New patient office visit (about 45 minutes) in Madison, WI costs $205 to $382. Here's every hospital's price.
3 hospitals in the Madison, WI metro area publish a cash price for new patient office visit (about 45 minutes) (CPT 99204). We read their files every month so you don't have to.
Across the Madison, WI metro area, 3 hospitals list a cash price for new patient office visit (about 45 minutes) (CPT 99204). The lowest is $205 at Ssm Health St Mary's Hospital - Madison, the median is $351 and the highest is $382 at Unitypoint Health - Meriter.
The Madison, WI median of $351 is 66% above the national median of $211 across 1130 US hospitals with a cash price for this code.
2 of these hospitals also publish the rates they negotiated with insurers, from $110 to $514. With insurance you pay a share of the negotiated rate, which is sometimes higher than the cash price; you may ask for the cash price instead.
The files behind these prices are dated between January 2026 and April 2026. 5 other hospitals in the metro area have no readable price for this code: some publish no file, some block automated reading, some leave the code out. They are listed below so you can call them.
Sorted by cash price
Hospital facility fee onlyMadison · 10 mi · File Apr 2026
Portage · 34 mi · File Apr 2026
Madison · 10 mi · File Jan 2026
What's in the price
The hospital facility fee for CPT 99204. The doctor, anesthesia and lab work usually bill separately.
Cash vs. insured
Cash is what you pay without insurance. With insurance you pay a share of the negotiated rate, which can be higher than cash. You may ask for the cash price.
What to say on the phone
"I'd like the self-pay price for CPT 99204, in writing, and whether it covers facility, physician and anesthesia."
About new patient office visit (about 45 minutes)
CPT 99204 is a new-patient office visit of moderate complexity, around 45 minutes: several problems, a chronic condition being evaluated, or a decision about prescription treatment. It is the most commonly billed new-patient level in specialty practices.
What the price covers
When listed by a hospital, this is the price at a hospital-owned clinic or outpatient department, which may add a facility fee on top of the clinician's professional fee. Tests, imaging and procedures are separate.
Why prices vary
The same 45 minutes with a physician can cost two or three times more at a hospital-owned practice than at an independent one, mostly because of the facility fee. Within hospitals, prices follow system size. Cash prices are usually well below gross charges.
Questions to ask
- What is the self-pay price for 99204, and is there a facility fee?
- Is the visit at a hospital outpatient department or an independent office?
- What level will be billed if the visit takes longer or is more complex?
Hospitals in Madison, WI without a price for this procedure
Listed so you know who to call. The reason is what we found on their website.
- Columbus Community HospitalNo website on record
- Stoughton HospitalNo website on record
- The Monroe Cliniccode not in file
- University of Wi Hospitals & Clinics Authoritycode not in file
- Upland Hills HealthNo website on record