Ther radiology tx plng smpl cost in Wisconsin

THER RADIOLOGY TX PLNG SMPL · CPT 77261

Hospital	City	Cash price	Negotiated range	Payers
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	not published	$256.02 – $256.02	1
SSM Health Ripon Community Hospital	Ripon	not published	$257.70 – $257.70	1
SSM Health Monroe Hospital	Monroe	not published	$205.44 – $205.44	1
Ascension St. Francis Hospital, Inc.	Milwaukee	not published	$256.02 – $256.02	1
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	not published	$75.50 – $174.15	7
UnityPoint Health - Meriter Hospital	Madison	not published	$66.22 – $219.19	9
SSM Health St. Mary's Hospital - Madison	Madison	not published	$630.09 – $630.09	1
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	not published	$115.74 – $248.60	6
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	not published	$115.74 – $248.60	6
Midwest Orthopedic Specialty Hospital	Franklin	not published	$256.02 – $256.02	1
SSM Health St. Mary's Hospital - Janesville	Janesville	not published	$600.57 – $600.57	1
SSM Health St. Clare Hospital - Baraboo	Baraboo	not published	$836.85 – $836.85	1
Ascension Calumet Hospital, Inc.	Chilton	not published	$75.50 – $174.15	7
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	not published	$75.50 – $174.15	7
SSM Health Waupun Memorial Hospital	Waupun	not published	$257.70 – $257.70	1
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	not published	$257.70 – $257.70	1