Fort Memorial Hospital
Fort Atkinson, WI
Posts prices for 47 of the 66 common shoppable procedures we track. Price file retrieved 2026-09-08.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Breast lesion removal (open) (19120) | $2,001.28 | $6,254 | 0.5× |
| Shoulder arthroscopy with decompression (29826) | $1,190.72 | $3,721 | — |
| Knee arthroscopy with meniscectomy (29881) | $1,526.08 | $4,769 | 0.5× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) unusually low: confirm this is the full procedure |
$2,312.64 | $7,227 | 0.4× |
| Upper GI endoscopy (EGD), diagnostic (43235) | $1,235.20 | $3,860 | 1.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) | $1,148.16 | $3,588 | 1.3× |
| Diagnostic colonoscopy (45378) | $1,328 | $4,150 | 1.4× |
| Colonoscopy with biopsy (45380) | $1,459.84 | $4,562 | 1.2× |
| Colonoscopy with lesion removal (45385) | $1,787.20 | $5,585 | 1.5× |
| Laparoscopic gallbladder removal (47562) | $5,236.48 | $16,364 | 0.9× |
| Inguinal hernia repair (age 5+) (49505) | $5,019.52 | $15,686 | 1.4× |
| Transforaminal epidural injection, lumbar/sacral (64483) | $480.32 | $1,501 | 0.5× |
| Cataract removal with lens insertion (66984) | $2,851.20 | $8,910 | 1.2× |
| CT head/brain without contrast (70450) | $634.24 | $1,982 | 6.1× |
| MRI brain without contrast (70551) range across 3 matching MRF lines |
$1,364.16–$1,631.68 | $4,263–$5,099 | varies |
| MRI brain with contrast (70552) | $1,841.60 | $5,755 | 5.3× |
| MRI brain without and with contrast (70553) range across 2 matching MRF lines |
$1,652.16–$2,312.96 | $5,163–$7,228 | varies |
| X-ray lower spine, 4+ views (72110) | $294.72 | $921 | 2.9× |
| MRI lumbar spine without contrast (72148) range across 3 matching MRF lines |
$1,440–$1,551.36 | $4,500–$4,848 | varies |
| CT pelvis with contrast (72193) range across 2 matching MRF lines |
$964.80–$984.32 | $3,015–$3,076 | varies |
| MRI lower-extremity joint without contrast (73721) | $1,213.44 | $3,792 | 5.1× |
| CT abdomen and pelvis with contrast (74177) range across 4 matching MRF lines |
$1,140.48–$1,299.20 | $3,564–$4,060 | varies |
| Ultrasound, abdomen complete (76700) | $402.56 | $1,258 | 3.9× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) | $324.80 | $1,015 | 3.1× |
| Ultrasound, transvaginal (76830) | $321.28 | $1,004 | 3.1× |
| Mammography, one breast (diagnostic) (77065) | $147.52 | $461 | 1.7× |
| Mammography, both breasts (diagnostic) (77066) | $181.12 | $566 | 1.6× |
| Mammography, screening (bilateral) (77067) range across 6 matching MRF lines |
$139.84–$144.64 | $437–$452 | varies |
| Basic metabolic panel (80048) | $40 | $125 | 4.7× |
| Comprehensive metabolic panel (80053) | $80 | $250 | 7.6× |
| Lipid panel (80061) range across 3 matching MRF lines |
$64–$68.48 | $200–$214 | varies |
| Renal function panel (80069) | $48 | $150 | 5.5× |
| Hepatic function panel (80076) | $40 | $125 | 4.9× |
| Urinalysis, non-automated, with microscopy (81000) | $24.96 | $78 | 6.2× |
| Urinalysis, non-automated, without microscopy (81002) range across 6 matching MRF lines |
$11.20–$36.16 | $35–$113 | varies |
| PSA, total (84153) range across 3 matching MRF lines |
$57.60–$75.20 | $180–$235 | varies |
| Thyroid stimulating hormone (TSH) (84443) | $64 | $200 | 3.8× |
| CBC with automated differential (85025) range across 3 matching MRF lines |
$40–$45.12 | $125–$141 | varies |
| CBC, automated (85027) range across 4 matching MRF lines |
$28.80–$37.12 | $90–$116 | varies |
| Prothrombin time (PT) (85610) | $16 | $50 | 3.7× |
| Partial thromboplastin time (PTT) (85730) range across 2 matching MRF lines |
$23.68–$40 | $74–$125 | varies |
| Electrocardiogram (ECG), complete (93000) | $81.92 | $256 | 1.4× |
| Sleep study (attended polysomnography) (95810) range across 2 matching MRF lines |
$696.96–$1,393.92 | $2,178–$4,356 | varies |
| Physical therapy, therapeutic exercise (per 15 min) (97110) range across 11 matching MRF lines |
$66.88–$81.60 | $209–$255 | varies |
| Office visit, new patient (low complexity, ~30 min) (99203) range across 2 matching MRF lines |
$68.48–$191.68 | $214–$599 | varies |
| Office visit, new patient (moderate complexity, ~45 min) (99204) range across 2 matching MRF lines |
$78.72–$246.72 | $246–$771 | varies |
| Office visit, new patient (high complexity, ~60 min) (99205) range across 2 matching MRF lines |
$88.96–$324.80 | $278–$1,015 | varies |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.
More prices at this hospital
- Imaging: 260 codes with posted prices and Medicare benchmarks
- Lab & pathology: 580 codes with posted prices and Medicare benchmarks
- Visits & medical services: 166 codes with posted prices and Medicare benchmarks
- Procedures & surgery: 1417 codes with posted prices and Medicare benchmarks
- Supplies, drugs & other: 13 codes with posted prices and Medicare benchmarks
Get the raw price file
Download the machine-readable file (UNKNOWN, 315.6 MB) ↓ — captured 2026-09-08
File links point at the hospital's own hosting and sometimes rotate — if the download fails, use the hospital's transparency page.