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Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm cost in Wisconsin

DRSG OASIS BURN WOUND MATRIX 3X3.5CM 10.5SQCM-Q4103-COST PER SQ CM · HCPCS Q4103

$822.03

lowest in Wisconsin

$1,459.20

state median

$2,055.61

highest in Wisconsin

$2,567.36

national median

Hospital	City	Cash price	Negotiated range	Payers
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	$822.03	$14.79 – $39.62	10
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	$1,357.71	$14.79 – $39.62	10
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	$1,459.20	$17.67 – $1,400.00	7
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	$1,459.20	$17.67 – $1,400.00	7
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	$2,055.61	$14.79 – $234.78	7
SSM Health St. Mary's Hospital - Janesville	Janesville	not published	$18.17 – $125.35	5
SSM Health St. Clare Hospital - Baraboo	Baraboo	not published	$18.17 – $120.88	5
UnityPoint Health - Meriter Hospital	Madison	not published	$8.64 – $12.38	4
SSM Health Waupun Memorial Hospital	Waupun	not published	$13.78 – $33.97	4
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	not published	$13.78 – $237.56	7
SSM Health Ripon Community Hospital	Ripon	not published	$13.78 – $33.97	4
SSM Health Monroe Hospital	Monroe	not published	$12.53 – $37.59	6
SSM Health St. Mary's Hospital - Madison	Madison	not published	$17.93 – $120.88	5