CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Henry Ford Allegiance Health

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $62
  • Cash Discount Price: $87
  • vs. Medicare Baseline: 0.65x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Henry Ford Allegiance Health is $62. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.65x the Medicare baseline. Located in 205 N East Ave, Jackson, MI.
Cash / Self-Pay
$87

Average discount available for prompt cash payment at this facility.

Insurance Median
$62

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: $87 (91%)
Insurance Median: $62 (65%)
Cash: $87 (91% of Medicare)
Ins. Median: $62 (65% 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
Blue Cross Blue Shield $33 - $117 35%
Hap Caresource $33 - $59 35%
Mclaren $33 35%
Meridian Health Plan Of Mi $33 35%
Priority Health $33 - $134 35%
Aetna $35 - $85 37%
Molina Mi Health Link $35 37%
Molina $36 - $85 38%
Mclaren Health Plan Inc. $42 - $85 44%
Meridian $42 - $59 44%
Priority $44 - $85 46%
Humana $50 - $86 53%
Hap $52 - $114 55%
Vitalcore Physicians Group Of Mi $58 - $110 61%
Mclaren Health $59 62%
Jackson County Offiice Of The Sheriff $61 64%
Bcn $62 - $85 65%
Cca Health Mi $62 - $85 65%
Health Alliance Plan Of Michigan $62 - $85 65%
Thomas Pace $62 - $85 65%
Vaccn $63 - $92 66%
Frontpath $65 - $170 68%
United Behavioral Health, Inc. $66 - $91 69%
Immergrun Inc $70 74%
Cigna $72 - $104 76%
University Of Michigan $82 86%
Cofinity $84 88%
UnitedHealthcare $87 91%
Cofinity Group Health $105 110%
Multiplan, Inc. $105 110%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 205 N East Ave, Jackson, MI 49201
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals