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Critical care, first hour

CPT 99291 · negotiated-rate distribution across hospitals in MI

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Hospitals
29
Min
$237.78
Median
$821.78
Max
$1,378.50
Range multiplier
5.8×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare2097$135.00$854.26$7,186.0053.2×
Blue Cross Blue Shield2192$279.56$2,367.00$3,735.0013.4×
Medicare1383$198.15$725.64$1,314.856.6×
Medicaid1279$135.47$460.91$3,671.0027.1×
Aetna2152$221.25$871.17$3,001.5013.6×
Humana1838$198.15$821.78$966.194.9×
priority health918$40.00$358.36$2,447.4361.2×
Medicare Advantage916$683.33$845.80$845.801.2×
smarthealth816$1,184.12$1,184.12$1,229.691.0×
Ambetter816$1,395.57$1,395.57$1,422.931.0×
priority health op rate915$313.29$1,079.69$2,121.396.8×
blue mcr replacement714$845.80$845.80$845.801.0×
WellCare714$845.80$845.80$845.801.0×
Oscar Health714$1,353.28$1,353.28$1,353.281.0×
occunet714$1,564.73$1,733.89$1,903.051.2×
facility billing - op714$845.80$845.80$845.801.0×
healthspring mcr replacement714$854.26$858.49$862.721.0×
First Health813$500.00$1,237.60$3,671.007.3×
mclaren commercial ins811$258.00$258.00$1,208.174.7×
TRICARE1011$454.82$803.41$878.351.9×
Cigna89$441.67$2,410.00$2,410.005.5×
hap - hmo op rate59$228.35$672.67$1,262.095.5×
u of m health plan89$227.87$227.87$1,094.814.8×
hap - hmo88$204.94$204.94$204.941.0×
hp - ppo op rate48$352.97$796.12$2,114.866.0×
hp - hmo op rate48$265.24$585.23$1,587.716.0×
mi amish medical board77$821.78$821.78$821.781.0×
cofinity auto77$1,561.38$1,561.38$1,561.381.0×
hcap op rate36$566.25$798.90$1,346.252.4×
hap - ppo op rate36$763.33$853.50$2,114.862.8×
cofinity - ppom op rate36$303.80$1,138.43$1,365.634.5×
cofinity - auto op rate46$351.42$1,531.20$2,279.696.5×
workers compensation66$559.84$981.64$1,494.212.7×
mclaren health op rate35$247.04$1,064.62$1,262.635.1×
hap preferred op rate35$254.20$1,142.67$1,635.186.4×
mhp - hmo op rate24$199.21$642.57$1,079.645.4×
harbor health plan14$439.21$483.13$819.381.9×
health advantage - commercial op rate24$423.05$466.69$510.331.2×
health advantage - ppo op rate24$199.21$642.57$1,079.645.4×
total health care priority health13$439.21$806.51$819.381.9×
hap op rate23$1,932.69$2,292.15$2,336.311.2×
Multiplan23$606.42$1,441.74$2,205.603.6×
cofinity op rate23$261.73$1,386.64$2,025.007.7×
bcn op rate23$321.25$1,161.86$1,169.623.6×
auto-cofinity op rate12$641.75$1,083.75$1,525.752.4×
blue care network op rate22$1,143.81$1,143.81$1,143.811.0×
hap ahl op rate12$383.54$647.70$911.862.4×
hap hmo op rate12$379.31$640.56$901.812.4×
hap ppo op rate12$477.69$806.70$1,135.702.4×
hap/ahl op rate12$228.35$627.40$1,026.454.5×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Tawas St. Joseph HospitalTawasMI9$5,953.00$1,964.49$518.10$922.27$1,422.93
Mclaren Lapeer RegionLapeerMI27$4,445.00$2,222.50$135.47$821.78$3,671.00
Garden City Hospital OsteopathicGarden CityMI20$4,500.00$819.00$30.00$819.38$1,482.15
Mclaren Greater LansingLansingMI21$2,686.00$1,343.00$135.47$803.04$1,880.20
Mclaren Bay Special CareBay CityMI17$757.10$351.60$784.83$1,244.88
Mclaren Northern MichiganPetoskeyMI17$4,038.00$2,019.00$135.47$782.40$3,028.50
Bay Regional Medical CenterBay CityMI26$1,798.00$899.00$135.47$679.91$1,561.38
Mclaren Central MichiganMt PleasantMI19$3,285.00$1,642.50$135.47$658.43$2,463.75
Mclaren Port HuronPort HuronMI31$2,433.50$1,216.75$135.47$576.79$1,795.00
Mclaren FlintFlintMI27$3,375.00$1,687.50$135.47$460.91$2,368.95
Ascension St John HospitalDetroitMI3$3,275.50$1,211.94$248.97$351.97$500.00
Mclaren Thumb RegionBad AxeMI12$1,280.00$640.00$135.47$237.78$1,087.36
Mclaren MacombMt. ClemensMI20$1,491.00$135.00$1,378.50$2,481.30
Mclaren OaklandPontiacMI14$993.20$422.53$1,203.30$1,910.00
Ascension Standish HospitalStandishMI14$11,833$4,733.20$845.80$1,184.12$7,186.00
Ascension Allegan HospitalAlleganMI14$11,833$4,733.20$845.80$1,184.12$7,186.00
Genesys Regional Medical Ctr.Grand BlancMI14$11,833$4,733.20$845.80$1,184.12$7,186.00
Ascension Borgess-Lee HospitalDowagiacMI14$11,833$4,733.20$845.80$1,184.12$7,186.00
Ascension Providence Rochester HospiRochesterMI14$11,833$4,733.20$845.80$1,184.12$7,186.00
Ascension Borgess HospitalKalamazooMI14$11,833$4,733.20$845.80$1,184.12$7,186.00
Borgess-Pipp Health CenterPlainwellMI14$11,833$4,733.20$845.80$1,184.12$7,186.00
Carson City HospitalCarson CityMI0$3,066.00$766.50
North Ottawa Community HospitalGrand HavenMI0$6,672.00$4,670.40
Mh - Mercy CampusMuskegonMI0$3,215.60$1,543.49
Southeast Michigan Surgical HospitalWarrenMI0$4,281.00$3,424.80
Mackinac Straits Health System IncSt. IgnaceMI0$843.00$590.10
Mckenzie Health SystemSanduskyMI0$1,060.00$848.00
Sparrow Clinton HospitalSt. JohnsMI0$2,347.00$586.75
Sparrow EatonCharlotteMI0$1,282.00$320.50

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.