CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Trinity Health Oakland Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $109
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Trinity Health Oakland Hospital is $109. 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 1.15x 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
$109

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: $109 (115%)
Ins. Median: $109 (115% 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
Geha $49 - $57 51%
UnitedHealthcare $49 - $94 51%
Medicaid / KanCare $50 - $80 53%
Albany County Correctional Facility $59 62%
Ambetter / Centene $59 62%
Amish Mennonite $59 62%
Ascension St. Vincent Public Safety Medical $59 62%
Bccp $59 62%
Blue Cross Blue Shield $59 - $94 62%
Bmc Healthnet $59 62%
Breast Grant-Connecticut $59 62%
Broward County Dept Of Health $59 62%
California Health And Wellness $59 62%
Cardinal Innovations Lme $59 62%
Care Connections Of Northern Iowa $59 62%
Care Oregon Ohp $59 62%
Cencal Health Plan $59 62%
Cenpatico $59 62%
Chhuny $59 62%
Childrens Comm Health Plan $59 62%
Childrens Medical Services Title 19 $59 62%
Cigna $59 - $138 62%
City Of Philadelphia $59 62%
Cmh Allegan County $59 62%
Cmh Ausable Valley $59 62%
Cmh Barry County $59 62%
Cmh Bay-Arenac County $59 62%
Cmh Berrien County $59 62%
Cmh Cass County $59 62%
Cmh Central Mi County $59 62%
Cmh Clinton-Eaton-Ingham County $59 62%
Cmh Detroit Wayne Integrated Health Network $59 62%
Cmh Genesee County $59 62%
Cmh Ionia County $59 62%
Cmh Jackson County/Lifeways $59 62%
Cmh Kalamazoo $59 62%
Cmh Kent County $59 62%
Cmh Lenawee County $59 62%
Cmh Livingston County $59 62%
Cmh Macomb $59 62%
Cmh Misc $59 62%
Cmh Monroe County $59 62%
Cmh Montcalm County $59 62%
Cmh Muskegon County $59 62%
Cmh Newaygo County $59 62%
Cmh North Country $59 62%
Cmh Northern Lakes County $59 62%
Cmh Oakland County $59 62%
Cmh Ottawa County $59 62%
Cmh Van Buren County $59 62%
Cmh Washtenaw County $59 62%
Cmh Wayne County/Carelink $59 62%
Cmh Wayne Cty/Com Liv Svcs $59 62%
Cmh West Mi County $59 62%
Community Benefit Health $59 62%
Community Care Behavorial Health $59 62%
Community Care Partners $59 62%
Community Health Choice $59 62%
Connections Csp $59 62%
County Coroner $59 62%
County Funding Generic $59 62%
Covid19 Hrsa Uninsured Testing And Treatment Fund $59 62%
Dean Wi Badgercare $59 62%
Delaware County Department Of Health $59 62%
Delaware First Health $59 62%
Delta Dental Nj $59 62%
Dph Tb Program $59 62%
Dscc $59 62%
Eastpointe Lme $59 62%
Family Health Network $59 62%
Freedom First Healthcare $59 62%
Fresno County Ccs $59 62%
Ghc Scw Wi Badgercare $59 62%
Harbor Health $59 62%
Health Safety Net $59 62%
Healthy Blue Ne $59 62%
Hennepin Health $59 62%
Humana $59 - $111 62%
Id County Ada $59 62%
Id County Canyon $59 62%
Id County Cat Fund $59 62%
Id County Other $59 62%
Id County Payette $59 62%
Idaho Dept Health And Wellfare $59 62%
Idaho Womens Health Check $59 62%
Indiana Breast Cervical Cancer $59 62%
Inland Empire Health Plan $59 62%
Intercommunity Health Ohp $59 62%
Iowa Total Care $59 62%
Jai Medical System $59 62%
Kern Family Health Plan $59 62%
Keystone First $59 62%
Keystone First Chip $59 62%
La Care Health Plan $59 62%
Lakeland Care Inc $59 62%
Managed Health Services - Indiana $59 62%
Maryland Breast & Cervical Program $59 62%
Maryland Healthy Smiles - Scion Dental $59 62%
Maryland Physicians Care $59 62%
Massachusetts Behavioral Health Partnership $59 62%
Mdwise $59 62%
Medi-Cal $59 62%
Medi-Cal Healthnet $59 62%
Medstar Dc Healthy Family $59 62%
Medstar Md Health Choice $59 62%
Mo Home State Health Plan $59 62%
Molina Centennial Care $59 62%
Nascentia Health Options $59 62%
Nebraska Total Care $59 62%
New York Cancer Services Program $59 62%
Nextlevel Health $59 62%
Oregon Screenwise $59 62%
Pace Of Southwest Michigan $59 - $94 62%
Paramount Advantage $59 62%
Parkland Community Health Plan $59 62%
Partners Behavioral Lme $59 62%
Peach State Healthplan $59 62%
Philadelphia County Funding $59 62%
Presbyterian Centennial Care $59 62%
Prestige Health Choice $59 62%
Priority Partners $59 62%
Robert F Sing Program $59 62%
Rx 340B Pass Along $59 62%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $59 62%
Rx Medi-Cal $59 62%
Rx Meridian Rx $59 62%
Ryan White Florida Mssrp $59 62%
Sandhills Center Lme $59 62%
Screening For Life $59 62%
St Joseph County Hlth Dpt $59 62%
Stephenson Cty Health $59 62%
Sunshine State Health Plan $59 62%
Superior Health $59 62%
Tenncare $59 62%
Texas Children'S Health Plan $59 62%
Trillium Community Ohp $59 62%
Tufts Health Public Plans $59 62%
Vaya Health Lme $59 62%
Washtenaw Health Plan $59 62%
Wellsense Health Plan $59 62%
Wi Womens Wellness $59 62%
Aetna $62 - $135 65%
Mclaren Health $64 67%
Blue Care Network $67 - $79 70%
Blue Benefit Administrators Of Massachusetts $73 - $86 77%
Blue Distinction Transplant $73 - $86 77%
Blue Shield - Ca $73 - $86 77%
Blue Shield - Id (Regence) $73 - $86 77%
Blue Shield - Ny Highmark Northeastern $73 - $86 77%
Blue Shield - Ny Highmark Western $73 - $86 77%
Blue Shield - Pa (Highmark) $73 - $86 77%
Blue Shield - Wa (Regence) $73 - $86 77%
Champva $76 - $89 80%
Tricare $76 - $89 80%
Triwest Health Alliance $76 - $89 80%
Us Family Health Plan $76 - $89 80%
Veterans Eval Services $76 - $89 80%
Asr Health Benefits $78 82%
Hap $78 82%
Health Partners $78 82%
Tufts Health Plan $78 82%
Varipro $78 82%
Ally Align Care Adv $80 - $94 84%
American Health Advantage Of Idaho $80 - $94 84%
American Health Plan $80 - $94 84%
Aurora Special Needs $80 - $94 84%
Blue Care Network Advantage $80 - $94 84%
Blue Shield - De (Highmark) Medciare Advantage $80 - $94 84%
Care Dimensions $80 - $94 84%
Care Improvement Plus $80 - $94 84%
Care Resources Pace $80 - $94 84%
Careplus Health Plans $80 - $94 84%
Cca Senior Care Options $80 - $94 84%
Central Valley Medical Services Corp Pace $80 - $94 84%
Champion Health Plan Mcr Advantage $80 - $94 84%
Clear Spring Health $80 - $94 84%
Clover Health $80 - $94 84%
Commonwealth Care Alliance $80 - $94 84%
Community Pace At Home $80 - $94 84%
Eddy Senior Care-Pace $80 - $94 84%
Eddy Seniorcare Pace $80 - $94 84%
Elementcare $80 - $94 84%
Evercare $80 - $94 84%
Everence $80 - $94 84%
Gateway Health Plan $80 - $94 84%
Genesys Pace Of Genesee County $80 - $94 84%
Georgia Health Advantage $80 - $94 84%
Gold Advantage $80 - $94 84%
Gpa Croell Redi Mix $80 - $94 84%
Health America Advantra $80 - $94 84%
Highmark Health Options Dual Plan $80 - $94 84%
Hope Select Pace $80 - $94 84%
Horizon Nj Total Care $80 - $94 84%
Hudson Headwaters Pace $80 - $94 84%
Huron Valley Pace $80 - $94 84%
Innovative Integrated Health Community Plans $80 - $94 84%
Iowa Health Advantage $80 - $94 84%
Johns Hopkins Advantage Md $80 - $94 84%
Lasso Healthcare Msa $80 - $94 84%
Life St Marys Pace $80 - $94 84%
Lifecircles Pace $80 - $94 84%
Longevity Health Plan $80 - $94 84%
Martins Point Generations Advantage $80 - $94 84%
Mass General Brigham Mcr Adv $80 - $94 84%
Medicare (plans) $80 - $98 84%
Medipak Advantage $80 - $94 84%
Mercy Life $80 - $94 84%
Mercyone Cedar Valley $80 - $94 84%
Meridian Complete $80 - $94 84%
Michigan Complete Health $80 - $94 84%
Nascentia Health Plus $80 - $94 84%
New Centry Health Careplus $80 - $94 84%
Osu Prime Care Advantage $80 - $94 84%
Pace Cny $80 - $94 84%
Pace Iowa Immanuel Pathways $80 - $94 84%
Pace Southeast $80 - $94 84%
Pace-Trinity Health $80 - $94 84%
Peak Pace Solutions $80 - $94 84%
Perennial Advantage $80 - $94 84%
Preferred Care Partners $80 - $94 84%
Presbyterian Senior Plan $80 - $94 84%
Provider Partners Health Plan Of Illinois $80 - $94 84%
Provider Partners Health Plan Of Indiana $80 - $94 84%
Pruitthealth Premier $80 - $94 84%
Reliance Community Care Partners Care Resources Pace $80 - $94 84%
Rx Allwin $80 - $94 84%
Rx Grane Grnmedd $80 - $94 84%
Rx Retiree Rx Care $80 - $94 84%
Scan Health Plan Mcr Ipa Meritage Oon $80 - $94 84%
Secure Horizons Ma Pffs $80 - $94 84%
Serenity Pace $80 - $94 84%
Siouxland Pace $80 - $94 84%
Solis Health Plans $80 - $94 84%
Sunnyview-Pace Finance Dept $80 - $94 84%
Texan Plus $80 - $94 84%
The Health Plan $80 - $111 84%
Thome Pace $80 - $94 84%
Todays Options $80 - $94 84%
Tribute Health Plans $80 - $94 84%
Um Health Advantage $80 - $94 84%
Union Health Service $80 - $94 84%
Welbe Health $80 - $94 84%
Wellmed $80 - $94 84%
Align Senior Care $81 - $96 85%
Veterans Administration $81 - $96 85%
Oscar $84 88%
Bcccp-Michigan $88 92%
Cca - Zing Health $88 - $103 92%
Longevity Ipa Of Michigan Llc Health Plan Isnp $92 - $108 97%
Priority Health $93 - $109 98%
U Of M Health Plan $97 - $115 102%
Meritain $103 - $121 108%
Wc Accident Fund $109 - $128 115%
Wc Advantage $109 - $128 115%
Wc Aig $109 - $128 115%
Wc Allied $109 - $128 115%
Wc Amerisure $109 - $128 115%
Wc Amtrust $109 - $128 115%
Wc Asu Risk Mgt $109 - $128 115%
Wc Berkley Admin $109 - $128 115%
Wc Broadspire $109 - $128 115%
Wc Bunch & Associates $109 - $128 115%
Wc Ccmsi $109 - $128 115%
Wc Emc Insurance Company $109 - $128 115%
Wc Esis $109 - $128 115%
Wc Fcci $109 - $128 115%
Wc Federated $109 - $128 115%
Wc Gallagher Bassett $109 - $128 115%
Wc Genex Care For Ohio $109 - $128 115%
Wc Guard Insurance Company $109 - $128 115%
Wc Hartford $109 - $128 115%
Wc Liberty Mutual $109 - $128 115%
Wc Meijers $109 - $128 115%
Wc Michigan $109 - $128 115%
Wc Mitchell Frankenmuth $109 - $128 115%
Wc Pma $109 - $128 115%
Wc Sedgwick $109 - $128 115%
Wc Sentry $109 - $128 115%
Wc Travelers $109 - $128 115%
Wc Tristar $109 - $128 115%
Wc Walmart $109 - $128 115%
Wc Zurich $109 - $128 115%
1199 National Benefit Fund $110 - $129 116%
Allied National Global Care $110 - $129 116%
Asrm - Reliance Standard Life Insurance $110 - $129 116%
Christian Care Ministry $110 - $129 116%
Dean Health $110 - $129 116%
Fallon Health $110 - $129 116%
Family Life Insurance Company $110 - $129 116%
International Benefit Administrators $110 - $129 116%
Lifetime Benefit Solutions $110 - $129 116%
Manhattan Life $110 - $129 116%
Molina Marketplace $110 - $129 116%
Multiplan $110 - $129 116%
Mvp $110 - $129 116%
Pai $110 - $129 116%
Pan-American Life $110 - $129 116%
Phcs $110 - $129 116%
Trinity Health Share $110 - $129 116%
Wellpath $110 - $129 116%
Access Health $111 117%
Acclaim $111 117%
Administrative Concepts $111 117%
Allegeant $111 117%
Allied Benefit Systems $111 117%
Ameriben $111 117%
American Family $111 117%
American Healthcare Alliance $111 117%
American National $111 117%
American Republic $111 117%
Amerihealth $111 117%
Aultcare $111 117%
Automated Benefit Services $111 117%
Auxiant $111 117%
Benefit Administrative Systems,Llc $111 117%
Boon Chapman $111 117%
Cam Administrative Services $111 117%
Christian Brother Services $111 117%
Christian Brothers Holy Cross $111 117%
Claimchoice Adminstrators $111 117%
Comprehensive Benefits $111 117%
Consociate $111 117%
Continental Life Insurance $111 117%
Coventry $111 117%
Custom Benefit Administrators $111 117%
Cypress Benefit Administrators $111 117%
Employee Benefit Concepts $111 117%
Employee Benefit Management $111 117%
Enterprise Group Planning $111 117%
First Health $111 117%
Forest County Potawatomi $111 117%
Freedom Life Insurance Company $111 117%
Group Administrators $111 117%
Group Marketing Services $111 117%
Group Pension Administrators $111 117%
Guardian $111 117%
Health America $111 117%
Health Choices $111 117%
Health Smart $111 117%
Healthcare Management Admin $111 117%
Healthez $111 117%
Healthgram $111 117%
Healthscope $111 117%
Insight $111 117%
Intercare $111 117%
Jfp Benefit Management $111 117%
Jp Farley Corporation $111 117%
Key Benefit Administrator $111 117%
Liberty Union Life Assurance Co $111 117%
Lucent Health $111 117%
Luminare Health $111 117%
Luminare Health (Detroit) $111 117%
Magnacare $111 117%
Medben $111 117%
Medcost $111 117%
Medical Mutual $111 117%
Mutual Health Services $111 117%
Mutual Of Omaha $111 117%
Ncas $111 117%
Nippon Life Ins $111 117%
Nova $111 117%
Painters Union Insurance Fund $111 117%
Physicians Mutual $111 117%
Plumbers Local 98 Insurance Fund $111 117%
Prairie States $111 117%
Preferred One $111 117%
Primary Physician Care $111 117%
Professional Benefit Administrators $111 117%
Secureone Preferred United Plans $111 117%
Siho Insurance Services $111 117%
Sisco Benefits $111 117%
The Loomis Company $111 117%
Trustmark Small Business Benefits $111 117%
Unicare $111 117%
Unified Group Services $111 117%
Us Health And Life $111 117%
Valenz $111 117%
Webtpa $111 117%
Western & Southern Financial Group $111 117%
Wps $111 117%
Andrie Inc $114 - $135 120%
East Greenbush Central School District $114 - $135 120%
Genex Wc $114 - $135 120%
Healthsmart Workers Comp $114 - $135 120%
Jag Source $114 - $135 120%
New York State Insurance Fund $114 - $135 120%
Njm Insurance Group $114 - $135 120%
Rx Heatlhcomp $114 - $135 120%
Rx Restat $114 - $135 120%
Rx Saif Opdp Wc $114 - $135 120%
Rx Worker'S Comp $114 - $135 120%
Wc Ace $114 - $135 120%
Wc Acs Federal Employees $114 - $135 120%
Wc Acuity $114 - $135 120%
Wc Aegis $114 - $135 120%
Wc Aims $114 - $135 120%
Wc Alaska National Ins $114 - $135 120%
Wc Align Network $114 - $135 120%
Wc Am Trust N America $114 - $135 120%
Wc American Claims Mgmt $114 - $135 120%
Wc Benetech $114 - $135 120%
Wc Broward County $114 - $135 120%
Wc California State Comp Ins $114 - $135 120%
Wc California State Ins Fund $114 - $135 120%
Wc Capitol Area Health Consortium $114 - $135 120%
Wc Chartis $114 - $135 120%
Wc Chubb $114 - $135 120%
Wc Cirma $114 - $135 120%
Wc City Of Albany $114 - $135 120%
Wc City Of Sioux City $114 - $135 120%
Wc Claims Mgmt Inc $114 - $135 120%
Wc Cna $114 - $135 120%
Wc Comp One Admin C/O Manageability $114 - $135 120%
Wc Compone Admin $114 - $135 120%
Wc Corvel $114 - $135 120%
Wc Ct Healthcare Trust $114 - $135 120%
Wc Donegal Insurance Group $114 - $135 120%
Wc Employee Mutual $114 - $135 120%
Wc Enablecomp $114 - $135 120%
Wc Encore Health Network $114 - $135 120%
Wc Erie $114 - $135 120%
Wc Evolutions $114 - $135 120%
Wc Fed Ex $114 - $135 120%
Wc Federal Black Lung $114 - $135 120%
Wc Finley Occupational Health $114 - $135 120%
Wc First Agency/Occunet $114 - $135 120%
Wc Ford Motor $114 - $135 120%
Wc Fresno Unified Emp $114 - $135 120%
Wc General Motors $114 - $135 120%
Wc Generic $114 - $135 120%
Wc Great West Casualty $114 - $135 120%
Wc Guarantee Insurance $114 - $135 120%
Wc Hab $114 - $135 120%
Wc Hastings $114 - $135 120%
Wc Health Management $114 - $135 120%
Wc Heritage Summit $114 - $135 120%
Wc Hireright $114 - $135 120%
Wc Horizon $114 - $135 120%
Wc Icw Group $114 - $135 120%
Wc Idaho State Ins Fund $114 - $135 120%
Wc Intercare Insurance $114 - $135 120%
Wc Intermountain $114 - $135 120%
Wc Johns Eastern $114 - $135 120%
Wc Kemberton $114 - $135 120%
Wc Key Ins & Benefit Solutions $114 - $135 120%
Wc Mac Risk Management $114 - $135 120%
Wc Massachusetts $114 - $135 120%
Wc Mdia $114 - $135 120%
Wc Meadowbrook Claim $114 - $135 120%
Wc Medical Administrators $114 - $135 120%
Wc Memic $114 - $135 120%
Wc Mercy Workcare $114 - $135 120%
Wc Michigan Millers Mutual $114 - $135 120%
Wc Mra $114 - $135 120%
Wc Nationwide $114 - $135 120%
Wc Nca Comp $114 - $135 120%
Wc New York $114 - $135 120%
Wc New York Special Funds $114 - $135 120%
Wc North American Rishces $114 - $135 120%
Wc Northeast Health $114 - $135 120%
Wc Notre Dame $114 - $135 120%
Wc Novanet $114 - $135 120%
Wc O'Hara Corp $114 - $135 120%
Wc Occ Health Allen $114 - $135 120%
Wc Ohio Bureau $114 - $135 120%
Wc One Call Medical $114 - $135 120%
Wc Paradigm $114 - $135 120%
Wc Peerless $114 - $135 120%
Wc Praxis Health Network $114 - $135 120%
Wc Price Chopper $114 - $135 120%
Wc Procura Management $114 - $135 120%
Wc Qualcare $114 - $135 120%
Wc Quiktrip $114 - $135 120%
Wc Reny Company $114 - $135 120%
Wc Rev Claims $114 - $135 120%
Wc Risico $114 - $135 120%
Wc Rural Mutual $114 - $135 120%
Wc Saif Oregon $114 - $135 120%
Wc Secura $114 - $135 120%
Wc Sheakley Unicomp $114 - $135 120%
Wc Smile Lodge $114 - $135 120%
Wc Society $114 - $135 120%
Wc Srs $114 - $135 120%
Wc Taconic (Mro) $114 - $135 120%
Wc Taconic Farms $114 - $135 120%
Wc Triad Group $114 - $135 120%
Wc Troy Ny $114 - $135 120%
Wc Tyson $114 - $135 120%
Wc Unified Health Services $114 - $135 120%
Wc United Heartland $114 - $135 120%
Wc Us Dept Of Labor $114 - $135 120%
Wc Velocity $114 - $135 120%
Wc West Bend $114 - $135 120%
Wc West Bend Mutual/Argent $114 - $135 120%
Wc Winnebago Industries $114 - $135 120%
Wc Yankee Trails $114 - $135 120%
Wc York Risk $114 - $135 120%
Wc Zenith $114 - $135 120%
American Postal Workers Secondary $117 - $138 123%
Partners Direct Health - Brio $118 - $139 124%
Claimdoc $126 - $148 132%
Kent County Jail $126 - $148 132%
Muskegon County Jail $126 - $148 132%

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