CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Trinity Health Oakland Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $153
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.13x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Trinity Health Oakland Hospital is $153. 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 $135.6, this hospital’s rate is 1.13x 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
$153

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$135.6

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $135.6 (100%)
Insurance Median: $153 (113%)
Ins. Median: $153 (113% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $135.6 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 $73 - $86 54%
UnitedHealthcare $73 - $134 54%
Medicaid / KanCare $75 - $113 55%
Albany County Correctional Facility $82 60%
Ambetter / Centene $82 60%
Amish Mennonite $82 60%
Ascension St. Vincent Public Safety Medical $82 60%
Bccp $82 60%
Blue Cross Blue Shield $82 - $134 60%
Bmc Healthnet $82 60%
Breast Grant-Connecticut $82 60%
Broward County Dept Of Health $82 60%
California Health And Wellness $82 60%
Cardinal Innovations Lme $82 60%
Care Connections Of Northern Iowa $82 60%
Care Oregon Ohp $82 60%
Cencal Health Plan $82 60%
Cenpatico $82 60%
Chhuny $82 60%
Childrens Comm Health Plan $82 60%
Childrens Medical Services Title 19 $82 60%
Cigna $82 - $197 60%
City Of Philadelphia $82 60%
Cmh Allegan County $82 60%
Cmh Ausable Valley $82 60%
Cmh Barry County $82 60%
Cmh Bay-Arenac County $82 60%
Cmh Berrien County $82 60%
Cmh Cass County $82 60%
Cmh Central Mi County $82 60%
Cmh Clinton-Eaton-Ingham County $82 60%
Cmh Detroit Wayne Integrated Health Network $82 60%
Cmh Genesee County $82 60%
Cmh Ionia County $82 60%
Cmh Jackson County/Lifeways $82 60%
Cmh Kalamazoo $82 60%
Cmh Kent County $82 60%
Cmh Lenawee County $82 60%
Cmh Livingston County $82 60%
Cmh Macomb $82 60%
Cmh Misc $82 60%
Cmh Monroe County $82 60%
Cmh Montcalm County $82 60%
Cmh Muskegon County $82 60%
Cmh Newaygo County $82 60%
Cmh North Country $82 60%
Cmh Northern Lakes County $82 60%
Cmh Oakland County $82 60%
Cmh Ottawa County $82 60%
Cmh Van Buren County $82 60%
Cmh Washtenaw County $82 60%
Cmh Wayne County/Carelink $82 60%
Cmh Wayne Cty/Com Liv Svcs $82 60%
Cmh West Mi County $82 60%
Community Benefit Health $82 60%
Community Care Behavorial Health $82 60%
Community Care Partners $82 60%
Community Health Choice $82 60%
Connections Csp $82 60%
County Coroner $82 60%
County Funding Generic $82 60%
Covid19 Hrsa Uninsured Testing And Treatment Fund $82 60%
Dean Wi Badgercare $82 60%
Delaware County Department Of Health $82 60%
Delaware First Health $82 60%
Delta Dental Nj $82 60%
Dph Tb Program $82 60%
Dscc $82 60%
Eastpointe Lme $82 60%
Family Health Network $82 60%
Freedom First Healthcare $82 60%
Fresno County Ccs $82 60%
Ghc Scw Wi Badgercare $82 60%
Harbor Health $82 60%
Health Safety Net $82 60%
Healthy Blue Ne $82 60%
Hennepin Health $82 60%
Humana $82 - $160 60%
Id County Ada $82 60%
Id County Canyon $82 60%
Id County Cat Fund $82 60%
Id County Other $82 60%
Id County Payette $82 60%
Idaho Dept Health And Wellfare $82 60%
Idaho Womens Health Check $82 60%
Indiana Breast Cervical Cancer $82 60%
Inland Empire Health Plan $82 60%
Intercommunity Health Ohp $82 60%
Iowa Total Care $82 60%
Jai Medical System $82 60%
Kern Family Health Plan $82 60%
Keystone First $82 60%
Keystone First Chip $82 60%
La Care Health Plan $82 60%
Lakeland Care Inc $82 60%
Managed Health Services - Indiana $82 60%
Maryland Breast & Cervical Program $82 60%
Maryland Healthy Smiles - Scion Dental $82 60%
Maryland Physicians Care $82 60%
Massachusetts Behavioral Health Partnership $82 60%
Mdwise $82 60%
Medi-Cal $82 60%
Medi-Cal Healthnet $82 60%
Medstar Dc Healthy Family $82 60%
Medstar Md Health Choice $82 60%
Mo Home State Health Plan $82 60%
Molina Centennial Care $82 60%
Nascentia Health Options $82 60%
Nebraska Total Care $82 60%
New York Cancer Services Program $82 60%
Nextlevel Health $82 60%
Oregon Screenwise $82 60%
Pace Of Southwest Michigan $82 - $134 60%
Paramount Advantage $82 60%
Parkland Community Health Plan $82 60%
Partners Behavioral Lme $82 60%
Peach State Healthplan $82 60%
Philadelphia County Funding $82 60%
Presbyterian Centennial Care $82 60%
Prestige Health Choice $82 60%
Priority Partners $82 60%
Robert F Sing Program $82 60%
Rx 340B Pass Along $82 60%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $82 60%
Rx Medi-Cal $82 60%
Rx Meridian Rx $82 60%
Ryan White Florida Mssrp $82 60%
Sandhills Center Lme $82 60%
Screening For Life $82 60%
St Joseph County Hlth Dpt $82 60%
Stephenson Cty Health $82 60%
Sunshine State Health Plan $82 60%
Superior Health $82 60%
Tenncare $82 60%
Texas Children'S Health Plan $82 60%
Trillium Community Ohp $82 60%
Tufts Health Public Plans $82 60%
Vaya Health Lme $82 60%
Washtenaw Health Plan $82 60%
Wellsense Health Plan $82 60%
Wi Womens Wellness $82 60%
Aetna $87 - $190 64%
Bcccp-Michigan $88 65%
Blue Care Network $98 - $115 72%
Mclaren Health $98 72%
Blue Benefit Administrators Of Massachusetts $106 - $124 78%
Blue Distinction Transplant $106 - $124 78%
Blue Shield - Ca $106 - $124 78%
Blue Shield - Id (Regence) $106 - $124 78%
Blue Shield - Ny Highmark Northeastern $106 - $124 78%
Blue Shield - Ny Highmark Western $106 - $124 78%
Blue Shield - Pa (Highmark) $106 - $124 78%
Blue Shield - Wa (Regence) $106 - $124 78%
Champva $107 - $125 79%
Tricare $107 - $125 79%
Triwest Health Alliance $107 - $125 79%
Us Family Health Plan $107 - $125 79%
Veterans Eval Services $107 - $125 79%
Ally Align Care Adv $114 - $134 84%
American Health Advantage Of Idaho $114 - $134 84%
American Health Plan $114 - $134 84%
Aurora Special Needs $114 - $134 84%
Blue Care Network Advantage $114 - $134 84%
Blue Shield - De (Highmark) Medciare Advantage $114 - $134 84%
Care Dimensions $114 - $134 84%
Care Improvement Plus $114 - $134 84%
Care Resources Pace $114 - $134 84%
Careplus Health Plans $114 - $134 84%
Cca Senior Care Options $114 - $134 84%
Central Valley Medical Services Corp Pace $114 - $134 84%
Champion Health Plan Mcr Advantage $114 - $134 84%
Clear Spring Health $114 - $134 84%
Clover Health $114 - $134 84%
Commonwealth Care Alliance $114 - $134 84%
Community Pace At Home $114 - $134 84%
Eddy Senior Care-Pace $114 - $134 84%
Eddy Seniorcare Pace $114 - $134 84%
Elementcare $114 - $134 84%
Evercare $114 - $134 84%
Everence $114 - $134 84%
Gateway Health Plan $114 - $134 84%
Genesys Pace Of Genesee County $114 - $134 84%
Georgia Health Advantage $114 - $134 84%
Gold Advantage $114 - $134 84%
Gpa Croell Redi Mix $114 - $134 84%
Health America Advantra $114 - $134 84%
Highmark Health Options Dual Plan $114 - $134 84%
Hope Select Pace $114 - $134 84%
Horizon Nj Total Care $114 - $134 84%
Hudson Headwaters Pace $114 - $134 84%
Huron Valley Pace $114 - $134 84%
Innovative Integrated Health Community Plans $114 - $134 84%
Iowa Health Advantage $114 - $134 84%
Johns Hopkins Advantage Md $114 - $134 84%
Lasso Healthcare Msa $114 - $134 84%
Life St Marys Pace $114 - $134 84%
Lifecircles Pace $114 - $134 84%
Longevity Health Plan $114 - $134 84%
Martins Point Generations Advantage $114 - $134 84%
Mass General Brigham Mcr Adv $114 - $134 84%
Medicare (plans) $114 - $140 84%
Medipak Advantage $114 - $134 84%
Mercy Life $114 - $134 84%
Mercyone Cedar Valley $114 - $134 84%
Meridian Complete $114 - $134 84%
Michigan Complete Health $114 - $134 84%
Nascentia Health Plus $114 - $134 84%
New Centry Health Careplus $114 - $134 84%
Osu Prime Care Advantage $114 - $134 84%
Pace Cny $114 - $134 84%
Pace Iowa Immanuel Pathways $114 - $134 84%
Pace Southeast $114 - $134 84%
Pace-Trinity Health $114 - $134 84%
Peak Pace Solutions $114 - $134 84%
Perennial Advantage $114 - $134 84%
Preferred Care Partners $114 - $134 84%
Presbyterian Senior Plan $114 - $134 84%
Provider Partners Health Plan Of Illinois $114 - $134 84%
Provider Partners Health Plan Of Indiana $114 - $134 84%
Pruitthealth Premier $114 - $134 84%
Reliance Community Care Partners Care Resources Pace $114 - $134 84%
Rx Allwin $114 - $134 84%
Rx Grane Grnmedd $114 - $134 84%
Rx Retiree Rx Care $114 - $134 84%
Scan Health Plan Mcr Ipa Meritage Oon $114 - $134 84%
Secure Horizons Ma Pffs $114 - $134 84%
Serenity Pace $114 - $134 84%
Siouxland Pace $114 - $134 84%
Solis Health Plans $114 - $134 84%
Sunnyview-Pace Finance Dept $114 - $134 84%
Texan Plus $114 - $134 84%
The Health Plan $114 - $160 84%
Thome Pace $114 - $134 84%
Todays Options $114 - $134 84%
Tribute Health Plans $114 - $134 84%
Um Health Advantage $114 - $134 84%
Union Health Service $114 - $134 84%
Welbe Health $114 - $134 84%
Wellmed $114 - $134 84%
Asr Health Benefits $115 85%
Hap $115 85%
Health Partners $115 85%
Tufts Health Plan $115 85%
Varipro $115 85%
Align Senior Care $116 - $136 86%
Veterans Administration $116 - $136 86%
Oscar $124 91%
Cca - Zing Health $125 - $147 92%
Longevity Ipa Of Michigan Llc Health Plan Isnp $131 - $154 97%
Priority Health $137 - $161 101%
U Of M Health Plan $139 - $164 103%
Meritain $147 - $173 108%
Wc Accident Fund $153 - $180 113%
Wc Advantage $153 - $180 113%
Wc Aig $153 - $180 113%
Wc Allied $153 - $180 113%
Wc Amerisure $153 - $180 113%
Wc Amtrust $153 - $180 113%
Wc Asu Risk Mgt $153 - $180 113%
Wc Berkley Admin $153 - $180 113%
Wc Broadspire $153 - $180 113%
Wc Bunch & Associates $153 - $180 113%
Wc Ccmsi $153 - $180 113%
Wc Emc Insurance Company $153 - $180 113%
Wc Esis $153 - $180 113%
Wc Fcci $153 - $180 113%
Wc Federated $153 - $180 113%
Wc Gallagher Bassett $153 - $180 113%
Wc Genex Care For Ohio $153 - $180 113%
Wc Guard Insurance Company $153 - $180 113%
Wc Hartford $153 - $180 113%
Wc Liberty Mutual $153 - $180 113%
Wc Meijers $153 - $180 113%
Wc Michigan $153 - $180 113%
Wc Mitchell Frankenmuth $153 - $180 113%
Wc Pma $153 - $180 113%
Wc Sedgwick $153 - $180 113%
Wc Sentry $153 - $180 113%
Wc Travelers $153 - $180 113%
Wc Tristar $153 - $180 113%
Wc Walmart $153 - $180 113%
Wc Zurich $153 - $180 113%
1199 National Benefit Fund $157 - $184 116%
Allied National Global Care $157 - $184 116%
Asrm - Reliance Standard Life Insurance $157 - $184 116%
Christian Care Ministry $157 - $184 116%
Dean Health $157 - $184 116%
Fallon Health $157 - $184 116%
Family Life Insurance Company $157 - $184 116%
International Benefit Administrators $157 - $184 116%
Lifetime Benefit Solutions $157 - $184 116%
Manhattan Life $157 - $184 116%
Molina Marketplace $157 - $184 116%
Multiplan $157 - $184 116%
Mvp $157 - $184 116%
Pai $157 - $184 116%
Pan-American Life $157 - $184 116%
Phcs $157 - $184 116%
Trinity Health Share $157 - $184 116%
Wellpath $157 - $184 116%
Access Health $160 118%
Acclaim $160 118%
Administrative Concepts $160 118%
Allegeant $160 118%
Allied Benefit Systems $160 118%
Ameriben $160 118%
American Family $160 118%
American Healthcare Alliance $160 118%
American National $160 118%
American Republic $160 118%
Amerihealth $160 118%
Aultcare $160 118%
Automated Benefit Services $160 118%
Auxiant $160 118%
Benefit Administrative Systems,Llc $160 118%
Boon Chapman $160 118%
Cam Administrative Services $160 118%
Christian Brother Services $160 118%
Christian Brothers Holy Cross $160 118%
Claimchoice Adminstrators $160 118%
Comprehensive Benefits $160 118%
Consociate $160 118%
Continental Life Insurance $160 118%
Coventry $160 118%
Custom Benefit Administrators $160 118%
Cypress Benefit Administrators $160 118%
Employee Benefit Concepts $160 118%
Employee Benefit Management $160 118%
Enterprise Group Planning $160 118%
First Health $160 118%
Forest County Potawatomi $160 118%
Freedom Life Insurance Company $160 118%
Group Administrators $160 118%
Group Marketing Services $160 118%
Group Pension Administrators $160 118%
Guardian $160 118%
Health America $160 118%
Health Choices $160 118%
Health Smart $160 118%
Healthcare Management Admin $160 118%
Healthez $160 118%
Healthgram $160 118%
Healthscope $160 118%
Insight $160 118%
Intercare $160 118%
Jfp Benefit Management $160 118%
Jp Farley Corporation $160 118%
Key Benefit Administrator $160 118%
Liberty Union Life Assurance Co $160 118%
Lucent Health $160 118%
Luminare Health $160 118%
Luminare Health (Detroit) $160 118%
Magnacare $160 118%
Medben $160 118%
Medcost $160 118%
Medical Mutual $160 118%
Mutual Health Services $160 118%
Mutual Of Omaha $160 118%
Ncas $160 118%
Nippon Life Ins $160 118%
Nova $160 118%
Painters Union Insurance Fund $160 118%
Physicians Mutual $160 118%
Plumbers Local 98 Insurance Fund $160 118%
Prairie States $160 118%
Preferred One $160 118%
Primary Physician Care $160 118%
Professional Benefit Administrators $160 118%
Secureone Preferred United Plans $160 118%
Siho Insurance Services $160 118%
Sisco Benefits $160 118%
The Loomis Company $160 118%
Trustmark Small Business Benefits $160 118%
Unicare $160 118%
Unified Group Services $160 118%
Us Health And Life $160 118%
Valenz $160 118%
Webtpa $160 118%
Western & Southern Financial Group $160 118%
Wps $160 118%
Andrie Inc $161 - $190 119%
East Greenbush Central School District $161 - $190 119%
Genex Wc $161 - $190 119%
Healthsmart Workers Comp $161 - $190 119%
Jag Source $161 - $190 119%
New York State Insurance Fund $161 - $190 119%
Njm Insurance Group $161 - $190 119%
Rx Heatlhcomp $161 - $190 119%
Rx Restat $161 - $190 119%
Rx Saif Opdp Wc $161 - $190 119%
Rx Worker'S Comp $161 - $190 119%
Wc Ace $161 - $190 119%
Wc Acs Federal Employees $161 - $190 119%
Wc Acuity $161 - $190 119%
Wc Aegis $161 - $190 119%
Wc Aims $161 - $190 119%
Wc Alaska National Ins $161 - $190 119%
Wc Align Network $161 - $190 119%
Wc Am Trust N America $161 - $190 119%
Wc American Claims Mgmt $161 - $190 119%
Wc Benetech $161 - $190 119%
Wc Broward County $161 - $190 119%
Wc California State Comp Ins $161 - $190 119%
Wc California State Ins Fund $161 - $190 119%
Wc Capitol Area Health Consortium $161 - $190 119%
Wc Chartis $161 - $190 119%
Wc Chubb $161 - $190 119%
Wc Cirma $161 - $190 119%
Wc City Of Albany $161 - $190 119%
Wc City Of Sioux City $161 - $190 119%
Wc Claims Mgmt Inc $161 - $190 119%
Wc Cna $161 - $190 119%
Wc Comp One Admin C/O Manageability $161 - $190 119%
Wc Compone Admin $161 - $190 119%
Wc Corvel $161 - $190 119%
Wc Ct Healthcare Trust $161 - $190 119%
Wc Donegal Insurance Group $161 - $190 119%
Wc Employee Mutual $161 - $190 119%
Wc Enablecomp $161 - $190 119%
Wc Encore Health Network $161 - $190 119%
Wc Erie $161 - $190 119%
Wc Evolutions $161 - $190 119%
Wc Fed Ex $161 - $190 119%
Wc Federal Black Lung $161 - $190 119%
Wc Finley Occupational Health $161 - $190 119%
Wc First Agency/Occunet $161 - $190 119%
Wc Ford Motor $161 - $190 119%
Wc Fresno Unified Emp $161 - $190 119%
Wc General Motors $161 - $190 119%
Wc Generic $161 - $190 119%
Wc Great West Casualty $161 - $190 119%
Wc Guarantee Insurance $161 - $190 119%
Wc Hab $161 - $190 119%
Wc Hastings $161 - $190 119%
Wc Health Management $161 - $190 119%
Wc Heritage Summit $161 - $190 119%
Wc Hireright $161 - $190 119%
Wc Horizon $161 - $190 119%
Wc Icw Group $161 - $190 119%
Wc Idaho State Ins Fund $161 - $190 119%
Wc Intercare Insurance $161 - $190 119%
Wc Intermountain $161 - $190 119%
Wc Johns Eastern $161 - $190 119%
Wc Kemberton $161 - $190 119%
Wc Key Ins & Benefit Solutions $161 - $190 119%
Wc Mac Risk Management $161 - $190 119%
Wc Massachusetts $161 - $190 119%
Wc Mdia $161 - $190 119%
Wc Meadowbrook Claim $161 - $190 119%
Wc Medical Administrators $161 - $190 119%
Wc Memic $161 - $190 119%
Wc Mercy Workcare $161 - $190 119%
Wc Michigan Millers Mutual $161 - $190 119%
Wc Mra $161 - $190 119%
Wc Nationwide $161 - $190 119%
Wc Nca Comp $161 - $190 119%
Wc New York $161 - $190 119%
Wc New York Special Funds $161 - $190 119%
Wc North American Rishces $161 - $190 119%
Wc Northeast Health $161 - $190 119%
Wc Notre Dame $161 - $190 119%
Wc Novanet $161 - $190 119%
Wc O'Hara Corp $161 - $190 119%
Wc Occ Health Allen $161 - $190 119%
Wc Ohio Bureau $161 - $190 119%
Wc One Call Medical $161 - $190 119%
Wc Paradigm $161 - $190 119%
Wc Peerless $161 - $190 119%
Wc Praxis Health Network $161 - $190 119%
Wc Price Chopper $161 - $190 119%
Wc Procura Management $161 - $190 119%
Wc Qualcare $161 - $190 119%
Wc Quiktrip $161 - $190 119%
Wc Reny Company $161 - $190 119%
Wc Rev Claims $161 - $190 119%
Wc Risico $161 - $190 119%
Wc Rural Mutual $161 - $190 119%
Wc Saif Oregon $161 - $190 119%
Wc Secura $161 - $190 119%
Wc Sheakley Unicomp $161 - $190 119%
Wc Smile Lodge $161 - $190 119%
Wc Society $161 - $190 119%
Wc Srs $161 - $190 119%
Wc Taconic (Mro) $161 - $190 119%
Wc Taconic Farms $161 - $190 119%
Wc Triad Group $161 - $190 119%
Wc Troy Ny $161 - $190 119%
Wc Tyson $161 - $190 119%
Wc Unified Health Services $161 - $190 119%
Wc United Heartland $161 - $190 119%
Wc Us Dept Of Labor $161 - $190 119%
Wc Velocity $161 - $190 119%
Wc West Bend $161 - $190 119%
Wc West Bend Mutual/Argent $161 - $190 119%
Wc Winnebago Industries $161 - $190 119%
Wc Yankee Trails $161 - $190 119%
Wc York Risk $161 - $190 119%
Wc Zenith $161 - $190 119%
American Postal Workers Secondary $167 - $197 123%
Partners Direct Health - Brio $168 - $198 124%
Claimdoc $180 - $212 133%
Kent County Jail $180 - $212 133%
Muskegon County Jail $180 - $212 133%

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