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CPT 99281 · negotiated-rate distribution across hospitals in MI

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Hospitals
28
Min
$23.29
Median
$85.87
Max
$123.73
Range multiplier
5.3×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare2096$7.24$89.26$968.00133.7×
Blue Cross Blue Shield2189$18.11$289.00$492.0027.2×
Medicare1383$11.01$85.87$450.0040.9×
Medicaid1277$7.24$48.16$315.0043.5×
Aetna2158$12.37$91.03$710.0057.4×
Humana1838$11.01$85.87$100.979.2×
priority health917$31.55$40.00$236.287.5×
Ambetter816$145.83$145.83$148.701.0×
smarthealth816$123.73$123.73$128.511.0×
Medicare Advantage916$71.62$88.38$88.381.2×
priority health op rate915$37.54$101.06$197.195.3×
healthspring mcr replacement714$89.26$89.71$90.151.0×
First Health814$25.27$125.80$500.0019.8×
facility billing - op714$88.38$88.38$88.381.0×
WellCare714$88.38$88.38$88.381.0×
blue mcr replacement714$88.38$88.38$88.381.0×
Oscar Health714$141.41$141.41$141.411.0×
occunet714$163.50$181.18$198.851.2×
TRICARE1011$40.51$83.64$91.792.3×
u of m health plan810$12.66$12.66$185.9014.7×
hap - hmo op rate59$27.36$58.93$122.834.5×
mclaren commercial ins89$26.00$26.00$111.604.3×
workers compensation88$47.03$90.28$130.092.8×
Cigna88$118.17$336.00$336.002.8×
hp - ppo op rate48$42.30$84.26$181.474.3×
hp - hmo op rate48$31.79$63.32$136.244.3×
safe response program88$175.00$175.00$175.001.0×
mi amish medical board77$85.87$85.87$85.871.0×
cofinity - auto op rate47$42.11$90.69$195.624.6×
cofinity - ppom op rate37$36.41$87.21$155.614.3×
hap preferred op rate36$30.46$68.69$126.064.1×
hap - ppo op rate35$65.38$116.66$181.472.8×
hcap op rate35$61.20$109.20$151.502.5×
cofinity auto55$93.52$163.16$163.161.7×
health advantage - commercial op rate24$35.75$49.77$63.791.8×
mhp - hmo op rate24$23.87$47.56$92.643.9×
mclaren health op rate34$66.09$110.13$117.371.8×
harbor health plan14$44.83$49.32$83.641.9×
health advantage - ppo op rate24$23.87$47.56$92.643.9×
hurley medical center op rate13$20.80$38.08$44.802.2×
hap op rate23$203.35$211.69$213.061.0×
mclaren health advantage op rate23$43.94$51.92$107.592.4×
cofinity wc op rate13$36.41$66.64$78.402.2×
beacon health strategies13$21.42$21.42$44.832.1×
cofinity - wc/auto op rate13$42.11$77.08$90.692.2×
total health care priority health13$44.83$82.33$83.641.9×
hap/ahl op rate13$27.36$50.09$58.932.2×
Multiplan23$96.80$114.40$162.251.7×
phpmm-commercial hmo op rate12$51.45$56.13$60.801.2×
gift of life op rate12$84.70$92.40$100.101.2×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Tawas St. Joseph HospitalTawasMI9$473.00$156.09$44.55$96.38$148.70
Mclaren Northern MichiganPetoskeyMI17$373.00$186.50$7.24$85.87$279.75
Mclaren Port HuronPort HuronMI30$245.10$122.55$7.24$85.87$450.00
Mclaren Lapeer RegionLapeerMI25$382.00$191.00$7.24$85.87$315.00
Mclaren Greater LansingLansingMI22$413.00$206.50$7.24$85.87$289.10
Garden City Hospital OsteopathicGarden CityMI20$434.00$83.00$21.42$83.64$129.64
Mclaren MacombMt. ClemensMI20$77.30$42.97$80.17$135.00
Mclaren Central MichiganMt PleasantMI19$286.00$143.00$7.24$79.82$214.50
Mclaren Bay Special CareBay CityMI17$94.65$35.75$78.98$155.61
Bay Regional Medical CenterBay CityMI26$228.00$114.00$7.24$73.27$450.00
Mclaren FlintFlintMI28$165.00$83.20$7.24$55.76$450.00
Ascension St John HospitalDetroitMI3$382.75$141.62$23.74$33.00$637.00
Mclaren Thumb RegionBad AxeMI12$134.20$67.10$7.24$23.29$180.00
Ascension Allegan HospitalAlleganMI14$612.00$244.80$88.38$123.73$968.00
Ascension Borgess HospitalKalamazooMI14$612.00$244.80$88.38$123.73$968.00
Ascension Providence Rochester HospiRochesterMI14$612.00$244.80$88.38$123.73$968.00
Ascension Borgess-Lee HospitalDowagiacMI14$612.00$244.80$88.38$123.73$968.00
Ascension Standish HospitalStandishMI14$612.00$244.80$88.38$123.73$968.00
Genesys Regional Medical Ctr.Grand BlancMI14$612.00$244.80$88.38$123.73$968.00
Borgess-Pipp Health CenterPlainwellMI14$612.00$244.80$88.38$123.73$968.00
Mclaren OaklandPontiacMI14$106.10$44.29$122.83$204.00
Carson City HospitalCarson CityMI0$305.00$76.25
North Ottawa Community HospitalGrand HavenMI0$556.00$389.20
Mh - Mercy CampusMuskegonMI0$190.10$91.25
Southeast Michigan Surgical HospitalWarrenMI0$428.00$342.40
Mckenzie Health SystemSanduskyMI0$193.00$154.40
Sparrow Clinton HospitalSt. JohnsMI0$191.00$47.75
Sparrow EatonCharlotteMI0$138.00$34.50

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.