CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: St Josephs Community Hospital West Bend

Billing Code: 99213 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$75
about 0.8× the $95 Medicare rate · typically $62–$208
modeled estimate · not a bill or quote
What this hospital charges insurers
$85
About the fair price
about $10 over the fair price · 0.9× Medicare
Medicare pays $95 Fair price $75 This hospital $85 Cash price $98 Hospital's list price $179

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

Highest price of the 9 WI hospitals we have prices for — worth calling around.

Cheapest $60 Priciest $85

Black dot = this hospital, among the 9 WI hospitals with a price for this procedure. Full list below.

A fair price for a Office visit, established patient (20-29 min) is about $75 (about 0.8× the $95 Medicare rate). St Josephs Community Hospital West Bend charges insurers about $85, or about $98 in cash — about the fair price. Located in West Bend, WI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $85 89%
Blue Cross Blue Shieldmajor $85 89%
Aetnamajor $87 - $238 91%
Cignamajor $170 - $323 179%
Humanamajor $85 89%
Health Net $57 60%
HealthPartners $85 - $221 89%
Molina $85 89%
Security Health Plan $85 89%
+ 12 smaller / regional plans $85 - $306
Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 3200 Pleasant Valley Road, West Bend, WI 53095
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals