ORTHOPAEDIC HOSPITAL OF WISCONSIN

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
10650	JOINT REPLACEMENT DEVICE	$21,500	$11,395	—	—	1
12024	CT EXTM LOWER W/ + W/O CON BI	$4,946	$2,621	—	—	1
12033	CT EXTM UPPER W/ + W/O CON BI	$4,946	$2,621	—	—	1
12027	CT EXTM UPPER W/ CONT BILAT	$4,790	$2,539	—	—	1
13006	MRI ANKLE W/ + W/O CONT BILAT	$4,135	$2,192	—	—	1
13035	MRI FEMUR W/ + W/O CONT BILAT	$4,135	$2,192	—	—	1
13080	MRI HIP W/ + W/O CONT BILAT	$4,135	$2,192	—	—	1
13098	MRI KNEE W/ + W/O CONT BILAT	$4,135	$2,192	—	—	1
13107	MRI EXTM LOWER W/+W/O CON BI	$4,135	$2,192	—	—	1
13151	MRI UPPER EXT W&WO CON BILAT	$4,135	$2,192	—	—	1
13147	MRI TMJ W &/OR WO UNI/BILAT	$3,590	$1,903	—	—	1
12030	CT EXTM UPPER W/O CONT BOTH	$3,500	$1,855	—	—	1
16043	HLA MATCHED WBC-GRANULOCYTES	$3,451	$1,829	—	—	1
13032	MRI FEMUR W/ CONT BILAT	$3,445	$1,826	—	—	1
13148	MRI UPPER EXT W/ CONT BILAT	$3,445	$1,826	—	—	1
13154	MRI UPPER EXT W/O CONT BILAT	$3,188	$1,690	—	—	1
12003	CT ANKLE W/ + W/O CONT BILAT	$2,968	$1,573	—	—	1
12036	CT FEMUR W/ + W/O CONT BILAT	$2,968	$1,573	—	—	1
12045	CT FOOT W/ + W/O CONT BILAT	$2,968	$1,573	—	—	1
12054	CT HAND W/ + W/O CONT BILAT	$2,968	$1,573	—	—	1
12066	CT HIP W/ + W/O CONT BILAT	$2,968	$1,573	—	—	1
12075	CT KNEE W/ + W/O CONT BILAT	$2,968	$1,573	—	—	1
12093	CT SHOULDER W/ + W/O CON BILAT	$2,968	$1,573	—	—	1
12102	CT TIB/FIB W/ + W/O CONT BILAT	$2,968	$1,573	—	—	1
12114	CT WRIST W/ + W/O CONT BILAT	$2,968	$1,573	—	—	1
12123	CT ELBOW W/ + W/O CONT BILAT	$2,968	$1,573	—	—	1
12132	CT FOREARM W/ + W/O CONT BILAT	$2,968	$1,573	—	—	1
12141	CT HUMERUS W/ + W/O CONT BILAT	$2,968	$1,573	—	—	1
12006	CT ANKLE W/ CONT BILAT	$2,874	$1,523	—	—	1
12018	CT EXTM LOWER W/ CONT BILAT	$2,874	$1,523	—	—	1
12039	CT FEMUR W/ CONT BILAT	$2,874	$1,523	—	—	1
12048	CT FOOT W/ CONT BILAT	$2,874	$1,523	—	—	1
12057	CT HAND W/ CONT BILAT	$2,874	$1,523	—	—	1
12069	CT HIP W/ CONT BILAT	$2,874	$1,523	—	—	1
12078	CT KNEE W/ CONT BILAT	$2,874	$1,523	—	—	1
12105	CT TIB/FIB W/ CONT BILAT	$2,874	$1,523	—	—	1
12117	CT WRIST W/ CONT BILAT	$2,874	$1,523	—	—	1
12126	CT ELBOW W/ CONT BILAT	$2,874	$1,523	—	—	1
12135	CT FOREARM W/ CONT BILAT	$2,874	$1,523	—	—	1
12144	CT HUMERUS W/ CONT BILAT	$2,874	$1,523	—	—	1
15001	PICC INSERTION	$2,850	$1,511	—	—	1
13169	MRI ANKLE W/+W/O CON BI PROFEE	$2,757	$1,461	—	—	1
13196	MRI FEMUR W/+W/O CON BI PROFEE	$2,757	$1,461	—	—	1
13241	MRI HIP W/ + W/O CON BI PROFEE	$2,757	$1,461	—	—	1
13259	MRI KNEE W/+W/O CONT BI PROFEE	$2,757	$1,461	—	—	1
13268	MRI EXT LOW W/+W/O CON BI PROF	$2,757	$1,461	—	—	1
13307	MRI UPPER EXT W&WO CON BI PROF	$2,757	$1,461	—	—	1
12162	CT LEG LENGTH W/O CONT BI	$2,700	$1,431	—	—	1
12042	CT FEMUR W/O CONT BILAT	$2,590	$1,373	—	—	1
12060	CT HAND W/O CONT BILAT	$2,590	$1,373	—	—	1

Showing top 50 of 1,806 priced procedures, sorted by gross charge.

Data straight from this hospital's federally-mandated machine-readable file (45 CFR § 180). The compliance grade reflects how completely the hospital published the six required data elements, not the quality of care.