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Office visit, established patient, 40-54 min

CPT 99215 · negotiated-rate distribution across hospitals in MI

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Hospitals
29
Min
$88.21
Median
$124.89
Max
$254.10
Range multiplier
2.9×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare1384$35.00$128.04$1,313.2037.5×
Aetna1369$40.83$147.16$896.2522.0×
priority health op rate946$27.77$127.61$947.9434.1×
First Health843$42.50$164.80$1,594.6037.5×
hap - hmo op rate533$23.10$98.14$690.9329.9×
hp - hmo op rate429$20.52$111.63$802.5539.1×
cofinity - auto op rate429$80.49$205.75$1,063.3213.2×
hp - ppo op rate429$28.46$148.55$1,068.0137.5×
Blue Cross Blue Shield1227$130.63$173.67$656.005.0×
hap preferred op rate427$58.22$149.65$769.1613.2×
Medicaid826$91.38$95.04$656.007.2×
Medicare824$124.31$124.31$126.801.0×
cofinity - ppom op rate323$42.75$127.86$919.2421.5×
priority health820$73.25$159.53$653.918.9×
health advantage - ppo op rate219$45.62$117.27$602.7613.2×
mhp - hmo op rate219$45.62$117.27$602.7613.2×
hap - ppo op rate316$32.05$100.00$377.9211.8×
mclaren commercial ins814$48.11$107.00$142.283.0×
hap/ahl op rate113$52.30$133.69$690.9313.2×
hcap op rate313$30.00$93.60$239.258.0×
cofinity wc op rate113$69.58$177.87$919.2413.2×
cofinity - wc/auto op rate113$80.49$205.75$1,063.3213.2×
hurley medical center op rate113$39.76$101.64$525.2813.2×
health advantage - commercial op rate210$17.52$51.17$105.856.0×
u of m health plan810$84.37$142.96$465.895.5×
great lakes research op rate210$30.00$87.60$181.206.0×
mclaren health advantage op rate210$51.56$80.43$356.566.9×
Multiplan29$113.60$136.54$785.606.9×
Humana88$124.31$124.31$124.311.0×
hap - hmo88$140.31$140.31$140.311.0×
mclaren health op rate37$53.76$100.45$433.068.1×
evernorth behavioral health77$117.66$117.66$117.661.0×
phpmm-commercial hmo op rate16$60.38$66.97$417.556.9×
beech street op rate16$127.80$141.75$883.806.9×
cofinity - wc op rate16$88.57$237.17$356.474.0×
cofinity w/c op rate16$90.47$100.34$625.636.9×
cofinity-ppom op rate16$88.72$237.56$357.064.0×
gift of life op rate16$99.40$110.25$687.406.9×
hap-hmo op rate16$64.06$71.05$442.986.9×
hospice care in michigan op rate16$71.00$78.75$491.006.9×
usa mco-ppo op rate16$120.70$133.88$834.706.9×
hap ahl op rate25$86.36$155.96$302.563.5×
Cigna25$85.20$179.59$280.803.3×
health plus hmo op rate25$94.35$170.39$334.623.5×
hap hmo op rate25$84.55$154.24$278.653.3×
cofinity op rate25$127.50$133.80$736.505.8×
oc inmates correct care solutions llc op rate14$89.46$142.70$189.632.1×
com php op rate14$65.22$76.63$384.775.9×
com mclaren commercial ins op rate14$63.95$75.15$377.325.9×
com cofinity auto op rate14$116.43$136.81$686.955.9×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Bay Regional Medical CenterBay CityMI20$409.00$204.50$17.52$99.70$258.21
Mclaren Bay Special CareBay CityMI12$157.05$17.52$88.21$258.21
Tawas St. Joseph HospitalTawasMI1$1,106.00$364.98$254.10$254.10$375.76
Mclaren Lapeer RegionLapeerMI23$207.00$341.10$47.94$192.93$656.00
Ascension St John HospitalDetroitMI3$714.75$264.46$122.03$173.67$186.07
Mclaren OaklandPontiacMI10$156.50$74.89$155.85$301.00
Garden City Hospital OsteopathicGarden CityMI3$398.00$67.00$147.72$398.00
Mclaren Port HuronPort HuronMI26$207.00$165.90$55.62$147.16$319.00
Mclaren Central MichiganMt PleasantMI15$1,195.00$597.50$74.97$142.96$896.25
Karmanos Cancer HospitalDetroitMI13$243.40$52.40$142.12$468.00
Mclaren FlintFlintMI26$207.00$975.50$39.76$138.66$1,594.60
Mclaren Greater LansingLansingMI16$1,143.00$571.50$63.95$126.80$800.10
Mclaren Northern MichiganPetoskeyMI10$1,038.00$519.00$61.93$124.89$629.13
Mclaren Thumb RegionBad AxeMI11$272.00$136.00$91.38$124.31$168.70
Ascension Borgess-Lee HospitalDowagiacMI1$1,067.00$426.80$117.66$117.66$117.66
Borgess-Pipp Health CenterPlainwellMI1$1,067.00$426.80$117.66$117.66$117.66
Ascension Borgess HospitalKalamazooMI1$1,067.00$426.80$117.66$117.66$117.66
Genesys Regional Medical Ctr.Grand BlancMI1$1,067.00$426.80$117.66$117.66$117.66
Ascension Providence Rochester HospiRochesterMI1$1,067.00$426.80$117.66$117.66$117.66
Ascension Allegan HospitalAlleganMI1$1,067.00$426.80$117.66$117.66$117.66
Ascension Standish HospitalStandishMI1$1,067.00$426.80$117.66$117.66$117.66
Mclaren MacombMt. ClemensMI15$531.10$51.56$108.97$883.80
Carson City HospitalCarson CityMI0$573.00$143.25
North Ottawa Community HospitalGrand HavenMI0$423.00$296.10
Mh - Mercy CampusMuskegonMI0$485.40$232.99
Mackinac Straits Health System IncSt. IgnaceMI0$361.00$252.70
Mckenzie Health SystemSanduskyMI0$240.00$192.00
Sparrow Clinton HospitalSt. JohnsMI0$359.00$135.00
Sparrow EatonCharlotteMI0$359.00$135.00

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.