CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: St Joe Mercy Hospital System Livonia

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $80
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.84x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at St Joe Mercy Hospital System Livonia is $80. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.84x the Medicare baseline. Located in 36475 Five Mile Road, Livonia, MI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$80

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$95.19

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $95.19 (100%)
Insurance Median: $80 (84%)
Ins. Median: $80 (84% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $95.19 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $42 - $98 44%
Albany County Correctional Facility $42 44%
Ambetter / Centene $42 44%
Amish Mennonite $42 44%
Ascension St. Vincent Public Safety Medical $42 44%
Bccp $42 44%
Blue Cross Blue Shield $42 - $86 44%
Bmc Healthnet $42 44%
Breast Grant-Connecticut $42 44%
Broward County Dept Of Health $42 44%
California Health And Wellness $42 44%
Cardinal Innovations Lme $42 44%
Care Connections Of Northern Iowa $42 44%
Care Oregon Ohp $42 44%
Cencal Health Plan $42 44%
Cenpatico $42 44%
Chhuny $42 44%
Childrens Comm Health Plan $42 44%
Childrens Medical Services Title 19 $42 44%
Cigna $42 - $70 44%
City Of Philadelphia $42 44%
Cmh Allegan County $42 44%
Cmh Ausable Valley $42 44%
Cmh Barry County $42 44%
Cmh Bay-Arenac County $42 44%
Cmh Berrien County $42 44%
Cmh Cass County $42 44%
Cmh Central Mi County $42 44%
Cmh Clinton-Eaton-Ingham County $42 44%
Cmh Detroit Wayne Integrated Health Network $42 44%
Cmh Genesee County $42 44%
Cmh Ionia County $42 44%
Cmh Jackson County/Lifeways $42 44%
Cmh Kalamazoo $42 44%
Cmh Kent County $42 44%
Cmh Lenawee County $42 44%
Cmh Livingston County $42 44%
Cmh Macomb $42 44%
Cmh Misc $42 44%
Cmh Monroe County $42 44%
Cmh Montcalm County $42 44%
Cmh Muskegon County $42 44%
Cmh Newaygo County $42 44%
Cmh North Country $42 44%
Cmh Northern Lakes County $42 44%
Cmh Oakland County $42 44%
Cmh Ottawa County $42 44%
Cmh Van Buren County $42 44%
Cmh Washtenaw County $42 44%
Cmh Wayne County/Carelink $42 44%
Cmh Wayne Cty/Com Liv Svcs $42 44%
Cmh West Mi County $42 44%
Community Benefit Health $42 44%
Community Care Behavorial Health $42 44%
Community Care Partners $42 44%
Community Health Choice $42 44%
Connections Csp $42 44%
County Coroner $42 44%
County Funding Generic $42 44%
Covid19 Hrsa Uninsured Testing And Treatment Fund $42 44%
Dean Wi Badgercare $42 44%
Delaware County Department Of Health $42 44%
Delaware First Health $42 44%
Delta Dental Nj $42 44%
Dph Tb Program $42 44%
Dscc $42 44%
Eastpointe Lme $42 44%
Family Health Network $42 44%
Freedom First Healthcare $42 44%
Fresno County Ccs $42 44%
Ghc Scw Wi Badgercare $42 44%
Harbor Health $42 44%
Health Safety Net $42 44%
Healthy Blue Ne $42 44%
Hennepin Health $42 44%
Humana $42 - $106 44%
Id County Ada $42 44%
Id County Canyon $42 44%
Id County Cat Fund $42 44%
Id County Other $42 44%
Id County Payette $42 44%
Idaho Dept Health And Wellfare $42 44%
Idaho Womens Health Check $42 44%
Indiana Breast Cervical Cancer $42 44%
Inland Empire Health Plan $42 44%
Intercommunity Health Ohp $42 44%
Iowa Total Care $42 44%
Jai Medical System $42 44%
Kern Family Health Plan $42 44%
Keystone First $42 44%
Keystone First Chip $42 44%
La Care Health Plan $42 44%
Lakeland Care Inc $42 44%
Managed Health Services - Indiana $42 44%
Maryland Breast & Cervical Program $42 44%
Maryland Healthy Smiles - Scion Dental $42 44%
Maryland Physicians Care $42 44%
Massachusetts Behavioral Health Partnership $42 44%
Mdwise $42 44%
Medi-Cal $42 44%
Medi-Cal Healthnet $42 44%
Medicaid / KanCare $42 - $56 44%
Medstar Dc Healthy Family $42 44%
Medstar Md Health Choice $42 44%
Mo Home State Health Plan $42 44%
Molina Centennial Care $42 44%
Nascentia Health Options $42 44%
Nebraska Total Care $42 44%
New York Cancer Services Program $42 44%
Nextlevel Health $42 44%
Oregon Screenwise $42 44%
Pace Of Southwest Michigan $42 - $58 44%
Paramount Advantage $42 44%
Parkland Community Health Plan $42 44%
Partners Behavioral Lme $42 44%
Peach State Healthplan $42 44%
Philadelphia County Funding $42 44%
Presbyterian Centennial Care $42 44%
Prestige Health Choice $42 44%
Priority Partners $42 44%
Robert F Sing Program $42 44%
Rx 340B Pass Along $42 44%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $42 44%
Rx Medi-Cal $42 44%
Rx Meridian Rx $42 44%
Ryan White Florida Mssrp $42 44%
Sandhills Center Lme $42 44%
Screening For Life $42 44%
St Joseph County Hlth Dpt $42 44%
Stephenson Cty Health $42 44%
Sunshine State Health Plan $42 44%
Superior Health $42 44%
Tenncare $42 44%
Texas Children'S Health Plan $42 44%
Trillium Community Ohp $42 44%
Tufts Health Public Plans $42 44%
UnitedHealthcare $42 - $58 44%
Vaya Health Lme $42 44%
Washtenaw Health Plan $42 44%
Wellsense Health Plan $42 44%
Wi Womens Wellness $42 44%
Ally Align Care Adv $58 61%
American Health Advantage Of Idaho $58 61%
American Health Plan $58 61%
Aurora Special Needs $58 61%
Blue Care Network Advantage $58 61%
Blue Shield - De (Highmark) Medciare Advantage $58 61%
Care Dimensions $58 61%
Care Improvement Plus $58 61%
Care Resources Pace $58 61%
Careplus Health Plans $58 61%
Cca Senior Care Options $58 61%
Central Valley Medical Services Corp Pace $58 61%
Champion Health Plan Mcr Advantage $58 61%
Clear Spring Health $58 61%
Clover Health $58 61%
Commonwealth Care Alliance $58 61%
Community Pace At Home $58 61%
Eddy Senior Care-Pace $58 61%
Eddy Seniorcare Pace $58 61%
Elementcare $58 61%
Evercare $58 61%
Everence $58 61%
Gateway Health Plan $58 61%
Genesys Pace Of Genesee County $58 61%
Georgia Health Advantage $58 61%
Gold Advantage $58 61%
Gpa Croell Redi Mix $58 61%
Health America Advantra $58 61%
Highmark Health Options Dual Plan $58 61%
Hope Select Pace $58 61%
Horizon Nj Total Care $58 61%
Hudson Headwaters Pace $58 61%
Huron Valley Pace $58 61%
Innovative Integrated Health Community Plans $58 61%
Iowa Health Advantage $58 61%
Johns Hopkins Advantage Md $58 61%
Lasso Healthcare Msa $58 61%
Life St Marys Pace $58 61%
Lifecircles Pace $58 61%
Longevity Health Plan $58 61%
Martins Point Generations Advantage $58 61%
Mass General Brigham Mcr Adv $58 61%
Medicare (plans) $58 - $61 61%
Medipak Advantage $58 61%
Mercy Life $58 61%
Mercyone Cedar Valley $58 61%
Meridian Complete $58 61%
Michigan Complete Health $58 61%
Nascentia Health Plus $58 61%
New Centry Health Careplus $58 61%
Osu Prime Care Advantage $58 61%
Pace Cny $58 61%
Pace Iowa Immanuel Pathways $58 61%
Pace Southeast $58 61%
Pace-Trinity Health $58 61%
Peak Pace Solutions $58 61%
Perennial Advantage $58 61%
Preferred Care Partners $58 61%
Presbyterian Senior Plan $58 61%
Provider Partners Health Plan Of Illinois $58 61%
Provider Partners Health Plan Of Indiana $58 61%
Pruitthealth Premier $58 61%
Reliance Community Care Partners Care Resources Pace $58 61%
Rx Allwin $58 61%
Rx Grane Grnmedd $58 61%
Rx Retiree Rx Care $58 61%
Scan Health Plan Mcr Ipa Meritage Oon $58 61%
Secure Horizons Ma Pffs $58 61%
Serenity Pace $58 61%
Siouxland Pace $58 61%
Solis Health Plans $58 61%
Sunnyview-Pace Finance Dept $58 61%
Texan Plus $58 61%
The Health Plan $58 - $106 61%
Thome Pace $58 61%
Todays Options $58 61%
Tribute Health Plans $58 61%
Um Health Advantage $58 61%
Union Health Service $58 61%
Welbe Health $58 61%
Wellmed $58 61%
Align Senior Care $59 62%
Veterans Administration $59 62%
Cca - Zing Health $64 67%
Champva $65 68%
Tricare $65 68%
Triwest Health Alliance $65 68%
Us Family Health Plan $65 68%
Veterans Eval Services $65 68%
Longevity Ipa Of Michigan Llc Health Plan Isnp $67 70%
American Postal Workers Secondary $70 74%
Priority Health $75 79%
Asr Health Benefits $78 82%
Hap $78 82%
Health Partners $78 82%
Tufts Health Plan $78 82%
Varipro $78 82%
1199 National Benefit Fund $80 84%
Allied National Global Care $80 84%
Asrm - Reliance Standard Life Insurance $80 84%
Blue Care Network $80 84%
Christian Care Ministry $80 84%
Dean Health $80 84%
Fallon Health $80 84%
Family Life Insurance Company $80 84%
International Benefit Administrators $80 84%
Lifetime Benefit Solutions $80 84%
Manhattan Life $80 84%
Molina Marketplace $80 84%
Multiplan $80 84%
Mvp $80 84%
Pai $80 84%
Pan-American Life $80 84%
Phcs $80 84%
Trinity Health Share $80 84%
Wellpath $80 84%
Blue Benefit Administrators Of Massachusetts $86 90%
Blue Distinction Transplant $86 90%
Blue Shield - Ca $86 90%
Blue Shield - Id (Regence) $86 90%
Blue Shield - Ny Highmark Northeastern $86 90%
Blue Shield - Ny Highmark Western $86 90%
Blue Shield - Pa (Highmark) $86 90%
Blue Shield - Wa (Regence) $86 90%
Meritain $86 90%
Partners Direct Health - Brio $86 90%
Bcccp-Michigan $88 92%
Claimdoc $92 97%
Kent County Jail $92 97%
Muskegon County Jail $92 97%
Wc Accident Fund $93 98%
Wc Advantage $93 98%
Wc Aig $93 98%
Wc Allied $93 98%
Wc Amerisure $93 98%
Wc Amtrust $93 98%
Wc Asu Risk Mgt $93 98%
Wc Berkley Admin $93 98%
Wc Broadspire $93 98%
Wc Bunch & Associates $93 98%
Wc Ccmsi $93 98%
Wc Emc Insurance Company $93 98%
Wc Esis $93 98%
Wc Fcci $93 98%
Wc Federated $93 98%
Wc Gallagher Bassett $93 98%
Wc Genex Care For Ohio $93 98%
Wc Guard Insurance Company $93 98%
Wc Hartford $93 98%
Wc Liberty Mutual $93 98%
Wc Meijers $93 98%
Wc Michigan $93 98%
Wc Mitchell Frankenmuth $93 98%
Wc Pma $93 98%
Wc Sedgwick $93 98%
Wc Sentry $93 98%
Wc Travelers $93 98%
Wc Tristar $93 98%
Wc Walmart $93 98%
Wc Zurich $93 98%
Andrie Inc $98 103%
East Greenbush Central School District $98 103%
Genex Wc $98 103%
Healthsmart Workers Comp $98 103%
Jag Source $98 103%
New York State Insurance Fund $98 103%
Njm Insurance Group $98 103%
Rx Heatlhcomp $98 103%
Rx Restat $98 103%
Rx Saif Opdp Wc $98 103%
Rx Worker'S Comp $98 103%
Wc Ace $98 103%
Wc Acs Federal Employees $98 103%
Wc Acuity $98 103%
Wc Aegis $98 103%
Wc Aims $98 103%
Wc Alaska National Ins $98 103%
Wc Align Network $98 103%
Wc Am Trust N America $98 103%
Wc American Claims Mgmt $98 103%
Wc Benetech $98 103%
Wc Broward County $98 103%
Wc California State Comp Ins $98 103%
Wc California State Ins Fund $98 103%
Wc Capitol Area Health Consortium $98 103%
Wc Chartis $98 103%
Wc Chubb $98 103%
Wc Cirma $98 103%
Wc City Of Albany $98 103%
Wc City Of Sioux City $98 103%
Wc Claims Mgmt Inc $98 103%
Wc Cna $98 103%
Wc Comp One Admin C/O Manageability $98 103%
Wc Compone Admin $98 103%
Wc Corvel $98 103%
Wc Ct Healthcare Trust $98 103%
Wc Donegal Insurance Group $98 103%
Wc Employee Mutual $98 103%
Wc Enablecomp $98 103%
Wc Encore Health Network $98 103%
Wc Erie $98 103%
Wc Evolutions $98 103%
Wc Fed Ex $98 103%
Wc Federal Black Lung $98 103%
Wc Finley Occupational Health $98 103%
Wc First Agency/Occunet $98 103%
Wc Ford Motor $98 103%
Wc Fresno Unified Emp $98 103%
Wc General Motors $98 103%
Wc Generic $98 103%
Wc Great West Casualty $98 103%
Wc Guarantee Insurance $98 103%
Wc Hab $98 103%
Wc Hastings $98 103%
Wc Health Management $98 103%
Wc Heritage Summit $98 103%
Wc Hireright $98 103%
Wc Horizon $98 103%
Wc Icw Group $98 103%
Wc Idaho State Ins Fund $98 103%
Wc Intercare Insurance $98 103%
Wc Intermountain $98 103%
Wc Johns Eastern $98 103%
Wc Kemberton $98 103%
Wc Key Ins & Benefit Solutions $98 103%
Wc Mac Risk Management $98 103%
Wc Massachusetts $98 103%
Wc Mdia $98 103%
Wc Meadowbrook Claim $98 103%
Wc Medical Administrators $98 103%
Wc Memic $98 103%
Wc Mercy Workcare $98 103%
Wc Michigan Millers Mutual $98 103%
Wc Mra $98 103%
Wc Nationwide $98 103%
Wc Nca Comp $98 103%
Wc New York $98 103%
Wc New York Special Funds $98 103%
Wc North American Rishces $98 103%
Wc Northeast Health $98 103%
Wc Notre Dame $98 103%
Wc Novanet $98 103%
Wc O'Hara Corp $98 103%
Wc Occ Health Allen $98 103%
Wc Ohio Bureau $98 103%
Wc One Call Medical $98 103%
Wc Paradigm $98 103%
Wc Peerless $98 103%
Wc Praxis Health Network $98 103%
Wc Price Chopper $98 103%
Wc Procura Management $98 103%
Wc Qualcare $98 103%
Wc Quiktrip $98 103%
Wc Reny Company $98 103%
Wc Rev Claims $98 103%
Wc Risico $98 103%
Wc Rural Mutual $98 103%
Wc Saif Oregon $98 103%
Wc Secura $98 103%
Wc Sheakley Unicomp $98 103%
Wc Smile Lodge $98 103%
Wc Society $98 103%
Wc Srs $98 103%
Wc Taconic (Mro) $98 103%
Wc Taconic Farms $98 103%
Wc Triad Group $98 103%
Wc Troy Ny $98 103%
Wc Tyson $98 103%
Wc Unified Health Services $98 103%
Wc United Heartland $98 103%
Wc Us Dept Of Labor $98 103%
Wc Velocity $98 103%
Wc West Bend $98 103%
Wc West Bend Mutual/Argent $98 103%
Wc Winnebago Industries $98 103%
Wc Yankee Trails $98 103%
Wc York Risk $98 103%
Wc Zenith $98 103%
U Of M Health Plan $102 107%
Acclaim $106 111%
Administrative Concepts $106 111%
Allegeant $106 111%
Allied Benefit Systems $106 111%
Ameriben $106 111%
American Family $106 111%
American Healthcare Alliance $106 111%
American National $106 111%
American Republic $106 111%
Amerihealth $106 111%
Aultcare $106 111%
Automated Benefit Services $106 111%
Auxiant $106 111%
Benefit Administrative Systems,Llc $106 111%
Boon Chapman $106 111%
Cam Administrative Services $106 111%
Christian Brother Services $106 111%
Christian Brothers Holy Cross $106 111%
Claimchoice Adminstrators $106 111%
Comprehensive Benefits $106 111%
Consociate $106 111%
Continental Life Insurance $106 111%
Coventry $106 111%
Custom Benefit Administrators $106 111%
Cypress Benefit Administrators $106 111%
Employee Benefit Concepts $106 111%
Employee Benefit Management $106 111%
Enterprise Group Planning $106 111%
First Health $106 111%
Forest County Potawatomi $106 111%
Freedom Life Insurance Company $106 111%
Group Administrators $106 111%
Group Marketing Services $106 111%
Group Pension Administrators $106 111%
Guardian $106 111%
Health America $106 111%
Health Choices $106 111%
Health Smart $106 111%
Healthcare Management Admin $106 111%
Healthez $106 111%
Healthgram $106 111%
Healthscope $106 111%
Insight $106 111%
Intercare $106 111%
Jfp Benefit Management $106 111%
Jp Farley Corporation $106 111%
Key Benefit Administrator $106 111%
Liberty Union Life Assurance Co $106 111%
Lucent Health $106 111%
Luminare Health $106 111%
Luminare Health (Detroit) $106 111%
Magnacare $106 111%
Medben $106 111%
Medcost $106 111%
Medical Mutual $106 111%
Mutual Health Services $106 111%
Mutual Of Omaha $106 111%
Ncas $106 111%
Nippon Life Ins $106 111%
Nova $106 111%
Painters Union Insurance Fund $106 111%
Physicians Mutual $106 111%
Plumbers Local 98 Insurance Fund $106 111%
Prairie States $106 111%
Preferred One $106 111%
Primary Physician Care $106 111%
Professional Benefit Administrators $106 111%
Secureone Preferred United Plans $106 111%
Siho Insurance Services $106 111%
Sisco Benefits $106 111%
The Loomis Company $106 111%
Trustmark Small Business Benefits $106 111%
Unicare $106 111%
Unified Group Services $106 111%
Us Health And Life $106 111%
Valenz $106 111%
Webtpa $106 111%
Western & Southern Financial Group $106 111%
Wps $106 111%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 36475 Five Mile Road, Livonia, MI 48154
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals