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Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level cost in Wisconsin

HC Injection(S) Diagnostic/Therapeutic Agent Facet Cervical/Thoracic Single Level · CPT 64490

$1,019.15

lowest in Wisconsin

$1,761.60

state median

$6,508.15

highest in Wisconsin

$1,961.05

national median

Hospital	City	Cash price	Negotiated range	Payers
SSM Health Monroe Hospital	Monroe	$1,019.15	$859.12 – $4,217.00	3
Ascension Calumet Hospital, Inc.	Chilton	$1,344.06	$110.75 – $693.41	7
Midwest Orthopedic Specialty Hospital	Franklin	$1,423.05	$699.45 – $1,210.29	4
Ascension St. Francis Hospital, Inc.	Milwaukee	$1,423.05	$699.45 – $1,210.29	4
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	$1,423.05	$699.45 – $1,210.29	4
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	$1,605.90	$168.30 – $1,906.70	9
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	$1,605.90	$168.30 – $1,906.70	9
UnityPoint Health - Meriter Hospital	Madison	$1,761.60	$96.91 – $323.68	13
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	$2,010.96	$110.75 – $1,797.37	12
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	$2,010.96	$110.75 – $1,797.37	12
SSM Health St. Mary's Hospital - Janesville	Janesville	$4,030.95	$668.17 – $4,074.00	4
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	$4,495.70	$656.13 – $3,030.00	6
SSM Health Waupun Memorial Hospital	Waupun	$4,495.70	$2,654.00 – $3,030.00	3
SSM Health Ripon Community Hospital	Ripon	$4,495.70	$2,654.00 – $3,030.00	3
SSM Health St. Clare Hospital - Baraboo	Baraboo	$4,572.70	$644.34 – $4,401.00	4
SSM Health St. Mary's Hospital - Madison	Madison	$6,508.15	$644.34 – $4,198.00	4
Orthopaedic Hospital of Wisconsin, LLC	Glendale	not published	$743.00 – $16,897.00	6