Excl laa opn oth px any meth 33268 cost in Wisconsin

Excl laa opn oth px any meth 33268 · CPT 33268

Hospital	City	Cash price	Negotiated range	Payers
SSM Health St. Mary's Hospital - Janesville	Janesville	not published	$13,711.00 – $13,711.00	1
SSM Health St. Clare Hospital - Baraboo	Baraboo	not published	$14,312.00 – $14,312.00	1
UnityPoint Health - Meriter Hospital	Madison	not published	$109.27 – $364.96	10
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	not published	$195.74 – $505.20	6
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	not published	$195.74 – $505.20	6
Ascension Calumet Hospital, Inc.	Chilton	not published	$125.46 – $462.08	6
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	not published	$125.46 – $462.08	6
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	not published	$475.46 – $475.46	1
Ascension St. Francis Hospital, Inc.	Milwaukee	not published	$475.46 – $475.46	1
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	not published	$125.46 – $462.08	6
Midwest Orthopedic Specialty Hospital	Franklin	not published	$475.46 – $475.46	1
SSM Health Waupun Memorial Hospital	Waupun	not published	$8,923.00 – $8,923.00	1
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	not published	$8,923.00 – $8,923.00	1
SSM Health Ripon Community Hospital	Ripon	not published	$8,923.00 – $8,923.00	1
SSM Health Monroe Hospital	Monroe	not published	$13,352.00 – $13,352.00	1
SSM Health St. Mary's Hospital - Madison	Madison	not published	$14,021.00 – $14,021.00	1