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Office visit, new patient, 60-74 min

CPT 99205 · negotiated-rate distribution across hospitals in MI

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Hospitals
28
Min
$128.32
Median
$171.42
Max
$366.3
Range multiplier
2.9×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare1273$101.93$163.91$1,313.212.9×
Aetna1356$71.06$181.96$882.8512.4×
priority health op rate938$72.86$162.51$947.9413.0×
First Health837$83.05$216.75$1,594.619.2×
Blue Cross Blue Shield1233$117.84$264.56$9347.9×
cofinity - auto op rate427$85.59$206.88$1,063.3212.4×
hap preferred op rate427$61.91$149.65$769.1612.4×
Medicaid826$115.66$120.29$9348.1×
hap - hmo op rate525$55.61$133.69$690.9312.4×
Medicare824$159.14$159.14$162.321.0×
hp - hmo op rate423$64.6$155.29$802.5512.4×
hp - ppo op rate423$85.96$206.66$1,068.0112.4×
health advantage - ppo op rate219$47.94$122.64$602.7612.6×
mhp - hmo op rate219$47.94$122.64$602.7612.6×
priority health817$88.16$200.8$243.132.8×
cofinity - ppom op rate317$73.99$186.39$919.2412.4×
hurley medical center op rate113$42.28$101.64$525.2812.4×
cofinity - wc/auto op rate113$85.59$205.75$1,063.3212.4×
hap/ahl op rate113$55.61$133.69$690.9312.4×
cofinity wc op rate113$73.99$177.87$919.2412.4×
mclaren commercial ins812$48.11$168$1683.5×
hap - ppo op rate310$93.9$236.7$538.085.7×
u of m health plan89$84.37$183.01$183.012.2×
Multiplan29$120.8$174.4$785.66.5×
hap - hmo88$177$177$1771.0×
safe response program88$275$275$2751.0×
Humana88$159.14$159.14$159.141.0×
mclaren health advantage op rate28$54.83$82.57$356.566.5×
mclaren health op rate37$55.62$127.61$433.067.8×
evernorth behavioral health77$171.42$171.42$171.421.0×
hcap op rate37$127.5$153$304.52.4×
bcccnp66$115$115$1151.0×
beech street op rate16$135.9$169.2$883.86.5×
hospice care in michigan op rate16$75.5$94$4916.5×
cofinity-ppom op rate16$88.72$323.04$508.385.7×
hap-hmo op rate16$68.12$84.81$442.986.5×
cofinity w/c op rate16$96.2$119.78$625.636.5×
usa mco-ppo op rate16$128.35$159.8$834.76.5×
gift of life op rate16$105.7$131.6$687.46.5×
phpmm-commercial hmo op rate16$64.21$79.94$417.556.5×
cofinity - wc op rate16$88.57$322.51$507.545.7×
workers compensation56$56.5$64.59$127.352.3×
hap ahl op rate25$86.36$198.12$287.053.3×
Cigna25$99.45$228.15$266.42.7×
cofinity op rate25$127.5$199.8$736.55.8×
hap hmo op rate25$85.41$195.94$264.363.1×
health plus hmo op rate25$94.35$216.45$317.463.4×
com php op rate14$69.29$92.12$140.212.0×
com priority health op rate14$102.09$135.71$206.572.0×
health advantage - commercial op rate24$76.41$82.9$89.381.2×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
TAWAS ST. JOSEPH HOSPITALTAWASMI1$1,106$364.98$366.3$366.3$541.68
MCLAREN LAPEER REGIONLAPEERMI24$731.7$485.7$47.94$274.69$934
ASCENSION ST JOHN HOSPITALDETROITMI3$750.5$277.69$183.33$264.56$283.45
GARDEN CITY HOSPITAL OSTEOPATHICGARDEN CITYMI3$488$115$211.34$488
MCLAREN OAKLANDPONTIACMI10$204.9$85.97$185.4$394
MCLAREN PORT HURONPORT HURONMI29$473$236.5$55.62$184.28$406
KARMANOS CANCER HOSPITALDETROITMI13$230.9$80.44$177.97$349.43
BORGESS-PIPP HEALTH CENTERPLAINWELLMI1$1,083$433.2$171.42$171.42$171.42
ASCENSION BORGESS HOSPITALKALAMAZOOMI1$1,083$433.2$171.42$171.42$171.42
GENESYS REGIONAL MEDICAL CTR.GRAND BLANCMI1$1,083$433.2$171.42$171.42$171.42
ASCENSION PROVIDENCE ROCHESTER HOSPIROCHESTERMI1$1,083$433.2$171.42$171.42$171.42
ASCENSION STANDISH HOSPITALSTANDISHMI1$1,083$433.2$171.42$171.42$171.42
ASCENSION BORGESS-LEE HOSPITALDOWAGIACMI1$1,083$433.2$171.42$171.42$171.42
ASCENSION ALLEGAN HOSPITALALLEGANMI1$1,083$433.2$171.42$171.42$171.42
MCLAREN THUMB REGIONBAD AXEMI12$339$169.5$99.17$165.96$275
MCLAREN NORTHERN MICHIGANPETOSKEYMI13$1,200$600$61.93$160.73$275
MCLAREN CENTRAL MICHIGANMT PLEASANTMI18$1,194$597$74.97$159.14$883.8
BAY REGIONAL MEDICAL CENTERBAY CITYMI23$409$204.5$64.45$159.14$428.68
MCLAREN FLINTFLINTMI28$2,271$1,135.5$42.28$153.3$1,594.6
MCLAREN GREATER LANSINGLANSING MI 489100MI17$1,143$571.5$65.39$147.72$334.28
MCLAREN BAY SPECIAL CAREBAY CITYMI12$132.6$76.41$143.39$218.03
MCLAREN MACOMBMT. CLEMENSMI15$531.1$54.83$128.32$883.8
CARSON CITY HOSPITALCARSON CITYMI0$573$181.5
SPARROW EATONCHARLOTTEMI0$459$181.5
MACKINAC STRAITS HEALTH SYSTEM INCST. IGNACEMI0$491$343.7
MCKENZIE HEALTH SYSTEMSANDUSYMI0$320$256
NORTH OTTAWA COMMUNITY HOSPITALGRAND HAVENMI0$477$333.9
SPARROW CLINTON HOSPITALST. JOHNSMI0$458$181.5

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.