Wisconsin

Cost of a Mastectomy Visit
in Wisconsin

Name: Mastectomy Cost in Wisconsin (2026)
Creator: Jayant Panwar
Published: 2026-03-18

Reviewed by Momentary Medical Group West PC

Wisconsin's healthcare market maintains costs roughly 1% above the national average, with strong rural provider networks serving the state's diverse geography. Mastectomy patients typically pay between $73 and $3,947, with a median out-of-pocket cost of $984, depending on insurance coverage and facility type. Wisconsin has many active Mastectomy providers across urban centers like Milwaukee and Madison as well as rural communities, allowing patients to browse all available providers throughout the state.

Average

$1,668

Median

$984

Lowest

$73

Highest

$3,947

Providers

2,389

National avg: $984Wisconsin: $1,668

70% above national average

HSA/FSA eligible

Always available primary care

Just $19.99/mo

Compare Similar Procedures

How does mastectomy compare to related procedures in Wisconsin?

Procedure	CPT	Low	Median	High	Providers
Knee Replacement Total knee replacement (arthroplasty)	27447	$73	$3,723	$10,559	2,606
Hip Replacement Total hip replacement (arthroplasty)	27130	$73	$3,602	$10,564	2,707
Cataract Surgery Cataract extraction with intraocular lens insertion	66984	$80	$95	$10,062	3,125
Knee Arthroscopy Arthroscopy of the knee with meniscectomy	29881	$73	$1,658	$4,236	2,595
Gallbladder Removal (Laparoscopic) Laparoscopic cholecystectomy	47562	$73	$1,221	$4,635	3,551
Appendectomy (Laparoscopic) Laparoscopic appendectomy	44970	$73	$1,115	$5,429	4,057
Hysterectomy (Laparoscopic) Laparoscopic total hysterectomy	58571	$73	$1,742	$5,848	5,130
Septoplasty Nasal septum repair	30520	$95	$1,082	$4,419	1,138
Tonsillectomy Tonsillectomy, primary or secondary	42820	$95	$547	$1,404	1,113
Inguinal Hernia Repair Inguinal hernia repair	49505	$73	$1,248	$4,031	2,412
Carpal Tunnel Surgery Open carpal tunnel release	64721	$85	$747	$5,357	2,273

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 19301 — Mastectomy, partial / simple complete). 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 19301 covers

Data source: Cost figures are derived from UnitedHealthcare Transparency in Coverage machine-readable files for CPT code 19301 (Mastectomy, partial / simple complete), as mandated by the CMS Price Transparency Rule.

What CPT 19301 covers: the provider's professional fee for mastectomy. 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.

Full data methodology and glossary

Top-Rated Hospitals in Wisconsin

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

ORTHOPAEDIC HOSPITAL OF WISCONSIN

GLENDALE, WI

5/5

95% would recommend370 patient surveys

OAKLEAF SURGICAL HOSPITAL

ALTOONA, WI

5/5

92% would recommend168 patient surveys

SAUK PRAIRIE HOSPITAL

PRAIRIE DU SAC, WI

5/5

89% would recommend289 patient surveys

MADISON VA MEDICAL CENTER

MADISON, WI

5/5

89% would recommend451 patient surveys

HOWARD YOUNG MEDICAL CENTER

WOODRUFF, WI

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 Mastectomy Visit Costs Vary Across Wisconsin

Wisconsin's healthcare costs run approximately 1% above national averages, reflecting the state's balanced mix of urban medical centers and extensive rural provider networks. The state's competitive insurance market and strong provider supply help moderate costs compared to neighboring states with more concentrated markets.

Urban vs. Rural Provider Availability

Wisconsin's major metropolitan areas like Milwaukee, Madison, and Green Bay concentrate most breast surgery specialists, while rural counties may have limited local options for mastectomy procedures. Patients in northern Wisconsin or smaller communities often travel to regional medical centers, potentially affecting total treatment costs when factoring in travel and lodging. The state's strong regional hospital systems help maintain access across rural areas, though specialist availability remains concentrated in larger population centers.

Facility Type and Overhead Costs

Hospital-based outpatient surgical centers in Wisconsin typically charge higher facility fees than independent surgical centers due to overhead costs and emergency readiness requirements. Major health systems like Ascension Wisconsin, Aurora Health Care, and UW Health operate extensive networks of both hospital-based and freestanding surgical facilities. Independent surgical centers often provide more predictable pricing for elective mastectomy procedures without the additional facility fees common at hospital outpatient departments.

Insurance Market Competition in Wisconsin

Wisconsin maintains moderate insurer competition with BCBS Wisconsin (Anthem), UHC, and WEA Trust serving as dominant players alongside several smaller regional plans. This competitive landscape helps negotiate reasonable rates for specialized procedures like mastectomy compared to states with single-insurer dominance. The presence of multiple insurer options creates pricing pressure that generally benefits patients through negotiated rate competition among providers.

Physician Supply and Demand in Wisconsin

Wisconsin maintains an adequate supply of breast surgeons and plastic surgeons qualified to perform mastectomy procedures, with 2,389 active providers handling these procedures throughout the state. This supply level indicates reasonable access for most patients without the severe shortages seen in some rural states, helping maintain competitive pricing and reasonable wait times. The concentration of providers in academic medical centers at UW-Madison and Medical College of Wisconsin ensures access to subspecialty expertise for complex cases.

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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 — Mastectomy Costs in Wisconsin

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

Without insurance, mastectomy consultation visits in Wisconsin typically range from $73 to $3,947, with a median cost of $984 for the initial evaluation. The actual procedure costs significantly more and vary based on facility type, complexity, and whether reconstruction is performed simultaneously. Many providers offer self-pay discounts that can reduce these costs by 30-50% when paid upfront, making it worthwhile to negotiate payment terms directly with the surgeon's office.

Does Wisconsin Medicaid cover Mastectomy visits?

Yes, Wisconsin's expanded Medicaid program covers mastectomy consultations and procedures when medically necessary, including both therapeutic and prophylactic surgeries for high-risk patients. Coverage includes the surgeon's fees, facility costs, anesthesia, and necessary follow-up care, though prior authorization may be required for certain types of procedures. Patients should verify that their chosen surgeon accepts Medicaid and understand any referral requirements that may apply through their managed care plan.

How do I find an affordable Mastectomy near me in Wisconsin?

Compare costs between hospital-based surgical centers and independent facilities, as independent centers often charge lower facility fees for the same procedures. Ask about self-pay discounts, payment plans, and sliding scale fees, particularly at community health systems throughout Wisconsin. Consider traveling to different regions within the state, as costs can vary significantly between Milwaukee, Madison, and smaller communities, though factor in travel expenses when making comparisons.

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

Initial mastectomy consultations typically cost between $73 and $3,947 with a median of $984, while follow-up visits generally cost less since they involve shorter appointment times and less comprehensive evaluation. New patient visits require detailed history taking, physical examination, and treatment planning, justifying higher fees than established patient follow-ups. The exact cost difference depends on your insurance plan's specialist visit copays and whether you've met your annual deductible.

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

Yes, both HSA and FSA funds can be used to pay for mastectomy consultations and procedures as they qualify as medical expenses under IRS guidelines. This includes the surgeon's fees, facility costs, anesthesia, and related medical supplies or medications prescribed as part of your treatment. Keep all receipts and documentation for tax purposes, and remember that HSA funds roll over year to year while FSA funds typically must be used within the plan year.

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

Telemedicine consultations for breast surgery typically cost less than in-person visits, though physical examination is usually necessary for proper evaluation of breast concerns. Many Wisconsin providers offer virtual follow-up appointments after surgery, which can reduce costs and travel time for patients in rural areas. Initial consultations for mastectomy usually require in-person evaluation, but telemedicine can be valuable for second opinions, pre-operative education, and post-operative monitoring visits.

Click a state to compare costs

Average Visit Cost

$610