48109773 — Hc Revasc Lithotr-stent Tib/per
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). HC REVASC LITHOTR-STENT TIB/PER (CDM 48109773) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/48109773?code_type=CDM
MLA (9th ed.)
“HC REVASC LITHOTR-STENT TIB/PER (CDM 48109773) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/48109773?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“HC REVASC LITHOTR-STENT TIB/PER (CDM 48109773) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/48109773?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $39,982–$61,506 (25th–75th percentile) across 6 hospitals · 37 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 48109773 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| Ascension SE Wisconsin Hospital - Franklin Campus Both | NETWORK HEALTH | 1289_NETWORK HEALTH PLAN 20250701 | $15,873.00 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION SE WISCONSIN HOSPITAL Both | NETWORK HEALTH | 1289_NETWORK HEALTH PLAN 20250701 | $15,873.00 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Both | NETWORK HEALTH | 1289_NETWORK HEALTH PLAN 20250701 | $15,873.00 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL Both | NETWORK HEALTH | 1289_NETWORK HEALTH PLAN 20250701 | $15,873.00 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | SMARTHEALTH | 1129_SMARTHEALTH EMPLOYEES 20221001 | $23,213.97 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| Ascension Columbia St. Mary's Hospital Ozaukee Outpatient | SMARTHEALTH | 1129_SMARTHEALTH EMPLOYEES 20221001 | $23,213.97 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| Ascension Columbia St. Mary's Hospital Ozaukee Outpatient | ANTHEM PATHWAYS | 1121_ANTHEM PATHWAYS 20221001 | $24,404.43 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | ANTHEM PATHWAYS | 1121_ANTHEM PATHWAYS 20221001 | $24,404.43 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| Ascension Columbia St. Mary's Hospital Ozaukee Outpatient | ANTHEM BLUE CONNECTION | 1117_ANTHEM BLUE CONNECTION 20221001 | $30,951.96 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | ANTHEM BLUE CONNECTION | 1117_ANTHEM BLUE CONNECTION 20221001 | $30,951.96 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| ASCENSION SE WISCONSIN HOSPITAL Outpatient | SMARTHEALTH EMPLOYEES 20191001 TLK ADJ - MODEL | 474_SMARTHEALTH EMPLOYEES 20191001 TLK ADJ - MODEL | $31,152.42 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | SMARTHEALTH EMPLOYEES 20191001 TLK ADJ - MODEL | 474_SMARTHEALTH EMPLOYEES 20191001 TLK ADJ - MODEL | $31,152.42 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL Outpatient | SMARTHEALTH EMPLOYEES 20191001 TLK ADJ - MODEL | 474_SMARTHEALTH EMPLOYEES 20191001 TLK ADJ - MODEL | $31,152.42 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Franklin Campus Outpatient | SMARTHEALTH EMPLOYEES 20191001 TLK ADJ - MODEL | 474_SMARTHEALTH EMPLOYEES 20191001 TLK ADJ - MODEL | $31,152.42 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | SEHN C89 | 1128_SEHN 20221001 | $31,547.19 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| Ascension Columbia St. Mary's Hospital Ozaukee Outpatient | SEHN C89 | 1128_SEHN 20221001 | $31,547.19 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| Ascension Columbia St. Mary's Hospital Ozaukee Outpatient | CCHP MARKETPLACE | 1124_CCHP MARKETPLACE 20221001 | $32,142.42 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | CCHP MARKETPLACE | 1124_CCHP MARKETPLACE 20221001 | $32,142.42 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| Ascension Columbia St. Mary's Hospital Ozaukee Outpatient | ANTHEM HMO POS | 1120_ANTHEM HMO POS 20221001 | $34,523.34 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | ANTHEM HMO POS | 1120_ANTHEM HMO POS 20221001 | $34,523.34 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| Ascension Columbia St. Mary's Hospital Ozaukee Outpatient | WEA PPP | 204_WEA PPP 20160101 | $35,118.57 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | NETWORK HEALTH PLAN | 1136_NETWORK HEALTH PLAN 20221001 | $35,118.57 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| Ascension Columbia St. Mary's Hospital Ozaukee Outpatient | NETWORK HEALTH PLAN | 1136_NETWORK HEALTH PLAN 20221001 | $35,118.57 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | ALLIANCE | 1066_ALLIANCE 20220101 | $35,118.57 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | WEA PPP | 204_WEA PPP 20160101 | $35,118.57 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| Ascension Columbia St. Mary's Hospital Ozaukee Outpatient | ALLIANCE | 1066_ALLIANCE 20220101 | $35,118.57 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | CENTIVO | 1125_CENTIVO 20221001 | $39,880.41 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| Ascension Columbia St. Mary's Hospital Ozaukee Outpatient | CENTIVO | 1125_CENTIVO 20221001 | $39,880.41 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | SEHN | 1171_SEHN 20241001 | $39,939.00 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL Outpatient | SEHN | 1171_SEHN 20241001 | $39,939.00 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Franklin Campus Outpatient | SEHN | 1171_SEHN 20241001 | $39,939.00 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION SE WISCONSIN HOSPITAL Outpatient | SEHN | 1171_SEHN 20241001 | $39,939.00 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | HUMANA WVN | 1135_HUMANA WVN 20221001 | $40,109.00 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| Ascension Columbia St. Mary's Hospital Ozaukee Outpatient | HUMANA WVN | 1135_HUMANA WVN 20221001 | $40,109.00 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| Ascension Columbia St. Mary's Hospital Ozaukee Outpatient | WPS | 1132_WISCONSIN PHYSICIAN SERVICES MCWI OCWI 20221001 | $41,070.87 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | WPS | 1132_WISCONSIN PHYSICIAN SERVICES MCWI OCWI 20221001 | $41,070.87 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| Ascension Columbia St. Mary's Hospital Ozaukee Outpatient | ARISE | 1123_ARISE PREMIER MCWI OCWI 20221001 | $41,666.10 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | ARISE | 1123_ARISE PREMIER MCWI OCWI 20221001 | $41,666.10 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| Ascension Columbia St. Mary's Hospital Ozaukee Outpatient | AETNA | 567_AETNA 20190701 | $41,666.10 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | AETNA | 567_AETNA 20190701 | $41,666.10 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL Outpatient | WEA TRUST PPO | 1164_WEA TRUST PPO MIL 20241001 | $42,335.34 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Franklin Campus Outpatient | WEA TRUST SELECT POS | 431_WEA TRUST SELECT POS MIL 20180201 | $42,335.34 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | WEA TRUST SELECT POS | 431_WEA TRUST SELECT POS MIL 20180201 | $42,335.34 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL Outpatient | WEA TRUST SELECT POS | 431_WEA TRUST SELECT POS MIL 20180201 | $42,335.34 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | WEA TRUST PPO | 1164_WEA TRUST PPO MIL 20241001 | $42,335.34 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Franklin Campus Outpatient | WEA TRUST PPO | 1164_WEA TRUST PPO MIL 20241001 | $42,335.34 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION SE WISCONSIN HOSPITAL Outpatient | WEA TRUST SELECT POS | 431_WEA TRUST SELECT POS MIL 20180201 | $42,335.34 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION SE WISCONSIN HOSPITAL Outpatient | WEA TRUST PPO | 1164_WEA TRUST PPO MIL 20241001 | $42,335.34 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | HEALTH PAYMENT SYSTEMS SOLUTIONS | 1160_HEALTH PAYMENT SYSTEMS SOLUTIONS MIL 20241001 | $43,134.12 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL Outpatient | HEALTH PAYMENT SYSTEMS SOLUTIONS | 1160_HEALTH PAYMENT SYSTEMS SOLUTIONS MIL 20241001 | $43,134.12 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Franklin Campus Outpatient | HEALTH PAYMENT SYSTEMS SOLUTIONS | 1160_HEALTH PAYMENT SYSTEMS SOLUTIONS MIL 20241001 | $43,134.12 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION SE WISCONSIN HOSPITAL Outpatient | HEALTH PAYMENT SYSTEMS SOLUTIONS | 1160_HEALTH PAYMENT SYSTEMS SOLUTIONS MIL 20241001 | $43,134.12 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | TRILOGY | 1070_TRILOGY 20220101 | $43,451.79 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| Ascension Columbia St. Mary's Hospital Ozaukee Outpatient | TRILOGY | 1070_TRILOGY 20220101 | $43,451.79 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| Ascension Columbia St. Mary's Hospital Ozaukee Outpatient | HEALTH PAYMENT SYSTEMS | 1126_HEALTH PAYMENT SYSTEMS 20221001 | $45,237.48 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | HEALTH PAYMENT SYSTEMS | 1126_HEALTH PAYMENT SYSTEMS 20221001 | $45,237.48 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | MOLINA MARKETPLACE | 1161_MOLINA MARKETPLACE ASWI 20241001 | $47,128.02 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Franklin Campus Outpatient | MOLINA MARKETPLACE | 1162_MOLINA MARKETPLACE MIL 20241001 | $47,128.02 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | MOLINA MARKETPLACE | 1162_MOLINA MARKETPLACE MIL 20241001 | $47,128.02 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION SE WISCONSIN HOSPITAL Outpatient | MOLINA MARKETPLACE | 1162_MOLINA MARKETPLACE MIL 20241001 | $47,128.02 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL Outpatient | MOLINA MARKETPLACE | 1162_MOLINA MARKETPLACE MIL 20241001 | $47,128.02 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| Ascension Columbia St. Mary's Hospital Ozaukee Outpatient | ANTHEM PPO | 1122_ANTHEM PPO 20221001 | $48,213.63 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | ANTHEM PPO | 1122_ANTHEM PPO 20221001 | $48,213.63 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| Ascension Columbia St. Mary's Hospital Ozaukee Outpatient | PARADIGM NETWORK | 580_PARADIGM NETWORK 20161001 | $48,808.86 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | PARADIGM NETWORK | 580_PARADIGM NETWORK 20161001 | $48,808.86 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | NEHA PPO | 989_NEHA PPO BROAD MCWI 20210101 | $49,999.32 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| Ascension Columbia St. Mary's Hospital Ozaukee Outpatient | WEA POS | 539_WEA POS 20090101 | $51,189.78 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | WEA POS | 539_WEA POS 20090101 | $51,189.78 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | WEA | 419_WEA 20090116 | $52,975.47 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| Ascension Columbia St. Mary's Hospital Ozaukee Outpatient | WEA | 419_WEA 20090116 | $52,975.47 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Both | TRILOGY | 1271_TRILOGY 20250701 | $55,115.82 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION SE WISCONSIN HOSPITAL Both | TRILOGY | 1271_TRILOGY 20250701 | $55,115.82 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL Both | TRILOGY | 1271_TRILOGY 20250701 | $55,115.82 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Franklin Campus Both | TRILOGY | 1271_TRILOGY 20250701 | $55,115.82 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Franklin Campus Outpatient | NEHA LIMITED | 821_NEHA LIMITED 20220101 | $55,914.60 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Franklin Campus Outpatient | NEHA ASCENSION ONLY | 820_NEHA ASCENSION ONLY 20220101 | $55,914.60 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL Outpatient | NEHA ASCENSION ONLY | 820_NEHA ASCENSION ONLY 20220101 | $55,914.60 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL Outpatient | NEHA LIMITED | 821_NEHA LIMITED 20220101 | $55,914.60 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION SE WISCONSIN HOSPITAL Outpatient | NEHA ASCENSION ONLY | 820_NEHA ASCENSION ONLY 20220101 | $55,914.60 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION SE WISCONSIN HOSPITAL Outpatient | NEHA LIMITED | 821_NEHA LIMITED 20220101 | $55,914.60 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | NEHA ASCENSION ONLY | 820_NEHA ASCENSION ONLY 20220101 | $55,914.60 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | NEHA LIMITED | 821_NEHA LIMITED 20220101 | $55,914.60 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | HEALTH PAYMENT SYSTEMS SOLUTIONS | 1159_HEALTH PAYMENT SYSTEMS SOLUTIONS ASWI 20241001 | $58,310.94 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $59,523.00 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| Ascension Columbia St. Mary's Hospital Ozaukee Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $59,523.00 | $59,523.00 | $31,547.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | WEA TRUST PPO | 1163_WEA TRUST PPO ASWI 20241001 | $59,908.50 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Franklin Campus Outpatient | FIRST HEALTH NETWORK | 1290_FIRST HEALTH 20240101 SJWI FNWI MWWI | $59,908.50 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | FIRST HEALTH NETWORK | 1290_FIRST HEALTH 20240101 SJWI FNWI MWWI | $59,908.50 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL Outpatient | FIRST HEALTH NETWORK | 1290_FIRST HEALTH 20240101 SJWI FNWI MWWI | $59,908.50 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION SE WISCONSIN HOSPITAL Outpatient | FIRST HEALTH NETWORK | 1290_FIRST HEALTH 20240101 SJWI FNWI MWWI | $59,908.50 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | WEA TRUST SELECT POS | 432_WEA TRUST SELECT POS ASWI 20180201 | $59,908.50 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL Outpatient | AETNA | 1279_AETNA MIL 20250701 | $61,506.06 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Franklin Campus Outpatient | AETNA | 1279_AETNA MIL 20250701 | $61,506.06 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION SE WISCONSIN HOSPITAL Outpatient | AETNA | 1279_AETNA MIL 20250701 | $61,506.06 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | AETNA | 1279_AETNA MIL 20250701 | $61,506.06 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL Outpatient | CIGNA | 1273_CIGNA 20250701 | $62,304.84 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Franklin Campus Outpatient | CIGNA | 1273_CIGNA 20250701 | $62,304.84 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | CIGNA | 1273_CIGNA 20250701 | $62,304.84 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION SE WISCONSIN HOSPITAL Outpatient | CIGNA | 1273_CIGNA 20250701 | $62,304.84 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | WEA PROVIDER AND POS | 434_WEA PROVIDER AND POS MIL 20180201 | $65,499.96 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION SE WISCONSIN HOSPITAL Outpatient | WEA PROVIDER AND POS | 434_WEA PROVIDER AND POS MIL 20180201 | $65,499.96 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Franklin Campus Outpatient | WEA PROVIDER AND POS | 434_WEA PROVIDER AND POS MIL 20180201 | $65,499.96 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL Outpatient | WEA PROVIDER AND POS | 434_WEA PROVIDER AND POS MIL 20180201 | $65,499.96 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | WEA PROVIDER AND POS | 433_WEA PROVIDER AND POS ASWI 20180201 | $67,896.30 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | FIRST HEALTH NETWORK | 1281_FIRST HEALTH 20240101 ASWI | $68,695.08 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | AETNA | 1278_AETNA ASWI 20250701 | $68,695.08 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION SE WISCONSIN HOSPITAL Outpatient | HEALTH EOS/MULTIPLAN | 1015_HEALTH EOS/MULTIPLAN 20230701 | $69,493.86 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL Outpatient | HEALTH EOS/MULTIPLAN | 1015_HEALTH EOS/MULTIPLAN 20230701 | $69,493.86 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Franklin Campus Outpatient | HEALTH EOS/MULTIPLAN | 1015_HEALTH EOS/MULTIPLAN 20230701 | $69,493.86 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | HEALTH EOS/MULTIPLAN | 1015_HEALTH EOS/MULTIPLAN 20230701 | $69,493.86 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL Outpatient | NEHA PPO ON/NEAR SITE | 390_NEHA PPO ON/NEAR SITE 20180701 | $71,091.42 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | NEHA PPO BROAD | 388_NEHA PPO BROAD 20180701 | $71,091.42 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | NEHA PPO ON/NEAR SITE | 390_NEHA PPO ON/NEAR SITE 20180701 | $71,091.42 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Franklin Campus Outpatient | NEHA PPO ON/NEAR SITE | 390_NEHA PPO ON/NEAR SITE 20180701 | $71,091.42 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL Outpatient | NEHA PPO BROAD | 388_NEHA PPO BROAD 20180701 | $71,091.42 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION SE WISCONSIN HOSPITAL Outpatient | NEHA PPO ON/NEAR SITE | 390_NEHA PPO ON/NEAR SITE 20180701 | $71,091.42 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Franklin Campus Outpatient | NEHA PPO BROAD | 388_NEHA PPO BROAD 20180701 | $71,091.42 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION SE WISCONSIN HOSPITAL Outpatient | NEHA PPO BROAD | 388_NEHA PPO BROAD 20180701 | $71,091.42 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | HEALTH EOS/MULTIPLAN WC | 1016_HEALTH EOS/MULTIPLAN (WORKERS COMP) 20230701 | $75,085.32 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Franklin Campus Outpatient | HEALTH EOS/MULTIPLAN WC | 1016_HEALTH EOS/MULTIPLAN (WORKERS COMP) 20230701 | $75,085.32 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION SE WISCONSIN HOSPITAL Outpatient | HEALTH EOS/MULTIPLAN WC | 1016_HEALTH EOS/MULTIPLAN (WORKERS COMP) 20230701 | $75,085.32 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL Outpatient | HEALTH EOS/MULTIPLAN WC | 1016_HEALTH EOS/MULTIPLAN (WORKERS COMP) 20230701 | $75,085.32 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $79,878.00 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Franklin Campus Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $79,878.00 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $79,878.00 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |
| ASCENSION SE WISCONSIN HOSPITAL Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $79,878.00 | $79,878.00 | $42,335.34 | 2026-01-01 | MRF ↗ |