CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Wyandotte Hospital and Medical Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $66
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.69x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Wyandotte Hospital and Medical Center is $66. 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 $95.19, this hospital’s rate is 0.69x the Medicare baseline. Located in 2333 Biddle Ave, Wyandotte, MI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$66

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%)
Insurance Median: $66 (69%)
Ins. Median: $66 (69% 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
Molina $22 - $124 23%
Molina Mi Health Link $22 - $124 23%
Cofinity Group Health $27 - $179 28%
Mclaren Health $31 - $176 33%
Aetna $32 - $257 34%
Hap $33 - $216 35%
Mclaren $35 37%
Meridian Health Plan Of Mi $35 37%
Priority Health $35 - $134 37%
Vitalcore Physicians Group Of Mi $37 - $208 39%
Amerihealth Michigan $42 - $89 44%
Hap Caresource $42 - $59 44%
Mclaren Health Plan Inc. $42 - $91 44%
Meridian $42 - $91 44%
Priority $44 - $91 46%
UnitedHealthcare $46 - $256 48%
Cigna $50 - $280 53%
Humana $50 - $93 53%
Multiplan, Inc. $50 - $278 53%
University Of Michigan $59 - $332 62%
Beacon Health $61 - $77 64%
Pace Se Mi $63 - $86 66%
Bcn $66 - $91 69%
Blue Cross Blue Shield $66 - $91 69%
Cca Health Mi $66 - $91 69%
Health Alliance Plan Of Michigan $66 - $91 69%
Mount Carmel Health Plan $66 - $91 69%
United Behavioral Health, Inc. $66 - $91 69%
Wellcare Ma $66 69%
Wellcare $67 70%
Cofinity $68 - $91 71%
Vaccn $72 - $101 76%
Bc3Np $73 - $93 77%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2333 Biddle Ave, Wyandotte, MI 48192
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals