Ultrasound trgt dyn mbubb ea addl cost in Wisconsin

US TRGT DYN MBUBB EA ADDL · CPT 76979

Hospital	City	Cash price	Negotiated range	Payers
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	not published	$145.14 – $519.00	2
SSM Health Ripon Community Hospital	Ripon	not published	$603.69 – $603.69	1
SSM Health Monroe Hospital	Monroe	not published	$478.68 – $478.68	1
Ascension St. Francis Hospital, Inc.	Milwaukee	not published	$145.14 – $519.00	2
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	not published	$42.89 – $104.14	6
UnityPoint Health - Meriter Hospital	Madison	not published	$37.52 – $124.19	10
SSM Health St. Mary's Hospital - Madison	Madison	not published	$1,461.48 – $1,461.48	1
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	not published	$66.66 – $140.93	6
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	not published	$66.66 – $140.93	6
Midwest Orthopedic Specialty Hospital	Franklin	not published	$145.14 – $519.00	2
SSM Health St. Mary's Hospital - Janesville	Janesville	not published	$1,392.93 – $1,392.93	1
SSM Health St. Clare Hospital - Baraboo	Baraboo	not published	$1,941.06 – $1,941.06	1
Ascension Calumet Hospital, Inc.	Chilton	not published	$42.89 – $104.14	6
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	not published	$42.89 – $104.14	6
SSM Health Waupun Memorial Hospital	Waupun	not published	$603.69 – $603.69	1
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	not published	$603.69 – $603.69	1