CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Mercy Health Lakeshore Campus

Billing Code: 99203 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$80
about 0.7× the $118 Medicare rate · typically $63–$111
modeled estimate · not a bill or quote
What this hospital charges insurers
$132
Above the fair price
about $52 over the fair price · 1.1× Medicare
Medicare pays $118 Fair price $80 This hospital $132 Hospital's list price $194

How we calculate the fair BaseRate →

How this hospital compares to other MI hospitals

Highest price of the 9 MI hospitals we have prices for — worth calling around.

Cheapest $47 Priciest $132

Black dot = this hospital, among the 9 MI hospitals with a price for this procedure. Full list below.

A fair price for a New patient office visit (30-44 min) is about $80 (about 0.7× the $118 Medicare rate). Mercy Health Lakeshore Campus charges insurers about $132 — above the fair price. Located in Shelby, MI.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $80. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

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 $77 - $115 65%
Blue Cross Blue Shieldmajor $75 - $117 64%
Aetnamajor $75 - $166 64%
Cignamajor $75 - $113 64%
Humanamajor $75 - $113 64%
Ambetter (Centene) $75 - $103 64%
AmeriHealth $113 96%
Dean Health Plan $130 - $153 111%
GEHA $94 - $111 80%
Health Net $75 - $166 64%
HealthPartners $75 - $117 64%
MagnaCare $113 96%
Medical Mutual $113 96%
Meridian $75 - $103 64%
Molina $75 - $153 64%
MVP Health Care $130 - $153 111%
Oscar Health $130 - $153 111%
Paramount $75 - $103 64%
Presbyterian $75 - $103 64%
Priority Health $102 - $119 87%
Tufts Health Plan $75 - $117 64%
UniCare $113 96%
WellSense $75 - $103 64%
+ 350 smaller / regional plans $75 - $175
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 16 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

Enter your details and press estimate to compare.

Facility Profile & Credentials

  • Address: 72 South State Street, Shelby, MI 49455
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals