Healthcare spending, insurance rates, and estimated procedure costs in Wisconsin (WI). Per-capita spending is 2% below the national average.
Estimates based on Wisconsin's cost index of 1.01x applied to national average procedure prices. Insured costs assume typical in-network copay/coinsurance at roughly 35% of the full price. Actual costs depend on provider, facility type, and insurance plan.
| Procedure | Estimated Cost | With Insurance | National Avg |
|---|---|---|---|
| Doctor Office Visit | $253 | $88 | $250 |
| Emergency Room Visit | $2,222 | $778 | $2,200 |
| MRI Scan | $1,338 | $468 | $1,325 |
| CT Scan | $833 | $292 | $825 |
| Childbirth (Vaginal) | $13,635 | $4,772 | $13,500 |
| Childbirth (C-Section) | $22,725 | $7,954 | $22,500 |
| Knee Replacement | $35,350 | $12,373 | $35,000 |
| Hip Replacement | $38,380 | $13,433 | $38,000 |
| Appendectomy | $16,160 | $5,656 | $16,000 |
| Colonoscopy | $2,778 | $972 | $2,750 |
| Dental Cleaning | $126 | $44 | $125 |
| Root Canal | $1,111 | $389 | $1,100 |
Wisconsin residents spend an average of $9,234 per person per year on healthcare, which is 2% lower than the national average of $9,421. The state's cost index of 1.01 means that a procedure costing $1,000 nationally would cost approximately $1,010 in Wisconsin.
Wisconsin has not expanded Medicaid under the ACA, contributing to an uninsured rate of 5.2%. A coverage gap may exist for adults who earn too much for traditional Medicaid but too little for marketplace subsidies.
For the best price on a planned procedure, compare quotes from at least three facilities. Hospital outpatient departments typically charge 2-3x more than ambulatory surgery centers for the same procedure. Under the CMS Hospital Price Transparency rule, all Wisconsin hospitals must publish their negotiated rates — use those files to comparison shop.
Data sources: CMS Hospital Price Transparency, Kaiser Family Foundation, Census Bureau ACS, Healthcare.gov marketplace data. Figures are estimates and may differ from actual billed amounts.
The average per-capita healthcare spending in Wisconsin is $9,234 per year. The cost index is 1.01x the national average, meaning medical procedures cost approximately 1% more than the US average.
Wisconsin has an uninsured rate of 5.2%, compared to the national average of approximately 8%. Wisconsin has not expanded Medicaid under the ACA, contributing to a higher uninsured rate.
Top-rated hospitals in Wisconsin include UW Health, Froedtert Hospital, Mayo Clinic Health System. Rankings are based on CMS Hospital Compare quality ratings, patient outcomes, and specialty accreditations.
The average monthly marketplace health insurance premium in Wisconsin is approximately $468. Actual costs vary based on plan tier (Bronze/Silver/Gold/Platinum), age, household size, and income-based subsidies available through Healthcare.gov.
No, Wisconsin has not expanded Medicaid under the ACA. This means a coverage gap may exist for adults who earn too much for traditional Medicaid but too little for marketplace subsidies.
Data verified · Source: CMS, KFF, Census Bureau & Healthcare.gov data
Our healthcare economists track procedure costs, insurance coverage, and medical pricing across 40+ countries and major US insurance networks. Data sourced from CMS, FAIR Health, and international health ministry databases.
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