All 24 procedures examined cost more in Wisconsin; 23 percent gap persists even within the same health system
September 8, 2026
Washington, D.C., September 8, 2026 — A new analysis of commercial hospital prices finds Wisconsin hospitals receive 26 percent higher negotiated rates than Illinois hospitals for the same inpatient services and the same payer, with the gap appearing across every procedure examined and even within a health system operating on both sides of the state line.
Published by the University of Wisconsin–Madison Center for Research on the Wisconsin Economy (CROWE), the researchers used commercial negotiated-rate data from federal hospital and payer price-transparency files. The primary inpatient sample included 67 Illinois hospitals and 58 Wisconsin hospitals, representing 20 health systems in each state.
Among the study’s key findings:
- Same service, same payer: After controlling for the specific inpatient service and insurer, Wisconsin negotiated rates were 25.6 percent higher than Illinois rates. The estimate remained essentially unchanged after accounting for hospital facility type and teaching status.
- Higher prices across the board: Every one of the 24 inpatient procedures available for direct comparison was more expensive in Wisconsin, spanning obstetric, surgical, cardiovascular, and other medical services.
- The gap persists within the same health system: Among Advocate Health hospitals, Wisconsin facilities operating as Aurora Health Care were paid 23.1 percent more for inpatient services than Illinois facilities operating as Advocate Health Care under the same parent organization.
“The consistency of these findings is what should get policymakers’ attention,” said Adam L. Buckalew, senior advisor for Hospital Watch. “This is not one procedure or one hospital system. Wisconsin prices are higher across the board, and the researchers point to provider-market structure as the leading explanation. That should prompt a much harder look at consolidation, competition, and how hospital market power affects what employers and families ultimately pay.”
The report notes that Wisconsin and Illinois are broadly similar on several factors relevant to commercial hospital demand, including median age, household income, poverty, private and employer-based insurance coverage and the uninsured rate. The researchers found that the Wisconsin price premium remained stable across hospital types and payers and persisted within the same hospital system. Taken together, they identify market structure — rather than differences in service mix, hospital type or insurer behavior — as the leading candidate explanation for the higher Wisconsin prices. Future phases of the research will examine hospital consolidation, service-line restructuring and provider-sponsored health plans as possible structural drivers.
The study also follows increased federal scrutiny of hospital price transparency. In June, more than 500 hospitals nationwide were warned by the federal government for failing to comply with hospital price-transparency requirements, including 10 hospitals in Wisconsin. The new Wisconsin–Illinois analysis adds a broader affordability concern: the report notes that elevated hospital prices have implications for insurance premiums, employer costs, and state budgets.
Read the full report HERE.
