Revitalon 1 square cm cost in Wisconsin
Revitalon 1 square cm · HCPCS Q4157
| Hospital | City | Cash price | Negotiated range | Payers |
|---|---|---|---|---|
| SSM Health Ripon Community Hospital | Ripon | not published | $552.40 – $552.40 | 1 |
| SSM Health Monroe Hospital | Monroe | not published | $120.88 – $552.40 | 2 |
| UnityPoint Health - Meriter Hospital | Madison | not published | $202.90 – $202.90 | 1 |
| Aurora West Allis Medical Center | West Allis | not published | $167.65 – $267.20 | 2 |
| Aurora Medical Center Washington County | Hartford | not published | $167.65 – $267.20 | 2 |
| Aurora Medical Center Summit | Summit | not published | $167.65 – $267.20 | 2 |
| Aurora Sinai Medical Center of Aurora Health Care Metro | Milwaukee | not published | $167.65 – $267.20 | 2 |
| Aurora Psychiatric Hospital | Wauwatosa | not published | $167.65 – $267.20 | 2 |
| Aurora Medical Center Sheboygan County | Sheboygan | not published | $167.65 – $267.20 | 2 |
| Aurora Medical Center Fond du Lac | Fond Du Lac | not published | $167.65 – $267.20 | 2 |
| Aurora Medical Center Kenosha | Kenosha | not published | $167.65 – $267.20 | 2 |
| Aurora Medical Center Manitowoc | Two Rivers | not published | $167.65 – $267.20 | 2 |
| Aurora Medical Center Grafton | Grafton | not published | $167.65 – $267.20 | 2 |
| Aurora Medical Center Burlington | Burlington | not published | $167.65 – $267.20 | 2 |
| Aurora Medical Center Bay Area | Marinette | not published | $167.65 – $267.20 | 2 |
| Aurora Baycare Medical Center | Green Bay | not published | $167.65 – $267.20 | 2 |
| SSM Health Waupun Memorial Hospital | Waupun | not published | $552.40 – $552.40 | 1 |
| SSM Health St. Agnes Hospital - Fond du Lac | Fond Du Lac | not published | $92.32 – $552.40 | 5 |