Pml/raralpha 1 breakpoint cost in Wisconsin

Pml/raralpha 1 breakpoint · CPT 81316

Hospital	City	Cash price	Negotiated range	Payers
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	not published	$207.31 – $1,418.88	17
SSM Health Ripon Community Hospital	Ripon	not published	$207.31 – $639.85	4
SSM Health Monroe Hospital	Monroe	not published	$207.31 – $362.79	4
Ascension St. Francis Hospital, Inc.	Milwaukee	not published	$207.31 – $1,418.88	17
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	not published	$207.31 – $800.22	15
Orthopaedic Hospital of Wisconsin, LLC	Glendale	not published	$201.09 – $549.20	5
UnityPoint Health - Meriter Hospital	Madison	not published	$124.39 – $322.50	9
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	not published	$207.31 – $1,377.75	16
SSM Health St. Mary's Hospital - Madison	Madison	not published	$155.48 – $2,571.59	5
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	not published	$207.31 – $1,377.75	16
Midwest Orthopedic Specialty Hospital	Franklin	not published	$207.31 – $1,418.88	17
SSM Health St. Mary's Hospital - Janesville	Janesville	not published	$155.48 – $2,514.45	5
SSM Health St. Clare Hospital - Baraboo	Baraboo	not published	$155.48 – $3,143.05	5
Ascension Calumet Hospital, Inc.	Chilton	not published	$217.68 – $800.22	10
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	not published	$207.31 – $800.22	15
SSM Health Waupun Memorial Hospital	Waupun	not published	$207.31 – $639.85	4
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	not published	$155.48 – $400.11	7