CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Mercy Health Saint Mary's

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $128
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.94x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Mercy Health Saint Mary's is $128. 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 0.94x 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
$128

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: $128 (94%)
Ins. Median: $128 (94% 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

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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 $75 - $125 55%
Bcccp-Michigan $88 65%
Geha $94 - $111 69%
UnitedHealthcare $94 - $128 69%
Champva $101 - $118 74%
Tricare $101 - $118 74%
Triwest Health Alliance $101 - $118 74%
Us Family Health Plan $101 - $118 74%
Veterans Eval Services $101 - $118 74%
Blue Care Network $103 - $121 76%
Blue Benefit Administrators Of Massachusetts $106 - $124 78%
Blue Cross Blue Shield $106 - $128 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%
Aetna $109 - $190 80%
Ally Align Care Adv $109 - $128 80%
American Health Advantage Of Idaho $109 - $128 80%
American Health Plan $109 - $128 80%
American Postal Workers Secondary $109 - $128 80%
Aurora Special Needs $109 - $128 80%
Blue Care Network Advantage $109 - $128 80%
Blue Shield - De (Highmark) Medciare Advantage $109 - $128 80%
Care Dimensions $109 - $128 80%
Care Improvement Plus $109 - $128 80%
Care Resources Pace $109 - $128 80%
Careplus Health Plans $109 - $128 80%
Cca Senior Care Options $109 - $128 80%
Central Valley Medical Services Corp Pace $109 - $128 80%
Champion Health Plan Mcr Advantage $109 - $128 80%
Cigna $109 - $128 80%
Clear Spring Health $109 - $128 80%
Clover Health $109 - $128 80%
Commonwealth Care Alliance $109 - $128 80%
Community Pace At Home $109 - $128 80%
Eddy Senior Care-Pace $109 - $128 80%
Eddy Seniorcare Pace $109 - $128 80%
Elementcare $109 - $128 80%
Evercare $109 - $128 80%
Everence $109 - $128 80%
Gateway Health Plan $109 - $128 80%
Genesys Pace Of Genesee County $109 - $128 80%
Georgia Health Advantage $109 - $128 80%
Gold Advantage $109 - $128 80%
Gpa Croell Redi Mix $109 - $128 80%
Health America Advantra $109 - $128 80%
Highmark Health Options Dual Plan $109 - $128 80%
Hope Select Pace $109 - $128 80%
Horizon Nj Total Care $109 - $128 80%
Hudson Headwaters Pace $109 - $128 80%
Humana $109 - $128 80%
Huron Valley Pace $109 - $128 80%
Innovative Integrated Health Community Plans $109 - $128 80%
Iowa Health Advantage $109 - $128 80%
Johns Hopkins Advantage Md $109 - $128 80%
Lasso Healthcare Msa $109 - $128 80%
Life St Marys Pace $109 - $128 80%
Lifecircles Pace $109 - $128 80%
Longevity Health Plan $109 - $128 80%
Martins Point Generations Advantage $109 - $128 80%
Mass General Brigham Mcr Adv $109 - $128 80%
Medicare (plans) $109 - $134 80%
Medipak Advantage $109 - $128 80%
Mercy Life $109 - $128 80%
Mercyone Cedar Valley $109 - $128 80%
Meridian Complete $109 - $128 80%
Michigan Complete Health $109 - $128 80%
Nascentia Health Plus $109 - $128 80%
New Centry Health Careplus $109 - $128 80%
Osu Prime Care Advantage $109 - $128 80%
Pace Cny $109 - $128 80%
Pace Iowa Immanuel Pathways $109 - $128 80%
Pace Of Southwest Michigan $109 - $128 80%
Pace Southeast $109 - $128 80%
Pace-Trinity Health $109 - $128 80%
Peak Pace Solutions $109 - $128 80%
Perennial Advantage $109 - $128 80%
Preferred Care Partners $109 - $128 80%
Presbyterian Senior Plan $109 - $128 80%
Provider Partners Health Plan Of Illinois $109 - $128 80%
Provider Partners Health Plan Of Indiana $109 - $128 80%
Pruitthealth Premier $109 - $128 80%
Reliance Community Care Partners Care Resources Pace $109 - $128 80%
Rx Allwin $109 - $128 80%
Rx Grane Grnmedd $109 - $128 80%
Rx Retiree Rx Care $109 - $128 80%
Scan Health Plan Mcr Ipa Meritage Oon $109 - $128 80%
Secure Horizons Ma Pffs $109 - $128 80%
Serenity Pace $109 - $128 80%
Siouxland Pace $109 - $128 80%
Solis Health Plans $109 - $128 80%
Sunnyview-Pace Finance Dept $109 - $128 80%
Texan Plus $109 - $128 80%
The Health Plan $109 - $128 80%
Thome Pace $109 - $128 80%
Todays Options $109 - $128 80%
Tribute Health Plans $109 - $128 80%
Um Health Advantage $109 - $128 80%
Union Health Service $109 - $128 80%
Welbe Health $109 - $128 80%
Wellmed $109 - $128 80%
Align Senior Care $111 - $130 82%
Veterans Administration $111 - $130 82%
Asr Health Benefits $113 - $133 83%
Hap $115 - $142 85%
Health Partners $115 85%
Tufts Health Plan $115 85%
Priority Health $116 - $136 86%
Acclaim $119 88%
Administrative Concepts $119 88%
Albany County Correctional Facility $119 88%
Allegeant $119 88%
Allied Benefit Systems $119 88%
Ambetter / Centene $119 88%
Ameriben $119 88%
American Family $119 88%
American Healthcare Alliance $119 88%
American National $119 88%
American Republic $119 88%
Amerihealth $119 88%
Amish Mennonite $119 88%
Ascension St. Vincent Public Safety Medical $119 88%
Aultcare $119 88%
Automated Benefit Services $119 88%
Auxiant $119 88%
Bccp $119 88%
Benefit Administrative Systems,Llc $119 88%
Bmc Healthnet $119 88%
Boon Chapman $119 88%
Breast Grant-Connecticut $119 88%
Broward County Dept Of Health $119 88%
California Health And Wellness $119 88%
Cam Administrative Services $119 88%
Cardinal Innovations Lme $119 88%
Care Connections Of Northern Iowa $119 88%
Care Oregon Ohp $119 88%
Cca - Zing Health $119 - $141 88%
Cencal Health Plan $119 88%
Cenpatico $119 88%
Chhuny $119 88%
Childrens Comm Health Plan $119 88%
Childrens Medical Services Title 19 $119 88%
Christian Brother Services $119 88%
Christian Brothers Holy Cross $119 88%
City Of Philadelphia $119 88%
Claimchoice Adminstrators $119 88%
Cmh Allegan County $119 88%
Cmh Ausable Valley $119 88%
Cmh Barry County $119 88%
Cmh Bay-Arenac County $119 88%
Cmh Berrien County $119 88%
Cmh Cass County $119 88%
Cmh Central Mi County $119 88%
Cmh Clinton-Eaton-Ingham County $119 88%
Cmh Detroit Wayne Integrated Health Network $119 88%
Cmh Genesee County $119 88%
Cmh Ionia County $119 88%
Cmh Jackson County/Lifeways $119 88%
Cmh Kalamazoo $119 88%
Cmh Kent County $119 88%
Cmh Lenawee County $119 88%
Cmh Livingston County $119 88%
Cmh Macomb $119 88%
Cmh Misc $119 88%
Cmh Monroe County $119 88%
Cmh Montcalm County $119 88%
Cmh Muskegon County $119 88%
Cmh Newaygo County $119 88%
Cmh North Country $119 88%
Cmh Northern Lakes County $119 88%
Cmh Oakland County $119 88%
Cmh Ottawa County $119 88%
Cmh Van Buren County $119 88%
Cmh Washtenaw County $119 88%
Cmh Wayne County/Carelink $119 88%
Cmh Wayne Cty/Com Liv Svcs $119 88%
Cmh West Mi County $119 88%
Community Benefit Health $119 88%
Community Care Behavorial Health $119 88%
Community Care Partners $119 88%
Community Health Choice $119 88%
Comprehensive Benefits $119 88%
Connections Csp $119 88%
Consociate $119 88%
Continental Life Insurance $119 88%
County Coroner $119 88%
County Funding Generic $119 88%
Coventry $119 88%
Covid19 Hrsa Uninsured Testing And Treatment Fund $119 88%
Custom Benefit Administrators $119 88%
Cypress Benefit Administrators $119 88%
Dean Wi Badgercare $119 88%
Delaware County Department Of Health $119 88%
Delaware First Health $119 88%
Delta Dental Nj $119 88%
Dph Tb Program $119 88%
Dscc $119 88%
Eastpointe Lme $119 88%
Employee Benefit Concepts $119 88%
Employee Benefit Management $119 88%
Enterprise Group Planning $119 88%
Family Health Network $119 88%
First Health $119 88%
Forest County Potawatomi $119 88%
Freedom First Healthcare $119 88%
Freedom Life Insurance Company $119 88%
Fresno County Ccs $119 88%
Ghc Scw Wi Badgercare $119 88%
Group Administrators $119 88%
Group Marketing Services $119 88%
Group Pension Administrators $119 88%
Guardian $119 88%
Harbor Health $119 88%
Health America $119 88%
Health Choices $119 88%
Health Safety Net $119 88%
Health Smart $119 88%
Healthcare Management Admin $119 88%
Healthez $119 88%
Healthgram $119 88%
Healthscope $119 88%
Healthy Blue Ne $119 88%
Hennepin Health $119 88%
Id County Ada $119 88%
Id County Canyon $119 88%
Id County Cat Fund $119 88%
Id County Other $119 88%
Id County Payette $119 88%
Idaho Dept Health And Wellfare $119 88%
Idaho Womens Health Check $119 88%
Indiana Breast Cervical Cancer $119 88%
Inland Empire Health Plan $119 88%
Insight $119 88%
Intercommunity Health Ohp $119 88%
Iowa Total Care $119 88%
Jai Medical System $119 88%
Jfp Benefit Management $119 88%
Jp Farley Corporation $119 88%
Kern Family Health Plan $119 88%
Key Benefit Administrator $119 88%
Keystone First $119 88%
Keystone First Chip $119 88%
La Care Health Plan $119 88%
Lakeland Care Inc $119 88%
Liberty Union Life Assurance Co $119 88%
Lucent Health $119 88%
Luminare Health $119 88%
Luminare Health (Detroit) $119 88%
Magnacare $119 88%
Managed Health Services - Indiana $119 88%
Maryland Breast & Cervical Program $119 88%
Maryland Healthy Smiles - Scion Dental $119 88%
Maryland Physicians Care $119 88%
Massachusetts Behavioral Health Partnership $119 88%
Mdwise $119 88%
Medben $119 88%
Medcost $119 88%
Medi-Cal $119 88%
Medi-Cal Healthnet $119 88%
Medical Mutual $119 88%
Medstar Dc Healthy Family $119 88%
Medstar Md Health Choice $119 88%
Mo Home State Health Plan $119 88%
Molina Centennial Care $119 88%
Mutual Health Services $119 88%
Mutual Of Omaha $119 88%
Nascentia Health Options $119 88%
Ncas $119 88%
Nebraska Total Care $119 88%
New York Cancer Services Program $119 88%
Nextlevel Health $119 88%
Nippon Life Ins $119 88%
Nova $119 88%
Oregon Screenwise $119 88%
Painters Union Insurance Fund $119 88%
Paramount Advantage $119 88%
Parkland Community Health Plan $119 88%
Partners Behavioral Lme $119 88%
Peach State Healthplan $119 88%
Philadelphia County Funding $119 88%
Physicians Mutual $119 88%
Plumbers Local 98 Insurance Fund $119 88%
Prairie States $119 88%
Preferred One $119 88%
Presbyterian Centennial Care $119 88%
Prestige Health Choice $119 88%
Primary Physician Care $119 88%
Priority Partners $119 88%
Professional Benefit Administrators $119 88%
Robert F Sing Program $119 88%
Rx 340B Pass Along $119 88%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $119 88%
Rx Medi-Cal $119 88%
Rx Meridian Rx $119 88%
Ryan White Florida Mssrp $119 88%
Sandhills Center Lme $119 88%
Screening For Life $119 88%
Secureone Preferred United Plans $119 88%
Siho Insurance Services $119 88%
Sisco Benefits $119 88%
St Joseph County Hlth Dpt $119 88%
Stephenson Cty Health $119 88%
Sunshine State Health Plan $119 88%
Superior Health $119 88%
Tenncare $119 88%
Texas Children'S Health Plan $119 88%
The Loomis Company $119 88%
Trillium Community Ohp $119 88%
Trustmark Small Business Benefits $119 88%
Tufts Health Public Plans $119 88%
Unicare $119 88%
Unified Group Services $119 88%
Valenz $119 88%
Vaya Health Lme $119 88%
Washtenaw Health Plan $119 88%
Webtpa $119 88%
Wellsense Health Plan $119 88%
Western & Southern Financial Group $119 88%
Wi Womens Wellness $119 88%
Wps $119 88%
Access Health $124 - $146 91%
Longevity Ipa Of Michigan Llc Health Plan Isnp $125 - $147 92%
Intercare $128 94%
Meritain $139 - $164 103%
Varipro $142 105%
Us Health And Life $144 106%
1199 National Benefit Fund $150 - $176 111%
Allied National Global Care $150 - $176 111%
Asrm - Reliance Standard Life Insurance $150 - $176 111%
Christian Care Ministry $150 - $176 111%
Dean Health $150 - $176 111%
Fallon Health $150 - $176 111%
Family Life Insurance Company $150 - $176 111%
International Benefit Administrators $150 - $176 111%
Lifetime Benefit Solutions $150 - $176 111%
Manhattan Life $150 - $176 111%
Molina Marketplace $150 - $176 111%
Multiplan $150 - $176 111%
Mvp $150 - $176 111%
Oscar $150 - $176 111%
Pai $150 - $176 111%
Pan-American Life $150 - $176 111%
Phcs $150 - $176 111%
Trinity Health Share $150 - $176 111%
Wellpath $150 - $176 111%
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%
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%
Partners Direct Health - Brio $161 - $189 119%
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%
U Of M Health Plan $165 - $195 122%
Claimdoc $172 - $202 127%
Kent County Jail $172 - $202 127%
Muskegon County Jail $172 - $202 127%
Nomi Health $172 - $202 127%

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