Aminolevulinic acid, 10% gel cost in Wisconsin

Aminolevulinic acid, 10% gel · HCPCS J7345

Hospital City Cash price Negotiated range Payers
SSM Health Waupun Memorial Hospital Waupun not published $1.86 – $4.69 5
SSM Health St. Mary's Hospital - Madison Madison not published $1.39 – $3.44 5
SSM Health St. Mary's Hospital - Janesville Janesville not published $1.39 – $3.44 5
SSM Health St. Clare Hospital - Baraboo Baraboo not published $1.39 – $3.44 5
SSM Health St. Agnes Hospital - Fond du Lac Fond Du Lac not published $1.39 – $4.69 8
SSM Health Ripon Community Hospital Ripon not published $1.86 – $4.69 5
SSM Health Monroe Hospital Monroe not published $1.78 – $4.85 6