Allograft graftjacket 2x12cm-q4107-cost per sq cm cost in Wisconsin
ALLOGRAFT GRAFTJACKET 2X12CM-Q4107-COST PER SQ CM · HCPCS Q4107
| Hospital | City | Cash price | Negotiated range | Payers |
|---|---|---|---|---|
| SSM Health Waupun Memorial Hospital | Waupun | not published | $371.55 – $371.55 | 1 |
| SSM Health St. Agnes Hospital - Fond du Lac | Fond Du Lac | not published | $92.32 – $371.55 | 5 |
| SSM Health Ripon Community Hospital | Ripon | not published | $371.55 – $371.55 | 1 |
| SSM Health Monroe Hospital | Monroe | not published | $120.88 – $371.55 | 2 |