Office visit, established patient (20-29 min)
Facility: Froedtert Memorial Lutheran Hospital
Billing Code: 99213 (CPT)
This hospital's typical commercial price is $85 compared to the $80 fair price benchmark.
3-Star CMS clinical quality rating paired with 1.06× fair market pricing.
Highest price of the 9 WI hospitals we have prices for — worth calling around.
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 $80 (about 0.8× the $95 Medicare rate). Froedtert Memorial Lutheran Hospital charges insurers about $85, or about $144 in cash — about the fair price. Located in Milwaukee, WI.
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
4 of 6 major insurers have a published price at this hospital
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 - $221 | 91% |
| Humanamajor | $85 | 89% |
| Dean Health Plan | $148 - $272 | 155% |
| Health Net | $46 | 48% |
| HealthPartners | $85 - $211 | 89% |
| Molina | $85 | 89% |
| Priority Health | $85 | 89% |
| Quartz | $85 | 89% |
| Security Health Plan | $85 - $267 | 89% |
| WellCare | $87 | 91% |
| + 11 smaller / regional plans | $85 - $289 |
Self-Pay How to get the cash price
Insurance Before you use insurance
Estimate your out-of-pocket cost
A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.
Other Procedures at Froedtert Memorial Lutheran Hospital
Compare: Office visit, established patient (20-29 min) at other WI hospitals
- Gundersen Lutheran Medical Center · La Crosse $58
- Tomah Memorial Hospital · Tomah $60
- Crossing Rivers Health Medical Center · Prairie Du Chien $60
- Richland Hospital · Richland Center $60
- Aspirus Eagle River Hospital · Eagle River $62
- Beloit Health System · Beloit $63
- Childrens Hospital of Wisconsin · Milwaukee $66
- Childrens Hospital of Wisconsin Fox Valley · Neenah $66
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at Froedtert Memorial Lutheran Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $95
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $95).
Self-Pay Cash Rate ($144) Beats Your Bill
Froedtert Memorial Lutheran Hospital's published 45 CFR § 180 self-pay cash rate is $144 (vs. $85 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $80 Fair BaseRate ($95 Medicare)
Your bill ($263) is $183 above the denoised Fair BaseRate ($80) and 2.8× the $95 Medicare rate.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.