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Initial hospital care, low complexity

CPT 99221 · negotiated-rate distribution across hospitals in MI

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Hospitals
25
Min
$67.81
Median
$75.96
Max
$1,080
Range multiplier
15.9×

By payer (45 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare927$52.4$76.33$263.555.0×
Medicare824$74.11$74.11$75.591.0×
Medicaid818$52.4$54.5$376.57.2×
Blue Cross Blue Shield1016$84.08$95.57$376.54.5×
Aetna1013$85.96$85.96$210.452.4×
priority health913$69.52$108.19$1,08115.5×
midmichigan health network111$1,080$1,080$1,0801.0×
Molina110$69.52$320$6108.8×
mclaren commercial ins88$97$97$971.0×
u of m health plan88$85.23$85.23$85.231.0×
Humana88$74.11$74.11$74.111.0×
evernorth behavioral health77$67.81$67.81$67.811.0×
meridian health plan16$69.52$401$6599.5×
southwest michigan behavioral health15$1,081$1,081$1,0811.0×
First Health34$111.73$306.83$380.123.4×
hap preferred op rate34$82.75$132.54$183.352.2×
priority health op rate34$77.85$154.64$225.972.9×
hp - hmo op rate23$119.36$162.84$191.311.6×
cofinity - auto op rate23$158.14$233.81$253.471.6×
northern michigan regional entity13$1,081.5$1,081.5$1,1561.1×
hap - hmo op rate23$102.76$129.44$164.71.6×
mhp - hmo op rate23$89.64$110.73$143.691.6×
health advantage - ppo op rate23$89.64$110.73$143.691.6×
hp - ppo op rate23$158.83$216.9$254.591.6×
cofinity - ppom op rate12$136.71$177.92$219.131.6×
cofinity - wc/auto op rate12$158.14$205.81$253.471.6×
cofinity wc op rate12$136.71$177.92$219.131.6×
hap/ahl op rate12$102.76$133.73$164.71.6×
hurley medical center op rate12$78.12$101.67$125.221.6×
livingston county community mental health11$1,134$1,134$1,1341.0×
lenawee community mental health authority11$1,112$1,112$1,1121.0×
mclaren health op rate11$48.46$48.46$48.461.0×
lapeer county community mental health11$1,134$1,134$1,1341.0×
health plus hmo op rate11$91.52$91.52$91.521.0×
hap hmo op rate11$76.21$76.21$76.211.0×
hap ahl op rate11$82.75$82.75$82.751.0×
hap - ppo op rate11$216.9$216.9$216.91.0×
genesse health system11$1,134$1,134$1,1341.0×
detroit medical center op rate11$47.23$47.23$47.231.0×
cofinity-ppom op rate11$204.93$204.93$204.931.0×
cofinity ppom op rate11$100.74$100.74$100.741.0×
cofinity - wc op rate11$204.59$204.59$204.591.0×
st. clair county community mental health11$1,134$1,134$1,1341.0×
Cigna11$76.8$76.8$76.81.0×
bsbs bcn op rate11$84.08$84.08$84.081.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
KARMANOS CANCER HOSPITALDETROITMI13$66.6$47.23$82.75$100.74
MCLAREN GREATER LANSINGLANSING MI 489100MI9$358$179$52.4$75.96$113.01
BAY REGIONAL MEDICAL CENTERBAY CITYMI9$358$179$52.4$75.96$113.01
MCLAREN PORT HURONPORT HURONMI9$358$179$52.4$75.96$113.01
MCLAREN CENTRAL MICHIGANMT PLEASANTMI9$358$179$52.4$75.96$113.01
MCLAREN THUMB REGIONBAD AXEMI9$358$179$52.4$75.96$113.01
MCLAREN NORTHERN MICHIGANPETOSKEYMI9$358$179$52.4$75.96$113.01
BORGESS-PIPP HEALTH CENTERPLAINWELLMI1$67.81$67.81$67.81
ASCENSION BORGESS HOSPITALKALAMAZOOMI1$67.81$67.81$67.81
GENESYS REGIONAL MEDICAL CTR.GRAND BLANCMI1$67.81$67.81$67.81
ASCENSION PROVIDENCE ROCHESTER HOSPIROCHESTERMI1$67.81$67.81$67.81
ASCENSION STANDISH HOSPITALSTANDISHMI1$67.81$67.81$67.81
ASCENSION BORGESS-LEE HOSPITALDOWAGIACMI1$67.81$67.81$67.81
ASCENSION ALLEGAN HOSPITALALLEGANMI1$67.81$67.81$67.81
TAWAS ST. JOSEPH HOSPITALTAWASMI1$174.9$174.9$258.64
MCLAREN FLINTFLINTMI23$358$232.55$52.4$134.01$380.12
MCLAREN LAPEER REGIONLAPEERMI21$358$195.8$52.4$113.01$376.5
ASCENSION ST JOHN HOSPITALDETROITMI2$111.73$112.11$112.48
HEALTHSOURCE SAGINAW INC.SAGINAWMI11$69.52$1,080$1,156
CARSON CITY HOSPITALCARSON CITYMI0$119$59.5
MCKENZIE HEALTH SYSTEMSANDUSYMI0$140$112
SPARROW EATONCHARLOTTEMI0$119$59.5
MACKINAC STRAITS HEALTH SYSTEM INCST. IGNACEMI0$215$150.5
SPARROW CLINTON HOSPITALST. JOHNSMI0$119$59.5
NORTH OTTAWA COMMUNITY HOSPITALGRAND HAVENMI0$7,600$5,320

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.