Ak sleeve susp neoprene/equa cost in Wisconsin

Ak sleeve susp neoprene/equa ยท HCPCS L5695

Hospital City Cash price Negotiated range Payers
UnityPoint Health - Meriter Hospital Madison not published $97.65 โ€“ $202.19 8
SSM Health St. Clare Hospital - Baraboo Baraboo not published $149.74 โ€“ $199.65 2
SSM Health St. Agnes Hospital - Fond du Lac Fond Du Lac not published $149.74 โ€“ $385.32 4