CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Gundersen St Josephs Hospital and Clinics

Billing Code: 99214 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$150
about 1.1× the $136 Medicare rate · typically $81–$352
modeled estimate · not a bill or quote
What this hospital charges insurers
$150
About the fair price
1.1× Medicare
Medicare pays $136 Fair price $150 This hospital $150 Cash price $87 Hospital's list price $150

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 $73 Priciest $150

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 (30-39 min) is about $150 (about 1.1× the $136 Medicare rate). Gundersen St Josephs Hospital and Clinics charges insurers about $150, or about $87 in cash — about the fair price. Located in Hillsboro, 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 $80 - $105 59%
Blue Cross Blue Shieldmajor $80 - $150 59%
Aetnamajor $142 105%
Cignamajor $123 91%
Humanamajor $128 94%
Amerigroup $150 111%
Quartz $82 60%
Security Health Plan $29 21%
UCare $78 - $120 58%
+ 4 smaller / regional plans $120 - $150
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 400 Water Ave, Hillsboro, WI 54634
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals