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New Patient Office Visit, Straightforward

Wisconsin rates for HCPCS 99201

A first visit at an office or clinic with a clinician who has not seen you before. It covers a short, uncomplicated visit for a minor problem, with a brief history, a limited examination and simple decision-making. Longer versions of the same visit are used when the problem is more involved.

Rates data updated July 2026.

How much does New Patient Office Visit, Straightforward cost?

$123

Typical negotiated rate. In Wisconsin, July 2026.

Insurers have agreed to pay about $123 for this service. The price depends on where it is billed: about $110 from a physician practice, and about $135 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$110$70.79 to $155
FacilityA hospital or hospital-owned outpatient department$135$89.13 to $178

How much rates vary

Facilitymedian $135 · 10th to 90th $71 to $178Professionalmedian $110 · 10th to 90th $51 to $209
$50$100$200facility $135professional $110

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$134.90
Typical High
$194.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$81.28
Typical High
$138.04
Medica
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$177.83
Typical High
$177.83
Medica
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$204.17
Typical High
$204.17
Molina
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$64.57
Typical High
$87.10
Quartz
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$177.83
Quartz
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$208.93
Typical High
$208.93

Where Wisconsin sits

The same service costs 7.2 times more in Kentucky than in South Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Wisconsin· 10th of 47

$123

KY $219SC $30.20

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.