CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: St Joe Mercy Hospital System Livonia

Billing Code: 99214 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$69

about 0.5× the $136 Medicare rate · typically $50–$69

modeled estimate · not a bill or quote

What this hospital charges insurers

$45

Below the fair price — a good deal

about $24 under the fair price · 0.3× Medicare

Medicare pays $136 Fair price $69 This hospital $45 Cash price $39 Hospital's list price $154

How we calculate the fair BaseRate →

How this hospital compares to other MI hospitals

Lowest price of the 9 MI hospitals we have prices for — a strong deal.

Cheapest $45 Priciest $87

Black dot = this hospital, among the 9 MI hospitals with a price for this procedure. Full list below.

A fair price for a Office visit, established patient (30-39 min) is about $69 (about 0.5× the $136 Medicare rate). St Joe Mercy Hospital System Livonia charges insurers about $45, or about $39 in cash — below the fair price — a good deal. Located in Livonia, MI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$14 - $134	10%
Blue Cross Blue Shieldmajor	$14 - $134	10%
Aetnamajor	$14 - $190	10%
Cignamajor	$14 - $134	10%
Humanamajor	$14 - $163	10%
Ambetter (Centene)	$18 - $110	13%
AmeriHealth	$19 - $163	14%
Clover Health	$14 - $134	10%
Dean Health Plan	$19 - $184	14%
Health Net	$18 - $190	13%
HealthPartners	$18 - $115	13%
MagnaCare	$19 - $163	14%
Medical Mutual	$19 - $163	14%
Meridian	$14 - $134	10%
Molina	$18 - $184	13%
MVP Health Care	$19 - $184	14%
Paramount	$18 - $110	13%
Presbyterian	$14 - $134	10%
Priority Health	$17 - $142	13%
Tufts Health Plan	$18 - $115	13%
UniCare	$19 - $163	14%
WellMed	$14 - $134	10%
WellSense	$18 - $110	13%
+ 420 smaller / regional plans	$14 - $212

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 16 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 39), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 99214.

Insurance Before you use insurance

Call your insurance company to confirm St Joe Mercy Hospital System Livonia is in-network.
Ask your insurer whether prior approval is required for CPT code 99214.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St Joe Mercy Hospital System Livonia

Compare: Office visit, established patient (30-39 min) at other MI hospitals

Insurance negotiated median for the same procedure, sorted lowest first.