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ED visit level 5

CPT 99285 · negotiated-rate distribution across hospitals in WI

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Hospitals
36
Min
$317.45
Median
$1,887.00
Max
$2,987.00
Range multiplier
9.4×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Anthem BCBS27156$23.29$2,106.00$5,714.00245.3×
UnitedHealthcare32141$158.44$1,985.00$6,052.0038.2×
Cigna1870$16.50$1,598.94$2,901.78175.9×
healthpartners1268$502.50$1,886.25$2,642.005.3×
Aetna1563$553.42$1,602.44$103,397186.8×
Medicare1446$188.31$595.33$1,402.137.4×
health eos1244$536.00$1,472.00$2,744.005.1×
health eos plus1244$402.00$1,104.00$2,058.005.1×
common ground1236$2,543.00$2,543.00$2,543.001.0×
wisconsin physician service1236$2,883.00$3,035.00$3,035.001.1×
Blue Cross Blue Shield430$31.75$463.16$4,234.00133.4×
health payment systems2426$631.68$3,400.00$3,979.006.3×
Molina1825$583.12$2,334.95$2,344.004.0×
First Health823$646.20$1,567.02$3,685.505.7×
VA Health1122$589.41$595.33$623.031.1×
aspirus222$12.65$263.03$2,250.82177.9×
trilogy1420$739.20$3,627.00$3,627.004.9×
centivo1619$470.40$2,513.00$2,513.005.3×
Humana617$166.36$410.29$2,444.8314.7×
security health plan515$17.05$896.00$2,000.00117.3×
Medicaid214$202.69$790.78$1,566.567.7×
smart health714$833.46$833.46$872.241.0×
network health plan1014$281.26$1,226.87$3,871.0013.8×
Multiplan514$896.00$1,704.00$2,609.652.9×
hs technology1212$2,701.00$2,701.00$2,701.001.0×
quartz group1212$2,740.00$3,420.00$3,420.001.2×
quartz one1212$2,340.00$2,920.00$2,920.001.2×
aurora caregiver1212$2,400.00$2,400.00$2,400.001.0×
everpointe elite1212$2,409.00$2,409.00$2,409.001.0×
wps health plan411$828.80$1,392.51$1,850.002.2×
health partners511$583.12$1,420.32$2,609.654.5×
medica [900156]310$295.54$996.66$2,974.0010.1×
froedtert health39$1,129.80$1,291.20$1,557.411.4×
sehn99$3,030.44$3,030.44$3,383.001.1×
prevea 36019$46.75$462.40$3,188.6668.2×
cchp99$313.66$4,522.00$4,522.0014.4×
quartz health insurance39$1,371.90$1,371.90$1,557.411.1×
ma wisconsin replacement [950271]28$867.00$1,412.50$4,095.004.7×
dean health plan48$560.00$1,291.20$1,465.802.6×
group health cooperative of eau claire48$619.47$1,859.17$2,609.654.2×
mercy care17$18.26$190.40$1,245.4568.2×
wps77$462.81$462.81$462.811.0×
network health77$3,220.00$3,220.00$3,220.001.0×
common ground healthcare cooperative36$1,210.50$1,371.90$1,557.411.3×
healthsmart36$929.60$1,452.60$2,075.002.2×
trilogy health solutions36$1,210.50$1,371.90$1,557.411.3×
security health plan (shp)15$584.41$1,427.89$1,586.672.7×
alliance55$449.30$449.30$3,138.007.0×
medical college of wisconsin45$369.60$1,129.80$1,282.583.5×
smarthealth24$825.17$825.17$825.171.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Holy Family Memorial IncManitowocWI25$2,500.00$1,375.00$369.60$929.60$6,052.00
Hudson HospitalHudsonWI8$4,095.00$1,847.25$183.98$811.54$5,191.00
Westfields HospitalNew RichmondWI8$2,249.00$1,182.97$188.31$810.26$2,249.00
Amery Regional Medical CenterAmeryWI6$2,438.00$1,271.17$188.31$646.20$2,363.88
Ascension Ne Wisconsin-St. ElizabethAppletonWI14$3,434.00$1,957.38$182.14$604.15$3,383.00
Mercy Medical CenterOshkoshWI14$3,434.00$1,957.38$182.14$604.15$3,383.00
Ascension Columbia St Marys MilwaukeMilwaukeeWI7$3,434.00$1,820.02$281.26$523.07$1,313.05
Ascension Columbia St Marys OzaukeeMequonWI7$3,434.00$1,820.02$281.26$523.07$1,313.05
Ascension Sacred Heart RehabilitatioMilwaukeeWI4$281.26$410.29$449.30
Meriter Hospital Inc.MadisonWI14$3,751.36$3,001.09$12.65$317.45$3,880.00
Ascension Se Wisconsin Hospital IncMilwaukeeWI10$3,434.00$1,820.02$462.81$2,987.00$4,880.00
Ascension Wisconsin Emerus MenomoneeMenomonee FallsWI10$3,434.00$1,820.02$462.81$2,987.00$4,880.00
All Saints - St. Luke S HospitalRacineWI10$3,434.00$1,820.02$462.81$2,987.00$4,880.00
Wheaton Franciscan Healthcare - AllRacineWI10$3,434.00$1,820.02$462.81$2,987.00$4,880.00
Wheaton Franciscan - FranklinFranklinWI10$3,434.00$1,820.02$462.81$2,987.00$4,880.00
Wfhc - Elmbrook MemorialBrookfieldWI10$3,434.00$1,820.02$462.81$2,987.00$4,880.00
MoshFranklinWI10$462.81$2,546.50$4,880.00
West Allis Memorial HospitalWest AllisWI18$3,430.00$1,715.00$876.00$2,528.00$103,397
Aurora Medical Center - HartfordHartfordWI18$2,870.00$1,435.00$1,722.00$2,416.54$3,627.00
Sheboygan Memorial HospitalSheboyganWI18$2,970.00$1,485.00$573.00$2,376.00$3,627.00
Aurora Med Ctr Of Manitowoc CountyTwo RiversWI18$2,930.00$1,465.00$402.00$2,344.00$3,627.00
Aurora Medical Center Of OshkoshOshkoshWI18$2,810.00$1,405.00$414.00$2,248.00$3,627.00
Memorial Hospital Of BurlingtonBurlingtonWI18$1,840.00$920.00$1,104.00$2,180.00$3,627.00
Beaver Dam Community HospitalsBeaver DamWI20$2,747.00$2,609.65$530.00$2,059.00$3,894.14
Aurora Medical Center - SummitSummitWI18$2,270.00$1,135.00$702.00$1,929.50$3,627.00
Aurora Health Care Metro Inc.MilwaukeeWI18$2,220.00$1,110.00$543.00$1,887.00$3,627.00
Aurora Medical Center GraftonGraftonWI18$2,220.00$1,110.00$543.00$1,887.00$3,627.00
Aurora Medical Center - Bay AreaMarinetteWI18$1,940.00$970.00$534.00$1,795.62$3,627.00
Aurora Lakeland Medical CenterElkhornWI18$1,840.00$920.00$810.00$1,564.00$3,627.00
Aurora Medical Center KenoshaKenoshaWI18$1,840.00$920.00$810.00$1,564.00$3,627.00
Childrens WisconsinMilwaukeeWI29$1,832.25$1,007.74$1,282.58$1,557.41$4,005.00
Ssh - Fox ValleyOshkoshWI30$1,614.00$887.70$1,129.80$1,371.90$4,005.00
Childrens Hospital Of Wi-Fox ValleyNeenahWI30$1,614.00$887.70$1,129.80$1,371.90$4,005.00
Uw Health Rehabilitation HospitalMadisonWI0$10,543$6,325.80
University Of Wi Hospitals & ClinicsMadisonWI0$10,543$6,325.80
River Falls Area HospitalRiver FallsWI0$1,818.50$1,018.36

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.