O shoe convert to sof counte cost in Wisconsin

O shoe convert to sof counte ยท HCPCS L3590

Hospital City Cash price Negotiated range Payers
UnityPoint Health - Meriter Hospital Madison not published $32.11 โ€“ $66.16 8
SSM Health St. Clare Hospital - Baraboo Baraboo not published $49.24 โ€“ $65.66 2
SSM Health St. Agnes Hospital - Fond du Lac Fond Du Lac not published $49.24 โ€“ $126.72 4