Lso flex no ri stays pre ots cost in Wisconsin

Lso flex no ri stays pre ots ยท HCPCS L0628

Hospital City Cash price Negotiated range Payers
UnityPoint Health - Meriter Hospital Madison not published $50.42 โ€“ $103.89 8
SSM Health St. Clare Hospital - Baraboo Baraboo not published $41.49 โ€“ $55.32 2
SSM Health St. Agnes Hospital - Fond du Lac Fond Du Lac not published $41.49 โ€“ $106.77 4