CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Trinity Health Oakland Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $117
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Trinity Health Oakland Hospital is $117. 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 $117.57, this hospital’s rate is 1.00x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$117

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)
Insurance Median: $117 (100%)
Ins. Median: $117 (100% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $117.57 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
Medicaid / KanCare $58 - $97 49%
Albany County Correctional Facility $72 61%
Ambetter / Centene $72 61%
Amish Mennonite $72 61%
Ascension St. Vincent Public Safety Medical $72 61%
Bccp $72 61%
Blue Cross Blue Shield $72 - $117 61%
Bmc Healthnet $72 61%
Breast Grant-Connecticut $72 61%
Broward County Dept Of Health $72 61%
California Health And Wellness $72 61%
Cardinal Innovations Lme $72 61%
Care Connections Of Northern Iowa $72 61%
Care Oregon Ohp $72 61%
Cencal Health Plan $72 61%
Cenpatico $72 61%
Chhuny $72 61%
Childrens Comm Health Plan $72 61%
Childrens Medical Services Title 19 $72 61%
Cigna $72 - $172 61%
City Of Philadelphia $72 61%
Cmh Allegan County $72 61%
Cmh Ausable Valley $72 61%
Cmh Barry County $72 61%
Cmh Bay-Arenac County $72 61%
Cmh Berrien County $72 61%
Cmh Cass County $72 61%
Cmh Central Mi County $72 61%
Cmh Clinton-Eaton-Ingham County $72 61%
Cmh Detroit Wayne Integrated Health Network $72 61%
Cmh Genesee County $72 61%
Cmh Ionia County $72 61%
Cmh Jackson County/Lifeways $72 61%
Cmh Kalamazoo $72 61%
Cmh Kent County $72 61%
Cmh Lenawee County $72 61%
Cmh Livingston County $72 61%
Cmh Macomb $72 61%
Cmh Misc $72 61%
Cmh Monroe County $72 61%
Cmh Montcalm County $72 61%
Cmh Muskegon County $72 61%
Cmh Newaygo County $72 61%
Cmh North Country $72 61%
Cmh Northern Lakes County $72 61%
Cmh Oakland County $72 61%
Cmh Ottawa County $72 61%
Cmh Van Buren County $72 61%
Cmh Washtenaw County $72 61%
Cmh Wayne County/Carelink $72 61%
Cmh Wayne Cty/Com Liv Svcs $72 61%
Cmh West Mi County $72 61%
Community Benefit Health $72 61%
Community Care Behavorial Health $72 61%
Community Care Partners $72 61%
Community Health Choice $72 61%
Connections Csp $72 61%
County Coroner $72 61%
County Funding Generic $72 61%
Covid19 Hrsa Uninsured Testing And Treatment Fund $72 61%
Dean Wi Badgercare $72 61%
Delaware County Department Of Health $72 61%
Delaware First Health $72 61%
Delta Dental Nj $72 61%
Dph Tb Program $72 61%
Dscc $72 61%
Eastpointe Lme $72 61%
Family Health Network $72 61%
Freedom First Healthcare $72 61%
Fresno County Ccs $72 61%
Ghc Scw Wi Badgercare $72 61%
Harbor Health $72 61%
Health Safety Net $72 61%
Healthy Blue Ne $72 61%
Hennepin Health $72 61%
Humana $72 - $152 61%
Id County Ada $72 61%
Id County Canyon $72 61%
Id County Cat Fund $72 61%
Id County Other $72 61%
Id County Payette $72 61%
Idaho Dept Health And Wellfare $72 61%
Idaho Womens Health Check $72 61%
Indiana Breast Cervical Cancer $72 61%
Inland Empire Health Plan $72 61%
Intercommunity Health Ohp $72 61%
Iowa Total Care $72 61%
Jai Medical System $72 61%
Kern Family Health Plan $72 61%
Keystone First $72 61%
Keystone First Chip $72 61%
La Care Health Plan $72 61%
Lakeland Care Inc $72 61%
Managed Health Services - Indiana $72 61%
Maryland Breast & Cervical Program $72 61%
Maryland Healthy Smiles - Scion Dental $72 61%
Maryland Physicians Care $72 61%
Massachusetts Behavioral Health Partnership $72 61%
Mdwise $72 61%
Medi-Cal $72 61%
Medi-Cal Healthnet $72 61%
Medstar Dc Healthy Family $72 61%
Medstar Md Health Choice $72 61%
Mo Home State Health Plan $72 61%
Molina Centennial Care $72 61%
Nascentia Health Options $72 61%
Nebraska Total Care $72 61%
New York Cancer Services Program $72 61%
Nextlevel Health $72 61%
Oregon Screenwise $72 61%
Pace Of Southwest Michigan $72 - $117 61%
Paramount Advantage $72 61%
Parkland Community Health Plan $72 61%
Partners Behavioral Lme $72 61%
Peach State Healthplan $72 61%
Philadelphia County Funding $72 61%
Presbyterian Centennial Care $72 61%
Prestige Health Choice $72 61%
Priority Partners $72 61%
Robert F Sing Program $72 61%
Rx 340B Pass Along $72 61%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $72 61%
Rx Medi-Cal $72 61%
Rx Meridian Rx $72 61%
Ryan White Florida Mssrp $72 61%
Sandhills Center Lme $72 61%
Screening For Life $72 61%
St Joseph County Hlth Dpt $72 61%
Stephenson Cty Health $72 61%
Sunshine State Health Plan $72 61%
Superior Health $72 61%
Tenncare $72 61%
Texas Children'S Health Plan $72 61%
Trillium Community Ohp $72 61%
Tufts Health Public Plans $72 61%
UnitedHealthcare $72 - $117 61%
Vaya Health Lme $72 61%
Washtenaw Health Plan $72 61%
Wellsense Health Plan $72 61%
Wi Womens Wellness $72 61%
Aetna $75 - $166 64%
Geha $89 76%
Mclaren Health $101 86%
Bcccp-Michigan $108 92%
Blue Care Network $109 93%
Champva $110 94%
Tricare $110 94%
Triwest Health Alliance $110 94%
Us Family Health Plan $110 94%
Veterans Eval Services $110 94%
Ally Align Care Adv $117 100%
American Health Advantage Of Idaho $117 100%
American Health Plan $117 100%
Asr Health Benefits $117 100%
Aurora Special Needs $117 100%
Blue Benefit Administrators Of Massachusetts $117 100%
Blue Care Network Advantage $117 100%
Blue Distinction Transplant $117 100%
Blue Shield - Ca $117 100%
Blue Shield - De (Highmark) Medciare Advantage $117 100%
Blue Shield - Id (Regence) $117 100%
Blue Shield - Ny Highmark Northeastern $117 100%
Blue Shield - Ny Highmark Western $117 100%
Blue Shield - Pa (Highmark) $117 100%
Blue Shield - Wa (Regence) $117 100%
Care Dimensions $117 100%
Care Improvement Plus $117 100%
Care Resources Pace $117 100%
Careplus Health Plans $117 100%
Cca Senior Care Options $117 100%
Central Valley Medical Services Corp Pace $117 100%
Champion Health Plan Mcr Advantage $117 100%
Clear Spring Health $117 100%
Clover Health $117 100%
Commonwealth Care Alliance $117 100%
Community Pace At Home $117 100%
Eddy Senior Care-Pace $117 100%
Eddy Seniorcare Pace $117 100%
Elementcare $117 100%
Evercare $117 100%
Everence $117 100%
Gateway Health Plan $117 100%
Genesys Pace Of Genesee County $117 100%
Georgia Health Advantage $117 100%
Gold Advantage $117 100%
Gpa Croell Redi Mix $117 100%
Hap $117 100%
Health America Advantra $117 100%
Health Partners $117 100%
Highmark Health Options Dual Plan $117 100%
Hope Select Pace $117 100%
Horizon Nj Total Care $117 100%
Hudson Headwaters Pace $117 100%
Huron Valley Pace $117 100%
Innovative Integrated Health Community Plans $117 100%
Iowa Health Advantage $117 100%
Johns Hopkins Advantage Md $117 100%
Lasso Healthcare Msa $117 100%
Life St Marys Pace $117 100%
Lifecircles Pace $117 100%
Longevity Health Plan $117 100%
Martins Point Generations Advantage $117 100%
Mass General Brigham Mcr Adv $117 100%
Medicare (plans) $117 - $123 100%
Medipak Advantage $117 100%
Mercy Life $117 100%
Mercyone Cedar Valley $117 100%
Meridian Complete $117 100%
Michigan Complete Health $117 100%
Nascentia Health Plus $117 100%
New Centry Health Careplus $117 100%
Osu Prime Care Advantage $117 100%
Pace Cny $117 100%
Pace Iowa Immanuel Pathways $117 100%
Pace Southeast $117 100%
Pace-Trinity Health $117 100%
Peak Pace Solutions $117 100%
Perennial Advantage $117 100%
Preferred Care Partners $117 100%
Presbyterian Senior Plan $117 100%
Provider Partners Health Plan Of Illinois $117 100%
Provider Partners Health Plan Of Indiana $117 100%
Pruitthealth Premier $117 100%
Reliance Community Care Partners Care Resources Pace $117 100%
Rx Allwin $117 100%
Rx Grane Grnmedd $117 100%
Rx Retiree Rx Care $117 100%
Scan Health Plan Mcr Ipa Meritage Oon $117 100%
Secure Horizons Ma Pffs $117 100%
Serenity Pace $117 100%
Siouxland Pace $117 100%
Solis Health Plans $117 100%
Sunnyview-Pace Finance Dept $117 100%
Texan Plus $117 100%
The Health Plan $117 - $152 100%
Thome Pace $117 100%
Todays Options $117 100%
Tribute Health Plans $117 100%
Tufts Health Plan $117 100%
Um Health Advantage $117 100%
Union Health Service $117 100%
Varipro $117 100%
Welbe Health $117 100%
Wellmed $117 100%
Align Senior Care $119 101%
Veterans Administration $119 101%
Oscar $125 106%
Cca - Zing Health $128 109%
Longevity Ipa Of Michigan Llc Health Plan Isnp $134 114%
U Of M Health Plan $143 122%
Meritain $151 128%
Access Health $152 129%
Acclaim $152 129%
Administrative Concepts $152 129%
Allegeant $152 129%
Allied Benefit Systems $152 129%
Ameriben $152 129%
American Family $152 129%
American Healthcare Alliance $152 129%
American National $152 129%
American Republic $152 129%
Amerihealth $152 129%
Aultcare $152 129%
Automated Benefit Services $152 129%
Auxiant $152 129%
Benefit Administrative Systems,Llc $152 129%
Boon Chapman $152 129%
Cam Administrative Services $152 129%
Christian Brother Services $152 129%
Christian Brothers Holy Cross $152 129%
Claimchoice Adminstrators $152 129%
Comprehensive Benefits $152 129%
Consociate $152 129%
Continental Life Insurance $152 129%
Coventry $152 129%
Custom Benefit Administrators $152 129%
Cypress Benefit Administrators $152 129%
Employee Benefit Concepts $152 129%
Employee Benefit Management $152 129%
Enterprise Group Planning $152 129%
First Health $152 129%
Forest County Potawatomi $152 129%
Freedom Life Insurance Company $152 129%
Group Administrators $152 129%
Group Marketing Services $152 129%
Group Pension Administrators $152 129%
Guardian $152 129%
Health America $152 129%
Health Choices $152 129%
Health Smart $152 129%
Healthcare Management Admin $152 129%
Healthez $152 129%
Healthgram $152 129%
Healthscope $152 129%
Insight $152 129%
Intercare $152 129%
Jfp Benefit Management $152 129%
Jp Farley Corporation $152 129%
Key Benefit Administrator $152 129%
Liberty Union Life Assurance Co $152 129%
Lucent Health $152 129%
Luminare Health $152 129%
Luminare Health (Detroit) $152 129%
Magnacare $152 129%
Medben $152 129%
Medcost $152 129%
Medical Mutual $152 129%
Mutual Health Services $152 129%
Mutual Of Omaha $152 129%
Ncas $152 129%
Nippon Life Ins $152 129%
Nova $152 129%
Painters Union Insurance Fund $152 129%
Physicians Mutual $152 129%
Plumbers Local 98 Insurance Fund $152 129%
Prairie States $152 129%
Preferred One $152 129%
Primary Physician Care $152 129%
Professional Benefit Administrators $152 129%
Secureone Preferred United Plans $152 129%
Siho Insurance Services $152 129%
Sisco Benefits $152 129%
The Loomis Company $152 129%
Trustmark Small Business Benefits $152 129%
Unicare $152 129%
Unified Group Services $152 129%
Us Health And Life $152 129%
Valenz $152 129%
Webtpa $152 129%
Western & Southern Financial Group $152 129%
Wps $152 129%
Wc Accident Fund $158 134%
Wc Advantage $158 134%
Wc Aig $158 134%
Wc Allied $158 134%
Wc Amerisure $158 134%
Wc Amtrust $158 134%
Wc Asu Risk Mgt $158 134%
Wc Berkley Admin $158 134%
Wc Broadspire $158 134%
Wc Bunch & Associates $158 134%
Wc Ccmsi $158 134%
Wc Emc Insurance Company $158 134%
Wc Esis $158 134%
Wc Fcci $158 134%
Wc Federated $158 134%
Wc Gallagher Bassett $158 134%
Wc Genex Care For Ohio $158 134%
Wc Guard Insurance Company $158 134%
Wc Hartford $158 134%
Wc Liberty Mutual $158 134%
Wc Meijers $158 134%
Wc Michigan $158 134%
Wc Mitchell Frankenmuth $158 134%
Wc Pma $158 134%
Wc Sedgwick $158 134%
Wc Sentry $158 134%
Wc Travelers $158 134%
Wc Tristar $158 134%
Wc Walmart $158 134%
Wc Zurich $158 134%
1199 National Benefit Fund $161 137%
Allied National Global Care $161 137%
Asrm - Reliance Standard Life Insurance $161 137%
Christian Care Ministry $161 137%
Dean Health $161 137%
Fallon Health $161 137%
Family Life Insurance Company $161 137%
International Benefit Administrators $161 137%
Lifetime Benefit Solutions $161 137%
Manhattan Life $161 137%
Molina Marketplace $161 137%
Multiplan $161 137%
Mvp $161 137%
Pai $161 137%
Pan-American Life $161 137%
Phcs $161 137%
Trinity Health Share $161 137%
Wellpath $161 137%
Priority Health $164 139%
Andrie Inc $166 141%
East Greenbush Central School District $166 141%
Genex Wc $166 141%
Healthsmart Workers Comp $166 141%
Jag Source $166 141%
New York State Insurance Fund $166 141%
Njm Insurance Group $166 141%
Rx Heatlhcomp $166 141%
Rx Restat $166 141%
Rx Saif Opdp Wc $166 141%
Rx Worker'S Comp $166 141%
Wc Ace $166 141%
Wc Acs Federal Employees $166 141%
Wc Acuity $166 141%
Wc Aegis $166 141%
Wc Aims $166 141%
Wc Alaska National Ins $166 141%
Wc Align Network $166 141%
Wc Am Trust N America $166 141%
Wc American Claims Mgmt $166 141%
Wc Benetech $166 141%
Wc Broward County $166 141%
Wc California State Comp Ins $166 141%
Wc California State Ins Fund $166 141%
Wc Capitol Area Health Consortium $166 141%
Wc Chartis $166 141%
Wc Chubb $166 141%
Wc Cirma $166 141%
Wc City Of Albany $166 141%
Wc City Of Sioux City $166 141%
Wc Claims Mgmt Inc $166 141%
Wc Cna $166 141%
Wc Comp One Admin C/O Manageability $166 141%
Wc Compone Admin $166 141%
Wc Corvel $166 141%
Wc Ct Healthcare Trust $166 141%
Wc Donegal Insurance Group $166 141%
Wc Employee Mutual $166 141%
Wc Enablecomp $166 141%
Wc Encore Health Network $166 141%
Wc Erie $166 141%
Wc Evolutions $166 141%
Wc Fed Ex $166 141%
Wc Federal Black Lung $166 141%
Wc Finley Occupational Health $166 141%
Wc First Agency/Occunet $166 141%
Wc Ford Motor $166 141%
Wc Fresno Unified Emp $166 141%
Wc General Motors $166 141%
Wc Generic $166 141%
Wc Great West Casualty $166 141%
Wc Guarantee Insurance $166 141%
Wc Hab $166 141%
Wc Hastings $166 141%
Wc Health Management $166 141%
Wc Heritage Summit $166 141%
Wc Hireright $166 141%
Wc Horizon $166 141%
Wc Icw Group $166 141%
Wc Idaho State Ins Fund $166 141%
Wc Intercare Insurance $166 141%
Wc Intermountain $166 141%
Wc Johns Eastern $166 141%
Wc Kemberton $166 141%
Wc Key Ins & Benefit Solutions $166 141%
Wc Mac Risk Management $166 141%
Wc Massachusetts $166 141%
Wc Mdia $166 141%
Wc Meadowbrook Claim $166 141%
Wc Medical Administrators $166 141%
Wc Memic $166 141%
Wc Mercy Workcare $166 141%
Wc Michigan Millers Mutual $166 141%
Wc Mra $166 141%
Wc Nationwide $166 141%
Wc Nca Comp $166 141%
Wc New York $166 141%
Wc New York Special Funds $166 141%
Wc North American Rishces $166 141%
Wc Northeast Health $166 141%
Wc Notre Dame $166 141%
Wc Novanet $166 141%
Wc O'Hara Corp $166 141%
Wc Occ Health Allen $166 141%
Wc Ohio Bureau $166 141%
Wc One Call Medical $166 141%
Wc Paradigm $166 141%
Wc Peerless $166 141%
Wc Praxis Health Network $166 141%
Wc Price Chopper $166 141%
Wc Procura Management $166 141%
Wc Qualcare $166 141%
Wc Quiktrip $166 141%
Wc Reny Company $166 141%
Wc Rev Claims $166 141%
Wc Risico $166 141%
Wc Rural Mutual $166 141%
Wc Saif Oregon $166 141%
Wc Secura $166 141%
Wc Sheakley Unicomp $166 141%
Wc Smile Lodge $166 141%
Wc Society $166 141%
Wc Srs $166 141%
Wc Taconic (Mro) $166 141%
Wc Taconic Farms $166 141%
Wc Triad Group $166 141%
Wc Troy Ny $166 141%
Wc Tyson $166 141%
Wc Unified Health Services $166 141%
Wc United Heartland $166 141%
Wc Us Dept Of Labor $166 141%
Wc Velocity $166 141%
Wc West Bend $166 141%
Wc West Bend Mutual/Argent $166 141%
Wc Winnebago Industries $166 141%
Wc Yankee Trails $166 141%
Wc York Risk $166 141%
Wc Zenith $166 141%
American Postal Workers Secondary $172 146%
Partners Direct Health - Brio $173 147%
Claimdoc $185 157%
Kent County Jail $185 157%
Muskegon County Jail $185 157%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 44405 Woodward Ave, Pontiac, MI 48341
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals