Chimerism anal w/cell select cost in Wisconsin

Chimerism anal w/cell select · CPT 81268

Hospital	City	Cash price	Negotiated range	Payers
UnityPoint Health - Meriter Hospital	Madison	not published	$156.47 – $405.69	9
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	not published	$260.79 – $1,137.06	16
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	not published	$260.79 – $1,137.06	16
SSM Health Waupun Memorial Hospital	Waupun	not published	$260.79 – $527.70	4
SSM Health St. Mary's Hospital - Madison	Madison	not published	$195.59 – $2,120.83	5
SSM Health St. Mary's Hospital - Janesville	Janesville	not published	$195.59 – $2,073.72	5
SSM Health St. Clare Hospital - Baraboo	Baraboo	not published	$195.59 – $2,592.14	5
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	not published	$195.59 – $503.32	7
SSM Health Ripon Community Hospital	Ripon	not published	$260.79 – $527.70	4
SSM Health Monroe Hospital	Monroe	not published	$260.79 – $456.38	4
Ascension St. Francis Hospital, Inc.	Milwaukee	not published	$260.79 – $1,171.00	17
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	not published	$260.79 – $1,171.00	17
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	not published	$260.79 – $1,006.65	15
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	not published	$260.79 – $1,006.65	15
Ascension Calumet Hospital, Inc.	Chilton	not published	$273.83 – $1,006.65	10
Midwest Orthopedic Specialty Hospital	Franklin	not published	$260.79 – $1,171.00	17
Orthopaedic Hospital of Wisconsin, LLC	Glendale	not published	$252.97 – $452.94	5