Amnio-maxx or lite per sq cm cost in Wisconsin

Amnio-maxx or lite per sq cm · HCPCS Q4239

Hospital City Cash price Negotiated range Payers
SSM Health Ripon Community Hospital Ripon not published $2,584.91 – $6,876.24 3
SSM Health Monroe Hospital Monroe not published $120.88 – $6,397.66 5
UnityPoint Health - Meriter Hospital Madison not published $2,038.50 – $2,385.00 3
SSM Health St. Mary's Hospital - Madison Madison not published $90.66 – $3,873.16 4
SSM Health St. Mary's Hospital - Janesville Janesville not published $94.01 – $3,873.16 4
SSM Health St. Clare Hospital - Baraboo Baraboo not published $90.66 – $3,873.16 4
SSM Health Waupun Memorial Hospital Waupun not published $2,584.91 – $6,876.24 3
SSM Health St. Agnes Hospital - Fond du Lac Fond Du Lac not published $92.32 – $6,876.24 6