Gi wireless capsule measure cost in Wisconsin

Gi wireless capsule measure · CPT 91112

Hospital	City	Cash price	Negotiated range	Payers
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	not published	$369.27 – $1,274.55	4
SSM Health Ripon Community Hospital	Ripon	not published	$3,579.00 – $4,761.00	2
SSM Health Monroe Hospital	Monroe	not published	$880.98 – $4,137.00	2
Ascension St. Francis Hospital, Inc.	Milwaukee	not published	$369.27 – $1,274.55	4
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	not published	$112.34 – $1,892.79	12
Orthopaedic Hospital of Wisconsin, LLC	Glendale	not published	$2,183.00 – $16,897.00	6
UnityPoint Health - Meriter Hospital	Madison	not published	$97.47 – $418.15	10
SSM Health St. Mary's Hospital - Madison	Madison	not published	$660.74 – $3,863.00	3
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	not published	$172.77 – $2,007.94	9
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	not published	$172.77 – $2,007.94	9
Midwest Orthopedic Specialty Hospital	Franklin	not published	$369.27 – $1,274.55	4
SSM Health St. Mary's Hospital - Janesville	Janesville	not published	$685.17 – $3,232.00	3
SSM Health St. Clare Hospital - Baraboo	Baraboo	not published	$660.74 – $3,179.00	3
Ascension Calumet Hospital, Inc.	Chilton	not published	$112.34 – $364.64	7
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	not published	$112.34 – $1,892.79	12
SSM Health Waupun Memorial Hospital	Waupun	not published	$3,579.00 – $4,761.00	2
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	not published	$672.83 – $4,761.00	6