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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
$366.30
Range multiplier
2.9×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare1273$101.93$163.91$1,313.2012.9×
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$1,594.6019.2×
Blue Cross Blue Shield1233$117.84$264.56$934.007.9×
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$934.008.1×
hap - hmo op rate525$55.61$133.69$690.9312.4×
Medicare824$159.14$159.14$162.321.0×
hp - hmo op rate423$64.60$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$200.80$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$168.00$168.003.5×
hap - ppo op rate310$93.90$236.70$538.085.7×
u of m health plan89$84.37$183.01$183.012.2×
Multiplan29$120.80$174.40$785.606.5×
hap - hmo88$177.00$177.00$177.001.0×
safe response program88$275.00$275.00$275.001.0×
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$127.50$153.00$304.502.4×
bcccnp66$115.00$115.00$115.001.0×
beech street op rate16$135.90$169.20$883.806.5×
hospice care in michigan op rate16$75.50$94.00$491.006.5×
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$96.20$119.78$625.636.5×
usa mco-ppo op rate16$128.35$159.80$834.706.5×
gift of life op rate16$105.70$131.60$687.406.5×
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$56.50$64.59$127.352.3×
hap ahl op rate25$86.36$198.12$287.053.3×
Cigna25$99.45$228.15$266.402.7×
cofinity op rate25$127.50$199.80$736.505.8×
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$82.90$89.381.2×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Tawas St. Joseph HospitalTawasMI1$1,106.00$364.98$366.30$366.30$541.68
Mclaren Lapeer RegionLapeerMI24$731.70$485.70$47.94$274.69$934.00
Ascension St John HospitalDetroitMI3$750.50$277.69$183.33$264.56$283.45
Garden City Hospital OsteopathicGarden CityMI3$488.00$115.00$211.34$488.00
Mclaren OaklandPontiacMI10$204.90$85.97$185.40$394.00
Mclaren Port HuronPort HuronMI29$473.00$236.50$55.62$184.28$406.00
Karmanos Cancer HospitalDetroitMI13$230.90$80.44$177.97$349.43
Borgess-Pipp Health CenterPlainwellMI1$1,083.00$433.20$171.42$171.42$171.42
Ascension Borgess HospitalKalamazooMI1$1,083.00$433.20$171.42$171.42$171.42
Genesys Regional Medical Ctr.Grand BlancMI1$1,083.00$433.20$171.42$171.42$171.42
Ascension Providence Rochester HospiRochesterMI1$1,083.00$433.20$171.42$171.42$171.42
Ascension Standish HospitalStandishMI1$1,083.00$433.20$171.42$171.42$171.42
Ascension Borgess-Lee HospitalDowagiacMI1$1,083.00$433.20$171.42$171.42$171.42
Ascension Allegan HospitalAlleganMI1$1,083.00$433.20$171.42$171.42$171.42
Mclaren Thumb RegionBad AxeMI12$339.00$169.50$99.17$165.96$275.00
Mclaren Northern MichiganPetoskeyMI13$1,200.00$600.00$61.93$160.73$275.00
Mclaren Central MichiganMt PleasantMI18$1,194.00$597.00$74.97$159.14$883.80
Bay Regional Medical CenterBay CityMI23$409.00$204.50$64.45$159.14$428.68
Mclaren FlintFlintMI28$2,271.00$1,135.50$42.28$153.30$1,594.60
Mclaren Greater LansingLansingMI17$1,143.00$571.50$65.39$147.72$334.28
Mclaren Bay Special CareBay CityMI12$132.60$76.41$143.39$218.03
Mclaren MacombMt. ClemensMI15$531.10$54.83$128.32$883.80
Carson City HospitalCarson CityMI0$573.00$181.50
Sparrow EatonCharlotteMI0$459.00$181.50
Mackinac Straits Health System IncSt. IgnaceMI0$491.00$343.70
Mckenzie Health SystemSanduskyMI0$320.00$256.00
North Ottawa Community HospitalGrand HavenMI0$477.00$333.90
Sparrow Clinton HospitalSt. JohnsMI0$458.00$181.50

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.