Inj lwr xtr fscl pln blk uni w/wo image cost in Wisconsin
HC INJ LWR XTR FSCL PLN BLK UNI W/WO IMAGE · CPT 64473
$622.40
lowest in Wisconsin
$3,866.50
state median
$3,866.50
highest in Wisconsin
$625.00
national median
| Hospital | City | Cash price | Negotiated range | Payers |
|---|---|---|---|---|
| UnityPoint Health - Meriter Hospital | Madison | $622.40 | $47.84 – $179.39 | 12 |
| SSM Health St. Agnes Hospital - Fond du Lac | Fond Du Lac | $3,866.50 | not published | 0 |
| SSM Health Waupun Memorial Hospital | Waupun | $3,866.50 | not published | 0 |
| SSM Health Ripon Community Hospital | Ripon | $3,866.50 | not published | 0 |
| Ascension SE Wisconsin Hospital - St. Joseph Campus | Milwaukee | not published | $398.85 – $398.85 | 1 |
| Ascension St. Francis Hospital, Inc. | Milwaukee | not published | $398.85 – $398.85 | 1 |
| Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Milwaukee | not published | $489.54 – $489.54 | 1 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | not published | $489.54 – $489.54 | 1 |
| Midwest Orthopedic Specialty Hospital | Franklin | not published | $398.85 – $398.85 | 1 |