CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Mercy Health Saint Mary's

Billing Code: 99214 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$89
about 0.7× the $136 Medicare rate · typically $60–$141
modeled estimate · not a bill or quote
What this hospital charges insurers
$138
Above the fair price
about $49 over the fair price · 1.0× Medicare
Medicare pays $136 Fair price $89 This hospital $138 Hospital's list price $205

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 $45 Priciest $138

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 (30-39 min) is about $89 (about 0.7× the $136 Medicare rate). Mercy Health Saint Mary's charges insurers about $138 — above the fair price. Located in Grand Rapids, MI.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $89. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

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

5 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 $94 - $128 69%
Blue Cross Blue Shieldmajor $103 - $128 76%
Aetnamajor $109 - $190 80%
Cignamajor $109 - $128 80%
Humanamajor $109 - $128 80%
Ambetter (Centene) $119 88%
AmeriHealth $119 88%
Clover Health $109 - $128 80%
Dean Health Plan $150 - $176 111%
GEHA $94 - $111 69%
Health Net $119 - $190 88%
HealthPartners $115 - $119 85%
MagnaCare $119 88%
Medical Mutual $119 88%
Meridian $109 - $128 80%
Molina $119 - $176 88%
MVP Health Care $150 - $176 111%
Oscar Health $150 - $176 111%
Paramount $119 88%
Presbyterian $109 - $128 80%
Priority Health $116 - $136 86%
Tufts Health Plan $115 - $119 85%
UniCare $119 88%
WellMed $109 - $128 80%
WellSense $119 88%
+ 421 smaller / regional plans $88 - $202
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.

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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