Wisconsin · 73560

X-Ray Of Knee, 1-2 Views in Wisconsin

Wisconsin Medicare Avg
$10.03
30% below national avg
National Medicare Avg
$14.40
All states combined
Billed Charge (WI)
$101.27
What providers submit
Est. Commercial (WI)
$29.51
National avg: $43.87
Est. Cash / Self-Pay (WI)
$38.29
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

22.3K
Services in WI
1.4K
Providers
N/A
Min Payment
N/A
Max Payment

Wisconsin Pricing in Context

In Wisconsin, CPT code 73560 (X-Ray Of Knee, 1-2 Views) carries an average Medicare payment of $10.03 — 30% below the national benchmark of $14.40. 1.4K providers across the state submitted claims for this procedure in 2023, performing 22.3K total services. Individual payments in WI ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in Wisconsin is $101.27, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Wisconsin sits below the national Medicare average, commercial rates in the state may also run lower than the US median.

Using RAND 2024 commercial-to-Medicare ratios for X-Ray procedures, the estimated commercial insurance price in Wisconsin lands near $29.51, with self-pay cash prices typically around $38.29. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does X-Ray Of Knee, 1-2 Views cost in Wisconsin?

The average Medicare payment for X-Ray Of Knee, 1-2 Views in Wisconsin is $10.03, which is 30% below the national average of $14.40. Providers in WI typically bill $101.27 for this procedure.

What does X-Ray Of Knee, 1-2 Views cost with insurance in Wisconsin?

With commercial insurance in Wisconsin, X-Ray Of Knee, 1-2 Views costs an estimated $29.51. Without insurance, the estimated cash price is $38.29. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform X-Ray Of Knee, 1-2 Views in Wisconsin?

1.4K providers in Wisconsin billed Medicare for X-Ray Of Knee, 1-2 Views in 2023, performing 22.3K total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is X-Ray Of Knee, 1-2 Views cheaper in Wisconsin than the national average?

Yes — X-Ray Of Knee, 1-2 Views costs 30% below the national average in Wisconsin. The state average Medicare payment is $10.03 compared to $14.40 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial