New patient office visit (about 60 minutes) in Madison, WI costs $227 to $498. Here's every hospital's price.
3 hospitals in the Madison, WI metro area publish a cash price for new patient office visit (about 60 minutes) (CPT 99205). 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 60 minutes) (CPT 99205). The lowest is $227 at Ssm Health St Mary's Hospital - Madison, the median is $459 and the highest is $498 at Unitypoint Health - Meriter. The most expensive hospital lists 2.2 times the cheapest for the same code.
The Madison, WI median of $459 is 71% above the national median of $268 across 1126 US hospitals with a cash price for this code.
2 of these hospitals also publish the rates they negotiated with insurers, from $143 to $631. 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 99205. 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 99205, in writing, and whether it covers facility, physician and anesthesia."
About new patient office visit (about 60 minutes)
CPT 99205 is the highest new-patient office visit level: about an hour, high complexity, typically a serious or complicated diagnosis, multiple chronic conditions, or decisions about major treatment. It is common in oncology, cardiology and neurology first visits.
What the price covers
When a hospital lists it, this is the price at a hospital-owned clinic or outpatient department, often with a facility fee on top of the clinician's fee. Any tests, imaging or procedures ordered are separate.
Why prices vary
Prices for the same visit level differ mainly by ownership: hospital-owned practices add facility fees; independent practices do not. Academic medical centers list the highest charges. Cash prices are usually far below the gross charge.
Questions to ask
- What is the self-pay price for 99205 including any facility fee?
- Could the visit be booked at an independent practice with the same specialist?
- What is included, and what will be billed separately?
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