Reported by 18 hospitals in the network.
Filter by billing methodology
Low
$19
Average
$121
Median
$57
High
$520
| # | Hospital | Location | Approximate number of payer billing records behind this hospital’s price. CMS privacy rules cap small counts as a range (e.g. “1–10”) rather than an exact number — more samples means a more reliable price. | |||||
|---|---|---|---|---|---|---|---|---|
| 1 | Gundersen Luthern Medical Center Inc | La Crosse, WI | $520 | $520 | $13 | — | $507 | $533 |
| 2 | Gundersen Palmer Lutheran Hospital and Clinic Inc | West Union, IA | $133 | $133 | — | — | $133 | $133 |
| 3 | Saint Elizabeth’s Hospital of Wabasha Inc | Wabasha, MN | $133 | $133 | — | — | $133 | $133 |
| 4 | Moundview Memorial Hospital and Clinics, Inc. | Friendship, WI | $133 | $133 | — | — | $133 | $133 |
| 5 | Memorial Hospital of Boscobel | Boscobel, WI | $133 | $133 | — | — | $133 | $133 |
| 6 | Tri-County Memorial Hospital Inc | Whitehall, WI | $520 | $520 | $13 | — | $507 | $533 |
| 7 | Henry Ford Health System | Detroit, MI | $35 | $35 | — | — | $35 | $48 |
| 8 | Henry Ford Health System | West Bloomfield, MI | $35 | $39 | $6 | — | $35 | $48 |
| 9 | Henry Ford Macomb Hospital Corporation | Clinton Twp, MI | $35 | $39 | $6 | — | $35 | $48 |
| 10 | Henry Ford Wyandotte Hospital | Wyandotte, MI | $35 | $39 | $6 | — | $35 | $48 |
Ask Claude or any MCP client for HCPCS 87521QW pricing at a specific hospital — see how to connect.