Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % cost in Wisconsin
HC SPLIT ATOGRFT F/S/N/H/F/G/M/D GT 1ST 100SQCM/</1 % · CPT 15120
$4,228.62
lowest in Wisconsin
$4,228.62
state median
$4,768.80
highest in Wisconsin
$4,619.65
national median
| Hospital | City | Cash price | Negotiated range | Payers |
|---|---|---|---|---|
| HSHS St. Vincent Hospital | Green Bay | $4,228.62 | $113.00 – $7,744.80 | 14 |
| HSHS St. Clare Memorial Hospital | OCONTO FALLS | $4,228.62 | $95.40 – $3,620.48 | 13 |
| UnityPoint Health - Meriter Hospital | Madison | $4,768.80 | $548.32 – $2,095.05 | 13 |
| HSHS St. Mary's Hospital Medical Center | GREEN BAY | not published | not published | 0 |
| Ascension SE Wisconsin Hospital - St. Joseph Campus | Milwaukee | not published | $3,089.71 – $3,089.71 | 1 |
| SSM Health Ripon Community Hospital | Ripon | not published | $3,735.00 – $8,770.00 | 3 |
| SSM Health Monroe Hospital | Monroe | not published | $3,442.14 – $10,137.00 | 3 |
| Ascension St. Francis Hospital, Inc. | Milwaukee | not published | $3,089.71 – $3,089.71 | 1 |
| Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.) | Oshkosh | not published | $716.92 – $3,062.10 | 7 |
| Orthopaedic Hospital of Wisconsin, LLC | Glendale | not published | $2,302.00 – $16,897.00 | 6 |
| Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Milwaukee | not published | $1,094.71 – $3,347.90 | 6 |
| SSM Health St. Mary's Hospital - Madison | Madison | not published | $2,581.60 – $9,052.00 | 4 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | not published | $1,094.71 – $3,347.90 | 6 |
| Midwest Orthopedic Specialty Hospital | Franklin | not published | $3,089.71 – $3,089.71 | 1 |
| SSM Health St. Mary's Hospital - Janesville | Janesville | not published | $2,677.07 – $10,498.00 | 4 |
| SSM Health St. Clare Hospital - Baraboo | Baraboo | not published | $2,581.60 – $11,257.00 | 4 |
| Ascension Calumet Hospital, Inc. | Chilton | not published | $716.92 – $3,062.10 | 7 |
| Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.) | Appleton | not published | $716.92 – $3,062.10 | 7 |
| SSM Health Waupun Memorial Hospital | Waupun | not published | $3,735.00 – $8,770.00 | 3 |
| SSM Health St. Agnes Hospital - Fond du Lac | Fond Du Lac | not published | $2,628.85 – $8,770.00 | 6 |