X-linked intellectual dblt cost in Wisconsin

X-LINKED INTELLECTUAL DBLT · CPT 81471

Hospital	City	Cash price	Negotiated range	Payers
Ascension SE Wisconsin Hospital - St. Joseph Campus	Milwaukee	not published	$914.00 – $2,990.05	14
SSM Health Ripon Community Hospital	Ripon	not published	$914.00 – $1,599.50	4
SSM Health Monroe Hospital	Monroe	not published	$914.00 – $1,599.50	4
Ascension St. Francis Hospital, Inc.	Milwaukee	not published	$914.00 – $2,990.05	14
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.)	Oshkosh	not published	$914.00 – $3,528.04	12
Orthopaedic Hospital of Wisconsin, LLC	Glendale	not published	$886.58 – $943.81	2
UnityPoint Health - Meriter Hospital	Madison	not published	$548.40 – $1,279.68	9
SSM Health St. Mary's Hospital - Madison	Madison	not published	$685.50 – $5,456.72	5
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Milwaukee	not published	$914.00 – $6,990.00	13
Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.)	Mequon	not published	$914.00 – $6,990.00	13
Midwest Orthopedic Specialty Hospital	Franklin	not published	$914.00 – $2,990.05	14
SSM Health St. Mary's Hospital - Janesville	Janesville	not published	$685.50 – $5,335.47	5
SSM Health St. Clare Hospital - Baraboo	Baraboo	not published	$685.50 – $6,669.32	5
Ascension Calumet Hospital, Inc.	Chilton	not published	$959.70 – $3,528.04	7
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.)	Appleton	not published	$914.00 – $3,528.04	12
SSM Health Waupun Memorial Hospital	Waupun	not published	$914.00 – $1,599.50	4
SSM Health St. Agnes Hospital - Fond du Lac	Fond Du Lac	not published	$685.50 – $1,764.02	7