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Office visit, new patient, 60-74 min

CPT 99205 · negotiated-rate distribution across hospitals in WI

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Hospitals
33
Min
$90.00
Median
$333.00
Max
$776.00
Range multiplier
8.6×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare23102$78.54$146.41$1,321.9416.8×
Anthem BCBS2079$66.00$308.89$1,334.5020.2×
healthpartners1254$74.00$341.25$1,177.5015.9×
Cigna1853$70.00$444.15$1,328.2219.0×
Aetna1551$78.00$450.17$1,296.8216.6×
common ground1236$65.00$65.00$65.001.0×
wisconsin physician service1236$90.00$95.00$95.001.1×
health eos1230$336.00$496.00$1,256.003.7×
health eos plus1230$252.00$372.00$942.003.7×
trilogy1422$116.00$116.00$720.006.2×
Molina1721$74.00$74.00$680.009.2×
First Health820$72.90$561.49$921.5012.6×
health payment systems1720$115.00$115.00$820.627.1×
Humana619$161.16$493.65$712.004.4×
Multiplan516$189.72$453.60$882.704.7×
centivo1515$76.00$76.00$708.109.3×
everpointe elite1212$75.00$75.00$75.001.0×
aurora caregiver1212$80.00$80.00$80.001.0×
Medicare312$29.06$199.48$418.1614.4×
quartz one1212$70.00$70.00$70.001.0×
hs technology1212$90.00$90.00$90.001.0×
Blue Cross Blue Shield412$24.19$142.12$532.9322.0×
quartz group1212$80.00$80.00$80.001.0×
health partners512$193.80$756.60$853.604.4×
network health plan812$170.34$476.53$823.534.8×
froedtert health39$776.00$824.50$873.001.1×
aspirus29$57.50$143.06$453.607.9×
security health plan59$75.00$453.60$805.1010.7×
group health cooperative of eau claire18$167.28$424.90$760.004.5×
security health plan (shp)18$106.04$266.84$462.084.4×
dean health plan47$283.50$776.00$776.002.7×
wps77$548.55$548.55$548.551.0×
wisconsin well woman77$209.02$209.02$209.021.0×
Medicaid26$213.69$235.24$388.061.8×
quartz health solutions36$824.50$824.50$824.501.0×
ma wisconsin replacement [950271]35$146.41$695.00$977.006.7×
medica [900156]35$72.33$389.13$517.677.2×
prevea 36014$166.07$264.35$528.703.2×
alliance34$209.02$532.53$532.532.5×
amish/mennonite14$112.20$276.10$440.003.9×
chorus community health plan44$155.19$155.19$364.582.3×
icare44$161.05$161.05$204.461.3×
wps health insurance14$137.29$337.85$538.403.9×
wps health plan44$419.58$679.00$679.001.6×
managed health services33$158.12$158.12$158.121.0×
healthsmart payers organization33$873.00$873.00$873.001.0×
medical college of wisconsin33$679.00$679.00$679.001.0×
healthpartners [900713]33$589.73$834.83$877.781.5×
mercy care13$87.50$130.20$217.702.5×
health payers organization33$921.50$921.50$921.501.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Aurora Med Ctr Of Manitowoc CountyTwo RiversWI18$545.00$272.50$65.00$93.00$463.25
Aurora Medical Center KenoshaKenoshaWI18$420.00$210.00$65.00$93.00$357.00
Aurora Medical Center - SummitSummitWI18$485.00$242.50$65.00$93.00$412.25
Memorial Hospital Of BurlingtonBurlingtonWI18$620.00$310.00$65.00$93.00$527.00
West Allis Memorial HospitalWest AllisWI18$525.00$262.50$65.00$93.00$446.25
Aurora Lakeland Medical CenterElkhornWI18$620.00$310.00$65.00$93.00$527.00
Aurora Medical Center Of OshkoshOshkoshWI18$845.00$422.50$65.00$93.00$718.25
Aurora Medical Center - HartfordHartfordWI18$800.00$400.00$65.00$93.00$680.00
Aurora Medical Center - Bay AreaMarinetteWI18$730.00$365.00$65.00$90.00$617.58
Ssh - Fox ValleyOshkoshWI32$970.00$533.50$146.41$776.00$921.50
Childrens Hospital Of Wi-Fox ValleyNeenahWI32$970.00$533.50$146.41$776.00$921.50
Childrens WisconsinMilwaukeeWI32$970.00$533.50$146.41$776.00$921.50
Ascension Sacred Heart RehabilitatioMilwaukeeWI4$286.00$151.58$209.02$493.65$532.53
Ascension Columbia St Marys MilwaukeMilwaukeeWI4$291.52$493.65$532.53
Ascension Columbia St Marys OzaukeeMequonWI4$291.52$493.65$532.53
Beaver Dam Community HospitalsBeaver DamWI17$800.00$760.00$103.59$411.04$796.00
Westfields HospitalNew RichmondWI8$977.00$513.90$132.49$388.06$977.00
Ascension Wisconsin Emerus MenomoneeMenomonee FallsWI2$209.02$378.79$548.55
All Saints - St. Luke S HospitalRacineWI2$209.02$378.79$548.55
Wheaton Franciscan Healthcare - AllRacineWI2$209.02$378.79$548.55
Ascension Se Wisconsin Hospital IncMilwaukeeWI2$209.02$378.79$548.55
Wfhc - Elmbrook MemorialBrookfieldWI2$209.02$378.79$548.55
Wheaton Franciscan - FranklinFranklinWI2$209.02$378.79$548.55
MoshFranklinWI2$209.02$378.79$548.55
Holy Family Memorial IncManitowocWI23$567.00$311.85$204.46$374.22$498.96
Sheboygan Memorial HospitalSheboyganWI18$990.00$495.00$65.00$333.00$841.50
Aurora Health Care Metro Inc.MilwaukeeWI18$1,570.00$785.00$65.00$273.00$1,334.50
Aurora Medical Center GraftonGraftonWI18$1,570.00$785.00$65.00$273.00$1,334.50
Hudson HospitalHudsonWI8$695.00$313.51$147.48$255.76$834.83
Ascension Ne Wisconsin-St. ElizabethAppletonWI4$668.00$380.76$190.58$190.58$451.68
Mercy Medical CenterOshkoshWI4$668.00$380.76$190.58$190.58$451.68
Meriter Hospital Inc.MadisonWI13$622.00$497.60$57.50$174.37$590.90
Amery Regional Medical CenterAmeryWI7$458.00$238.80$24.19$146.41$877.78

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.