The objective of this study was to modify a farm-level stochastic simulation model to estimate the cost per case of 3 hoof diseases by severity, incidence timing, and parity group. Disease expenditures considered within the model included therapeutics, outside labor, and on-farm labor. Disease losses considered within the model included discarded milk, reduced milk production, extended days open, an increased risk of culling, an increased risk of death (natural or euthanized), and disease recurrence. All estimates of expenditures and losses were defined using data from previously published research in stochastic distributions; the program evaluation and review technique and normal distributions were the most commonly used. Stochastic simulation was used to account for variation within the farm model; 1,000 iterations were run. Sensitivity of hoof disease costs to selected market prices and herd specific performance variables was analyzed. Using our model assumptions, the cost per case of disease over all combinations of severity, incidence timing, and parity group was lowest for digital dermatitis (mean ± SD = $137 ± 36), followed by white line disease (mean ± SD = $203 ± 33), and sole ulcers (mean ± SD = $252 ± 39). Disease costs were greater in severe versus mild cases and multiparous versus primiparous cows and were always highest at the beginning of lactation. The greatest contributing cost categories were decreased milk production, increased risk of culling, disease recurrence, and, in severe cases, increased risk of death. The contribution of cost categories to the total cost of disease varied by disease type, severity, incidence timing, and parity group. For all diseases, the average cost per case of disease increased as milk price, rolling herd average milk production, or replacement heifer price increased and decreased as feed price, pregnancy rate, or slaughter price increased. Understanding how hoof disease costs change according to cow- and herd-specific conditions can help improve on-farm decisions about treatment and prevention of hoof diseases.