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Office visit, established patient, 20-29 minutes
CPT 99213 · negotiated-rate distribution across hospitals in MI
Hospitals
29
Min
$51.26
Median
$73.43
Max
$117.15
Range multiplier
2.3×
By payer (50 payers with published rates)
| Payer | Hosp. | Rates | Min | Median | Max | Range× |
|---|---|---|---|---|---|---|
| UnitedHealthcare | 13 | 117 | $23.80 | $89.00 | $798.00 | 33.5× |
| Aetna | 13 | 96 | $22.76 | $92.95 | $798.00 | 35.1× |
| priority health op rate | 9 | 68 | $25.27 | $74.28 | $514.94 | 20.4× |
| First Health | 8 | 63 | $27.50 | $105.40 | $672.80 | 24.5× |
| hap - hmo op rate | 5 | 50 | $18.42 | $54.52 | $237.92 | 12.9× |
| cofinity - auto op rate | 4 | 47 | $26.39 | $106.10 | $626.06 | 23.7× |
| hp - ppo op rate | 4 | 44 | $28.46 | $70.59 | $367.77 | 12.9× |
| hp - hmo op rate | 4 | 44 | $20.52 | $51.13 | $276.36 | 13.5× |
| hap preferred op rate | 4 | 43 | $20.50 | $77.10 | $518.96 | 25.3× |
| cofinity - ppom op rate | 3 | 34 | $24.50 | $92.46 | $316.54 | 12.9× |
| Blue Cross Blue Shield | 13 | 32 | $57.98 | $85.82 | $398.00 | 6.9× |
| health advantage - ppo op rate | 2 | 30 | $16.07 | $55.46 | $207.56 | 12.9× |
| Medicaid | 8 | 30 | $41.96 | $43.64 | $398.00 | 9.5× |
| mhp - hmo op rate | 2 | 30 | $16.07 | $55.46 | $207.56 | 12.9× |
| priority health | 8 | 29 | $48.14 | $101.83 | $582.40 | 12.1× |
| mclaren commercial ins | 8 | 24 | $25.39 | $47.67 | $370.80 | 14.6× |
| Medicare | 8 | 24 | $56.88 | $56.88 | $58.02 | 1.0× |
| hap - ppo op rate | 3 | 24 | $32.05 | $73.51 | $229.29 | 7.2× |
| hap/ahl op rate | 1 | 20 | $18.42 | $63.57 | $237.92 | 12.9× |
| hurley medical center op rate | 1 | 20 | $14.00 | $48.33 | $180.88 | 12.9× |
| cofinity - wc/auto op rate | 1 | 20 | $28.34 | $97.83 | $366.15 | 12.9× |
| cofinity wc op rate | 1 | 20 | $24.50 | $84.58 | $316.54 | 12.9× |
| hcap op rate | 3 | 17 | $30.00 | $70.20 | $163.50 | 5.5× |
| mclaren health advantage op rate | 2 | 17 | $17.93 | $54.47 | $317.71 | 17.7× |
| great lakes research op rate | 2 | 14 | $30.00 | $65.40 | $74.40 | 2.5× |
| health advantage - commercial op rate | 2 | 14 | $17.52 | $38.20 | $43.46 | 2.5× |
| u of m health plan | 8 | 14 | $65.41 | $65.41 | $691.60 | 10.6× |
| Multiplan | 2 | 14 | $40.00 | $118.64 | $700.00 | 17.5× |
| hap-hmo op rate | 1 | 11 | $22.56 | $60.90 | $394.71 | 17.5× |
| gift of life op rate | 1 | 11 | $35.00 | $94.50 | $612.50 | 17.5× |
| cofinity w/c op rate | 1 | 11 | $31.86 | $86.01 | $557.46 | 17.5× |
| usa mco-ppo op rate | 1 | 11 | $42.50 | $114.75 | $743.75 | 17.5× |
| phpmm-commercial hmo op rate | 1 | 11 | $21.26 | $57.40 | $372.05 | 17.5× |
| hospice care in michigan op rate | 1 | 11 | $25.00 | $67.50 | $437.50 | 17.5× |
| beech street op rate | 1 | 11 | $45.00 | $121.50 | $787.50 | 17.5× |
| cofinity-ppom op rate | 1 | 10 | $32.71 | $105.21 | $216.63 | 6.6× |
| cofinity - wc op rate | 1 | 10 | $32.66 | $105.04 | $216.27 | 6.6× |
| workers compensation | 6 | 9 | $44.59 | $55.65 | $79.29 | 1.8× |
| Humana | 8 | 8 | $56.88 | $56.88 | $56.88 | 1.0× |
| hap - hmo | 8 | 8 | $64.16 | $64.16 | $64.16 | 1.0× |
| mclaren health op rate | 3 | 7 | $33.70 | $68.71 | $385.88 | 11.5× |
| evernorth behavioral health | 7 | 7 | $51.26 | $51.26 | $51.26 | 1.0× |
| hap - preferred op rate | 1 | 6 | $25.87 | $125.17 | $154.46 | 6.0× |
| bcccnp | 6 | 6 | $87.68 | $87.68 | $87.68 | 1.0× |
| cofinity and wc op rate | 1 | 6 | $23.66 | $114.48 | $141.27 | 6.0× |
| oakland county community mental health op rate | 1 | 6 | $34.00 | $164.50 | $203.00 | 6.0× |
| oc inmates correct care solutions llc op rate | 1 | 6 | $21.42 | $103.64 | $127.89 | 6.0× |
| health plus hmo op rate | 2 | 5 | $63.63 | $116.55 | $160.16 | 2.5× |
| hap hmo op rate | 2 | 5 | $52.99 | $105.50 | $133.37 | 2.5× |
| hap ahl op rate | 2 | 5 | $57.54 | $106.68 | $144.82 | 2.5× |
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 | 16 | $1,064.00 | $532.00 | $41.96 | $99.80 | $798.00 |
| Mclaren Greater Lansing | Lansing | MI | 17 | $1,018.00 | $509.00 | $29.98 | $86.16 | $712.60 |
| Mclaren Macomb | Mt. Clemens | MI | 17 | — | $473.20 | $18.16 | $84.32 | $787.50 |
| Karmanos Cancer Hospital | Detroit | MI | 13 | — | $116.50 | $32.84 | $82.05 | $176.29 |
| Mclaren Lapeer Region | Lapeer | MI | 24 | $337.40 | $207.00 | $17.68 | $81.21 | $398.00 |
| Ascension St John Hospital | Detroit | MI | 3 | $447.00 | $165.39 | $55.58 | $79.88 | $85.59 |
| Mclaren Flint | Flint | MI | 27 | $782.00 | $391.00 | $14.00 | $78.63 | $549.10 |
| Garden City Hospital Osteopathic | Garden City | MI | 4 | $256.00 | — | $37.00 | $73.43 | $256.00 |
| Mclaren Northern Michigan | Petoskey | MI | 12 | $858.00 | $429.00 | $41.96 | $61.96 | $520.03 |
| Bay Regional Medical Center | Bay City | MI | 23 | $291.00 | $145.50 | $17.52 | $58.59 | $237.63 |
| Mclaren Thumb Region | Bad Axe | MI | 11 | $552.49 | $276.25 | $41.96 | $57.45 | $92.52 |
| Mclaren Bay Special Care | Bay City | MI | 12 | — | $64.50 | $17.52 | $54.52 | $106.02 |
| Ascension Allegan Hospital | Allegan | MI | 1 | $593.00 | $237.20 | $51.26 | $51.26 | $51.26 |
| Ascension Standish Hospital | Standish | MI | 1 | $593.00 | $237.20 | $51.26 | $51.26 | $51.26 |
| Ascension Borgess Hospital | Kalamazoo | MI | 1 | $593.00 | $237.20 | $51.26 | $51.26 | $51.26 |
| Ascension Borgess-Lee Hospital | Dowagiac | MI | 1 | $593.00 | $237.20 | $51.26 | $51.26 | $51.26 |
| Ascension Providence Rochester Hospi | Rochester | MI | 1 | $593.00 | $237.20 | $51.26 | $51.26 | $51.26 |
| Genesys Regional Medical Ctr. | Grand Blanc | MI | 1 | $593.00 | $237.20 | $51.26 | $51.26 | $51.26 |
| Borgess-Pipp Health Center | Plainwell | MI | 1 | $593.00 | $237.20 | $51.26 | $51.26 | $51.26 |
| Tawas St. Joseph Hospital | Tawas | MI | 1 | $677.00 | $223.41 | $117.15 | $117.15 | $173.24 |
| Mclaren Port Huron | Port Huron | MI | 28 | $48,848 | $24,424 | $41.96 | $109.51 | $218.00 |
| Mclaren Oakland | Pontiac | MI | 10 | — | $105.55 | $17.93 | $106.80 | $203.00 |
| Carson City Hospital | Carson City | MI | 0 | $434.00 | $108.50 | — | — | — |
| North Ottawa Community Hospital | Grand Haven | MI | 0 | $322.00 | $225.40 | — | — | — |
| Mh - Mercy Campus | Muskegon | MI | 0 | $358.20 | $171.94 | — | — | — |
| Mackinac Straits Health System Inc | St. Ignace | MI | 0 | $176.00 | $123.20 | — | — | — |
| Mckenzie Health System | Sandusky | MI | 0 | $120.00 | $96.00 | — | — | — |
| Sparrow Clinton Hospital | St. Johns | MI | 0 | $206.00 | $68.50 | — | — | — |
| Sparrow Eaton | Charlotte | MI | 0 | $206.00 | $68.50 | — | — | — |
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.