Nrv grf 1strnd hnd/foot <4cm cost in Wisconsin
NRV GRF 1STRND HND/FOOT <4CM · CPT 64890
| Hospital | City | Cash price | Negotiated range | Payers |
|---|---|---|---|---|
| Ascension SE Wisconsin Hospital - St. Joseph Campus | Milwaukee | not published | $4,015.98 – $4,015.98 | 1 |
| SSM Health Ripon Community Hospital | Ripon | not published | $4,428.00 – $16,106.00 | 3 |
| SSM Health Monroe Hospital | Monroe | not published | $8,524.27 – $15,012.00 | 3 |
| Ascension St. Francis Hospital, Inc. | Milwaukee | not published | $4,015.98 – $4,015.98 | 1 |
| Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.) | Oshkosh | not published | $1,106.11 – $3,851.14 | 7 |
| Orthopaedic Hospital of Wisconsin, LLC | Glendale | not published | $2,302.00 – $16,897.00 | 6 |
| UnityPoint Health - Meriter Hospital | Madison | not published | $968.12 – $3,233.52 | 10 |
| Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Milwaukee | not published | $1,693.03 – $4,210.58 | 6 |
| SSM Health St. Mary's Hospital - Madison | Madison | not published | $6,393.20 – $16,624.00 | 4 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | not published | $1,693.03 – $4,210.58 | 6 |
| Midwest Orthopedic Specialty Hospital | Franklin | not published | $4,015.98 – $4,015.98 | 1 |
| SSM Health St. Mary's Hospital - Janesville | Janesville | not published | $6,629.63 – $14,543.00 | 4 |
| SSM Health St. Clare Hospital - Baraboo | Baraboo | not published | $6,393.20 – $14,304.00 | 4 |
| Ascension Calumet Hospital, Inc. | Chilton | not published | $1,106.11 – $3,851.14 | 7 |
| Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.) | Appleton | not published | $1,106.11 – $3,851.14 | 7 |
| SSM Health Waupun Memorial Hospital | Waupun | not published | $4,428.00 – $16,106.00 | 3 |
| SSM Health St. Agnes Hospital - Fond du Lac | Fond Du Lac | not published | $4,428.00 – $16,752.93 | 6 |