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Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level cost in Wisconsin

HC Injection(S) Diagnostic/Therapeutic Agent Facet Lumbar/Sacral Single Level · CPT 64493

$1,340.07

lowest in Wisconsin

$2,005.52

state median

$5,979.52

highest in Wisconsin

$2,154.68

national median

Hospital	City	Cash price	Negotiated range	Payers
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	$1,340.07	$95.27 – $1,797.37	12
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	$1,340.07	$95.27 – $1,797.37	12
Ascension Calumet Hospital, Inc.	Chilton	$1,344.06	$95.27 – $632.63	7
Midwest Orthopedic Specialty Hospital	Franklin	$1,453.79	$634.88 – $1,210.29	4
Ascension St. Francis Hospital, Inc.	Milwaukee	$1,453.79	$634.88 – $1,210.29	4
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	$1,453.79	$634.88 – $1,210.29	4
SSM Health St. Clare Hospital - Baraboo	Baraboo	$1,925.00	$644.34 – $4,401.00	4
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	$2,005.52	$144.28 – $1,906.70	9
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	$2,005.52	$144.28 – $1,906.70	9
SSM Health Monroe Hospital	Monroe	$2,298.45	$859.12 – $4,217.00	3
SSM Health St. Mary's Hospital - Janesville	Janesville	$2,417.25	$668.17 – $4,074.00	4
SSM Health St. Mary's Hospital - Madison	Madison	$3,083.85	$644.34 – $4,198.00	4
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	$4,495.70	$656.13 – $3,030.00	7
SSM Health Waupun Memorial Hospital	Waupun	$4,495.70	$1,221.00 – $3,030.00	4
SSM Health Ripon Community Hospital	Ripon	$4,495.70	$1,221.00 – $3,030.00	4
UnityPoint Health - Meriter Hospital	Madison	$5,979.52	$83.38 – $2,332.01	14
Orthopaedic Hospital of Wisconsin, LLC	Glendale	not published	$743.00 – $16,897.00	6