Adj gastric band via subq port cost in Wisconsin

HC ADJ GASTRIC BAND VIA SUBQ PORT · CPT 43999

Hospital	City	Cash price	Negotiated range	Payers
SSM Health Waupun Memorial Hospital	Waupun	not published	$3,579.00 – $10,779.00	3
SSM Health St. Mary's Hospital - Madison	Madison	not published	$660.74 – $14,021.00	4
SSM Health St. Mary's Hospital - Janesville	Janesville	not published	$685.17 – $13,711.00	4
SSM Health St. Clare Hospital - Baraboo	Baraboo	not published	$660.74 – $14,312.00	4
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	not published	$672.83 – $4,761.00	6
SSM Health Ripon Community Hospital	Ripon	not published	$3,579.00 – $10,779.00	3
SSM Health Monroe Hospital	Monroe	not published	$880.98 – $13,723.00	3
Ascension St. Francis Hospital, Inc.	Milwaukee	not published	$910.39 – $1,274.55	3
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	not published	$910.39 – $1,274.55	3
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	not published	$901.33 – $1,892.79	5
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	not published	$912.70 – $2,007.94	3
Orthopaedic Hospital of Wisconsin, LLC	Glendale	not published	$2,183.00 – $16,897.00	6
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	not published	$901.33 – $1,892.79	5
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	not published	$912.70 – $2,007.94	3
Midwest Orthopedic Specialty Hospital	Franklin	not published	$910.39 – $1,274.55	3
UnityPoint Health - Meriter Hospital	Madison	not published	$905.61 – $19,696.00	8