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Initial hospital care, high complexity

CPT 99223 · negotiated-rate distribution across hospitals in MI

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Hospitals
23
Min
$156.04
Median
$158.79
Max
$1,080
Range multiplier
6.9×

By payer (48 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare826$110.12$159.56$402.53.7×
Medicare824$154.91$154.91$158.011.0×
Medicaid818$110.12$114.52$2972.7×
Blue Cross Blue Shield914$126.37$200.85$519.724.1×
priority health913$90$226.05$1,08112.0×
Aetna912$174.99$178.9$418.792.4×
midmichigan health network111$1,080$1,080$1,0801.0×
Molina110$148.58$320$6104.1×
mclaren commercial ins88$181$181$1811.0×
u of m health plan88$178.15$178.15$178.151.0×
Humana88$154.91$154.91$154.911.0×
evernorth behavioral health77$156.04$156.04$156.041.0×
meridian health plan17$148.58$373$6594.4×
southwest michigan behavioral health15$1,081$1,081$1,0811.0×
First Health34$224.49$360.21$756.423.4×
priority health op rate23$178.65$290.55$449.672.5×
northern michigan regional entity13$1,081.5$1,081.5$1,1561.1×
mhp - hmo op rate12$184.75$235.34$285.921.5×
cofinity - ppom op rate12$281.75$358.9$436.051.5×
cofinity - auto op rate12$325.91$415.16$504.41.5×
hurley medical center op rate12$161$205.09$249.171.5×
health advantage - ppo op rate12$184.75$235.34$285.921.5×
hap/ahl op rate12$211.77$269.76$327.751.5×
hap preferred op rate12$235.75$300.31$364.861.5×
hp - hmo op rate12$245.99$313.35$380.71.5×
hp - ppo op rate12$327.35$416.99$506.621.5×
hap - hmo op rate12$211.77$269.76$327.751.5×
cofinity wc op rate12$281.75$358.9$436.051.5×
cofinity - wc/auto op rate12$325.91$415.16$504.41.5×
CHAMPVA11$171.06$171.06$171.061.0×
st. clair county community mental health11$1,134$1,134$1,1341.0×
theramatrix physical therapy op rate11$297$297$2971.0×
bcn op rate11$126.37$126.37$126.371.0×
hap ahl op rate11$150.88$150.88$150.881.0×
auto-cofinity op rate11$252.45$252.45$252.451.0×
hap hmo op rate11$149.21$149.21$149.211.0×
hap ppo op rate11$187.91$187.91$187.911.0×
hcap op rate11$222.75$222.75$222.751.0×
health plus hmo op rate11$164.84$164.84$164.841.0×
health plus ppo op rate11$178.2$178.2$178.21.0×
lapeer county community mental health11$1,134$1,134$1,1341.0×
lenawee community mental health authority11$1,112$1,112$1,1121.0×
livingston county community mental health11$1,134$1,134$1,1341.0×
genesse health system11$1,134$1,134$1,1341.0×
mclaren health op rate11$97.18$97.18$97.181.0×
cofinity op rate11$189.73$189.73$189.731.0×
Multiplan11$238.55$238.55$238.551.0×
Cigna11$173.74$173.74$173.741.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
TAWAS ST. JOSEPH HOSPITALTAWASMI1$351.45$351.45$519.72
MCLAREN FLINTFLINTMI23$675$462.75$110.12$272.8$756.42
ASCENSION ST JOHN HOSPITALDETROITMI2$224.49$224.56$224.63
MCLAREN PORT HURONPORT HURONMI25$675$337.5$97.18$176.57$297
MCLAREN THUMB REGIONBAD AXEMI9$675$337.5$110.12$158.79$226.05
MCLAREN GREATER LANSINGLANSING MI 489100MI9$675$337.5$110.12$158.79$226.05
MCLAREN LAPEER REGIONLAPEERMI9$675$337.5$110.12$158.79$226.05
BAY REGIONAL MEDICAL CENTERBAY CITYMI9$675$337.5$110.12$158.79$226.05
MCLAREN NORTHERN MICHIGANPETOSKEYMI9$675$337.5$110.12$158.79$226.05
MCLAREN CENTRAL MICHIGANMT PLEASANTMI9$675$337.5$110.12$158.79$226.05
BORGESS-PIPP HEALTH CENTERPLAINWELLMI1$156.04$156.04$156.04
ASCENSION BORGESS HOSPITALKALAMAZOOMI1$156.04$156.04$156.04
GENESYS REGIONAL MEDICAL CTR.GRAND BLANCMI1$156.04$156.04$156.04
ASCENSION PROVIDENCE ROCHESTER HOSPIROCHESTERMI1$156.04$156.04$156.04
ASCENSION STANDISH HOSPITALSTANDISHMI1$156.04$156.04$156.04
ASCENSION BORGESS-LEE HOSPITALDOWAGIACMI1$156.04$156.04$156.04
ASCENSION ALLEGAN HOSPITALALLEGANMI1$156.04$156.04$156.04
HEALTHSOURCE SAGINAW INC.SAGINAWMI11$90$1,080$1,156
MCKENZIE HEALTH SYSTEMSANDUSYMI0$289$231.2
CARSON CITY HOSPITALCARSON CITYMI0$251$125.5
SPARROW CLINTON HOSPITALST. JOHNSMI0$251$125.5
SPARROW EATONCHARLOTTEMI0$251$125.5
MACKINAC STRAITS HEALTH SYSTEM INCST. IGNACEMI0$373$261.1

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.