Ortho sidebar disconnect cost in Wisconsin

Ortho sidebar disconnect ยท HCPCS L2768

Hospital City Cash price Negotiated range Payers
UnityPoint Health - Meriter Hospital Madison not published $78.31 โ€“ $161.38 8
SSM Health St. Clare Hospital - Baraboo Baraboo not published $120.08 โ€“ $160.11 2
SSM Health St. Agnes Hospital - Fond du Lac Fond Du Lac not published $120.08 โ€“ $309.01 4