Allograft amnioexcel plus 17mm disk cost in Wisconsin

HC ALLOGRAFT AMNIOEXCEL PLUS 17MM DISK · HCPCS Q4137

Hospital City Cash price Negotiated range Payers
SSM Health Waupun Memorial Hospital Waupun not published $112.40 – $317.66 4
SSM Health St. Mary's Hospital - Madison Madison not published $90.66 – $215.86 5
SSM Health St. Mary's Hospital - Janesville Janesville not published $94.01 – $215.86 5
SSM Health St. Clare Hospital - Baraboo Baraboo not published $90.66 – $215.86 5
SSM Health St. Agnes Hospital - Fond du Lac Fond Du Lac not published $92.32 – $317.66 7
SSM Health Ripon Community Hospital Ripon not published $112.40 – $317.66 4
SSM Health Monroe Hospital Monroe not published $102.18 – $278.19 6