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Assisted Living Visit, New Patient, High Complexity

Wisconsin rates for HCPCS 99328

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. This is the highest level, used when the patient is unstable or has serious conditions that interact, so the assessment and the decisions are extensive.

Rates data updated July 2026.

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

$603

Typical facility fee. In Wisconsin, July 2026.

Insurers have agreed to pay about $603 for this service. Most negotiated rates run $457 to $676.

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 $631 · 10th to 90th $151 to $933Professionalmedian $603 · 10th to 90th $347 to $708
$200.0$500.0$1.0Kfacility $631professional $603

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
$549.54
Median
$645.65
Typical High
$1,023.29
Cigna
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$602.56
Typical High
$707.95
Quartz
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$416.87
Typical High
$831.76
Quartz
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,023.29
Typical High
$1,023.29
United
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$151.36
Typical High
$162.18

Where Wisconsin sits

The same service costs 27.5 times more in North Carolina than in South Carolina. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Wisconsin $603 · 8th of 34
NC $832SC $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.