Clot factor wght kininogen cost in Wisconsin

Clot factor wght kininogen · CPT 85293

Hospital	City	Cash price	Negotiated range	Payers
SSM Health St. Mary's Hospital - Janesville	Janesville	not published	$14.20 – $150.61	5
SSM Health St. Clare Hospital - Baraboo	Baraboo	not published	$14.20 – $188.27	5
UnityPoint Health - Meriter Hospital	Madison	not published	$11.36 – $29.46	9
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	not published	$18.93 – $82.54	16
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	not published	$18.93 – $82.54	16
Ascension Calumet Hospital, Inc.	Chilton	not published	$19.88 – $73.07	11
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	not published	$18.93 – $73.07	16
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	not published	$18.93 – $85.01	17
Ascension St. Francis Hospital, Inc.	Milwaukee	not published	$18.93 – $85.01	17
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	not published	$18.93 – $73.07	16
Midwest Orthopedic Specialty Hospital	Franklin	not published	$18.93 – $85.01	17
SSM Health Waupun Memorial Hospital	Waupun	not published	$18.93 – $38.32	4
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	not published	$14.20 – $36.53	7
SSM Health Ripon Community Hospital	Ripon	not published	$18.93 – $38.32	4
SSM Health Monroe Hospital	Monroe	not published	$18.93 – $33.13	4
Orthopaedic Hospital of Wisconsin, LLC	Glendale	not published	$18.36 – $33.93	5
SSM Health St. Mary's Hospital - Madison	Madison	not published	$14.20 – $154.02	5