Price Transparency Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

Payer comparison · CPT 99213 · WAUSAU, WI

99213 — Pr Visit Office Outpatient Established Low Level

What each payer pays NORTH CENTRAL HEALTH CARE (CCN 524017) for this procedure, and where each sits versus the all-payer median at this facility. Find your plan to see whether you're above or below the market here.

$129 All-payer median here
$216 Cash / self-pay here
21 payer/plan-name variants
← This hospital National rates for 99213 →
Per-payer negotiated rate at this facility. Use the column headers to sort, the filter row to narrow results.
Payer / plan Median negotiated vs all-payer median Rate rows
   
Security Health Plan of Wisconsin $141 9.5% 3
Cenpatico $138 7.2% 1
Group Health Cooperative $135 4.9% 1
Blue Cross Blue Advantage $129 0.0% 1
Cigna Healthcare $129 0.0% 1
Advantage by Managed $129 0.0% 1
Aetna $129 0.0% 1
Aspirus Health Plan - First Health Network $129 0.0% 1
UMR (UnitedHealthcare TPA) $129 0.0% 1
United Behavioral Health (Optum) $129 0.0% 1
WEA Insurance $129 0.0% 1
WPS Government Health Administrators $129 0.0% 1
Humana $129 0.0% 2
Medica $129 0.0% 1
Molina Healthcare $129 0.0% 1
North American Insurance $129 0.0% 1
The Alliance $129 0.0% 1
UnitedHealthcare $128 -0.7% 4
MA HMO-Blue Cross/Blue Shield/Ameri Group $127 -1.4% 1
Anthem (Elevance Health) $127 -1.5% 1
Forward Health - Medicaid $83 -35.9% 1

Median over current-blob negotiated rates (COALESCE of standard / median / min–max midpoint, $0.01–$5M sentinel guard). Payers are canonical-grouped where a mapping exists; unmapped regional-plan name variants may appear as separate rows.