CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Mercy Health Saint Mary's

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $113
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.96x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Mercy Health Saint Mary's is $113. 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 $117.57, this hospital’s rate is 0.96x the Medicare baseline. Located in 200 Jefferson Avenue Se, Grand Rapids, MI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$113

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)
Insurance Median: $113 (96%)
Ins. Median: $113 (96% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $117.57 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
Medicaid / KanCare $58 - $97 49%
Aetna $75 - $166 64%
Albany County Correctional Facility $75 64%
Ambetter / Centene $75 64%
Amish Mennonite $75 64%
Ascension St. Vincent Public Safety Medical $75 64%
Bccp $75 64%
Blue Cross Blue Shield $75 - $117 64%
Bmc Healthnet $75 64%
Breast Grant-Connecticut $75 64%
Broward County Dept Of Health $75 64%
California Health And Wellness $75 64%
Cardinal Innovations Lme $75 64%
Care Connections Of Northern Iowa $75 64%
Care Oregon Ohp $75 64%
Cencal Health Plan $75 64%
Cenpatico $75 64%
Chhuny $75 64%
Childrens Comm Health Plan $75 64%
Childrens Medical Services Title 19 $75 64%
Cigna $75 - $113 64%
City Of Philadelphia $75 64%
Cmh Allegan County $75 64%
Cmh Ausable Valley $75 64%
Cmh Barry County $75 64%
Cmh Bay-Arenac County $75 64%
Cmh Berrien County $75 64%
Cmh Cass County $75 64%
Cmh Central Mi County $75 64%
Cmh Clinton-Eaton-Ingham County $75 64%
Cmh Detroit Wayne Integrated Health Network $75 64%
Cmh Genesee County $75 64%
Cmh Ionia County $75 64%
Cmh Jackson County/Lifeways $75 64%
Cmh Kalamazoo $75 64%
Cmh Kent County $75 64%
Cmh Lenawee County $75 64%
Cmh Livingston County $75 64%
Cmh Macomb $75 64%
Cmh Misc $75 64%
Cmh Monroe County $75 64%
Cmh Montcalm County $75 64%
Cmh Muskegon County $75 64%
Cmh Newaygo County $75 64%
Cmh North Country $75 64%
Cmh Northern Lakes County $75 64%
Cmh Oakland County $75 64%
Cmh Ottawa County $75 64%
Cmh Van Buren County $75 64%
Cmh Washtenaw County $75 64%
Cmh Wayne County/Carelink $75 64%
Cmh Wayne Cty/Com Liv Svcs $75 64%
Cmh West Mi County $75 64%
Community Benefit Health $75 64%
Community Care Behavorial Health $75 64%
Community Care Partners $75 64%
Community Health Choice $75 64%
Connections Csp $75 64%
County Coroner $75 64%
County Funding Generic $75 64%
Covid19 Hrsa Uninsured Testing And Treatment Fund $75 64%
Dean Wi Badgercare $75 64%
Delaware County Department Of Health $75 64%
Delaware First Health $75 64%
Delta Dental Nj $75 64%
Dph Tb Program $75 64%
Dscc $75 64%
Eastpointe Lme $75 64%
Family Health Network $75 64%
Freedom First Healthcare $75 64%
Fresno County Ccs $75 64%
Ghc Scw Wi Badgercare $75 64%
Harbor Health $75 64%
Health Safety Net $75 64%
Healthy Blue Ne $75 64%
Hennepin Health $75 64%
Humana $75 - $113 64%
Id County Ada $75 64%
Id County Canyon $75 64%
Id County Cat Fund $75 64%
Id County Other $75 64%
Id County Payette $75 64%
Idaho Dept Health And Wellfare $75 64%
Idaho Womens Health Check $75 64%
Indiana Breast Cervical Cancer $75 64%
Inland Empire Health Plan $75 64%
Intercommunity Health Ohp $75 64%
Iowa Total Care $75 64%
Jai Medical System $75 64%
Kern Family Health Plan $75 64%
Keystone First $75 64%
Keystone First Chip $75 64%
La Care Health Plan $75 64%
Lakeland Care Inc $75 64%
Managed Health Services - Indiana $75 64%
Maryland Breast & Cervical Program $75 64%
Maryland Healthy Smiles - Scion Dental $75 64%
Maryland Physicians Care $75 64%
Massachusetts Behavioral Health Partnership $75 64%
Mdwise $75 64%
Medi-Cal $75 64%
Medi-Cal Healthnet $75 64%
Medstar Dc Healthy Family $75 64%
Medstar Md Health Choice $75 64%
Mo Home State Health Plan $75 64%
Molina Centennial Care $75 64%
Nascentia Health Options $75 64%
Nebraska Total Care $75 64%
New York Cancer Services Program $75 64%
Nextlevel Health $75 64%
Oregon Screenwise $75 64%
Pace Of Southwest Michigan $75 - $111 64%
Paramount Advantage $75 64%
Parkland Community Health Plan $75 64%
Partners Behavioral Lme $75 64%
Peach State Healthplan $75 64%
Philadelphia County Funding $75 64%
Presbyterian Centennial Care $75 64%
Prestige Health Choice $75 64%
Priority Partners $75 64%
Robert F Sing Program $75 64%
Rx 340B Pass Along $75 64%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $75 64%
Rx Medi-Cal $75 64%
Rx Meridian Rx $75 64%
Ryan White Florida Mssrp $75 64%
Sandhills Center Lme $75 64%
Screening For Life $75 64%
St Joseph County Hlth Dpt $75 64%
Stephenson Cty Health $75 64%
Sunshine State Health Plan $75 64%
Superior Health $75 64%
Tenncare $75 64%
Texas Children'S Health Plan $75 64%
Trillium Community Ohp $75 64%
Tufts Health Public Plans $75 64%
UnitedHealthcare $75 - $115 64%
Vaya Health Lme $75 64%
Washtenaw Health Plan $75 64%
Wellsense Health Plan $75 64%
Wi Womens Wellness $75 64%
Champva $103 88%
Tricare $103 88%
Triwest Health Alliance $103 88%
Us Family Health Plan $103 88%
Veterans Eval Services $103 88%
Bcccp-Michigan $108 92%
Ally Align Care Adv $111 94%
American Health Advantage Of Idaho $111 94%
American Health Plan $111 94%
Aurora Special Needs $111 94%
Blue Care Network Advantage $111 94%
Blue Shield - De (Highmark) Medciare Advantage $111 94%
Care Dimensions $111 94%
Care Improvement Plus $111 94%
Care Resources Pace $111 94%
Careplus Health Plans $111 94%
Cca Senior Care Options $111 94%
Central Valley Medical Services Corp Pace $111 94%
Champion Health Plan Mcr Advantage $111 94%
Clear Spring Health $111 94%
Clover Health $111 94%
Commonwealth Care Alliance $111 94%
Community Pace At Home $111 94%
Eddy Senior Care-Pace $111 94%
Eddy Seniorcare Pace $111 94%
Elementcare $111 94%
Evercare $111 94%
Everence $111 94%
Gateway Health Plan $111 94%
Geha $111 94%
Genesys Pace Of Genesee County $111 94%
Georgia Health Advantage $111 94%
Gold Advantage $111 94%
Gpa Croell Redi Mix $111 94%
Health America Advantra $111 94%
Highmark Health Options Dual Plan $111 94%
Hope Select Pace $111 94%
Horizon Nj Total Care $111 94%
Hudson Headwaters Pace $111 94%
Huron Valley Pace $111 94%
Innovative Integrated Health Community Plans $111 94%
Iowa Health Advantage $111 94%
Johns Hopkins Advantage Md $111 94%
Lasso Healthcare Msa $111 94%
Life St Marys Pace $111 94%
Lifecircles Pace $111 94%
Longevity Health Plan $111 94%
Martins Point Generations Advantage $111 94%
Mass General Brigham Mcr Adv $111 94%
Medicare (plans) $111 - $116 94%
Medipak Advantage $111 94%
Mercy Life $111 94%
Mercyone Cedar Valley $111 94%
Meridian Complete $111 94%
Michigan Complete Health $111 94%
Nascentia Health Plus $111 94%
New Centry Health Careplus $111 94%
Osu Prime Care Advantage $111 94%
Pace Cny $111 94%
Pace Iowa Immanuel Pathways $111 94%
Pace Southeast $111 94%
Pace-Trinity Health $111 94%
Peak Pace Solutions $111 94%
Perennial Advantage $111 94%
Preferred Care Partners $111 94%
Presbyterian Senior Plan $111 94%
Provider Partners Health Plan Of Illinois $111 94%
Provider Partners Health Plan Of Indiana $111 94%
Pruitthealth Premier $111 94%
Reliance Community Care Partners Care Resources Pace $111 94%
Rx Allwin $111 94%
Rx Grane Grnmedd $111 94%
Rx Retiree Rx Care $111 94%
Scan Health Plan Mcr Ipa Meritage Oon $111 94%
Secure Horizons Ma Pffs $111 94%
Serenity Pace $111 94%
Siouxland Pace $111 94%
Solis Health Plans $111 94%
Sunnyview-Pace Finance Dept $111 94%
Texan Plus $111 94%
The Health Plan $111 - $113 94%
Thome Pace $111 94%
Todays Options $111 94%
Tribute Health Plans $111 94%
Um Health Advantage $111 94%
Union Health Service $111 94%
Welbe Health $111 94%
Wellmed $111 94%
Acclaim $113 96%
Administrative Concepts $113 96%
Align Senior Care $113 96%
Allegeant $113 96%
Allied Benefit Systems $113 96%
Ameriben $113 96%
American Family $113 96%
American Healthcare Alliance $113 96%
American National $113 96%
American Postal Workers Secondary $113 96%
American Republic $113 96%
Amerihealth $113 96%
Aultcare $113 96%
Automated Benefit Services $113 96%
Auxiant $113 96%
Benefit Administrative Systems,Llc $113 96%
Boon Chapman $113 96%
Cam Administrative Services $113 96%
Christian Brother Services $113 96%
Christian Brothers Holy Cross $113 96%
Claimchoice Adminstrators $113 96%
Comprehensive Benefits $113 96%
Consociate $113 96%
Continental Life Insurance $113 96%
Coventry $113 96%
Custom Benefit Administrators $113 96%
Cypress Benefit Administrators $113 96%
Employee Benefit Concepts $113 96%
Employee Benefit Management $113 96%
Enterprise Group Planning $113 96%
First Health $113 96%
Forest County Potawatomi $113 96%
Freedom Life Insurance Company $113 96%
Group Administrators $113 96%
Group Marketing Services $113 96%
Group Pension Administrators $113 96%
Guardian $113 96%
Health America $113 96%
Health Choices $113 96%
Health Smart $113 96%
Healthcare Management Admin $113 96%
Healthez $113 96%
Healthgram $113 96%
Healthscope $113 96%
Insight $113 96%
Jfp Benefit Management $113 96%
Jp Farley Corporation $113 96%
Key Benefit Administrator $113 96%
Liberty Union Life Assurance Co $113 96%
Lucent Health $113 96%
Luminare Health $113 96%
Luminare Health (Detroit) $113 96%
Magnacare $113 96%
Medben $113 96%
Medcost $113 96%
Medical Mutual $113 96%
Mutual Health Services $113 96%
Mutual Of Omaha $113 96%
Ncas $113 96%
Nippon Life Ins $113 96%
Nova $113 96%
Painters Union Insurance Fund $113 96%
Physicians Mutual $113 96%
Plumbers Local 98 Insurance Fund $113 96%
Prairie States $113 96%
Preferred One $113 96%
Primary Physician Care $113 96%
Professional Benefit Administrators $113 96%
Secureone Preferred United Plans $113 96%
Siho Insurance Services $113 96%
Sisco Benefits $113 96%
The Loomis Company $113 96%
Trustmark Small Business Benefits $113 96%
Unicare $113 96%
Unified Group Services $113 96%
Valenz $113 96%
Veterans Administration $113 96%
Webtpa $113 96%
Western & Southern Financial Group $113 96%
Wps $113 96%
Blue Care Network $114 97%
Us Health And Life $114 97%
Blue Benefit Administrators Of Massachusetts $117 100%
Blue Distinction Transplant $117 100%
Blue Shield - Ca $117 100%
Blue Shield - Id (Regence) $117 100%
Blue Shield - Ny Highmark Northeastern $117 100%
Blue Shield - Ny Highmark Western $117 100%
Blue Shield - Pa (Highmark) $117 100%
Blue Shield - Wa (Regence) $117 100%
Hap $117 - $140 100%
Health Partners $117 100%
Tufts Health Plan $117 100%
Priority Health $119 101%
Cca - Zing Health $122 104%
Access Health $127 108%
Intercare $128 109%
Longevity Ipa Of Michigan Llc Health Plan Isnp $128 109%
Asr Health Benefits $134 114%
Varipro $140 119%
Meritain $144 122%
1199 National Benefit Fund $153 130%
Allied National Global Care $153 130%
Asrm - Reliance Standard Life Insurance $153 130%
Christian Care Ministry $153 130%
Dean Health $153 130%
Fallon Health $153 130%
Family Life Insurance Company $153 130%
International Benefit Administrators $153 130%
Lifetime Benefit Solutions $153 130%
Manhattan Life $153 130%
Molina Marketplace $153 130%
Multiplan $153 130%
Mvp $153 130%
Oscar $153 130%
Pai $153 130%
Pan-American Life $153 130%
Phcs $153 130%
Trinity Health Share $153 130%
Wellpath $153 130%
Wc Accident Fund $158 134%
Wc Advantage $158 134%
Wc Aig $158 134%
Wc Allied $158 134%
Wc Amerisure $158 134%
Wc Amtrust $158 134%
Wc Asu Risk Mgt $158 134%
Wc Berkley Admin $158 134%
Wc Broadspire $158 134%
Wc Bunch & Associates $158 134%
Wc Ccmsi $158 134%
Wc Emc Insurance Company $158 134%
Wc Esis $158 134%
Wc Fcci $158 134%
Wc Federated $158 134%
Wc Gallagher Bassett $158 134%
Wc Genex Care For Ohio $158 134%
Wc Guard Insurance Company $158 134%
Wc Hartford $158 134%
Wc Liberty Mutual $158 134%
Wc Meijers $158 134%
Wc Michigan $158 134%
Wc Mitchell Frankenmuth $158 134%
Wc Pma $158 134%
Wc Sedgwick $158 134%
Wc Sentry $158 134%
Wc Travelers $158 134%
Wc Tristar $158 134%
Wc Walmart $158 134%
Wc Zurich $158 134%
Partners Direct Health - Brio $164 139%
Andrie Inc $166 141%
East Greenbush Central School District $166 141%
Genex Wc $166 141%
Healthsmart Workers Comp $166 141%
Jag Source $166 141%
New York State Insurance Fund $166 141%
Njm Insurance Group $166 141%
Rx Heatlhcomp $166 141%
Rx Restat $166 141%
Rx Saif Opdp Wc $166 141%
Rx Worker'S Comp $166 141%
Wc Ace $166 141%
Wc Acs Federal Employees $166 141%
Wc Acuity $166 141%
Wc Aegis $166 141%
Wc Aims $166 141%
Wc Alaska National Ins $166 141%
Wc Align Network $166 141%
Wc Am Trust N America $166 141%
Wc American Claims Mgmt $166 141%
Wc Benetech $166 141%
Wc Broward County $166 141%
Wc California State Comp Ins $166 141%
Wc California State Ins Fund $166 141%
Wc Capitol Area Health Consortium $166 141%
Wc Chartis $166 141%
Wc Chubb $166 141%
Wc Cirma $166 141%
Wc City Of Albany $166 141%
Wc City Of Sioux City $166 141%
Wc Claims Mgmt Inc $166 141%
Wc Cna $166 141%
Wc Comp One Admin C/O Manageability $166 141%
Wc Compone Admin $166 141%
Wc Corvel $166 141%
Wc Ct Healthcare Trust $166 141%
Wc Donegal Insurance Group $166 141%
Wc Employee Mutual $166 141%
Wc Enablecomp $166 141%
Wc Encore Health Network $166 141%
Wc Erie $166 141%
Wc Evolutions $166 141%
Wc Fed Ex $166 141%
Wc Federal Black Lung $166 141%
Wc Finley Occupational Health $166 141%
Wc First Agency/Occunet $166 141%
Wc Ford Motor $166 141%
Wc Fresno Unified Emp $166 141%
Wc General Motors $166 141%
Wc Generic $166 141%
Wc Great West Casualty $166 141%
Wc Guarantee Insurance $166 141%
Wc Hab $166 141%
Wc Hastings $166 141%
Wc Health Management $166 141%
Wc Heritage Summit $166 141%
Wc Hireright $166 141%
Wc Horizon $166 141%
Wc Icw Group $166 141%
Wc Idaho State Ins Fund $166 141%
Wc Intercare Insurance $166 141%
Wc Intermountain $166 141%
Wc Johns Eastern $166 141%
Wc Kemberton $166 141%
Wc Key Ins & Benefit Solutions $166 141%
Wc Mac Risk Management $166 141%
Wc Massachusetts $166 141%
Wc Mdia $166 141%
Wc Meadowbrook Claim $166 141%
Wc Medical Administrators $166 141%
Wc Memic $166 141%
Wc Mercy Workcare $166 141%
Wc Michigan Millers Mutual $166 141%
Wc Mra $166 141%
Wc Nationwide $166 141%
Wc Nca Comp $166 141%
Wc New York $166 141%
Wc New York Special Funds $166 141%
Wc North American Rishces $166 141%
Wc Northeast Health $166 141%
Wc Notre Dame $166 141%
Wc Novanet $166 141%
Wc O'Hara Corp $166 141%
Wc Occ Health Allen $166 141%
Wc Ohio Bureau $166 141%
Wc One Call Medical $166 141%
Wc Paradigm $166 141%
Wc Peerless $166 141%
Wc Praxis Health Network $166 141%
Wc Price Chopper $166 141%
Wc Procura Management $166 141%
Wc Qualcare $166 141%
Wc Quiktrip $166 141%
Wc Reny Company $166 141%
Wc Rev Claims $166 141%
Wc Risico $166 141%
Wc Rural Mutual $166 141%
Wc Saif Oregon $166 141%
Wc Secura $166 141%
Wc Sheakley Unicomp $166 141%
Wc Smile Lodge $166 141%
Wc Society $166 141%
Wc Srs $166 141%
Wc Taconic (Mro) $166 141%
Wc Taconic Farms $166 141%
Wc Triad Group $166 141%
Wc Troy Ny $166 141%
Wc Tyson $166 141%
Wc Unified Health Services $166 141%
Wc United Heartland $166 141%
Wc Us Dept Of Labor $166 141%
Wc Velocity $166 141%
Wc West Bend $166 141%
Wc West Bend Mutual/Argent $166 141%
Wc Winnebago Industries $166 141%
Wc Yankee Trails $166 141%
Wc York Risk $166 141%
Wc Zenith $166 141%
U Of M Health Plan $171 145%
Claimdoc $175 149%
Kent County Jail $175 149%
Muskegon County Jail $175 149%
Nomi Health $175 149%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Jefferson Avenue Se, Grand Rapids, MI 49503
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals