Amniowrap2 per sq cm cost in Wisconsin

Amniowrap2 per sq cm · HCPCS Q4221

Hospital City Cash price Negotiated range Payers
SSM Health Ripon Community Hospital Ripon not published $2,215.40 – $5,229.21 3
SSM Health Monroe Hospital Monroe not published $120.88 – $5,483.12 5
UnityPoint Health - Meriter Hospital Madison not published $1,855.00 – $1,961.00 3
SSM Health St. Mary's Hospital - Madison Madison not published $90.66 – $3,725.90 4
SSM Health St. Mary's Hospital - Janesville Janesville not published $94.01 – $3,725.90 4
SSM Health St. Clare Hospital - Baraboo Baraboo not published $90.66 – $3,725.90 4
SSM Health Waupun Memorial Hospital Waupun not published $2,215.40 – $5,229.21 3
SSM Health St. Agnes Hospital - Fond du Lac Fond Du Lac not published $92.32 – $5,229.21 6