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Office visit, established patient, 10-19 min

CPT 99212 · negotiated-rate distribution across hospitals in MI

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Hospitals
29
Min
$31.60
Median
$59.81
Max
$129.96
Range multiplier
4.1×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare1399$21.70$84.38$751.5034.6×
Aetna1381$20.24$87.04$751.5037.1×
priority health op rate958$21.73$85.35$484.3422.3×
First Health854$28.00$135.95$632.8022.6×
hap - hmo op rate545$15.84$67.40$231.0014.6×
cofinity - auto op rate441$24.07$103.72$588.8624.5×
hp - ppo op rate440$24.48$101.28$284.6511.6×
hp - hmo op rate440$18.40$76.11$205.1511.1×
hap preferred op rate438$17.63$80.15$488.1227.7×
cofinity - ppom op rate334$21.07$94.91$427.5020.3×
Blue Cross Blue Shield1233$39.37$79.20$378.009.6×
mhp - hmo op rate230$13.82$66.73$111.178.0×
health advantage - ppo op rate230$13.82$66.73$111.178.0×
Medicaid826$22.37$23.26$378.0016.9×
cofinity - wc/auto op rate124$24.37$108.54$193.858.0×
Medicare824$30.83$30.83$31.451.0×
cofinity wc op rate124$21.07$93.84$167.588.0×
hurley medical center op rate124$12.04$53.62$95.768.0×
hap/ahl op rate124$15.84$70.53$125.968.0×
priority health823$39.04$83.00$548.0714.0×
mclaren commercial ins820$25.00$42.03$302.6312.1×
hap - ppo op rate316$57.69$74.30$320.505.6×
hcap op rate313$54.00$69.00$300.005.6×
u of m health plan812$35.45$35.45$651.3018.4×
mclaren health advantage op rate211$16.35$45.39$298.8318.3×
great lakes research op rate210$54.00$66.60$300.005.6×
health advantage - commercial op rate210$31.54$38.91$175.255.6×
Multiplan29$80.00$105.60$658.408.2×
Humana88$30.83$30.83$30.831.0×
hap - hmo88$34.44$34.44$34.441.0×
mclaren health op rate37$23.47$59.54$362.9415.5×
evernorth behavioral health77$37.61$37.61$37.611.0×
workers compensation46$44.76$59.19$88.172.0×
bcccnp66$21.87$21.87$21.871.0×
beech street op rate16$90.00$110.25$740.708.2×
cofinity - wc op rate16$70.64$147.81$205.412.9×
cofinity w/c op rate16$63.71$78.05$524.338.2×
cofinity-ppom op rate16$70.76$148.05$205.752.9×
gift of life op rate16$70.00$85.75$576.108.2×
hap-hmo op rate16$45.11$55.26$371.268.2×
hospice care in michigan op rate16$50.00$61.25$411.508.2×
phpmm-commercial hmo op rate16$42.52$52.09$349.948.2×
usa mco-ppo op rate16$85.00$104.13$699.558.2×
hap hmo op rate25$36.91$89.43$124.443.4×
health plus hmo op rate25$44.33$98.79$149.443.4×
hap - preferred op rate15$23.59$98.92$137.725.8×
cofinity and wc op rate15$21.57$90.47$125.965.8×
Cigna25$37.20$104.13$125.403.4×
oakland county community mental health op rate15$31.00$130.00$181.005.8×
oc inmates correct care solutions llc op rate15$19.53$81.90$114.035.8×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Mclaren Port HuronPort HuronMI27$215.30$107.65$21.87$93.98$185.00
Mclaren OaklandPontiacMI10$94.10$16.35$90.74$181.00
Tawas St. Joseph HospitalTawasMI1$509.00$167.97$79.20$79.20$117.12
Mclaren MacombMt. ClemensMI15$445.05$36.31$77.69$740.70
Mclaren FlintFlintMI26$414.00$207.00$12.04$76.37$290.70
Mclaren Greater LansingLansingMI16$958.00$479.00$13.99$75.59$670.60
Mclaren Bay Special CareBay CityMI12$260.00$31.54$68.45$427.50
Mclaren Central MichiganMt PleasantMI16$1,002.00$501.00$21.87$65.63$751.50
Bay Regional Medical CenterBay CityMI22$272.00$270.40$21.87$63.19$427.50
Karmanos Cancer HospitalDetroitMI13$108.70$22.88$59.81$164.48
Garden City Hospital OsteopathicGarden CityMI4$207.00$21.87$40.37$207.00
Ascension St John HospitalDetroitMI3$354.25$131.07$28.20$39.37$42.18
Genesys Regional Medical Ctr.Grand BlancMI1$395.00$158.00$37.61$37.61$37.61
Borgess-Pipp Health CenterPlainwellMI1$395.00$158.00$37.61$37.61$37.61
Ascension Allegan HospitalAlleganMI1$395.00$158.00$37.61$37.61$37.61
Ascension Borgess HospitalKalamazooMI1$395.00$158.00$37.61$37.61$37.61
Ascension Borgess-Lee HospitalDowagiacMI1$395.00$158.00$37.61$37.61$37.61
Ascension Providence Rochester HospiRochesterMI1$395.00$158.00$37.61$37.61$37.61
Ascension Standish HospitalStandishMI1$395.00$158.00$37.61$37.61$37.61
Mclaren Northern MichiganPetoskeyMI11$779.00$389.50$21.87$33.10$584.25
Mclaren Thumb RegionBad AxeMI11$368.47$184.24$22.37$31.60$138.47
Mclaren Lapeer RegionLapeerMI23$337.40$196.60$22.37$129.96$378.00
Carson City HospitalCarson CityMI0$376.00$94.00
North Ottawa Community HospitalGrand HavenMI0$286.00$200.20
Mh - Mercy CampusMuskegonMI0$289.20$138.82
Mackinac Straits Health System IncSt. IgnaceMI0$132.00$92.40
Mckenzie Health SystemSanduskyMI0$80.00$64.00
Sparrow Clinton HospitalSt. JohnsMI0$154.00$43.50
Sparrow EatonCharlotteMI0$154.00$43.50

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.