Unlisted fetal invas px w/us cost in Wisconsin

UNLISTED FETAL INVAS PX W/US · CPT 59897

Hospital	City	Cash price	Negotiated range	Payers
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	not published	$195.34 – $273.48	3
SSM Health Ripon Community Hospital	Ripon	not published	$1,887.00 – $2,654.00	3
SSM Health Monroe Hospital	Monroe	not published	$196.38 – $4,217.00	3
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	not published	$193.40 – $406.14	5
Orthopaedic Hospital of Wisconsin, LLC	Glendale	not published	$743.00 – $16,897.00	6
UnityPoint Health - Meriter Hospital	Madison	not published	$194.31 – $3,937.00	8
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	not published	$195.83 – $430.83	3
SSM Health St. Mary's Hospital - Madison	Madison	not published	$147.28 – $4,198.00	4
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	not published	$195.83 – $430.83	3
Midwest Orthopedic Specialty Hospital	Franklin	not published	$195.34 – $273.48	3
SSM Health St. Mary's Hospital - Janesville	Janesville	not published	$152.73 – $4,074.00	4
SSM Health St. Clare Hospital - Baraboo	Baraboo	not published	$147.28 – $4,401.00	4
Ascension St. Francis Hospital, Inc.	Milwaukee	not published	$195.34 – $273.48	3
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	not published	$193.40 – $406.14	5
SSM Health Waupun Memorial Hospital	Waupun	not published	$1,887.00 – $2,654.00	3
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	not published	$149.98 – $2,334.00	6