Pdt dstr prmlg les phys/qhp cost in Wisconsin

Pdt dstr prmlg les phys/qhp · CPT 96573

Hospital	City	Cash price	Negotiated range	Payers
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	not published	$192.94 – $625.92	4
SSM Health Ripon Community Hospital	Ripon	not published	$1,887.00 – $2,334.00	2
SSM Health Monroe Hospital	Monroe	not published	$194.88 – $2,181.00	2
Ascension St. Francis Hospital, Inc.	Milwaukee	not published	$192.94 – $625.92	4
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	not published	$191.02 – $699.49	11
Orthopaedic Hospital of Wisconsin, LLC	Glendale	not published	$949.00 – $16,897.00	6
UnityPoint Health - Meriter Hospital	Madison	not published	$191.93 – $874.95	10
SSM Health St. Mary's Hospital - Madison	Madison	not published	$146.16 – $2,036.00	3
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	not published	$193.43 – $765.72	9
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	not published	$193.43 – $765.72	9
Midwest Orthopedic Specialty Hospital	Franklin	not published	$192.94 – $625.92	4
SSM Health St. Mary's Hospital - Janesville	Janesville	not published	$151.57 – $1,704.00	3
SSM Health St. Clare Hospital - Baraboo	Baraboo	not published	$146.16 – $1,676.00	3
Ascension Calumet Hospital, Inc.	Chilton	not published	$242.92 – $699.49	6
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	not published	$191.02 – $699.49	11
SSM Health Waupun Memorial Hospital	Waupun	not published	$1,887.00 – $2,334.00	2
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	not published	$148.84 – $2,334.00	6