Ant sgm img ir flrscn angrph cost in Wisconsin

ANT SGM IMG IR FLRSCN ANGRPH · CPT 92287

Hospital	City	Cash price	Negotiated range	Payers
SSM Health St. Mary's Hospital - Madison	Madison	not published	$96.93 – $129.23	2
SSM Health St. Mary's Hospital - Janesville	Janesville	not published	$100.51 – $134.01	2
SSM Health St. Clare Hospital - Baraboo	Baraboo	not published	$96.93 – $129.23	2
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	not published	$98.70 – $253.99	4
SSM Health Monroe Hospital	Monroe	not published	$129.23 – $129.23	1
Ascension St. Francis Hospital, Inc.	Milwaukee	not published	$125.16 – $175.22	4
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	not published	$125.16 – $175.22	4
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	not published	$31.45 – $260.23	12
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	not published	$59.35 – $276.06	9
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	not published	$31.45 – $260.23	12
Ascension Calumet Hospital, Inc.	Chilton	not published	$31.45 – $157.07	7
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	not published	$59.35 – $276.06	9
Midwest Orthopedic Specialty Hospital	Franklin	not published	$125.16 – $175.22	4
UnityPoint Health - Meriter Hospital	Madison	not published	$22.02 – $94.47	10