CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: University of Michigan Health - West

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $194
Cash Discount Price: $109
vs. Medicare Baseline: 1.65x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at University of Michigan Health - West is $194. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $109. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.65x the Medicare baseline. Located in 5900 Byron Center Avenue, Sw, Wyoming, MI.

Cash / Self-Pay

$109

Average discount available for prompt cash payment at this facility.

Insurance Median

$194

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)

Cash / Self-Pay: $109 (93%)

Insurance Median: $194 (165%)

Cash: $109 (93% of Medicare)

Ins. Median: $194 (165% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $117.57 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Web Tpa	$102 - $138	87%
Aetna	$155 - $211	132%
Alliance Health & Life Ppo	$155 - $211	132%
Asr Physicians	$155 - $211	132%
Hap	$155 - $211	132%
Golden Rule Ins	$167 - $227	142%
Medica	$167 - $227	142%
Student Ins/Mega Life	$167 - $227	142%
UnitedHealthcare	$167 - $227	142%
Humana	$174 - $236	148%
Asr Cofinity	$194 - $263	165%
Cofinity Commercial	$194 - $263	165%
Cofinity Weyco	$194 - $263	165%
Core Source	$194 - $263	165%
Epoch Group	$194 - $263	165%
Health Partners	$194 - $263	165%
Hlthcomp Admin	$194 - $263	165%
Mid America	$194 - $263	165%
Priority Health	$207	176%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $109.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99203.

Insurance In-Network Protection Plan

Contact your insurance company to confirm University of Michigan Health - West is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99203.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.