Bld exchange truj oth thn nb cost in Wisconsin

BLD EXCHANGE TRUJ OTH THN NB · CPT 36455

Hospital	City	Cash price	Negotiated range	Payers
SSM Health Waupun Memorial Hospital	Waupun	not published	$1,887.00 – $2,654.00	3
SSM Health St. Mary's Hospital - Madison	Madison	not published	$321.40 – $4,198.00	4
SSM Health St. Mary's Hospital - Janesville	Janesville	not published	$333.28 – $4,074.00	4
SSM Health St. Clare Hospital - Baraboo	Baraboo	not published	$321.40 – $4,401.00	4
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	not published	$327.28 – $2,334.00	6
SSM Health Ripon Community Hospital	Ripon	not published	$1,887.00 – $2,654.00	3
SSM Health Monroe Hospital	Monroe	not published	$428.53 – $4,217.00	3
Ascension St. Francis Hospital, Inc.	Milwaukee	not published	$424.51 – $594.31	4
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	not published	$424.51 – $594.31	4
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	not published	$121.78 – $882.61	12
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	not published	$187.70 – $936.30	9
Orthopaedic Hospital of Wisconsin, LLC	Glendale	not published	$743.00 – $16,897.00	6
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	not published	$121.78 – $882.61	12
Ascension Calumet Hospital, Inc.	Chilton	not published	$121.78 – $441.90	7
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	not published	$187.70 – $936.30	9
Midwest Orthopedic Specialty Hospital	Franklin	not published	$424.51 – $594.31	4
UnityPoint Health - Meriter Hospital	Madison	not published	$106.08 – $354.31	10