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Wisconsin

Cost of a Cataract Surgery Visit
in Wisconsin

Reviewed by Momentary Medical Group West PC

Wisconsin's aging population drives demand for Cataract Surgery services across the state's diverse healthcare landscape. Patients typically experience variable costs for cataract surgery procedures, with negotiated rates showing significant variation between providers and facilities throughout Wisconsin. The state maintains many active Cataract Surgery providers, allowing patients to browse all providers in Wisconsin when seeking care.

Average

$3,412

Median

$95

Lowest

$80

Highest

$10,062

Providers

3,125

National avg: $888Wisconsin: $3,412

284% above national average

Compare Similar Procedures

How does cataract surgery compare to related procedures in Wisconsin?

ProcedureCPTLowMedianHighProviders
Knee Replacement

Total knee replacement (arthroplasty)

27447$73$3,723$10,5592,606
Hip Replacement

Total hip replacement (arthroplasty)

27130$73$3,602$10,5642,707
Knee Arthroscopy

Arthroscopy of the knee with meniscectomy

29881$73$1,658$4,2362,595
Gallbladder Removal (Laparoscopic)

Laparoscopic cholecystectomy

47562$73$1,221$4,6353,551
Appendectomy (Laparoscopic)

Laparoscopic appendectomy

44970$73$1,115$5,4294,057
Hysterectomy (Laparoscopic)

Laparoscopic total hysterectomy

58571$73$1,742$5,8485,130
Septoplasty

Nasal septum repair

30520$95$1,082$4,4191,138
Tonsillectomy

Tonsillectomy, primary or secondary

42820$95$547$1,4041,113
Inguinal Hernia Repair

Inguinal hernia repair

49505$73$1,248$4,0312,412
Mastectomy

Partial or simple mastectomy

19301$73$984$3,9472,389
Carpal Tunnel Surgery

Open carpal tunnel release

64721$85$747$5,3572,273

Important: These are cost estimates only — not a quote and not medical advice.

The prices on this page are self-pay rates, drawn from federal Transparency in Coverage machine-readable files (CPT 66984Extracapsular cataract removal with insertion of intraocular lens). They represent what a patient might pay without insurance.

Your actual cost depends on: your specific insurance plan, your remaining deductible, your coinsurance percentage, whether you have met your out-of-pocket maximum, whether the facility and provider are both in-network, and any separate anesthesia or implant fees billed independently.

This page does not constitute medical advice. Whether you need this procedure, and which approach is right for you, is a decision to make with a licensed healthcare provider.

Where this data comes from & what CPT 66984 covers

Data source: Cost figures are derived from UnitedHealthcare Transparency in Coverage machine-readable files for CPT code 66984 (Extracapsular cataract removal with insertion of intraocular lens), as mandated by the CMS Price Transparency Rule.

What CPT 66984 covers: the provider's professional fee for cataract surgery. It does not include facility/hospital fees, anesthesia, pre-operative imaging, post-operative care, or any add-on codes billed separately.

How to read this data

Negotiated Rate

The discounted price an insurer has agreed to pay a specific provider. Most insured patients' bills are calculated from this number, not the higher list price hospitals publish separately.

P5, Median, P95

P5 is the rate at the 5th percentile (low end), Median is the middle value, and P95 is the 95th percentile (high end). This range shows how much the same visit can vary between providers.

What this does not tell you

These rates do not tell you what you personally will pay out of pocket. That depends on your specific plan, how much of your deductible you have already met, your coinsurance rate, and whether the provider is in your network. Call your insurer's member line to get your exact estimate.

Top-Rated Hospitals in Wisconsin

These hospitals in Wisconsin are top-rated for patient satisfaction. Review data sourced from HCAHPS Patient Survey.

5/5
95% would recommend370 patient surveys
5/5
92% would recommend168 patient surveys
SAUK PRAIRIE HOSPITAL

PRAIRIE DU SAC, WI

5/5
89% would recommend289 patient surveys
5/5
89% would recommend451 patient surveys
5/5
88% would recommend135 patient surveys

Hospital ratings are based on HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey data published by CMS.

Why Cataract Surgery Visit Costs Vary Across Wisconsin

Wisconsin's healthcare costs run approximately 1% above national averages, reflecting the state's mix of urban medical centers and rural healthcare challenges. The state's geographic spread from Lake Superior to the Illinois border creates distinct regional cost patterns for specialized services like Cataract Surgery.

Urban vs. Rural Provider Availability

Milwaukee and Madison concentrate most of Wisconsin's high-volume cataract surgeons, while rural areas often require patients to travel significant distances for specialized care. Northern Wisconsin's sparse population density limits local competition, sometimes resulting in higher procedure costs. The Fox Valley region provides a middle ground with moderate provider density and competitive pricing.

Facility Type and Overhead Costs

Large health systems like Froedtert, UW Health, and Advocate Aurora dominate Wisconsin's hospital-based cataract surgery market, often charging higher facility fees than independent surgery centers. Free-standing ambulatory surgery centers throughout the state typically offer lower overhead costs and more transparent pricing. Academic medical centers in Madison and Milwaukee may include teaching hospital premiums in their surgical fees.

Insurance Market Competition in Wisconsin

BCBS Wisconsin holds significant market share alongside UHC and WEA Trust, creating moderate competition that affects negotiated rates for Cataract Surgery procedures. Rural areas often have fewer insurer options, potentially limiting patient leverage in cost negotiations. The state's insurance marketplace provides additional coverage choices that can impact out-of-pocket expenses.

Physician Supply and Demand in Wisconsin

Wisconsin maintains adequate ophthalmologist supply in urban areas while experiencing shortages in rural regions, affecting both access and pricing patterns. The state's aging population increases demand for cataract surgery, potentially influencing wait times and costs. Physician recruitment challenges in northern Wisconsin sometimes lead to higher compensation requirements that affect patient pricing.

JP

Jayant Panwar

CEO, Momentary Labs · San Francisco, CA

Jayant has analyzed healthcare pricing data from CMS Transparency in Coverage files since 2022, covering more than 50 million negotiated rate records across all 50 states. His work focuses on making insurer machine-readable files accessible to patients and researchers.

The cost figures on this page reflect his ongoing work to make this data accessible to patients.

Healthcare Data AnalyticsCMS TiC DataInsurance Price Transparency

Frequently Asked Questions — Cataract Surgery Costs in Wisconsin

What is the average cost of a Cataract Surgery visit in Wisconsin without insurance?

Cataract surgery consultations and procedures vary widely across Wisconsin providers. Self-pay patients should expect significant cost variations between hospital-based and independent surgery centers. Many Wisconsin practices offer cash-pay discounts and financing options to help manage these expenses.

Does Wisconsin Medicaid cover Cataract Surgery visits?

Wisconsin's expanded Medicaid program covers medically necessary cataract surgery for qualifying patients, including both consultation visits and surgical procedures. Prior authorization may be required for premium lens upgrades or advanced surgical techniques. Patients should verify their specific Medicaid plan's coverage details and provider network before scheduling.

How do I find an affordable Cataract Surgery near me in Wisconsin?

Compare pricing between hospital-based surgery centers and independent ambulatory facilities throughout Wisconsin, as costs can vary significantly. Many practices offer self-pay discounts for uninsured patients, while community health centers may provide sliding-scale fee options. Consider traveling to areas with higher provider competition for potentially better pricing.

What is the difference in cost between an initial consultation and a follow-up visit?

Initial cataract surgery consultations typically involve comprehensive eye examinations and diagnostic testing, resulting in higher costs than follow-up visits. Post-operative follow-up appointments focus on healing progress and vision assessment, generally requiring less time and fewer tests. Many Wisconsin practices include several follow-up visits in their surgical package pricing.

Can I use an HSA or FSA to pay for a Cataract Surgery visit in Wisconsin?

Both HSA and FSA funds can cover cataract surgery consultations, procedures, and related medical expenses as qualified healthcare costs. This includes diagnostic testing, surgical fees, and follow-up care throughout Wisconsin. Keep detailed receipts and documentation for reimbursement or direct payment using these tax-advantaged accounts.

How does telemedicine affect the cost of seeing a Cataract Surgery in Wisconsin?

Telemedicine consultations for cataract surgery are limited since physical eye examinations and diagnostic testing are essential for proper evaluation. Some Wisconsin practices use telehealth for pre-operative consultations or post-surgical follow-ups, which may reduce overall costs. However, in-person visits remain necessary for comprehensive cataract assessment and surgical planning.

Click a state to compare costs

Average Visit Cost

$351
$3,412

Office visit (CPT 66984)

Compare With Other States

RankStateAverage
1Wisconsin
Range: $80$10,062
$3,412
2Wyoming
Range: $667$2,130
$1,240
3Rhode Island
Range: $448$2,135
$1,181
4Massachusetts
Range: $403$2,078
$1,139
5Montana
Range: $85$2,744
$1,127
6Delaware
Range: $343$2,135
$1,056
7Nebraska
Range: $641$1,313
$1,055
8Washington
Range: $616$1,521
$1,034
9New Hampshire
Range: $528$1,548
$1,023
10New York
Range: $364$2,135
$1,005
11Colorado
Range: $85$2,114
$1,003
12New Mexico
Range: $474$1,551
$982
13Alaska
Range: $85$2,135
$972
14Georgia
Range: $93$2,005
$970
15Connecticut
Range: $70$2,135
$961
16Pennsylvania
Range: $85$2,135
$946
17Maine
Range: $643$1,123
$945
18North Carolina
Range: $390$1,609
$940
19California
Range: $85$1,401
$899
20Nevada
Range: $415$1,453
$892
21District of Columbia
Range: $414$1,311
$871
22Vermont
Range: $403$1,548
$865
23Iowa
Range: $85$1,313
$861
24Oregon
Range: $85$1,687
$858
25North Dakota
Range: $80$1,609
$812
26Mississippi
Range: $430$1,451
$806
27Minnesota
Range: $90$1,548
$800
28Utah
Range: $85$1,209
$791
29New Jersey
Range: $364$1,380
$790
30South Carolina
Range: $327$1,383
$785
31Illinois
Range: $418$1,200
$771
32Alabama
Range: $418$1,195
$767
33Idaho
Range: $85$1,348
$743
34Tennessee
Range: $418$1,090
$741
35Hawaii
Range: $85$1,386
$739
36Louisiana
Range: $226$1,345
$730
37South Dakota
Range: $95$1,313
$729
38West Virginia
Range: $85$1,409
$721
39Maryland
Range: $477$1,083
$714
40Kansas
Range: $502$912
$711
41Virginia
Range: $360$1,157
$710
42Indiana
Range: $70$1,385
$708
43Kentucky
Range: $85$1,313
$691
44Missouri
Range: $502$811
$680
45Ohio
Range: $335$1,087
$678
46Texas
Range: $85$1,210
$662
47Michigan
Range: $85$1,073
$645
48Arkansas
Range: $85$1,042
$624
49Arizona
Range: $448$898
$614
50Oklahoma
Range: $85$960
$525
51Florida
Range: $35$964
$351
Cataract Surgery in Other States