CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Mercy Health Saint Mary's

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$81
about 0.9× the $95 Medicare rate · typically $44–$105
modeled estimate · not a bill or quote
What this hospital charges insurers
$84
About the fair price
about $3 over the fair price · 0.9× Medicare
Medicare pays $95 Fair price $81 This hospital $84 Cash price $83 Hospital's list price $142

How we calculate the fair BaseRate →

How this hospital compares to other MI hospitals

Highest price of the 9 MI hospitals we have prices for — worth calling around.

Cheapest $34 Priciest $84

Black dot = this hospital, among the 9 MI hospitals with a price for this procedure. Full list below.

A fair price for a Office visit, established patient (20-29 min) is about $81 (about 0.9× the $95 Medicare rate). Mercy Health Saint Mary's charges insurers about $84, or about $83 in cash — about the fair price. Located in Grand Rapids, MI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $59 - $84 62%
Blue Cross Blue Shieldmajor $31 - $104 33%
Aetnamajor $56 - $114 59%
Cignamajor $76 - $84 80%
Humanamajor $76 - $84 80%
Kaiser Permanentemajor $104 109%
Ambetter (Centene) $84 88%
AmeriHealth $82 86%
Clover Health $76 80%
Dean Health Plan $105 110%
GEHA $63 66%
Health Net $84 - $114 88%
HealthPartners $78 - $84 82%
MagnaCare $82 86%
Medical Mutual $82 86%
Meridian $76 - $84 80%
Molina $74 - $105 78%
MVP Health Care $105 110%
Oscar Health $57 - $105 60%
Paramount $84 88%
Presbyterian $76 - $84 80%
Priority Health $82 86%
Tufts Health Plan $78 - $84 82%
UniCare $82 86%
WellMed $76 80%
WellSense $84 88%
+ 426 smaller / regional plans $40 - $132
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 16 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

Enter your details and press estimate to compare.

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