CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Stoughton Hospital

Billing Code: 99203 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$112
about 0.9× the $118 Medicare rate · typically $81–$237
modeled estimate · not a bill or quote
What this hospital charges insurers
$76
Below the fair price — a good deal
about $36 under the fair price · 0.6× Medicare
Medicare pays $118 Fair price $112 This hospital $76 Cash price $189 Hospital's list price $343

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

A typical price — 3 charge more and 5 charge less, among the 9 WI hospitals compared.

Cheapest $70 Priciest $82

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

A fair price for a New patient office visit (30-44 min) is about $112 (about 0.9× the $118 Medicare rate). Stoughton Hospital charges insurers about $76, or about $189 in cash — below the fair price — a good deal. Located in Stoughton, 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 $163 - $296 139%
Blue Cross Blue Shieldmajor $151 - $321 128%
Aetnamajor $111 - $314 94%
Cignamajor $254 - $296 216%
Humanamajor $84 - $332 71%
Dean Health Plan $64 - $277 54%
GEHA $238 - $277 202%
Health Net $98 83%
Quartz $103 - $225 88%
+ 2 smaller / regional plans $104 - $332
Government programs also on file: Medicaid, Military & VA.
Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 900 Ridge St, Stoughton, WI 53589
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals