Bhv id assmt by phys/qhp cost in Wisconsin

BHV ID ASSMT BY PHYS/QHP · CPT 97151

Hospital	City	Cash price	Negotiated range	Payers
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	not published	$89.82 – $152.73	4
SSM Health Monroe Hospital	Monroe	not published	$98.68 – $98.68	1
Ascension St. Francis Hospital, Inc.	Milwaukee	not published	$89.82 – $152.73	4
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	not published	$88.93 – $186.75	5
UnityPoint Health - Meriter Hospital	Madison	not published	$36.14 – $89.35	8
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	not published	$68.00 – $198.11	8
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	not published	$68.00 – $198.11	8
Midwest Orthopedic Specialty Hospital	Franklin	not published	$89.82 – $152.73	4
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	not published	$88.93 – $186.75	5
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	not published	$75.36 – $193.93	4