Tissue amnio epifix inj 100mg cost in Wisconsin

TISSUE AMNIO EPIFIX INJ 100MG · HCPCS Q4145

Hospital City Cash price Negotiated range Payers
SSM Health Ripon Community Hospital Ripon not published $37.01 – $37.01 1
UnityPoint Health - Meriter Hospital Madison not published $18.54 – $21.50 4
SSM Health St. Mary's Hospital - Madison Madison not published $37.01 – $37.01 1
Aurora Medical Center Summit Summit not published $24.00 – $38.25 2
Aurora Psychiatric Hospital Wauwatosa not published $24.00 – $38.25 2
Aurora Medical Center Sheboygan County Sheboygan not published $24.00 – $38.25 2
Aurora Medical Center Burlington Burlington not published $24.00 – $38.25 2
Aurora Medical Center Bay Area Marinette not published $24.00 – $38.25 2
SSM Health St. Mary's Hospital - Janesville Janesville not published $37.01 – $37.01 1
SSM Health St. Clare Hospital - Baraboo Baraboo not published $37.01 – $37.01 1
SSM Health Waupun Memorial Hospital Waupun not published $37.01 – $37.01 1
SSM Health St. Agnes Hospital - Fond du Lac Fond Du Lac not published $37.01 – $37.01 1