CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: University of Michigan Health System

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $56
  • Cash Discount Price: $35
  • vs. Medicare Baseline: 0.59x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at University of Michigan Health System is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.59x the Medicare baseline. Located in 1500 E Medical Center Drive, Spc 5474, Ann Arbor, MI.
Cash / Self-Pay
$35

Average discount available for prompt cash payment at this facility.

Insurance Median
$56

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%)
Cash / Self-Pay: $35 (37%)
Insurance Median: $56 (59%)
Cash: $35 (37% of Medicare)
Ins. Median: $56 (59% 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
Point Comfort Underwriters Unaccompanied Children Program $38 40%
Priority Health [1038] $40 - $59 42%
Metrocare $41 43%
Aetna $42 - $66 44%
Ambetter / Centene $42 44%
Amerihealth Michigan Inc $42 - $53 44%
Blue Cross Blue Shield $42 - $86 44%
Buckeye Community Health Plan $42 44%
Hap Midwest $42 44%
Mclaren Health Plan Inc $42 - $66 44%
Medicaid / KanCare $42 - $44 44%
Molina Healthcare Of Michigan Inc $42 - $67 44%
Priority Health $42 - $88 44%
UnitedHealthcare $42 - $67 44%
Hap [1023] $48 - $66 50%
Huron Valley Pace $50 - $63 53%
Blue Care Network Of Michigan $52 - $86 55%
Health Alliance Plan $52 - $66 55%
Humana $52 - $66 55%
Medigold Trinity Health Plan Of Michigan $52 - $66 55%
Meridian Health Plan Of Michigan Inc $52 - $66 55%
Paramount Elite-Ohio $52 - $66 55%
Paramount Health Care $52 - $73 55%
Thome Pace $52 - $66 55%
Triwest $52 - $66 55%
Veteran Affairs Community Care Program $52 - $66 55%
Medicare (plans) $53 - $67 56%
Plain Church Group $53 56%
Zing Health $55 - $69 58%
First Health $57 60%
Cofinity $58 61%
Confinity Advantage $58 61%
Beaumont Health Network $62 65%
Nomi Health $62 65%
Provider Network Of America $62 65%
First Agency $66 69%
Parkview Health Plan Services $66 69%
Bronson Healthcare Group $75 79%
Multiplan $75 79%
Employee Benefit Logistic $89 - $112 93%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 E Medical Center Drive, Spc 5474, Ann Arbor, MI 48109
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals