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Office visit, established patient, 20-29 minutes

CPT 99213 · negotiated-rate distribution across hospitals in WI

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Hospitals
37
Min
$69.68
Median
$134.11
Max
$309.60
Range multiplier
4.4×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare23110$60.42$90.00$404.166.7×
Anthem BCBS2095$60.77$103.50$796.0013.1×
Cigna1858$25.76$236.88$406.0815.8×
Aetna1557$73.92$268.45$396.485.4×
healthpartners1254$74.00$210.00$360.004.9×
wisconsin physician service1236$90.00$95.00$95.001.1×
common ground1236$65.00$65.00$65.001.0×
health eos1230$200.00$272.00$384.001.9×
health eos plus1230$150.00$204.00$288.001.9×
First Health826$39.60$217.89$417.0510.5×
health payment systems1723$45.94$115.00$371.398.1×
Multiplan522$61.38$126.63$417.056.8×
trilogy1422$59.40$116.00$232.203.9×
Molina1721$56.10$74.00$219.303.9×
Humana619$52.14$178.43$229.624.4×
health partners518$62.70$245.10$386.326.2×
froedtert health318$58.80$309.60$373.156.3×
centivo1518$65.52$76.00$342.425.2×
Blue Cross Blue Shield417$16.02$74.06$194.7712.2×
network health plan815$55.11$106.79$328.566.0×
security health plan514$27.60$123.45$364.3713.2×
aspirus213$21.16$78.89$224.5110.6×
dean health plan413$67.20$309.60$351.205.2×
wps health plan413$63.84$133.20$395.106.2×
hs technology1212$90.00$90.00$90.001.0×
aurora caregiver1212$80.00$80.00$80.001.0×
quartz one1212$70.00$70.00$70.001.0×
everpointe elite1212$75.00$75.00$75.001.0×
quartz group1212$80.00$80.00$80.001.0×
Medicare312$63.47$76.19$379.426.0×
group health cooperative of eau claire211$54.12$92.00$351.206.5×
Medicaid311$68.06$108.46$264.433.9×
trilogy health solutions39$63.00$309.60$373.155.9×
common ground healthcare cooperative39$63.00$278.64$373.155.9×
quartz health insurance19$71.40$97.75$373.155.2×
security health plan (shp)18$34.31$86.12$149.024.3×
wisconsin well woman77$86.74$86.74$86.741.0×
ma wisconsin replacement [950271]37$60.42$264.00$415.006.9×
medica [900156]37$114.55$215.16$338.233.0×
wps77$193.80$193.80$193.801.0×
prevea 36016$60.77$164.05$545.249.0×
aspirus health plan36$63.00$278.64$329.255.2×
employer health care alliance cooperative36$65.94$182.88$344.625.2×
group health cooperative of south central wisconsin36$75.60$348.30$395.105.2×
medical college of wisconsin36$58.80$270.90$307.305.2×
oan llc36$67.20$309.60$351.205.2×
advocate aurora healthcare36$64.68$290.25$338.035.2×
quartz health solutions36$328.95$328.95$328.951.0×
sheboygan employer's health network36$71.40$328.95$373.155.2×
mercy care15$32.20$83.65$224.517.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Aurora Medical Center KenoshaKenoshaWI18$340.00$170.00$65.00$93.00$289.00
Aurora Lakeland Medical CenterElkhornWI18$280.00$140.00$65.00$93.00$238.00
Aurora Med Ctr Of Manitowoc CountyTwo RiversWI18$340.00$170.00$65.00$93.00$289.00
Aurora Medical Center - SummitSummitWI18$250.00$125.00$65.00$93.00$212.50
Aurora Medical Center - HartfordHartfordWI18$415.00$207.50$65.00$93.00$352.75
West Allis Memorial HospitalWest AllisWI18$390.00$195.00$65.00$93.00$331.50
Aurora Medical Center Of OshkoshOshkoshWI18$460.00$230.00$65.00$93.00$391.00
Memorial Hospital Of BurlingtonBurlingtonWI18$280.00$140.00$65.00$93.00$238.00
Aurora Medical Center - Bay AreaMarinetteWI18$450.00$225.00$65.00$90.00$380.70
Hudson HospitalHudsonWI8$254.00$114.58$42.23$86.02$347.63
Meriter Hospital Inc.MadisonWI13$641.46$513.17$21.16$83.65$609.39
Ascension Ne Wisconsin-St. ElizabethAppletonWI4$369.00$210.33$69.68$69.68$163.26
Mercy Medical CenterOshkoshWI4$369.00$210.33$69.68$69.68$163.26
Ssh - Fox ValleyOshkoshWI32$387.00$212.85$60.42$309.60$367.65
Childrens Hospital Of Wi-Fox ValleyNeenahWI32$387.00$212.85$60.42$309.60$367.65
Aurora Health Care Metro Inc.MilwaukeeWI18$480.00$240.00$65.00$195.00$408.00
Aurora Medical Center GraftonGraftonWI18$480.00$240.00$65.00$195.00$408.00
Sheboygan Memorial HospitalSheboyganWI18$345.00$172.50$65.00$192.00$293.25
Ascension Sacred Heart RehabilitatioMilwaukeeWI4$110.00$58.30$86.74$178.43$188.14
Ascension Columbia St Marys OzaukeeMequonWI4$806.00$427.18$86.74$178.43$188.14
Ascension Columbia St Marys MilwaukeMilwaukeeWI4$806.00$427.18$106.79$178.43$188.14
Westfields HospitalNew RichmondWI8$415.00$218.29$72.99$177.62$415.00
MoshFranklinWI2$434.00$230.02$86.74$140.27$193.80
Ascension Se Wisconsin Hospital IncMilwaukeeWI2$450.00$238.50$86.74$140.27$193.80
All Saints - St. Luke S HospitalRacineWI2$450.00$238.50$86.74$140.27$193.80
Wfhc - Elmbrook MemorialBrookfieldWI2$434.00$230.02$86.74$140.27$193.80
Wheaton Franciscan - FranklinFranklinWI2$434.00$230.02$86.74$140.27$193.80
Wheaton Franciscan Healthcare - AllRacineWI2$450.00$238.50$86.74$140.27$193.80
Ascension Wisconsin Emerus MenomoneeMenomonee FallsWI2$450.00$238.50$86.74$140.27$193.80
Beaver Dam Community HospitalsBeaver DamWI17$258.00$245.10$33.51$134.11$796.00
Holy Family Memorial IncManitowocWI23$180.00$99.00$84.91$118.80$158.40
Amery Regional Medical CenterAmeryWI8$273.00$142.34$16.02$106.20$379.42
Childrens WisconsinMilwaukeeWI37$439.00$241.45$58.80$102.55$417.05
Willow Creek Behavioral HealthGreen BayWI0$150.00
River Falls Area HospitalRiver FallsWI0$199.40$111.66
Uw Health Rehabilitation HospitalMadisonWI0$210.00$126.00
University Of Wi Hospitals & ClinicsMadisonWI0$210.00$126.00

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.