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Office visit, established patient, 30-39 minutes
CPT 99214 · negotiated-rate distribution across hospitals in MI
Hospitals
29
Min
$76.20
Median
$98.00
Max
$177.59
Range multiplier
2.3×
By payer (50 payers with published rates)
| Payer | Hosp. | Rates | Min | Median | Max | Range× |
|---|---|---|---|---|---|---|
| UnitedHealthcare | 13 | 97 | $35.00 | $107.10 | $1,007.30 | 28.8× |
| Aetna | 13 | 79 | $40.83 | $108.61 | $845.25 | 20.7× |
| priority health op rate | 9 | 52 | $27.77 | $98.86 | $600.80 | 21.6× |
| First Health | 8 | 49 | $42.50 | $135.15 | $1,010.65 | 23.8× |
| hap - hmo op rate | 5 | 38 | $23.10 | $73.46 | $437.91 | 19.0× |
| hp - hmo op rate | 4 | 35 | $20.52 | $66.17 | $508.65 | 24.8× |
| hp - ppo op rate | 4 | 35 | $28.46 | $90.52 | $676.90 | 23.8× |
| hap preferred op rate | 4 | 32 | $41.41 | $128.11 | $549.21 | 13.3× |
| cofinity - auto op rate | 4 | 32 | $57.25 | $129.98 | $673.93 | 11.8× |
| cofinity - ppom op rate | 3 | 29 | $42.75 | $111.15 | $582.61 | 13.6× |
| priority health | 8 | 29 | $64.31 | $107.47 | $692.73 | 10.8× |
| Blue Cross Blue Shield | 13 | 28 | $26.75 | $124.45 | $518.00 | 19.4× |
| Medicaid | 8 | 26 | $61.77 | $64.24 | $518.00 | 8.4× |
| Medicare | 8 | 24 | $83.74 | $83.74 | $85.41 | 1.0× |
| mhp - hmo op rate | 2 | 23 | $32.45 | $96.32 | $382.03 | 11.8× |
| health advantage - ppo op rate | 2 | 23 | $32.45 | $96.32 | $382.03 | 11.8× |
| mclaren commercial ins | 8 | 21 | $35.09 | $72.00 | $340.54 | 9.7× |
| hap - ppo op rate | 3 | 18 | $32.05 | $87.18 | $298.42 | 9.3× |
| cofinity wc op rate | 1 | 17 | $49.49 | $105.35 | $582.61 | 11.8× |
| hap/ahl op rate | 1 | 17 | $37.20 | $79.18 | $437.91 | 11.8× |
| cofinity - wc/auto op rate | 1 | 17 | $57.25 | $121.86 | $673.93 | 11.8× |
| hurley medical center op rate | 1 | 17 | $28.28 | $60.20 | $332.92 | 11.8× |
| hcap op rate | 3 | 15 | $30.00 | $79.80 | $191.25 | 6.4× |
| u of m health plan | 8 | 14 | $78.67 | $96.30 | $732.55 | 9.3× |
| health advantage - commercial op rate | 2 | 12 | $17.52 | $46.09 | $55.73 | 3.2× |
| great lakes research op rate | 2 | 12 | $30.00 | $78.90 | $95.40 | 3.2× |
| workers compensation | 6 | 9 | $48.76 | $60.34 | $140.73 | 2.9× |
| mclaren health advantage op rate | 2 | 9 | $48.29 | $58.54 | $336.23 | 7.0× |
| Multiplan | 2 | 9 | $106.40 | $127.71 | $740.80 | 7.0× |
| Humana | 8 | 8 | $83.74 | $83.74 | $83.74 | 1.0× |
| mclaren health op rate | 3 | 8 | $52.02 | $86.97 | $408.37 | 7.9× |
| hap - hmo | 8 | 8 | $94.55 | $94.55 | $94.55 | 1.0× |
| evernorth behavioral health | 7 | 7 | $80.56 | $80.56 | $80.56 | 1.0× |
| usa mco-ppo op rate | 1 | 6 | $113.05 | $122.40 | $787.10 | 7.0× |
| health plus hmo op rate | 2 | 6 | $88.25 | $156.21 | $245.24 | 2.8× |
| cofinity-ppom op rate | 1 | 6 | $83.28 | $196.77 | $281.95 | 3.4× |
| cofinity w/c op rate | 1 | 6 | $84.73 | $91.74 | $589.95 | 7.0× |
| hap ahl op rate | 2 | 6 | $80.77 | $142.03 | $221.75 | 2.7× |
| hap hmo op rate | 2 | 6 | $79.88 | $135.21 | $204.22 | 2.6× |
| cofinity - wc op rate | 1 | 6 | $83.14 | $196.44 | $281.48 | 3.4× |
| hospice care in michigan op rate | 1 | 6 | $66.50 | $72.00 | $463.00 | 7.0× |
| Cigna | 2 | 6 | $93.02 | $146.29 | $205.80 | 2.2× |
| hap-hmo op rate | 1 | 6 | $60.00 | $64.96 | $417.72 | 7.0× |
| phpmm-commercial hmo op rate | 1 | 6 | $56.55 | $61.23 | $393.74 | 7.0× |
| beech street op rate | 1 | 6 | $119.70 | $129.60 | $833.40 | 7.0× |
| bcccnp | 6 | 6 | $87.68 | $87.68 | $87.68 | 1.0× |
| gift of life op rate | 1 | 6 | $93.10 | $100.80 | $648.20 | 7.0× |
| cofinity group 15892 & 15893 | 3 | 5 | $63.42 | $81.06 | $207.35 | 3.3× |
| com priority health op rate | 1 | 4 | $67.86 | $109.59 | $534.45 | 7.9× |
| com php op rate | 1 | 4 | $46.06 | $74.39 | $362.76 | 7.9× |
By hospital (top 200 by negotiated median, descending)
| Hospital | City | ST | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| Mclaren Macomb | Mt. Clemens | MI | 15 | — | $500.75 | $48.29 | $98.00 | $833.40 |
| Mclaren Northern Michigan | Petoskey | MI | 12 | $943.00 | $471.50 | $57.75 | $86.95 | $571.55 |
| Mclaren Thumb Region | Bad Axe | MI | 11 | $210.00 | $105.00 | $61.77 | $85.83 | $178.40 |
| Bay Regional Medical Center | Bay City | MI | 24 | $361.00 | $180.50 | $17.52 | $81.60 | $294.79 |
| Borgess-Pipp Health Center | Plainwell | MI | 1 | $729.00 | $291.60 | $80.56 | $80.56 | $80.56 |
| Ascension Standish Hospital | Standish | MI | 1 | $729.00 | $291.60 | $80.56 | $80.56 | $80.56 |
| Genesys Regional Medical Ctr. | Grand Blanc | MI | 1 | $729.00 | $291.60 | $80.56 | $80.56 | $80.56 |
| Ascension Borgess-Lee Hospital | Dowagiac | MI | 1 | $729.00 | $291.60 | $80.56 | $80.56 | $80.56 |
| Ascension Borgess Hospital | Kalamazoo | MI | 1 | $729.00 | $291.60 | $80.56 | $80.56 | $80.56 |
| Ascension Allegan Hospital | Allegan | MI | 1 | $729.00 | $291.60 | $80.56 | $80.56 | $80.56 |
| Ascension Providence Rochester Hospi | Rochester | MI | 1 | $729.00 | $291.60 | $80.56 | $80.56 | $80.56 |
| Mclaren Bay Special Care | Bay City | MI | 14 | — | $82.70 | $17.52 | $76.20 | $135.94 |
| Karmanos Cancer Hospital | Detroit | MI | 13 | — | $178.40 | $88.19 | $177.59 | $343.00 |
| Tawas St. Joseph Hospital | Tawas | MI | 1 | $852.00 | $281.16 | $176.55 | $176.55 | $261.08 |
| Mclaren Lapeer Region | Lapeer | MI | 24 | $193.00 | $269.40 | $35.09 | $153.54 | $518.00 |
| Mclaren Port Huron | Port Huron | MI | 28 | $36,494 | $18,247 | $49.91 | $124.24 | $255.00 |
| Ascension St John Hospital | Detroit | MI | 3 | $576.25 | $213.21 | $85.98 | $123.31 | $132.12 |
| Mclaren Central Michigan | Mt Pleasant | MI | 16 | $1,127.00 | $563.50 | $61.77 | $119.25 | $845.25 |
| Mclaren Oakland | Pontiac | MI | 10 | — | $121.15 | $58.54 | $109.05 | $233.00 |
| Mclaren Flint | Flint | MI | 27 | $1,439.00 | $719.50 | $28.28 | $106.57 | $1,010.65 |
| Garden City Hospital Osteopathic | Garden City | MI | 4 | $337.00 | — | $42.00 | $104.49 | $337.00 |
| Mclaren Greater Lansing | Lansing | MI | 17 | $1,078.00 | $539.00 | $45.17 | $101.49 | $754.60 |
| Carson City Hospital | Carson City | MI | 0 | $498.00 | $124.50 | — | — | — |
| North Ottawa Community Hospital | Grand Haven | MI | 0 | $365.00 | $255.50 | — | — | — |
| Mh - Mercy Campus | Muskegon | MI | 0 | $427.60 | $205.25 | — | — | — |
| Mackinac Straits Health System Inc | St. Ignace | MI | 0 | $242.00 | $169.40 | — | — | — |
| Mckenzie Health System | Sandusky | MI | 0 | $175.00 | $140.00 | — | — | — |
| Sparrow Clinton Hospital | St. Johns | MI | 0 | $283.00 | $99.50 | — | — | — |
| Sparrow Eaton | Charlotte | MI | 0 | $283.00 | $99.50 | — | — | — |
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.