Membrane amnio clarix 4x3cm 1k -cost per sq cm cost in Wisconsin

MEMBRANE AMNIO CLARIX 4X3CM 1K -COST PER SQ CM · HCPCS Q4155

Hospital City Cash price Negotiated range Payers
SSM Health Ripon Community Hospital Ripon not published $28.94 – $78.19 4
SSM Health Monroe Hospital Monroe not published $26.31 – $78.93 6
UnityPoint Health - Meriter Hospital Madison not published $21.82 – $27.31 3
SSM Health St. Mary's Hospital - Madison Madison not published $31.64 – $53.13 3
SSM Health St. Mary's Hospital - Janesville Janesville not published $38.15 – $53.13 3
SSM Health St. Clare Hospital - Baraboo Baraboo not published $38.15 – $53.13 3
SSM Health Waupun Memorial Hospital Waupun not published $28.94 – $78.19 4
SSM Health St. Agnes Hospital - Fond du Lac Fond Du Lac not published $28.94 – $78.19 4