CMS Price Transparency Data
Office visit, established patient (20-29 min)
Facility: Helen Newberry Joy Hospital
Billing Code: 99213 (CPT)
The BaseRate · fair price high confidence
A fair price for this
$75
about 0.8× the $95 Medicare rate · typically $49–$117
modeled estimate · not a bill or quote
Medicare pays $95 Fair price $75 Cash price $97 Hospital's list price $155
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 | $57 - $287 | 60% |
| Blue Cross Blue Shieldmajor | $58 - $321 | 61% |
| Aetnamajor | $53 - $321 | 56% |
| Cignamajor | $57 - $287 | 60% |
| Humanamajor | $321 | 337% |
| Priority Health | $57 - $287 | 60% |
| + 7 smaller / regional plans | $37 - $321 |
Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.
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Other Procedures at Helen Newberry Joy Hospital
Compare: Office visit, established patient (20-29 min) at other MI hospitals
- Sparrow Ionia Hospital · Ionia $34
- Huron Valley-Sinai Hospital · Commerce Township $46
- Trinity Health Livingston Hospital · Howell $47
- University of Michigan Health System · Ann Arbor $56
- Harper University Hospital · Detroit $56
- Munson Healthcare Otsego Memorial Hospital · Gaylord $57
- St Joe Mercy Hospital System Livonia · Livonia $58
- Henry Ford Health Brighton Center for Recovery · Brighton $59
Insurance negotiated median for the same procedure, sorted lowest first.