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Wausau Area Hospital Prices

Cash and insurance-negotiated prices at hospitals in and around Wausau, WI. Part of all Wisconsin hospital prices.

Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.High Markup · Shop Alternatives
1.69×vs. Fair Market Price
Position vs. 1.00× Fair Price+69% Above Fair Price 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

Typical commercial prices here are +69% above the fair benchmark (1.69×) even after accounting for local nurse/doctor wages and patient complexity.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).86/100 · Verified
86/100Hover Any Check Below to See How Prices Were Audited
File Completeness90Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic88Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment86Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing83Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount84Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Wisconsin Market & Best ValueSummarizes statewide hospital price coverage across Wisconsin, the average commercial markup over federal Medicare rates, and the #1 best-value hospital in the state.3 Hospitals · 47 Procedures
Hospitals Priced3 in WITotal hospitals in Wisconsin with verified machine-readable price disclosures indexed in the Crystal.
Avg vs. Medicare1.4× MedicareAverage commercial insurance negotiated rate across Wisconsin hospitals compared to what federal Medicare pays for the same procedure.
Best Value in WI1.69× FairLowest confounder-adjusted hospital in Wisconsin: Marshfield Medical Center - Weston (Weston) at 1.69× fair market price.

Most affordable Wisconsin hospital: Marshfield Medical Center - Weston (Weston) at 1.69× the fair price (1% below benchmark).

Behavioral Pricing FingerprintUpper-Quartile Spread · +42% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

This hospital prices routine shoppable procedures at 2.2× Medicare (median 1.58× Fair BaseRate) while upper-quartile commercial rates jump +42% to 2.24× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#60 of 99 in WI · 59th State Percentile#2,873 of 3,385 in U.S. · 84th National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Bottom-quartile procedures (Q25) price at 0.98× the peer BaseRate benchmark
  • Self-pay cash beats commercial insurance on 28% of shoppable procedures (41/100 Cash Honesty)
  • CMS clinical safety score (76/100 safety score) with 76% patient recommendation
  • IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (85.0% AGB cap)
Watchout

Where You Can Get Burned (Markup Traps)

  • Even at low-cost facilities (1.69× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
  • Commercial insurance median sits at 1.58× Fair BaseRate (2.2× Medicare), so insured patients should always compare the self-pay cash price before paying.
  • Upper-quartile procedures (Q75 2.24×) jump +42% above the median procedure ratio (Q50 1.58×)
  • Consolidated metro market (HHI 5,418) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Front-Door ShoppableElective / Imaging
2.2× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.82× Divergence
1.8× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+42% Upper Tail
Q25 0.98× · Q50 1.58× · Q75 2.24×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.
Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×
Front-Door Shoppable CareFront-Door Shoppable
2.2× MedicareFair
Outpatient Surgery & ORBack-Door Captive
0.6× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
2.8× MedicareFair
Back-Door Captive ER VisitsBack-Door Captive
1.7× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
4.4× MedicareWatchout
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
1.0× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
28% Cash Edge · 41/100Watchout
CMS Clinical Safety & Star ValueIntegrity & Outcomes
3 CMS · 76/100Fair

Hospitals in the Wausau area

Ranked by how their prices compare to the fair BaseRate — best value first. The × fair figure is geo-adjusted. Tap any hospital for its full price list.

Compare prices by procedure in Wausau

Local prices across Wausau-area hospitals for 47 procedures.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Inpatient MS-DRG vs. Outpatient CPT Care-Setting Savings

Total Hip Arthroplasty (Replacement)DRG 470 vs CPT 27130
Inpatient: $29,415Outpatient: $9,488 Save $19,928 outpatient

Clinical Scope Note:Inpatient MS-DRG reflects a multi-day hospital admission (room, nursing, higher clinical acuity); outpatient CPT reflects the outpatient facility fee for clinically eligible low-acuity patients and excludes separate surgeon and anesthesia professional fees.

Total Knee Arthroplasty (Replacement)DRG 470 vs CPT 27447
Inpatient: $29,415Outpatient: $13,580 Save $15,835 outpatient

Clinical Scope Note:Inpatient MS-DRG reflects a multi-day hospital admission (room, nursing, higher clinical acuity); outpatient CPT reflects the outpatient facility fee for clinically eligible low-acuity patients and excludes separate surgeon and anesthesia professional fees.

Laparoscopic Gallbladder RemovalDRG 419 vs CPT 47562
Inpatient: $19,207Outpatient: $7,907 Save $11,300 outpatient

Clinical Scope Note:Inpatient MS-DRG reflects a multi-day hospital admission (room, nursing, higher clinical acuity); outpatient CPT reflects the outpatient facility fee for clinically eligible low-acuity patients and excludes separate surgeon and anesthesia professional fees.

Prices are sourced from each hospital's federally-required public price file, most recently published October 2026. The BaseRate is a modeled fair-price estimate — not a bill or quote. How we build these numbers →