CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Trinity Health Oakland Hospital

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$59
about 0.6× the $95 Medicare rate · typically $46–$76
modeled estimate · not a bill or quote
What this hospital charges insurers
$103
Above the fair price
about $44 over the fair price · 1.1× Medicare
Medicare pays $95 Fair price $59 This hospital $103 Hospital's list price $182

How we calculate the fair BaseRate →

How this hospital compares to other MI hospitals

Highest price of the 9 MI hospitals we have prices for — worth calling around.

Cheapest $34 Priciest $103

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 (20-29 min) is about $59 (about 0.6× the $95 Medicare rate). Trinity Health Oakland Hospital charges insurers about $103 — above the fair price. Located in Pontiac, MI.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $59. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

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 $49 - $94 51%
Blue Cross Blue Shieldmajor $59 - $94 62%
Aetnamajor $62 - $135 65%
Cignamajor $59 - $138 62%
Humanamajor $59 - $111 62%
Ambetter (Centene) $59 62%
AmeriHealth $111 117%
Clover Health $80 - $94 84%
Dean Health Plan $110 - $129 116%
GEHA $49 - $57 51%
Health Net $59 - $135 62%
HealthPartners $59 - $78 62%
MagnaCare $111 117%
Medical Mutual $111 117%
Meridian $59 - $94 62%
Molina $59 - $129 62%
MVP Health Care $110 - $129 116%
Oscar Health $84 88%
Paramount $59 62%
Presbyterian $59 - $94 62%
Priority Health $93 - $109 98%
Tufts Health Plan $59 - $78 62%
UniCare $111 117%
WellMed $80 - $94 84%
WellSense $59 62%
+ 421 smaller / regional plans $59 - $148
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

Insurance Before you use insurance

Estimate your out-of-pocket cost

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

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Facility Profile & Credentials

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