CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Wyandotte Hospital and Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $97
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.72x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Wyandotte Hospital and Medical Center is $97. 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 0.72x 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
$97

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: $97 (72%)
Ins. Median: $97 (72% 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

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 $30 - $156 22%
Molina Mi Health Link $30 - $156 22%
Cofinity Group Health $37 - $224 27%
Mclaren Health $42 - $220 31%
Aetna $44 - $322 32%
Hap $45 - $270 33%
Vitalcore Physicians Group Of Mi $50 - $260 37%
Mclaren $52 38%
Meridian Health Plan Of Mi $52 38%
Priority Health $52 - $184 38%
Amerihealth Michigan $62 - $125 46%
Hap Caresource $62 - $82 46%
Mclaren Health Plan Inc. $62 - $128 46%
Meridian $62 - $128 46%
UnitedHealthcare $62 - $321 46%
Priority $65 - $128 48%
Cigna $67 - $350 49%
Multiplan, Inc. $67 - $348 49%
Humana $70 - $131 52%
Bc3Np $73 - $93 54%
University Of Michigan $80 - $415 59%
Pace Se Mi $92 - $122 68%
Beacon Health $93 - $113 69%
Bcn $97 - $128 72%
Blue Cross Blue Shield $97 - $128 72%
Cca Health Mi $97 - $128 72%
Health Alliance Plan Of Michigan $97 - $128 72%
Mount Carmel Health Plan $97 - $128 72%
United Behavioral Health, Inc. $97 - $128 72%
Wellcare Ma $97 72%
Wellcare $98 72%
Cofinity $100 - $129 74%
Vaccn $107 - $142 79%

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