Ther radiology tx plng intrm cost in Wisconsin

THER RADIOLOGY TX PLNG INTRM · CPT 77262

Hospital	City	Cash price	Negotiated range	Payers
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	not published	$382.26 – $382.26	1
SSM Health Ripon Community Hospital	Ripon	not published	$384.77 – $384.77	1
SSM Health Monroe Hospital	Monroe	not published	$305.29 – $305.29	1
Ascension St. Francis Hospital, Inc.	Milwaukee	not published	$382.26 – $382.26	1
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	not published	$115.42 – $264.29	7
UnityPoint Health - Meriter Hospital	Madison	not published	$101.68 – $336.56	9
SSM Health St. Mary's Hospital - Madison	Madison	not published	$940.83 – $940.83	1
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	not published	$176.31 – $371.18	6
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	not published	$176.31 – $371.18	6
Midwest Orthopedic Specialty Hospital	Franklin	not published	$382.26 – $382.26	1
SSM Health St. Mary's Hospital - Janesville	Janesville	not published	$896.71 – $896.71	1
SSM Health St. Clare Hospital - Baraboo	Baraboo	not published	$1,249.50 – $1,249.50	1
Ascension Calumet Hospital, Inc.	Chilton	not published	$115.42 – $264.29	7
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	not published	$115.42 – $264.29	7
SSM Health Waupun Memorial Hospital	Waupun	not published	$384.77 – $384.77	1
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	not published	$384.77 – $384.77	1