Proph rta dtchmnt crtx dthrm cost in Wisconsin

PROPH RTA DTCHMNT CRTX DTHRM · CPT 67141

Hospital	City	Cash price	Negotiated range	Payers
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	not published	$290.27 – $1,908.83	4
SSM Health Ripon Community Hospital	Ripon	not published	$1,887.00 – $2,654.00	3
SSM Health Monroe Hospital	Monroe	not published	$308.31 – $4,217.00	3
Ascension St. Francis Hospital, Inc.	Milwaukee	not published	$290.27 – $1,908.83	4
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	not published	$229.52 – $1,910.66	12
Orthopaedic Hospital of Wisconsin, LLC	Glendale	not published	$743.00 – $16,897.00	6
UnityPoint Health - Meriter Hospital	Madison	not published	$198.20 – $888.18	10
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	not published	$291.00 – $2,088.99	9
SSM Health St. Mary's Hospital - Madison	Madison	not published	$231.23 – $4,198.00	4
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	not published	$291.00 – $2,088.99	9
Midwest Orthopedic Specialty Hospital	Franklin	not published	$290.27 – $1,908.83	4
SSM Health St. Mary's Hospital - Janesville	Janesville	not published	$239.78 – $4,074.00	4
SSM Health St. Clare Hospital - Baraboo	Baraboo	not published	$231.23 – $4,401.00	4
Ascension Calumet Hospital, Inc.	Chilton	not published	$229.52 – $1,910.66	7
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	not published	$229.52 – $1,910.66	12
SSM Health Waupun Memorial Hospital	Waupun	not published	$1,887.00 – $2,654.00	3
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	not published	$235.46 – $2,334.00	6