Membrane amniotic barrier 4x4cm-q4163-cost per sq cm cost in Wisconsin
MEMBRANE AMNIOTIC BARRIER 4X4CM-Q4163-COST PER SQ CM · HCPCS Q4163
| Hospital | City | Cash price | Negotiated range | Payers |
|---|---|---|---|---|
| SSM Health Ripon Community Hospital | Ripon | not published | $200.40 – $495.99 | 4 |
| SSM Health Monroe Hospital | Monroe | not published | $120.88 – $495.99 | 6 |
| UnityPoint Health - Meriter Hospital | Madison | not published | $181.01 – $276.46 | 4 |
| SSM Health St. Mary's Hospital - Madison | Madison | not published | $18.96 – $346.14 | 5 |
| SSM Health St. Mary's Hospital - Janesville | Janesville | not published | $94.01 – $346.14 | 5 |
| SSM Health St. Clare Hospital - Baraboo | Baraboo | not published | $90.66 – $346.14 | 5 |
| SSM Health Waupun Memorial Hospital | Waupun | not published | $200.40 – $495.99 | 4 |
| SSM Health St. Agnes Hospital - Fond du Lac | Fond Du Lac | not published | $92.32 – $495.99 | 7 |