healthcosts.net

Ot evaluation low complexity patient/family cost in Wisconsin

HC Ot Evaluation Low Complexity Patient/Family · CPT 97165

$113.85

lowest in Wisconsin

$153.33

state median

$478.39

highest in Wisconsin

$238.00

national median

Hospital	City	Cash price	Negotiated range	Payers
SSM Health Waupun Memorial Hospital	Waupun	$113.85	not published	0
SSM Health Ripon Community Hospital	Ripon	$113.85	not published	0
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	$113.85	$73.70 – $189.64	4
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	$127.73	$97.60 – $251.33	9
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	$127.73	$97.60 – $251.33	9
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	$153.33	$97.60 – $204.96	11
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	$153.33	$97.60 – $204.96	11
SSM Health St. Mary's Hospital - Janesville	Janesville	$157.30	not published	0
SSM Health St. Clare Hospital - Baraboo	Baraboo	$160.60	$73.70 – $98.26	2
SSM Health Monroe Hospital	Monroe	$200.75	$98.26 – $98.26	1
SSM Health St. Mary's Hospital - Madison	Madison	$204.60	$73.70 – $98.26	2
Ascension Calumet Hospital, Inc.	Chilton	$222.30	$110.00 – $110.91	6
Adventhealth Durand	Durand	$272.32	not published	0
UnityPoint Health - Meriter Hospital	Madison	$478.39	$89.44 – $290.85	14
Ascension St. Francis Hospital, Inc.	Milwaukee	not published	$97.60 – $258.94	4
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	not published	$97.60 – $258.94	4
Midwest Orthopedic Specialty Hospital	Franklin	not published	$97.60 – $258.94	4