Replace trilateral socket br cost in Wisconsin

Replace trilateral socket br ยท HCPCS L4010

Hospital City Cash price Negotiated range Payers
UnityPoint Health - Meriter Hospital Madison not published $482.78 โ€“ $967.72 8
SSM Health St. Clare Hospital - Baraboo Baraboo not published $740.30 โ€“ $987.07 2
SSM Health St. Agnes Hospital - Fond du Lac Fond Du Lac not published $740.30 โ€“ $1,905.05 4