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Office visit, established patient, 20-29 minutes

CPT 99213 · negotiated-rate distribution across hospitals in MI

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Hospitals
29
Min
$51.26
Median
$73.43
Max
$117.15
Range multiplier
2.3×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare13117$23.8$89$79833.5×
Aetna1396$22.76$92.95$79835.1×
priority health op rate968$25.27$74.28$514.9420.4×
First Health863$27.5$105.4$672.824.5×
hap - hmo op rate550$18.42$54.52$237.9212.9×
cofinity - auto op rate447$26.39$106.1$626.0623.7×
hp - ppo op rate444$28.46$70.59$367.7712.9×
hp - hmo op rate444$20.52$51.13$276.3613.5×
hap preferred op rate443$20.5$77.1$518.9625.3×
cofinity - ppom op rate334$24.5$92.46$316.5412.9×
Blue Cross Blue Shield1332$57.98$85.82$3986.9×
health advantage - ppo op rate230$16.07$55.46$207.5612.9×
Medicaid830$41.96$43.64$3989.5×
mhp - hmo op rate230$16.07$55.46$207.5612.9×
priority health829$48.14$101.83$582.412.1×
mclaren commercial ins824$25.39$47.67$370.814.6×
Medicare824$56.88$56.88$58.021.0×
hap - ppo op rate324$32.05$73.51$229.297.2×
hap/ahl op rate120$18.42$63.57$237.9212.9×
hurley medical center op rate120$14$48.33$180.8812.9×
cofinity - wc/auto op rate120$28.34$97.83$366.1512.9×
cofinity wc op rate120$24.5$84.58$316.5412.9×
hcap op rate317$30$70.2$163.55.5×
mclaren health advantage op rate217$17.93$54.47$317.7117.7×
great lakes research op rate214$30$65.4$74.42.5×
health advantage - commercial op rate214$17.52$38.2$43.462.5×
u of m health plan814$65.41$65.41$691.610.6×
Multiplan214$40$118.64$70017.5×
hap-hmo op rate111$22.56$60.9$394.7117.5×
gift of life op rate111$35$94.5$612.517.5×
cofinity w/c op rate111$31.86$86.01$557.4617.5×
usa mco-ppo op rate111$42.5$114.75$743.7517.5×
phpmm-commercial hmo op rate111$21.26$57.4$372.0517.5×
hospice care in michigan op rate111$25$67.5$437.517.5×
beech street op rate111$45$121.5$787.517.5×
cofinity-ppom op rate110$32.71$105.21$216.636.6×
cofinity - wc op rate110$32.66$105.04$216.276.6×
workers compensation69$44.59$55.65$79.291.8×
Humana88$56.88$56.88$56.881.0×
hap - hmo88$64.16$64.16$64.161.0×
mclaren health op rate37$33.7$68.71$385.8811.5×
evernorth behavioral health77$51.26$51.26$51.261.0×
hap - preferred op rate16$25.87$125.17$154.466.0×
bcccnp66$87.68$87.68$87.681.0×
cofinity and wc op rate16$23.66$114.48$141.276.0×
oakland county community mental health op rate16$34$164.5$2036.0×
oc inmates correct care solutions llc op rate16$21.42$103.64$127.896.0×
health plus hmo op rate25$63.63$116.55$160.162.5×
hap hmo op rate25$52.99$105.5$133.372.5×
hap ahl op rate25$57.54$106.68$144.822.5×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
MCLAREN CENTRAL MICHIGANMT PLEASANTMI16$1,064$532$41.96$99.8$798
MCLAREN GREATER LANSINGLANSING MI 489100MI17$1,018$509$29.98$86.16$712.6
MCLAREN MACOMBMT. CLEMENSMI17$473.2$18.16$84.32$787.5
KARMANOS CANCER HOSPITALDETROITMI13$116.5$32.84$82.05$176.29
MCLAREN LAPEER REGIONLAPEERMI24$337.4$207$17.68$81.21$398
ASCENSION ST JOHN HOSPITALDETROITMI3$447$165.39$55.58$79.88$85.59
MCLAREN FLINTFLINTMI27$782$391$14$78.63$549.1
GARDEN CITY HOSPITAL OSTEOPATHICGARDEN CITYMI4$256$37$73.43$256
MCLAREN NORTHERN MICHIGANPETOSKEYMI12$858$429$41.96$61.96$520.03
BAY REGIONAL MEDICAL CENTERBAY CITYMI23$291$145.5$17.52$58.59$237.63
MCLAREN THUMB REGIONBAD AXEMI11$552.49$276.25$41.96$57.45$92.52
MCLAREN BAY SPECIAL CAREBAY CITYMI12$64.5$17.52$54.52$106.02
ASCENSION ALLEGAN HOSPITALALLEGANMI1$593$237.2$51.26$51.26$51.26
ASCENSION STANDISH HOSPITALSTANDISHMI1$593$237.2$51.26$51.26$51.26
ASCENSION BORGESS HOSPITALKALAMAZOOMI1$593$237.2$51.26$51.26$51.26
ASCENSION BORGESS-LEE HOSPITALDOWAGIACMI1$593$237.2$51.26$51.26$51.26
ASCENSION PROVIDENCE ROCHESTER HOSPIROCHESTERMI1$593$237.2$51.26$51.26$51.26
GENESYS REGIONAL MEDICAL CTR.GRAND BLANCMI1$593$237.2$51.26$51.26$51.26
BORGESS-PIPP HEALTH CENTERPLAINWELLMI1$593$237.2$51.26$51.26$51.26
TAWAS ST. JOSEPH HOSPITALTAWASMI1$677$223.41$117.15$117.15$173.24
MCLAREN PORT HURONPORT HURONMI28$48,848$24,424$41.96$109.51$218
MCLAREN OAKLANDPONTIACMI10$105.55$17.93$106.8$203
CARSON CITY HOSPITALCARSON CITYMI0$434$108.5
NORTH OTTAWA COMMUNITY HOSPITALGRAND HAVENMI0$322$225.4
MH - MERCY CAMPUSMUSKEGONMI0$358.2$171.94
MACKINAC STRAITS HEALTH SYSTEM INCST. IGNACEMI0$176$123.2
MCKENZIE HEALTH SYSTEMSANDUSYMI0$120$96
SPARROW CLINTON HOSPITALST. JOHNSMI0$206$68.5
SPARROW EATONCHARLOTTEMI0$206$68.5

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.