CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Upland Hills Health

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$78

about 0.8× the $95 Medicare rate · typically $61–$181

modeled estimate · not a bill or quote

What this hospital charges insurers

$85

About the fair price

about $7 over the fair price · 0.9× Medicare

Medicare pays $95 Fair price $78 This hospital $85 Cash price $192 Hospital's list price $355

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 $78 (about 0.8× the $95 Medicare rate). Upland Hills Health charges insurers about $85, or about $192 in cash — about the fair price. Located in Dodgeville, 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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Cigna✓ Humana AetnaKaiser 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	$67 - $363	70%
Cignamajor	$177 - $370	186%
Humanamajor	$60 - $399	63%
Dean Health Plan	$116 - $308	122%
Quartz	$164 - $306	172%
Security Health Plan	$67 - $124	70%
+ 4 smaller / regional plans	$67 - $332

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 192), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 99213.

Insurance Before you use insurance

Call your insurance company to confirm Upland Hills Health is in-network.
Ask your insurer whether prior approval is required for CPT code 99213.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Upland Hills Health

Compare: Office visit, established patient (20-29 min) at other WI hospitals

Insurance negotiated median for the same procedure, sorted lowest first.