Ghs hla-dr/dq, multiple antigens cost in Wisconsin

GHS HLA-DR/DQ, MULTIPLE ANTIGENS · CPT 86817

Hospital	City	Cash price	Negotiated range	Payers
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	not published	$106.14 – $289.21	17
SSM Health Ripon Community Hospital	Ripon	not published	$106.14 – $185.75	4
SSM Health Monroe Hospital	Monroe	not published	$106.14 – $185.75	4
Ascension St. Francis Hospital, Inc.	Milwaukee	not published	$106.14 – $289.21	17
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	not published	$92.09 – $409.70	16
Orthopaedic Hospital of Wisconsin, LLC	Glendale	not published	$90.97 – $115.35	5
UnityPoint Health - Meriter Hospital	Madison	not published	$63.68 – $148.61	9
SSM Health St. Mary's Hospital - Madison	Madison	not published	$79.60 – $523.59	5
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	not published	$106.14 – $332.18	16
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	not published	$106.14 – $332.18	16
Midwest Orthopedic Specialty Hospital	Franklin	not published	$106.14 – $289.21	17
SSM Health St. Mary's Hospital - Janesville	Janesville	not published	$79.60 – $511.95	5
SSM Health St. Clare Hospital - Baraboo	Baraboo	not published	$79.60 – $639.92	5
Ascension Calumet Hospital, Inc.	Chilton	not published	$92.09 – $409.70	11
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	not published	$92.09 – $409.70	16
SSM Health Waupun Memorial Hospital	Waupun	not published	$106.14 – $185.75	4
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	not published	$79.60 – $204.85	7