Procedures & surgery prices at Upland Hills Health

Dodgeville, WI · every code in this section with a posted price and a Medicare benchmark.

218 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
Abd paracentesis w/imaging (49083) $887.36 $1,643.25 1.0×
Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) $409.05 $757.50 0.5×
Anoscopy diagnostic (46600) $376.68 $697.55 2.9×
Anrct Xm Surg Req Anes General Spi/Edrl Dx (45990) $944.43 $1,748.95 0.4×
Application finger splint static (29130) $209.49 $387.95 1.6×
Application long arm splint shoulder hand (29105) $114.80 $212.60 0.7×
Application Long Leg Splint (29505) $387.99 $718.50 2.5×
Application of rigid total contact leg cast (29445) $726.08 $1,344.60 2.7×
Application short arm splint forearm-hand static (29125) $299.21 $554.10 2.3×
Application short leg splint calf foot (29515) $367.61 $680.75 2.3×
Arterial puncture (36600) $33.21 $61.50 0.3×
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $170.05 $314.90 0.6×
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) $257.26 $476.40 0.9×
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) $101.76 $188.45 0.3×
Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft (27130)
likely a partial charge, not the full procedure
$1,649.24 $3,054.15 0.1×
Aspirate pleura w/ imaging (32555) $500.61 $927.05 0.8×
Avulsion nail plate partial/complete simple 1 (11730) $253.07 $468.65 1.3×
Bladder Irrigation (51700) $137.40 $254.45 0.6×
Bladder Scan (51798) $120.91 $223.90 2.1×
Blepharotomy drainage abscess eyelid (67700) $261.36 $484 0.8×
Blood Transfusion Service (36430)
range across 6 matching MRF lines
$490–$883.58 $907.40–$1,636.25 varies
Bx breast 1st lesion strtctc (19081) $3,803.57 $7,043.65 2.4×
Bx breast 1st lesion us imag (19083) $2,366.44 $4,382.30 1.5×
Change Cystostomy Tube Complicated (51710) $371.52 $688 0.5×
Chest tube placement (32551) $693.82 $1,284.85 0.5×
Circumcision w/clamp/oth dev w/block (54150)
range across 2 matching MRF lines
$168.43–$341.15 $311.90–$631.75 varies
Cl Tx Tib Shft Fx W Manip (27752) $2,310.28 $4,278.30 1.5×
Clear outer ear canal (69200) $220.19 $407.75 1.7×
Closed tx ankle dislocation w/o anesthesia (27840) $1,840.21 $3,407.80 7.7×
Closed Tx Bimalleolar Ankle Fracture W Manip (27810) $2,034.05 $3,766.75 1.3×
Closed tx carpal scaphoid fracture w/manj (25624) $2,143.50 $3,969.45 1.4×
Closed tx knee dislocation w/o anesthesia (27550) $612.98 $1,135.15 2.6×
Closed Tx Lunate Dislocation W/Manipulation (25690) $2,339.82 $4,333 1.5×
Closed tx patellar dislocation w/o anesthesia (27560) $1,632.53 $3,023.20 6.8×
Closed tx radial head/neck fx w/manipulation (24655) $1,943.62 $3,599.30 1.2×
Closed Tx Radial&Ulnar Shaft Fractures W/Manj (25565) $2,204.06 $4,081.60 1.4×
Closed tx temporomandibular dislocation 1st/sbsq (21480) $140.70 $260.55 0.6×
Closed Tx Ulnar Fracture Prox End W/O Manipulate (24670) $622.40 $1,152.60 2.6×
Clsd tx shoulder dislc w/manipulation req anes (23655) $922.94 $1,709.15 0.6×
Clsd tx shoulder dislc w/manipulation w/o anes (23650) $691.88 $1,281.25 2.9×
Cltx dstl fibular fx lat malls w/manj (27788) $1,839.65 $3,406.75 7.7×
Cltx dstl radial fx/epiphysl sep w/o manj (25600) $981.48 $1,817.55 4.1×
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $1,803.68 $3,340.15 1.2×
Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) $701 $1,298.15 2.9×
Cltx fx w8 brg artclr prtn dstl tib w/skel tracj (27825) $2,326.54 $4,308.40 1.5×
Cltx hip dislocation traumatic req anesthesia (27252) $3,439.21 $6,368.90 2.2×
Cltx hip dislocation traumatic w/o anesthesia (27250) $794.48 $1,471.25 3.3×
Cltx Interphalangeal Joint Dislocation W/O Anes (28660) $441.05 $816.75 1.8×
Cltx iphal jt dislc w/manj w/o anes (26770) $785.97 $1,455.50 3.3×
Cltx metacarpal fx w/manipulation each bone (26605) $1,443.45 $2,673.05 6.0×
Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) $1,474.12 $2,729.85 6.2×
Cltx post hip arthrp dislc req anes (27266) $2,711.07 $5,020.50 1.7×
Cltx post hip arthrp dislc w/o anes (27265) $1,975.21 $3,657.80 8.2×
Cltx prox humrl fx w/manj w/wo skeletal tracj (23605) $2,034.75 $3,768.05 1.3×
Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) $377.49 $699.05 1.6×
Cltx shoulder dislc w/fx humeral tubrst w/manj (23665) $913.82 $1,692.25 0.6×
Cltx trimalleolar ankle fx w/manipulation (27818) $2,088.34 $3,867.30 1.3×
Collect Blood From Catheter Venous Nos (36592) $76.82 $142.25 0.6×
Collection of venous blood by venipuncture (36415) $21.60 $40 2.3×
Colonoscopy Flexible With Decompression (45393) $703.24 $1,302.30 0.6×
Colonoscopy through stoma; with biopsy, single or multiple (44389) $1,528.63 $2,830.80 1.3×
Colonoscopy thru stoma (44388) $709.21 $1,313.35 0.8×
Colonoscopy Thru Stoma,Lesn Rmvl W/Snare - Colonoscopy (44394) $2,002.16 $3,707.70 1.7×
Colonoscopy w/ablation (45388) $2,402.60 $4,449.25 2.1×
Colonoscopy W/Band Ligation (45398) $791.24 $1,465.25 0.7×
Colonoscopy w/fb removal (45379) $809.46 $1,499 0.7×
Colonoscopy w/submucosal inj (45381) $1,791.02 $3,316.70 1.5×
Colsc Flexible W/Control Bleeding Any Method (45382) $2,308.82 $4,275.60 2.0×
Colsc flx w/removal lesion by hot bx forceps (45384) $2,015.39 $3,732.20 1.7×
Control Nasal Hemorrhage Anterior Simple (30901) $404.33 $748.75 3.1×
Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) $758.70 $1,405 5.9×
Ctrl Nsl Hemrrg Pst Nasal Packs&/Cautery Subsq (30906) $944.60 $1,749.25 4.1×
Cysto calibration dilat urtl strix/stenosis (52281) $700.33 $1,296.90 0.3×
Dbrdmt w/rmvl fm fx&/dislc skin&subq tissus (11010) $1,266.89 $2,346.10 1.8×
Debridement subcutaneous tissue 20 sq cm/< (11042) $280.75 $519.90 0.7×
Declot vascular device (36593) $161.95 $299.90 0.5×
Delivery of placenta (59414) $148.96 $275.85 0.0×
Destr W Neurolytic; Celiac Plexus (64680) $755.87 $1,399.75 0.9×
Destroy cerv/thor facet jnt (64633) $902.48 $1,671.25 0.5×
Destroy lumb/sac facet jnt (64635) $903.47 $1,673.10 0.5×
Diagnostic sigmoidoscopy (45330) $566.54 $1,049.15 0.6×
Dise Dyn Eval Sleep Disordered Breathing Flx Dx (42975) $877.23 $1,624.50 0.5×
Drainage external ear abscess/hematoma cmplx (69005) $560.71 $1,038.35 0.3×
Drainage External Ear Abscess/Hematoma Simple (69000) $280.10 $518.70 0.4×
Drainage of finger abscess simple (26010) $662.04 $1,226 3.4×
Drainage of gum lesion (41800) $744.80 $1,379.25 5.8×
Drainage of hematoma/fluid (10140) $343.36 $635.85 0.2×
Drainage of nose lesion (30000) $572.83 $1,060.80 2.5×
Draw Blood Off Venous Device (36591) $76.82 $142.25 0.6×
Drg Absc Cst Hmtma Vestibule Mouth Smpl (40800) $570.89 $1,057.20 0.8×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) $258.12 $478 1.3×
Dstrj Neurolytic Agent Other Peripheral Nerve (64640) $563.19 $1,042.95 0.7×
Dx lmbr spi pnxr w/fluor/CT (62328) $1,150.50 $2,130.55 1.7×
Egd Balloon Dilation Esophagus <30 Mm Diam (43249) $1,697.25 $3,143.05 0.9×
Egd control bleeding any (43255) $1,791.83 $3,318.20 1.0×
Egd Flexible Foreign Body Removal (43247) $1,917.57 $3,551.05 2.2×
Egd guide wire insertion (43248) $1,483.76 $2,747.70 1.7×
Egd place gastrostomy tube (43246) $1,768.74 $3,275.45 0.9×
Egd remove lesion snare (43251) $1,748.52 $3,238 0.9×
Endometrial Biopsy (58100) $212.71 $393.90 1.1×
Epidural Blood Patch (62273) $528.15 $978.05 0.8×
Evacuation of subungual hematoma (11740) $119.69 $221.65 0.9×
Excision Lingual Frenum Frenectomy (41115) $683.88 $1,266.45 0.5×
External cephalic version (59412) $559.20 $1,035.55 0.2×
Fetal non-stress test (59025) $229.12 $424.30 1.2×
Fluid Pressure Muscle (20950) $409.43 $758.20 0.6×
Fna bx w/us gdn 1st les (10005) $1,051.95 $1,948.05 1.5×
Hysteroscopy Biopsy (58558) $1,050.71 $1,945.75 0.3×
I&d abscess simple (10060) $311.88 $577.55 1.6×
I&d perianal abscess superficial (46050) $472.88 $875.70 0.5×
I&d pilonidal cyst complicated (10081) $299.24 $554.15 0.4×
I&d pilonidal cyst simple (10080) $302.59 $560.35 0.4×
Implant neuroelectrodes (63650)
unusually low: confirm this is the full procedure
$1,934.04 $3,581.55 0.3×
Incise external hemorrhoid (46083) $511.25 $946.75 2.1×
Incision & drainage abscess complicated/multiple (10061) $419.99 $777.75 1.1×
Incision & removal foreign body subq tiss compl (10121) $526.45 $974.90 0.3×
Incision & removal foreign body subq tiss simple (10120) $306.72 $568 0.8×
Incision and drainage of bartholin's gland abscess (56420) $242.81 $449.65 1.2×
Incision and drainage of vulva or perineal abscess (56405) $281.37 $521.05 1.0×
Incision of lingual frenum (frenotomy) (41010) $514.92 $953.55 0.3×
Incision of rectal abscess (46040) $1,978.83 $3,664.50 1.7×
Initial Tx 1st Degree Burn Local Tx (16000) $206.87 $383.10 1.1×
Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Cerv/Thorac, 1st Level (64490) $924.75 $1,712.50 1.1×
Inj W/Fluor Eval Cv Device (36598) $163.08 $302 0.8×
Inject Anes/Steroid Foramen Cerv/Thoracic W Img Guide ,1 Level (64479) $612.71 $1,134.65 0.7×
Injection 1 tendon sheath/ligament aponeurosis (20550) $179.52 $332.45 0.6×
Injection aa&/strd intercostal nrv ea addl lvl (64421) $114.53 $212.10 0.1×
Injection Aa&/Strd Sciatic Nerve W/Img Gdn (64445) $333.96 $618.45 0.5×
Injection Anes Superior Hypogastric Plexus (64517) $594.19 $1,100.35 0.7×
Injection anesthetic agent suprascapular nerve (64418) $256.15 $474.35 0.4×
Injection for identification of sentinel node (38792) $335.75 $621.75 0.9×
Injection single/mlt trigger point 1/2 muscles (20552) $169.34 $313.60 0.6×
Injection, anesthetic agent; brachial plexus, single (64415) $325.22 $602.25 0.4×
Injection, anesthetic agent; femoral nerve, single (64447) $295.73 $547.65 0.4×
Injection, anesthetic agent; other peripheral nerve or branch (64450) $193.64 $358.60 0.3×
Insert Bladder Cath Complex (51703) $400.90 $742.40 3.2×
Insert cervical dilator (59200) $138.78 $257 0.5×
Insert non-tunnel cv cath (36556) $382.37 $708.10 0.1×
Insert Temp Bladder Cath (51702) $131.52 $243.55 1.0×
Insert,Non-Indwelling Bladder Catheter (51701) $132.14 $244.70 1.0×
Insertion Picc W/Rs&I 5 Yr/> (36573) $1,371.68 $2,540.15 0.9×
Insj prph cvc w/o subq port/pmp age 5 yr/> (36569) $426.68 $790.15 0.3×
Intro Gastrointestinal Tube (44500) $88.56 $164 0.1×
Intubation endotracheal emergency procedure (31500) $639.82 $1,184.85 2.8×
Iridotomy/irridectomy laser surg per session (66761) $817.94 $1,514.70 1.5×
Irrigation of corpora cavernosa for priapism (54220) $968.27 $1,793.10 4.0×
N Block Inj Ilio-Ing/Hypogi (64425) $253.80 $470 0.4×
N block inj intercost sng (64420) $272.81 $505.20 0.4×
N Block Lumbar/Thoracic (64520) $398.25 $737.50 0.5×
Nasal/Orogastric W/Tube Plmt (43752) $183.09 $339.05 0.4×
Needle Biopsy Lymph Nodes (38505) $745.28 $1,380.15 0.5×
Needle insertion w/o injection 1 or 2 muscles (20560)
range across 2 matching MRF lines
$32.40–$48.60 $60–$90 varies
Needle insertion w/o injection 3 or more muscles (20561)
range across 2 matching MRF lines
$40.50–$54 $75–$100 varies
Njx Anes Trigeminal Nrv Any Div/Branch (64400) $231.23 $428.20 0.8×
Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) $424.74 $786.55 0.5×
Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn (62321) $813.94 $1,507.30 1.2×
Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62323) $848.29 $1,570.90 1.2×
Occipital Nerve Block (64405) $234.68 $434.60 0.8×
Perq dev breast 1st strtctc (19283) $824.55 $1,526.95 1.2×
Perq dev breast 1st us imag (19285) $900.83 $1,668.20 1.3×
Perq device breast 1st imag (19281) $821.61 $1,521.50 0.5×
Perq sft tiss loc device plmt 1st les w/gdnce (10035) $108.92 $201.70 0.2×
Placement of needle for intraosseous infusion (36680) $267.54 $495.45 0.6×
Puncture aspiration abscess hematoma bulla/cyst (10160) $279.99 $518.50 0.7×
Puncture Aspiration Cyst Breast (19000) $350.84 $649.70 0.5×
Pvb Thoracic Single Injection Site W/Img Gid (64461) $360.15 $666.95 0.5×
Reduction of rectal prolapse (45900) $716.23 $1,326.35 0.8×
Removal Embedded Foreign Body Eyelid (67938) $259.25 $480.10 0.8×
Removal impacted cerumen irrigation/lvg unilat (69209) $73.12 $135.40 1.3×
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) $148.50 $275 2.6×
Removal skn tags mlt fibrq tags any area upw/15 (11200) $271.43 $502.65 1.4×
Remove foreign body from eye (65205) $136.03 $251.90 1.1×
Remove Intrauterine Device (58301) $142.91 $264.65 0.5×
Remove Nasal Foreign Body (30300) $568.35 $1,052.50 4.4×
Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) $818.99 $1,516.65 1.1×
Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) $866.19 $1,604.05 2.2×
Repair complex scalp/arm/leg 2.6-7.5 cm (13121) $739.34 $1,369.15 1.9×
Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) $487.27 $902.35 1.2×
Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) $575.21 $1,065.20 1.5×
Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) $619.62 $1,147.45 1.6×
Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) $419.53 $776.90 1.1×
Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) $565.46 $1,047.15 1.4×
Repair intermediate s/a/t/e 12.6-20.0cm (12035) $684.53 $1,267.65 1.7×
Repair intermediate s/a/t/e 2.5 cm/< (12031) $437.51 $810.20 1.1×
Repair intermediate s/a/t/e 2.6-7.5 cm (12032) $551.26 $1,020.85 1.4×
Repair intermediate s/a/t/e 7.6-12.5 cm (12034) $589.63 $1,091.90 1.5×
Repair of nail bed (11760) $244.92 $453.55 0.3×
Repair tongue laceration (41252) $966.95 $1,790.65 4.2×
Rmvl fb xtrnl eye corneal w/o slit lamp (65220) $189.16 $350.30 0.4×
Rmvl fb xtrnl eye corneal w/slit lamp (65222) $235.20 $435.55 1.8×
Rmvl tun ctr vad w/subq port/pmp ctr/prph insj (36590) $858.25 $1,589.35 0.6×
Rmvl Tun Cvc W/O Subq Port/Pmp (36589) $362.56 $671.40 0.6×
Rplc Gtube No Revj Trc (43762) $166.48 $308.30 0.7×
Rpr F/E/E/N/L/M 7.6-12.5 Cm (12015) $256.26 $474.55 1.3×
Sgmdsc flx dired sbmcsl njx any sbst (45335) $649.84 $1,203.40 0.7×
Sgmdsc flx rmvl tum polyp/oth les snare tq (45338) $1,077.14 $1,994.70 0.9×
Sigmoidoscopy Flx Ablation Tumor Polyp/Oth Les (45346) $1,432 $2,651.85 1.2×
Sigmoidoscopy flx tndsc balo dilat (45340) $266.41 $493.35 0.2×
Sigmoidoscopy, flexible; with biopsy, single or multiple (45331) $1,571.81 $2,910.75 1.7×
Sigmoidoscopy,Flex,W/Control,Bleeding (45334) $1,054.73 $1,953.20 0.9×
Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) $346.92 $642.45 0.9×
Simple repair f/e/e/n/l/m 2.5cm/< (12011) $153.60 $284.45 0.8×
Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) $158.17 $292.90 0.8×
Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) $203.50 $376.85 1.0×
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) $123.71 $229.10 0.6×
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $201.29 $372.75 1.0×
Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) $162 $300 0.8×
Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) $257.82 $477.45 0.7×
Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) $515.67 $954.95 1.3×
Spinal puncture lumbar diagnostic (62270) $514.22 $952.25 0.7×
Strapping Unna Boot (29580) $190.89 $353.50 1.2×
Trabeculoplasty by laser surgery (65855) $712.40 $1,319.25 1.3×
Treat Humerus Fracture (24505) $2,151.31 $3,983.90 1.4×
Treat Knuckle Dislocation (26700) $1,513.03 $2,801.90 6.3×
Treatment closed elbow dislocation w/o anes (24600) $781.89 $1,447.95 3.3×
Tx Gastro Intub W/Asp (43753) $96.90 $179.45 0.5×
Tx Superficial Wound Dehiscence Simple Closure (12020) $540.08 $1,000.15 0.8×
Vaginal delivery only (59409) $1,330.59 $2,464.05 0.4×

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.