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Assisted Living Visit, New Patient, Low Complexity

Wisconsin rates for HCPCS 99325

A first visit by a doctor or other qualified provider to a patient living in an assisted living residence, rest home, or similar place that provides housing and personal care rather than skilled nursing. It covers a low level of complexity, with a fuller history and examination than the briefest first visit for a problem that is not severe.

Rates data updated July 2026.

How much does Assisted Living Visit, New Patient, Low Complexity cost?

$219

Typical facility fee. In Wisconsin, July 2026.

Insurers have agreed to pay about $219 for this service. Most negotiated rates run $166 to $245.

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 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $229 · 10th to 90th $81 to $339Professionalmedian $219 · 10th to 90th $126 to $257
$100$200facility $229professional $219

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
$199.53
Median
$234.42
Typical High
$371.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$218.78
Typical High
$257.04
Quartz
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$323.59
Quartz
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$426.58
United
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$81.28
Typical High
$85.11

Where Wisconsin sits

The same service costs 10.7 times more in North Carolina 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· 8th of 34

$219

NC $324SC $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.