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Office visit, new patient, 30-44 minutes
CPT 99203 · negotiated-rate distribution across hospitals in MI
Hospitals
28
Min
$74.00
Median
$95.12
Max
$191.40
Range multiplier
2.6×
By payer (50 payers with published rates)
| Payer | Hosp. | Rates | Min | Median | Max | Range× |
|---|---|---|---|---|---|---|
| UnitedHealthcare | 12 | 84 | $52.19 | $105.76 | $798.00 | 15.3× |
| Aetna | 13 | 64 | $47.06 | $110.88 | $656.25 | 13.9× |
| priority health op rate | 9 | 42 | $50.53 | $109.73 | $514.94 | 10.2× |
| First Health | 8 | 39 | $65.45 | $155.55 | $672.80 | 10.3× |
| Blue Cross Blue Shield | 12 | 33 | $72.68 | $129.01 | $518.00 | 7.1× |
| hap - hmo op rate | 5 | 29 | $36.83 | $84.55 | $237.92 | 6.5× |
| Medicaid | 8 | 26 | $52.19 | $54.28 | $518.00 | 9.9× |
| hap preferred op rate | 4 | 26 | $41.00 | $116.34 | $518.96 | 12.7× |
| cofinity - auto op rate | 4 | 26 | $56.68 | $149.82 | $626.06 | 11.0× |
| hp - ppo op rate | 4 | 26 | $56.93 | $109.93 | $367.77 | 6.5× |
| hp - hmo op rate | 4 | 26 | $42.78 | $82.61 | $276.36 | 6.5× |
| Medicare | 8 | 24 | $71.06 | $71.06 | $72.48 | 1.0× |
| priority health | 8 | 20 | $57.77 | $90.73 | $600.04 | 10.4× |
| cofinity - ppom op rate | 3 | 20 | $49.00 | $116.53 | $316.54 | 6.5× |
| health advantage - ppo op rate | 2 | 18 | $32.13 | $90.30 | $207.56 | 6.5× |
| mhp - hmo op rate | 2 | 18 | $32.13 | $90.30 | $207.56 | 6.5× |
| mclaren commercial ins | 8 | 15 | $41.37 | $74.00 | $74.00 | 1.8× |
| hap - ppo op rate | 3 | 14 | $76.28 | $105.45 | $298.42 | 3.9× |
| hap/ahl op rate | 1 | 12 | $36.83 | $87.59 | $237.92 | 6.5× |
| cofinity - wc/auto op rate | 1 | 12 | $56.68 | $134.80 | $366.15 | 6.5× |
| cofinity wc op rate | 1 | 12 | $49.00 | $116.53 | $316.54 | 6.5× |
| u of m health plan | 8 | 12 | $72.55 | $81.72 | $414.94 | 5.7× |
| hurley medical center op rate | 1 | 12 | $28.00 | $66.59 | $180.88 | 6.5× |
| hcap op rate | 3 | 11 | $71.40 | $87.60 | $191.25 | 2.7× |
| Humana | 8 | 8 | $71.06 | $71.06 | $71.06 | 1.0× |
| hap - hmo | 8 | 8 | $80.13 | $80.13 | $80.13 | 1.0× |
| mclaren health op rate | 3 | 8 | $47.77 | $81.80 | $385.88 | 8.1× |
| great lakes research op rate | 2 | 8 | $71.40 | $82.20 | $109.80 | 1.5× |
| mclaren health advantage op rate | 2 | 8 | $43.21 | $75.23 | $317.71 | 7.4× |
| Multiplan | 2 | 8 | $95.20 | $143.04 | $700.00 | 7.4× |
| safe response program | 8 | 8 | $225.00 | $225.00 | $225.00 | 1.0× |
| health advantage - commercial op rate | 2 | 8 | $41.71 | $48.02 | $64.14 | 1.5× |
| evernorth behavioral health | 7 | 7 | $95.12 | $95.12 | $95.12 | 1.0× |
| workers compensation | 6 | 7 | $48.59 | $55.65 | $140.73 | 2.9× |
| hap ahl op rate | 2 | 6 | $74.17 | $127.00 | $234.68 | 3.2× |
| bcccnp | 6 | 6 | $108.06 | $108.06 | $108.06 | 1.0× |
| Cigna | 2 | 6 | $77.40 | $146.25 | $217.80 | 2.8× |
| cofinity - wc op rate | 1 | 6 | $76.08 | $196.44 | $281.48 | 3.7× |
| cofinity-ppom op rate | 1 | 6 | $76.20 | $196.77 | $281.95 | 3.7× |
| hap hmo op rate | 2 | 6 | $73.35 | $125.60 | $216.13 | 2.9× |
| health plus hmo op rate | 2 | 6 | $81.03 | $138.76 | $259.55 | 3.2× |
| cofinity w/c op rate | 1 | 5 | $75.81 | $86.01 | $557.46 | 7.4× |
| gift of life op rate | 1 | 5 | $83.30 | $94.50 | $612.50 | 7.4× |
| usa mco-ppo op rate | 1 | 5 | $101.15 | $114.75 | $743.75 | 7.4× |
| beech street op rate | 1 | 5 | $107.10 | $121.50 | $787.50 | 7.4× |
| hap-hmo op rate | 1 | 5 | $53.68 | $60.90 | $394.71 | 7.4× |
| phpmm-commercial hmo op rate | 1 | 5 | $50.60 | $57.40 | $372.05 | 7.4× |
| hospice care in michigan op rate | 1 | 5 | $59.50 | $67.50 | $437.50 | 7.4× |
| cofinity op rate | 2 | 4 | $106.81 | $149.38 | $656.25 | 6.1× |
| com cofinity auto op rate | 1 | 4 | $82.23 | $115.70 | $612.00 | 7.4× |
By hospital (top 200 by negotiated median, descending)
| Hospital | City | ST | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| Mclaren Central Michigan | Mt Pleasant | MI | 17 | $1,064.00 | $532.00 | $52.19 | $99.40 | $798.00 |
| Mclaren Macomb | Mt. Clemens | MI | 15 | — | $473.20 | $43.21 | $95.18 | $787.50 |
| Ascension Borgess Hospital | Kalamazoo | MI | 1 | $732.00 | $292.80 | $95.12 | $95.12 | $95.12 |
| Genesys Regional Medical Ctr. | Grand Blanc | MI | 1 | $732.00 | $292.80 | $95.12 | $95.12 | $95.12 |
| Ascension Borgess-Lee Hospital | Dowagiac | MI | 1 | $732.00 | $292.80 | $95.12 | $95.12 | $95.12 |
| Ascension Standish Hospital | Standish | MI | 1 | $732.00 | $292.80 | $95.12 | $95.12 | $95.12 |
| Ascension Allegan Hospital | Allegan | MI | 1 | $732.00 | $292.80 | $95.12 | $95.12 | $95.12 |
| Borgess-Pipp Health Center | Plainwell | MI | 1 | $732.00 | $292.80 | $95.12 | $95.12 | $95.12 |
| Ascension Providence Rochester Hospi | Rochester | MI | 1 | $732.00 | $292.80 | $95.12 | $95.12 | $95.12 |
| Mclaren Greater Lansing | Lansing | MI | 18 | $1,018.00 | $509.00 | $45.17 | $90.57 | $712.60 |
| Mclaren Bay Special Care | Bay City | MI | 12 | — | $95.15 | $41.71 | $83.93 | $156.47 |
| Bay Regional Medical Center | Bay City | MI | 24 | $291.00 | $145.50 | $41.71 | $83.30 | $264.40 |
| Mclaren Northern Michigan | Petoskey | MI | 13 | $990.00 | $495.00 | $52.19 | $80.13 | $600.04 |
| Mclaren Thumb Region | Bad Axe | MI | 12 | $830.50 | $415.25 | $52.19 | $74.00 | $225.00 |
| Tawas St. Joseph Hospital | Tawas | MI | 1 | $677.00 | $223.41 | $191.40 | $191.40 | $283.04 |
| Mclaren Lapeer Region | Lapeer | MI | 24 | $446.10 | $269.40 | $41.17 | $168.92 | $518.00 |
| Karmanos Cancer Hospital | Detroit | MI | 13 | — | $188.80 | $47.60 | $163.74 | $285.68 |
| Mclaren Oakland | Pontiac | MI | 10 | — | $121.15 | $73.84 | $142.12 | $233.00 |
| Ascension St John Hospital | Detroit | MI | 3 | $447.00 | $165.39 | $83.81 | $120.41 | $129.01 |
| Mclaren Port Huron | Port Huron | MI | 29 | $48,468 | $24,234 | $46.03 | $117.31 | $255.00 |
| Garden City Hospital Osteopathic | Garden City | MI | 3 | $325.00 | — | $108.06 | $110.49 | $325.00 |
| Mclaren Flint | Flint | MI | 27 | $782.00 | $391.00 | $28.00 | $107.38 | $549.10 |
| Sparrow Eaton | Charlotte | MI | 0 | $346.00 | $94.00 | — | — | — |
| North Ottawa Community Hospital | Grand Haven | MI | 0 | $361.00 | $252.70 | — | — | — |
| Carson City Hospital | Carson City | MI | 0 | $434.00 | $108.50 | — | — | — |
| Mackinac Straits Health System Inc | St. Ignace | MI | 0 | $273.00 | $191.10 | — | — | — |
| Mckenzie Health System | Sandusky | MI | 0 | $165.00 | $132.00 | — | — | — |
| Sparrow Clinton Hospital | St. Johns | MI | 0 | $346.00 | $94.00 | — | — | — |
Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.