Inc&subq plmt crnl bone grf cost in Wisconsin

INC&SUBQ PLMT CRNL BONE GRF · CPT 61316

Hospital	City	Cash price	Negotiated range	Payers
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	not published	$311.83 – $311.83	1
SSM Health Ripon Community Hospital	Ripon	not published	$6,779.00 – $6,779.00	1
SSM Health Monroe Hospital	Monroe	not published	$14,758.00 – $14,758.00	1
Ascension St. Francis Hospital, Inc.	Milwaukee	not published	$311.83 – $311.83	1
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	not published	$82.76 – $292.54	7
Orthopaedic Hospital of Wisconsin, LLC	Glendale	not published	$2,302.00 – $20,066.00	6
UnityPoint Health - Meriter Hospital	Madison	not published	$72.22 – $241.21	10
SSM Health St. Mary's Hospital - Madison	Madison	not published	$19,855.00 – $19,855.00	1
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	not published	$126.87 – $319.84	6
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	not published	$126.87 – $319.84	6
Midwest Orthopedic Specialty Hospital	Franklin	not published	$311.83 – $311.83	1
SSM Health St. Mary's Hospital - Janesville	Janesville	not published	$18,190.00 – $18,190.00	1
SSM Health St. Clare Hospital - Baraboo	Baraboo	not published	$20,477.00 – $20,477.00	1
Ascension Calumet Hospital, Inc.	Chilton	not published	$82.76 – $292.54	7
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	not published	$82.76 – $292.54	7
SSM Health Waupun Memorial Hospital	Waupun	not published	$6,779.00 – $6,779.00	1
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	not published	$6,779.00 – $6,779.00	1