Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution cost in Wisconsin

HUMAN PROTHROMBIN COMPLEX CONCENTRATE (PCC)-LANS 500 UNIT (400-640 UNIT) IV SOLUTION · HCPCS J7165

Hospital City Cash price Negotiated range Payers
SSM Health Ripon Community Hospital Ripon not published $4.90 – $4.90 1
SSM Health Monroe Hospital Monroe not published $1.73 – $10.30 2
UnityPoint Health - Meriter Hospital Madison not published $1.26 – $1.26 8
SSM Health Waupun Memorial Hospital Waupun not published $4.90 – $4.90 1
SSM Health St. Agnes Hospital - Fond du Lac Fond Du Lac not published $1.30 – $4.90 5