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Hospital Outpatient Clinic Visit

Wisconsin rates for HCPCS G0463

Hospital outpatient clinic visit for assessment and management of a patient

Rates data updated July 2026.

How much does Hospital Outpatient Clinic Visit cost?

$87.10

Typical negotiated rate. In Wisconsin, July 2026.

Insurers have agreed to pay about $87.10 for this service. The price depends on where it is billed: about $87.10 from a physician practice, and about $95.50 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 9 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$87.10$74.13 to $87.10
FacilityA hospital or hospital-owned outpatient department$95.50$70.79 to $120

How much rates vary

Facilitymedian $95 · 10th to 90th $50 to $191Professionalmedian $87 · 10th to 90th $54 to $107
$10$20$50$100$200$500facility $95professional $87

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$95.50
Typical High
$190.55
Aetna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$87.10
Typical High
$107.15
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$6.61
Median
$93.33
Typical High
$93.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$346.74
Typical High
$512.86
Cigna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$141.25
Typical High
$158.49
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$87.10
Typical High
$123.03
Medica
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$87.10
Typical High
$131.83
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$58.88
Typical High
$70.79
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$87.10
Typical High
$123.03
Quartz
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$100.00
Quartz
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$97.72
United
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$75.86
Typical High
$79.43

Where Wisconsin sits

The same service costs 9.1 times more in North Carolina than in Minnesota. 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· 34th of 51

$87.10

NC $166MN $18.20

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.