CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Munson Healthcare Grayling Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $93
  • Cash Discount Price: $130
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Munson Healthcare Grayling Hospital is $93. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $130. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.98x the Medicare baseline. Located in 1100 E Michigan Ave, Grayling, MI.
Cash / Self-Pay
$130

Average discount available for prompt cash payment at this facility.

Insurance Median
$93

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: $130 (137%)
Insurance Median: $93 (98%)
Cash: $130 (137% of Medicare)
Ins. Median: $93 (98% 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
Mclaren Health Plan $42 - $93 44%
Meridian $42 - $48 44%
Molina $42 - $99 44%
Priority Health $42 - $159 44%
UnitedHealthcare $42 - $100 44%
Blue Cross Blue Shield $43 - $116 45%
Aetna $57 - $126 60%
Atrium King Centre Skilled Nursing Services $57 - $91 60%
Blue Care Network $57 - $91 60%
Hap (Health Alliance Plan) $57 - $133 60%
Humana $57 - $91 60%
Medicare (plans) $57 - $91 60%
Northern Michigan Mennonite Group $57 - $91 60%
Promedica $57 - $91 60%
Wellcare (Meridian) $57 - $91 60%
Wellspring Lutheran Services Skilling Nursing Services $57 - $91 60%
Michigan Amish Medical Board $65 - $91 68%
Cigna $75 - $159 79%
Cofinity $75 - $129 79%
Provider Network Of America Group Health $80 - $141 84%
Hospice Of Michigan $83 - $100 87%
Asr/Physicians Care $85 - $133 89%
Nomi Health $91 - $133 96%
Employee Benefits Logistics $97 - $155 102%
Munson Hospice $97 - $852 102%
Medical Cost Savings Solution $111 - $133 117%
The Robbins Group And Regency Employee Benefits $111 - $133 117%
Wds Enterprise Group Planning $111 - $133 117%
First Health/Coventry Network $118 - $141 124%
Three Rivers Provider Network $118 - $141 124%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 E Michigan Ave, Grayling, MI 49738
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals