smear - vagina CPT 88141 | not published | not published | $24.49 – $40.59 | 4 |
| Ghs peritonsillar abscess i andd CPT 42700 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs phenylketonurid CPT 84030 | not published | not published | $5.33 – $9.86 | 5 |
| Ghs picc line insert < 5 CPT 36568 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs plngl fx pm cl CPT 26725 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs plt ct-manual CPT 85032 | $20.14 | $38.00 | $4.18 – $7.70 | 5 |
| Ghs ppd (tb intradermal) CPT 86580 | not published | not published | $6.95 – $8.42 | 4 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | not published | not published | $9.37 – $17.30 | 5 |
| Ghs protein, misc fluid CPT 84160 | $45.05 | $85.00 | $5.44 – $9.27 | 5 |
| Ghs protoporphyrins fract CPT 84202 | $135.68 | $256.00 | $13.92 – $25.71 | 5 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | not published | not published | $11.88 – $21.94 | 5 |
| Ghs quinidine CPT 80194 | not published | not published | $14.16 – $26.15 | 5 |
| Ghs refill of implantable pump CPT 95990 | not published | not published | $949.00 – $16,897.00 | 6 |
| Ghs removal intranasal foreign body CPT 30300 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs removal pharyngeal foreign body CPT 42809 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | not published | not published | $1,549.00 – $16,897.00 | 6 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | not published | not published | $1,104.00 – $16,897.00 | 6 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | not published | not published | $8.22 – $23.10 | 5 |
| Ghs reticulocyte count CPT 85044 | not published | not published | $4.18 – $7.70 | 5 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | not published | not published | $13.49 – $21.49 | 5 |
| Ghs sedimentation rate CPT 85651 | not published | not published | $4.14 – $6.37 | 5 |
| Ghs semen analysis fert CPT 89320 | not published | not published | $11.94 – $21.59 | 5 |
| Ghs semen analysis, post-vas CPT 89300 | not published | not published | $9.54 – $15.98 | 5 |
| Ghs sensitivity (per antimicro) CPT 87184 | $55.12 | $104.00 | $7.26 – $12.36 | 5 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs sphenopalatine ganglion block CPT 64505 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs strapping shoulder - 29240 CPT 29240 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | not published | not published | $1,549.00 – $16,897.00 | 6 |
| Ghs trypsin (fecal) CPT 84488 | not published | not published | $7.08 – $13.07 | 5 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $743.00 – $16,897.00 | 6 |
| Ghs urine, hydroxproline total CPT 83505 | not published | not published | $23.57 – $43.55 | 5 |
| Ghs urine, porphyrins quant CPT 84120 | not published | not published | $14.27 – $26.35 | 5 |
| Ghs vaginal delivery only CPT 59409 | not published | not published | $1,549.00 – $16,897.00 | 6 |
| Ghs windowing of cast CPT 29730 | not published | not published | $743.00 – $16,897.00 | 6 |
| Giardia ag if CPT 87269 | not published | not published | $13.20 – $21.49 | 5 |
| Giardia lamblia antibody CPT 86674 | not published | not published | $14.28 – $26.37 | 5 |
| Gi inhouse confirmation CPT 87045 | $42.93 | $81.00 | $9.16 – $16.91 | 5 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $1,549.00 – $16,897.00 | 6 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | not published | not published | $2,183.00 – $16,897.00 | 6 |
| Gi trc img intral esophagus CPT 91111 | not published | not published | $2,183.00 – $16,897.00 | 6 |
| Gi wireless capsule measure CPT 91112 | not published | not published | $2,183.00 – $16,897.00 | 6 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $98.09 – $104.43 | 2 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $59.67 – $63.54 | 2 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $33.95 – $36.14 | 2 |
| Glaucoma surgery CPT 66150 | not published | not published | $4,744.00 – $16,897.00 | 6 |
| Glaucoma surgery CPT 66155 | not published | not published | $4,744.00 – $16,897.00 | 6 |
| Glaucoma surgery CPT 66160 | not published | not published | $1,549.00 – $16,897.00 | 6 |
| Glaucoma surgery CPT 66170 | not published | not published | $1,104.00 – $16,897.00 | 6 |
| Glucagon plasma - sendout CPT 82943 | not published | not published | $13.86 – $25.60 | 5 |
| Glucagon tolerance panel CPT 80422 | not published | not published | $44.69 – $82.54 | 5 |
| Glucagon tolerance panel CPT 80424 | not published | not published | $48.98 – $90.46 | 5 |
| Glucagon tolerance test CPT 82946 | not published | not published | $10.50 – $27.00 | 5 |
| Glucose 1 hr post dose CPT 82950 | not published | not published | $4.61 – $8.51 | 5 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | not published | not published | $5.87 – $10.84 | 5 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $9.54 | $18.00 | $3.18 – $4.19 | 5 |
| Glucose blood quantitative CPT 82947 | $27.03 | $51.00 | $3.81 – $7.02 | 5 |
| Glucose body fluid CPT 82945 | not published | not published | $3.81 – $7.02 | 5 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | not published | not published | $12.48 – $23.06 | 5 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | not published | not published | $3.80 – $7.01 | 5 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $85.86 | $162.00 | $18.02 – $33.29 | 5 |
| Gonadotropin hormone panel CPT 80426 | not published | not published | $143.96 – $265.87 | 5 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $97.52 | $184.00 | $17.96 – $33.17 | 5 |
| Goniotomy CPT 65820 | not published | not published | $4,744.00 – $16,897.00 | 6 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $4,754.00 – $16,897.00 | 6 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $2,302.00 – $16,897.00 | 6 |
| Great toe-hand transfer CPT 26551 | not published | not published | $4,754.00 – $20,066.00 | 6 |
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.