Sio rig pnl pelv/sac pre ots cost in Wisconsin

Sio rig pnl pelv/sac pre ots ยท HCPCS L0623

Hospital City Cash price Negotiated range Payers
UnityPoint Health - Meriter Hospital Madison not published $106.38 โ€“ $135.16 8
SSM Health St. Clare Hospital - Baraboo Baraboo not published $87.31 โ€“ $116.41 2
SSM Health St. Agnes Hospital - Fond du Lac Fond Du Lac not published $87.31 โ€“ $224.67 4