Apply surf ldr radionuclide cost in Wisconsin

Apply surf ldr radionuclide · CPT 77789

Hospital	City	Cash price	Negotiated range	Payers
SSM Health Waupun Memorial Hospital	Waupun	not published	$202.71 – $202.71	1
SSM Health St. Mary's Hospital - Madison	Madison	not published	$74.33 – $495.59	3
SSM Health St. Mary's Hospital - Janesville	Janesville	not published	$77.08 – $472.38	3
SSM Health St. Clare Hospital - Baraboo	Baraboo	not published	$74.33 – $658.24	3
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	not published	$75.69 – $194.77	4
SSM Health Ripon Community Hospital	Ripon	not published	$202.71 – $202.71	1
SSM Health Monroe Hospital	Monroe	not published	$99.11 – $159.48	2
Ascension St. Francis Hospital, Inc.	Milwaukee	not published	$106.33 – $201.38	4
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	not published	$106.33 – $201.38	4
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	not published	$64.53 – $221.07	12
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	not published	$99.23 – $234.52	9
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	not published	$64.53 – $221.07	12
Ascension Calumet Hospital, Inc.	Chilton	not published	$64.53 – $150.19	7
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	not published	$99.23 – $234.52	9
Midwest Orthopedic Specialty Hospital	Franklin	not published	$106.33 – $201.38	4
UnityPoint Health - Meriter Hospital	Madison	not published	$56.81 – $188.04	10