Tc-99m pyroph diag per dose up to 25 mci cost in Wisconsin

TC-99M PYROPH DIAG PER DOSE UP TO 25 MCI · HCPCS A9538

$71.82

lowest in Wisconsin

$110.00

state median

$242.33

highest in Wisconsin

$138.50

national median

Hospital	City	Cash price	Negotiated range	Payers
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	$71.82	$79.40 – $79.40	2
Ascension Calumet Hospital, Inc.	Chilton	$87.78	$79.40 – $79.40	2
Aurora Baycare Medical Center	Green Bay	$110.00	$61.49 – $98.00	3
Aurora Medical Center Bay Area	Marinette	$110.00	$61.49 – $98.00	3
Aurora Medical Center Burlington	Burlington	$110.00	$61.49 – $98.00	3
Aurora Medical Center Grafton	Grafton	$110.00	$61.49 – $98.00	3
Aurora Medical Center Manitowoc	Two Rivers	$110.00	$61.49 – $98.00	3
Aurora Medical Center Kenosha	Kenosha	$110.00	$61.49 – $98.00	3
Aurora Medical Center Fond du Lac	Fond Du Lac	$110.00	$61.49 – $98.00	3
Aurora Medical Center Sheboygan County	Sheboygan	$110.00	$61.49 – $98.00	3
Aurora Sinai Medical Center of Aurora Health Care Metro	Milwaukee	$110.00	$61.49 – $98.00	3
Aurora Medical Center Summit	Summit	$110.00	$61.49 – $98.00	3
Aurora Medical Center Washington County	Hartford	$110.00	$61.49 – $98.00	3
Aurora West Allis Medical Center	West Allis	$110.00	$61.49 – $98.00	3
SSM Health Monroe Hospital	Monroe	$121.00	$110.96 – $110.96	1
Midwest Orthopedic Specialty Hospital	Franklin	$134.62	$72.00 – $199.26	2
Ascension St. Francis Hospital, Inc.	Milwaukee	$134.62	$72.00 – $199.26	2
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	$134.62	$72.00 – $199.26	2
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	$157.41	$63.51 – $199.26	7
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	$157.41	$63.51 – $199.26	7
SSM Health St. Mary's Hospital - Janesville	Janesville	$209.55	not published	0
SSM Health St. Clare Hospital - Baraboo	Baraboo	$224.40	not published	0
UnityPoint Health - Meriter Hospital	Madison	$242.33	$25.41 – $174.87	14
SSM Health Ripon Community Hospital	Ripon	not published	$104.79 – $104.79	1
Aurora Psychiatric Hospital	Wauwatosa	not published	$61.49 – $98.00	3
SSM Health Waupun Memorial Hospital	Waupun	not published	$104.79 – $104.79	1
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	not published	$104.79 – $104.79	1