Administration And Interpretation Of Patient-Focused Health Risk Assessment in Wisconsin
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
Wisconsin Pricing in Context
In Wisconsin, CPT code 96160 (Administration And Interpretation Of Patient-Focused Health Risk Assessment) carries an average Medicare payment of $1.65 — 9% below the national benchmark of $1.82. 20 providers across the state submitted claims for this procedure in 2023, performing 153 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 $38.12, 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 Medicine procedures, the estimated commercial insurance price in Wisconsin lands near $5.15, with self-pay cash prices typically around $12.31. 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 Administration And Interpretation Of Patient-Focused Health Risk Assessment cost in Wisconsin?
The average Medicare payment for Administration And Interpretation Of Patient-Focused Health Risk Assessment in Wisconsin is $1.65, which is 9% below the national average of $1.82. Providers in WI typically bill $38.12 for this procedure.
What does Administration And Interpretation Of Patient-Focused Health Risk Assessment cost with insurance in Wisconsin?
With commercial insurance in Wisconsin, Administration And Interpretation Of Patient-Focused Health Risk Assessment costs an estimated $5.15. Without insurance, the estimated cash price is $12.31. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.
How many providers perform Administration And Interpretation Of Patient-Focused Health Risk Assessment in Wisconsin?
20 providers in Wisconsin billed Medicare for Administration And Interpretation Of Patient-Focused Health Risk Assessment in 2023, performing 153 total services. Medicare payments ranged from N/A to N/A depending on the provider.
Is Administration And Interpretation Of Patient-Focused Health Risk Assessment cheaper in Wisconsin than the national average?
Yes — Administration And Interpretation Of Patient-Focused Health Risk Assessment costs 9% below the national average in Wisconsin. The state average Medicare payment is $1.65 compared to $1.82 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.
Related Guides
Related Data Sources
Data from CMS Medicare Physician & Other Practitioners (2023).
Read our methodology — how this data is sourced, computed, and verified.