Cerv sr wire occ/man pre ots cost in Wisconsin

Cerv sr wire occ/man pre ots ยท HCPCS L0160

Hospital City Cash price Negotiated range Payers
UnityPoint Health - Meriter Hospital Madison not published $93.95 โ€“ $202.65 8
SSM Health St. Clare Hospital - Baraboo Baraboo not published $144.06 โ€“ $192.08 2
SSM Health St. Agnes Hospital - Fond du Lac Fond Du Lac not published $144.06 โ€“ $370.71 4