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Office visit, new patient, 45-59 min

CPT 99204 · negotiated-rate distribution across hospitals in WI

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Hospitals
33
Min
$90.00
Median
$234.00
Max
$587.20
Range multiplier
6.5×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare2398$82.00$110.94$842.0010.3×
Anthem BCBS2079$66.00$227.42$850.0012.9×
healthpartners1254$74.00$292.50$750.0010.1×
Cigna1751$53.76$346.86$846.0015.7×
Aetna1551$78.00$367.57$826.0010.6×
common ground1236$65.00$65.00$65.001.0×
wisconsin physician service1236$90.00$95.00$95.001.1×
health eos plus1230$222.00$303.00$600.002.7×
health eos1230$296.00$404.00$800.002.7×
Molina1721$74.00$74.00$518.507.0×
trilogy1320$116.00$116.00$549.004.7×
health payment systems1619$108.58$115.00$620.965.7×
Humana619$123.24$390.43$542.904.4×
First Health718$67.50$478.41$743.7411.0×
centivo1515$76.00$76.00$535.827.1×
Multiplan414$145.08$378.15$667.944.6×
network health plan812$130.26$357.64$623.174.8×
quartz group1212$80.00$80.00$80.001.0×
hs technology1212$90.00$90.00$90.001.0×
aurora caregiver1212$80.00$80.00$80.001.0×
everpointe elite1212$75.00$75.00$75.001.0×
quartz one1212$70.00$70.00$70.001.0×
health partners511$148.20$572.52$645.924.4×
Medicare310$28.09$150.05$388.2013.8×
froedtert health39$587.20$623.90$660.601.1×
security health plan (shp)18$81.09$203.60$352.344.3×
Blue Cross Blue Shield48$97.65$139.26$391.834.0×
group health cooperative of eau claire18$127.92$324.20$579.504.5×
wisconsin well woman77$158.64$158.64$158.641.0×
wps77$437.33$437.33$437.331.0×
security health plan57$57.60$155.08$609.2210.6×
Medicaid37$158.04$188.05$360.262.3×
aspirus17$44.16$99.75$166.953.8×
dean health plan36$587.20$587.20$587.201.0×
quartz health solutions36$623.90$623.90$623.901.0×
amish/mennonite14$85.80$210.65$335.503.9×
ma wisconsin replacement [950271]24$416.00$558.50$907.002.2×
prevea 36014$122.27$202.73$405.453.3×
icare44$122.03$122.03$155.081.3×
wps health insurance14$104.99$257.76$410.533.9×
oan llc33$587.20$587.20$587.201.0×
alliance33$424.56$424.56$424.561.0×
aspirus health plan33$528.48$528.48$528.481.0×
chorus community health plan33$117.60$117.60$117.601.0×
common ground healthcare cooperative33$528.48$528.48$528.481.0×
employer health care alliance cooperative33$335.14$335.14$335.141.0×
group health cooperative of south central wisconsin33$660.60$660.60$660.601.0×
health payers organization33$697.30$697.30$697.301.0×
healthpartners [900713]33$323.40$447.32$633.232.0×
healthsmart payers organization33$660.60$660.60$660.601.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
West Allis Memorial HospitalWest AllisWI18$505.00$252.50$65.00$93.00$429.25
Aurora Med Ctr Of Manitowoc CountyTwo RiversWI18$410.00$205.00$65.00$93.00$348.50
Aurora Lakeland Medical CenterElkhornWI18$540.00$270.00$65.00$93.00$459.00
Aurora Medical Center Of OshkoshOshkoshWI18$445.00$222.50$65.00$93.00$378.25
Aurora Medical Center - HartfordHartfordWI18$660.00$330.00$65.00$93.00$561.00
Aurora Medical Center - SummitSummitWI18$410.00$205.00$65.00$93.00$348.50
Aurora Medical Center KenoshaKenoshaWI18$370.00$185.00$65.00$93.00$314.50
Memorial Hospital Of BurlingtonBurlingtonWI18$540.00$270.00$65.00$93.00$459.00
Aurora Medical Center - Bay AreaMarinetteWI18$650.00$325.00$65.00$90.00$549.90
Ssh - Fox ValleyOshkoshWI32$734.00$403.70$110.94$587.20$697.30
Childrens Hospital Of Wi-Fox ValleyNeenahWI32$734.00$403.70$110.94$587.20$697.30
Childrens WisconsinMilwaukeeWI32$734.00$403.70$110.94$587.20$697.30
Ascension Columbia St Marys MilwaukeMilwaukeeWI4$214.69$390.43$424.56
Ascension Columbia St Marys OzaukeeMequonWI4$214.69$390.43$424.56
Ascension Sacred Heart RehabilitatioMilwaukeeWI4$214.69$390.43$424.56
Westfields HospitalNew RichmondWI8$907.00$477.08$97.65$337.70$907.00
Beaver Dam Community HospitalsBeaver DamWI17$610.00$579.50$79.22$313.42$796.00
MoshFranklinWI2$158.64$297.99$437.33
Ascension Wisconsin Emerus MenomoneeMenomonee FallsWI2$158.64$297.99$437.33
Wfhc - Elmbrook MemorialBrookfieldWI2$158.64$297.99$437.33
All Saints - St. Luke S HospitalRacineWI2$158.64$297.99$437.33
Ascension Se Wisconsin Hospital IncMilwaukeeWI2$158.64$297.99$437.33
Wheaton Franciscan Healthcare - AllRacineWI2$158.64$297.99$437.33
Wheaton Franciscan - FranklinFranklinWI2$158.64$297.99$437.33
Sheboygan Memorial HospitalSheboyganWI18$790.00$395.00$65.00$282.00$671.50
Aurora Health Care Metro Inc.MilwaukeeWI18$1,000.00$500.00$65.00$234.00$850.00
Aurora Medical Center GraftonGraftonWI18$1,000.00$500.00$65.00$234.00$850.00
Amery Regional Medical CenterAmeryWI7$365.00$190.31$28.09$215.88$375.88
Hudson HospitalHudsonWI8$511.00$230.51$108.43$188.05$633.23
Holy Family Memorial IncManitowocWI10$155.08$155.08$167.49
Ascension Ne Wisconsin-St. ElizabethAppletonWI4$537.00$306.09$140.21$140.21$357.24
Mercy Medical CenterOshkoshWI4$537.00$306.09$140.21$140.21$357.24
Meriter Hospital Inc.MadisonWI13$477.00$381.60$44.16$128.38$453.15

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.