Tc-99m exametazime diag cost in Wisconsin
TC-99M EXAMETAZIME DIAG · HCPCS A9521
$717.20
lowest in Wisconsin
$1,515.00
state median
$3,733.85
highest in Wisconsin
$2,033.20
national median
| Hospital | City | Cash price | Negotiated range | Payers |
|---|---|---|---|---|
| SSM Health St. Agnes Hospital - Fond du Lac | Fond Du Lac | $717.20 | $2,184.37 – $2,184.37 | 1 |
| SSM Health Waupun Memorial Hospital | Waupun | $717.20 | $2,184.37 – $2,184.37 | 1 |
| SSM Health Ripon Community Hospital | Ripon | $717.20 | $2,184.37 – $2,184.37 | 1 |
| SSM Health St. Mary's Hospital - Madison | Madison | $939.95 | not published | 0 |
| Aurora Baycare Medical Center | Green Bay | $1,515.00 | $802.34 – $2,622.38 | 4 |
| Aurora Medical Center Bay Area | Marinette | $1,515.00 | $802.34 – $2,622.38 | 4 |
| Aurora Medical Center Grafton | Grafton | $1,515.00 | $802.34 – $2,622.38 | 4 |
| Aurora Medical Center Manitowoc | Two Rivers | $1,515.00 | $802.34 – $2,622.38 | 4 |
| Aurora Medical Center Kenosha | Kenosha | $1,515.00 | $802.34 – $2,622.38 | 4 |
| Aurora Medical Center Fond du Lac | Fond Du Lac | $1,515.00 | $802.34 – $2,622.38 | 4 |
| Aurora Sinai Medical Center of Aurora Health Care Metro | Milwaukee | $1,515.00 | $802.34 – $2,622.38 | 4 |
| Aurora Medical Center Summit | Summit | $1,515.00 | $802.34 – $2,622.38 | 4 |
| Aurora Medical Center Washington County | Hartford | $1,515.00 | $802.34 – $2,622.38 | 4 |
| Aurora West Allis Medical Center | West Allis | $1,515.00 | $802.34 – $2,622.38 | 4 |
| UnityPoint Health - Meriter Hospital | Madison | $2,923.64 | $802.34 – $1,333.91 | 14 |
| Midwest Orthopedic Specialty Hospital | Franklin | $3,200.67 | $2,380.20 – $5,332.16 | 2 |
| Ascension St. Francis Hospital, Inc. | Milwaukee | $3,200.67 | $2,380.20 – $5,332.16 | 2 |
| Ascension SE Wisconsin Hospital - St. Joseph Campus | Milwaukee | $3,200.67 | $2,380.20 – $5,332.16 | 2 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon | $3,733.85 | $1,323.86 – $4,937.19 | 7 |
| Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Milwaukee | $3,733.85 | $1,323.86 – $4,937.19 | 7 |
| SSM Health Monroe Hospital | Monroe | not published | $2,184.37 – $2,184.37 | 1 |
| Aurora Psychiatric Hospital | Wauwatosa | not published | $802.34 – $2,622.38 | 4 |
| Aurora Medical Center Sheboygan County | Sheboygan | not published | $802.34 – $2,622.38 | 4 |
| Aurora Medical Center Burlington | Burlington | not published | $802.34 – $2,622.38 | 4 |