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Ghs nerve blk intercostal, ea addtl level cost in Wisconsin

GHS NERVE BLK INTERCOSTAL, EA ADDTL LEVEL · CPT 64421

$518.87

lowest in Wisconsin

$866.25

state median

$2,605.06

highest in Wisconsin

$1,618.50

national median

Hospital	City	Cash price	Negotiated range	Payers
Midwest Orthopedic Specialty Hospital	Franklin	$518.87	$555.43 – $1,210.29	4
Ascension St. Francis Hospital, Inc.	Milwaukee	$518.87	$555.43 – $1,210.29	4
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	$518.87	$555.43 – $1,210.29	4
SSM Health Monroe Hospital	Monroe	$552.20	$859.12 – $4,217.00	3
SSM Health St. Mary's Hospital - Janesville	Janesville	$619.85	$668.17 – $4,074.00	4
Ascension Calumet Hospital, Inc.	Chilton	$657.21	$26.04 – $345.18	7
SSM Health St. Mary's Hospital - Madison	Madison	$685.30	$644.34 – $4,198.00	4
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	$866.25	$656.13 – $3,030.00	6
SSM Health Waupun Memorial Hospital	Waupun	$866.25	$2,654.00 – $3,030.00	3
SSM Health Ripon Community Hospital	Ripon	$866.25	$2,654.00 – $3,030.00	3
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	$1,026.00	$26.04 – $1,797.37	12
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	$1,026.00	$26.04 – $1,797.37	12
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	$2,236.60	$39.37 – $1,906.70	9
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	$2,236.60	$39.37 – $1,906.70	9
UnityPoint Health - Meriter Hospital	Madison	$2,605.06	$22.48 – $1,015.97	14
Orthopaedic Hospital of Wisconsin, LLC	Glendale	not published	$743.00 – $16,897.00	6
SSM Health St. Clare Hospital - Baraboo	Baraboo	not published	$644.34 – $4,401.00	4