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ED visit level 5

CPT 99285 · negotiated-rate distribution across hospitals in MI

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Hospitals
29
Min
$200
Median
$597.94
Max
$861.59
Range multiplier
4.3×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare20102$35$621.57$4,977142.2×
Blue Cross Blue Shield2197$26.75$2,367$3,735139.6×
Medicare1383$171.53$546.96$956.715.6×
Medicaid1278$111.19$335.37$2,09818.9×
Aetna2166$40.83$633.88$5,318130.2×
Humana1838$171.53$597.94$703.024.1×
priority health op rate920$27.77$552.25$975.7835.1×
priority health918$40$279.6$1,228.330.7×
First Health818$42.5$529.45$2,09849.4×
mclaren commercial ins816$218$275.06$678.243.1×
Ambetter816$1,015.44$1,015.44$1,035.361.0×
smarthealth816$861.59$861.59$894.751.0×
Medicare Advantage916$515.07$615.42$615.421.2×
facility billing - op714$615.42$615.42$615.421.0×
healthspring mcr replacement714$621.57$624.65$627.731.0×
Oscar Health714$984.67$984.67$984.671.0×
occunet714$1,138.53$1,261.61$1,384.691.2×
WellCare714$615.42$615.42$615.421.0×
blue mcr replacement714$615.42$615.42$615.421.0×
hap - hmo op rate513$23.1$456.46$755.6432.7×
hp - ppo op rate411$28.46$562.47$1,208.6642.5×
hp - hmo op rate411$20.52$405.38$907.3844.2×
cofinity - ppom op rate311$42.75$294$919.2421.5×
TRICARE1011$540.63$590.73$1,493.772.8×
u of m health plan810$197.26$197.26$875.124.4×
hap - ppo op rate39$32.05$633.31$1,208.6637.7×
hcap op rate39$30$592.8$1,08636.2×
cofinity - auto op rate48$143.1$527.08$1,302.869.1×
safe response program88$375$375$3751.0×
Cigna88$847.08$1,399$1,3991.7×
health advantage - commercial op rate28$17.52$208.22$350.8520.0×
mi amish medical board77$597.94$597.94$597.941.0×
hap preferred op rate37$118.62$246$839.627.1×
cofinity auto77$1,136.09$1,136.09$1,136.091.0×
workers compensation77$373.33$617.83$693.311.9×
blue care network op rate26$26.75$200.1$682.1325.5×
harbor health plan14$316.65$348.31$590.731.9×
bcn op rate24$200$471.45$697.533.5×
mclaren health advantage op rate24$72.62$226.58$661.899.1×
mclaren health op rate34$465.7$514.41$580.771.2×
Multiplan24$160$499.2$1,163.037.3×
hap/ahl op rate13$184.15$220.98$690.933.8×
hap op rate23$913.76$1,007.58$1,054.321.2×
hurley medical center op rate13$140$168$525.283.8×
gift of life op rate13$140$175$698.65.0×
hap-hmo op rate13$90.22$112.78$450.25.0×
cofinity wc op rate13$245$294$919.243.8×
cofinity - wc/auto op rate13$283.4$340.08$1,063.323.8×
phpmm-commercial hmo op rate13$85.04$106.3$424.355.0×
hospice care in michigan op rate13$100$125$4995.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
GENESYS REGIONAL MEDICAL CTR.GRAND BLANCMI14$11,795$4,718$615.42$861.59$5,318
ASCENSION BORGESS HOSPITALKALAMAZOOMI14$11,795$4,718$615.42$861.59$5,318
ASCENSION BORGESS-LEE HOSPITALDOWAGIACMI14$11,795$4,718$615.42$861.59$5,318
ASCENSION STANDISH HOSPITALSTANDISHMI14$11,795$4,718$615.42$861.59$5,318
ASCENSION ALLEGAN HOSPITALALLEGANMI14$11,795$4,718$615.42$861.59$5,318
ASCENSION PROVIDENCE ROCHESTER HOSPIROCHESTERMI14$11,795$4,718$615.42$861.59$5,318
BORGESS-PIPP HEALTH CENTERPLAINWELLMI14$11,795$4,718$615.42$861.59$5,318
MCLAREN OAKLANDPONTIACMI14$652.6$318.49$781.67$1,255
TAWAS ST. JOSEPH HOSPITALTAWASMI9$4,023$1,327.59$376.2$671.07$1,035.36
MCLAREN GREATER LANSINGLANSING MI 489100MI22$2,147$1,073.5$111.19$597.94$1,502.9
MCLAREN LAPEER REGIONLAPEERMI27$2,540$1,270$111.19$597.94$2,098
GARDEN CITY HOSPITAL OSTEOPATHICGARDEN CITYMI21$3,627.39$590$21.05$586.09$915.63
MCLAREN PORT HURONPORT HURONMI31$1,753$876.5$111.19$548.08$1,448
MCLAREN NORTHERN MICHIGANPETOSKEYMI18$1,775$887.5$111.19$540.63$1,380.6
MCLAREN CENTRAL MICHIGANMT PLEASANTMI19$1,285$642.5$111.19$496.31$1,136.09
BAY REGIONAL MEDICAL CENTERBAY CITYMI27$1,199$599.5$17.52$335.37$1,136.09
MCLAREN FLINTFLINTMI28$2,271$1,135.5$111.19$335.37$1,594.6
MCLAREN BAY SPECIAL CAREBAY CITYMI18$520.5$17.52$318.49$855.86
ASCENSION ST JOHN HOSPITALDETROITMI3$3,114.75$1,152.46$194.56$283.61$3,183
MCLAREN THUMB REGIONBAD AXEMI11$7,497.83$3,748.92$111.19$242.54$1,493.77
MCLAREN MACOMBMT. CLEMENSMI20$539.7$72.62$200$898.2
CARSON CITY HOSPITALCARSON CITYMI0$2,429$607.25
NORTH OTTAWA COMMUNITY HOSPITALGRAND HAVENMI0$38,336$26,835
MH - MERCY CAMPUSMUSKEGONMI0$1,902.6$913.25
SOUTHEAST MICHIGAN SURGICAL HOSPITALWARRENMI0$3,099$2,479.2
MACKINAC STRAITS HEALTH SYSTEM INCST. IGNACEMI0$655$458.5
MCKENZIE HEALTH SYSTEMSANDUSYMI0$953$762.4
SPARROW CLINTON HOSPITALST. JOHNSMI0$1,867$466.75
SPARROW EATONCHARLOTTEMI0$1,004$251

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.