Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr cost in Wisconsin

RIFAMPIN IN NS IV SYRINGE 3 MG/ML (NEO/PED) - CNR · HCPCS J2804

Hospital City Cash price Negotiated range Payers
SSM Health Ripon Community Hospital Ripon not published $0.15 – $0.30 2
SSM Health Monroe Hospital Monroe not published $0.14 – $0.43 5
UnityPoint Health - Meriter Hospital Madison not published $0.16 – $0.16 2
SSM Health St. Mary's Hospital - Madison Madison not published $0.20 – $0.30 2
Aurora West Allis Medical Center West Allis not published $0.14 – $0.14 1
Aurora Medical Center Washington County Hartford not published $0.14 – $0.14 1
Aurora Medical Center Summit Summit not published $0.14 – $0.14 1
Aurora Sinai Medical Center of Aurora Health Care Metro Milwaukee not published $0.14 – $0.14 1
Aurora Psychiatric Hospital Wauwatosa not published $0.14 – $0.14 1
Aurora Medical Center Sheboygan County Sheboygan not published $0.14 – $0.14 1
Aurora Medical Center Fond du Lac Fond Du Lac not published $0.14 – $0.14 1
Aurora Medical Center Kenosha Kenosha not published $0.14 – $0.14 1
Aurora Medical Center Manitowoc Two Rivers not published $0.14 – $0.14 1
Aurora Medical Center Grafton Grafton not published $0.14 – $0.14 1
Aurora Medical Center Burlington Burlington not published $0.14 – $0.14 1
Aurora Baycare Medical Center Green Bay not published $0.14 – $0.14 1
Aurora Medical Center Bay Area Marinette not published $0.14 – $0.14 1
SSM Health St. Mary's Hospital - Janesville Janesville not published $0.20 – $0.30 2
SSM Health St. Clare Hospital - Baraboo Baraboo not published $0.20 – $0.30 2
SSM Health Waupun Memorial Hospital Waupun not published $0.15 – $0.30 2
SSM Health St. Agnes Hospital - Fond du Lac Fond Du Lac not published $0.15 – $0.30 2