Dx dark adaptation exam i&r cost in Wisconsin

DX DARK ADAPTATION EXAM I&R · CPT 92284

Hospital	City	Cash price	Negotiated range	Payers
SSM Health Monroe Hospital	Monroe	not published	$433.92 – $433.92	1
UnityPoint Health - Meriter Hospital	Madison	not published	$23.32 – $119.99	10
SSM Health St. Mary's Hospital - Madison	Madison	not published	$325.44 – $433.92	2
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	not published	$75.16 – $854.61	9
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	not published	$75.16 – $854.61	9
Ascension Calumet Hospital, Inc.	Chilton	not published	$25.21 – $42.42	7
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	not published	$25.21 – $805.60	12
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	not published	$198.12 – $542.47	4
SSM Health St. Clare Hospital - Baraboo	Baraboo	not published	$325.44 – $433.92	2
Ascension St. Francis Hospital, Inc.	Milwaukee	not published	$198.12 – $542.47	4
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	not published	$25.21 – $805.60	12
Midwest Orthopedic Specialty Hospital	Franklin	not published	$198.12 – $542.47	4
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	not published	$331.39 – $852.79	4