CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Mercy Health Lakeshore Campus

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $84
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.88x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Mercy Health Lakeshore Campus is $84. 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 0.88x the Medicare baseline. Located in 72 South State Street, Shelby, MI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$84

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: $84 (88%)
Ins. Median: $84 (88% 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
Medicaid / KanCare $50 - $88 53%
Geha $63 66%
UnitedHealthcare $63 - $86 66%
Blue Care Network $71 75%
Champva $71 75%
Tricare $71 75%
Triwest Health Alliance $71 75%
Us Family Health Plan $71 75%
Veterans Eval Services $71 75%
Blue Benefit Administrators Of Massachusetts $73 77%
Blue Cross Blue Shield $73 - $88 77%
Blue Distinction Transplant $73 77%
Blue Shield - Ca $73 77%
Blue Shield - Id (Regence) $73 77%
Blue Shield - Ny Highmark Northeastern $73 77%
Blue Shield - Ny Highmark Western $73 77%
Blue Shield - Pa (Highmark) $73 77%
Blue Shield - Wa (Regence) $73 77%
Aetna $76 - $114 80%
Align Senior Care $76 80%
Ally Align Care Adv $76 80%
American Health Advantage Of Idaho $76 80%
American Health Plan $76 80%
Asr Health Benefits $76 80%
Aurora Special Needs $76 80%
Blue Care Network Advantage $76 80%
Blue Shield - De (Highmark) Medciare Advantage $76 80%
Care Dimensions $76 80%
Care Improvement Plus $76 80%
Care Resources Pace $76 80%
Careplus Health Plans $76 80%
Cca - Zing Health $76 80%
Cca Senior Care Options $76 80%
Central Valley Medical Services Corp Pace $76 80%
Champion Health Plan Mcr Advantage $76 80%
Cigna $76 - $84 80%
Clear Spring Health $76 80%
Clover Health $76 80%
Commonwealth Care Alliance $76 80%
Community Pace At Home $76 80%
Eddy Senior Care-Pace $76 80%
Eddy Seniorcare Pace $76 80%
Elementcare $76 80%
Evercare $76 80%
Everence $76 80%
Gateway Health Plan $76 80%
Genesys Pace Of Genesee County $76 80%
Georgia Health Advantage $76 80%
Gold Advantage $76 80%
Gpa Croell Redi Mix $76 80%
Health America Advantra $76 80%
Highmark Health Options Dual Plan $76 80%
Hope Select Pace $76 80%
Horizon Nj Total Care $76 80%
Hudson Headwaters Pace $76 80%
Humana $76 - $84 80%
Huron Valley Pace $76 80%
Innovative Integrated Health Community Plans $76 80%
Iowa Health Advantage $76 80%
Johns Hopkins Advantage Md $76 80%
Lasso Healthcare Msa $76 80%
Life St Marys Pace $76 80%
Lifecircles Pace $76 80%
Longevity Health Plan $76 80%
Longevity Ipa Of Michigan Llc Health Plan Isnp $76 80%
Martins Point Generations Advantage $76 80%
Mass General Brigham Mcr Adv $76 80%
Medicare (plans) $76 - $90 80%
Medipak Advantage $76 80%
Mercy Life $76 80%
Mercyone Cedar Valley $76 80%
Meridian Complete $76 80%
Michigan Complete Health $76 80%
Nascentia Health Plus $76 80%
New Centry Health Careplus $76 80%
Osu Prime Care Advantage $76 80%
Pace Cny $76 80%
Pace Iowa Immanuel Pathways $76 80%
Pace Of Southwest Michigan $76 - $84 80%
Pace Southeast $76 80%
Pace-Trinity Health $76 80%
Peak Pace Solutions $76 80%
Perennial Advantage $76 80%
Preferred Care Partners $76 80%
Presbyterian Senior Plan $76 80%
Provider Partners Health Plan Of Illinois $76 80%
Provider Partners Health Plan Of Indiana $76 80%
Pruitthealth Premier $76 80%
Reliance Community Care Partners Care Resources Pace $76 80%
Rx Allwin $76 80%
Rx Grane Grnmedd $76 80%
Rx Retiree Rx Care $76 80%
Scan Health Plan Mcr Ipa Meritage Oon $76 80%
Secure Horizons Ma Pffs $76 80%
Serenity Pace $76 80%
Siouxland Pace $76 80%
Solis Health Plans $76 80%
Sunnyview-Pace Finance Dept $76 80%
Texan Plus $76 80%
The Health Plan $76 - $82 80%
Thome Pace $76 80%
Todays Options $76 80%
Tribute Health Plans $76 80%
Um Health Advantage $76 80%
Union Health Service $76 80%
Welbe Health $76 80%
Wellmed $76 80%
American Postal Workers Secondary $77 81%
Hap $78 - $97 82%
Health Partners $78 82%
Tufts Health Plan $78 82%
Veterans Administration $78 82%
Acclaim $82 86%
Administrative Concepts $82 86%
Allegeant $82 86%
Allied Benefit Systems $82 86%
Ameriben $82 86%
American Family $82 86%
American Healthcare Alliance $82 86%
American National $82 86%
American Republic $82 86%
Amerihealth $82 86%
Aultcare $82 86%
Automated Benefit Services $82 86%
Auxiant $82 86%
Benefit Administrative Systems,Llc $82 86%
Boon Chapman $82 86%
Cam Administrative Services $82 86%
Christian Brother Services $82 86%
Christian Brothers Holy Cross $82 86%
Claimchoice Adminstrators $82 86%
Comprehensive Benefits $82 86%
Consociate $82 86%
Continental Life Insurance $82 86%
Coventry $82 86%
Custom Benefit Administrators $82 86%
Cypress Benefit Administrators $82 86%
Employee Benefit Concepts $82 86%
Employee Benefit Management $82 86%
Enterprise Group Planning $82 86%
First Health $82 86%
Forest County Potawatomi $82 86%
Freedom Life Insurance Company $82 86%
Group Administrators $82 86%
Group Marketing Services $82 86%
Group Pension Administrators $82 86%
Guardian $82 86%
Health America $82 86%
Health Choices $82 86%
Health Smart $82 86%
Healthcare Management Admin $82 86%
Healthez $82 86%
Healthgram $82 86%
Healthscope $82 86%
Insight $82 86%
Intercare $82 86%
Jfp Benefit Management $82 86%
Jp Farley Corporation $82 86%
Key Benefit Administrator $82 86%
Liberty Union Life Assurance Co $82 86%
Lucent Health $82 86%
Luminare Health $82 86%
Luminare Health (Detroit) $82 86%
Magnacare $82 86%
Medben $82 86%
Medcost $82 86%
Medical Mutual $82 86%
Mutual Health Services $82 86%
Mutual Of Omaha $82 86%
Ncas $82 86%
Nippon Life Ins $82 86%
Nova $82 86%
Painters Union Insurance Fund $82 86%
Physicians Mutual $82 86%
Plumbers Local 98 Insurance Fund $82 86%
Prairie States $82 86%
Preferred One $82 86%
Primary Physician Care $82 86%
Priority Health $82 86%
Professional Benefit Administrators $82 86%
Secureone Preferred United Plans $82 86%
Siho Insurance Services $82 86%
Sisco Benefits $82 86%
The Loomis Company $82 86%
Trustmark Small Business Benefits $82 86%
Unicare $82 86%
Unified Group Services $82 86%
Valenz $82 86%
Webtpa $82 86%
Western & Southern Financial Group $82 86%
Wps $82 86%
Albany County Correctional Facility $84 88%
Ambetter / Centene $84 88%
Amish Mennonite $84 88%
Ascension St. Vincent Public Safety Medical $84 88%
Bccp $84 88%
Bmc Healthnet $84 88%
Breast Grant-Connecticut $84 88%
Broward County Dept Of Health $84 88%
California Health And Wellness $84 88%
Can Community Health Inc $84 88%
Cardinal Innovations Lme $84 88%
Care Connections Of Northern Iowa $84 88%
Care Oregon Ohp $84 88%
Cencal Health Plan $84 88%
Cenpatico $84 88%
Chhuny $84 88%
Childrens Comm Health Plan $84 88%
Childrens Medical Services Title 19 $84 88%
City Of Philadelphia $84 88%
Cmh Allegan County $84 88%
Cmh Ausable Valley $84 88%
Cmh Barry County $84 88%
Cmh Bay-Arenac County $84 88%
Cmh Berrien County $84 88%
Cmh Cass County $84 88%
Cmh Central Mi County $84 88%
Cmh Clinton-Eaton-Ingham County $84 88%
Cmh Detroit Wayne Integrated Health Network $84 88%
Cmh Genesee County $84 88%
Cmh Ionia County $84 88%
Cmh Jackson County/Lifeways $84 88%
Cmh Kalamazoo $84 88%
Cmh Kent County $84 88%
Cmh Lenawee County $84 88%
Cmh Livingston County $84 88%
Cmh Macomb $84 88%
Cmh Misc $84 88%
Cmh Monroe County $84 88%
Cmh Montcalm County $84 88%
Cmh Muskegon County $84 88%
Cmh Newaygo County $84 88%
Cmh North Country $84 88%
Cmh Northern Lakes County $84 88%
Cmh Oakland County $84 88%
Cmh Ottawa County $84 88%
Cmh Van Buren County $84 88%
Cmh Washtenaw County $84 88%
Cmh Wayne County/Carelink $84 88%
Cmh Wayne Cty/Com Liv Svcs $84 88%
Cmh West Mi County $84 88%
Community Benefit Health $84 88%
Community Care Behavorial Health $84 88%
Community Care Partners $84 88%
Community Health Choice $84 88%
Connections Csp $84 88%
County Coroner $84 88%
County Funding Generic $84 88%
Covid19 Hrsa Uninsured Testing And Treatment Fund $84 88%
Dean Wi Badgercare $84 88%
Delaware County Department Of Health $84 88%
Delaware First Health $84 88%
Delta Dental Nj $84 88%
Dph Tb Program $84 88%
Dscc $84 88%
Eastpointe Lme $84 88%
Family Health Network $84 88%
Freedom First Healthcare $84 88%
Fresno County Ccs $84 88%
Ghc Scw Wi Badgercare $84 88%
Harbor Health $84 88%
Health Safety Net $84 88%
Healthy Blue Ne $84 88%
Hennepin Health $84 88%
Id County Ada $84 88%
Id County Canyon $84 88%
Id County Cat Fund $84 88%
Id County Other $84 88%
Id County Payette $84 88%
Idaho Dept Health And Wellfare $84 88%
Idaho Womens Health Check $84 88%
Indiana Breast Cervical Cancer $84 88%
Inland Empire Health Plan $84 88%
Intercommunity Health Ohp $84 88%
Iowa Total Care $84 88%
Jai Medical System $84 88%
Kern Family Health Plan $84 88%
Keystone First $84 88%
Keystone First Chip $84 88%
La Care Health Plan $84 88%
Lakeland Care Inc $84 88%
Managed Health Services - Indiana $84 88%
Maryland Breast & Cervical Program $84 88%
Maryland Healthy Smiles - Scion Dental $84 88%
Maryland Physicians Care $84 88%
Massachusetts Behavioral Health Partnership $84 88%
Mdwise $84 88%
Medi-Cal $84 88%
Medi-Cal Healthnet $84 88%
Medstar Dc Healthy Family $84 88%
Medstar Md Health Choice $84 88%
Mo Home State Health Plan $84 88%
Molina Centennial Care $84 88%
Nascentia Health Options $84 88%
Nebraska Total Care $84 88%
New York Cancer Services Program $84 88%
Nextlevel Health $84 88%
Oregon Screenwise $84 88%
Paramount Advantage $84 88%
Parkland Community Health Plan $84 88%
Partners Behavioral Lme $84 88%
Peach State Healthplan $84 88%
Philadelphia County Funding $84 88%
Presbyterian Centennial Care $84 88%
Prestige Health Choice $84 88%
Priority Partners $84 88%
Robert F Sing Program $84 88%
Rx 340B Pass Along $84 88%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $84 88%
Rx Medi-Cal $84 88%
Rx Meridian Rx $84 88%
Ryan White Florida Mssrp $84 88%
Sandhills Center Lme $84 88%
Screening For Life $84 88%
St Joseph County Hlth Dpt $84 88%
Stephenson Cty Health $84 88%
Sunshine State Health Plan $84 88%
Superior Health $84 88%
Tenncare $84 88%
Texas Children'S Health Plan $84 88%
Trillium Community Ohp $84 88%
Tufts Health Public Plans $84 88%
Vaya Health Lme $84 88%
Washtenaw Health Plan $84 88%
Wellsense Health Plan $84 88%
Wi Womens Wellness $84 88%
Access Health $87 91%
Bcccp-Michigan $88 92%
Varipro $97 102%
Meritain $98 103%
Us Health And Life $98 103%
1199 National Benefit Fund $105 110%
Allied National Global Care $105 110%
Asrm - Reliance Standard Life Insurance $105 110%
Christian Care Ministry $105 110%
Dean Health $105 110%
Fallon Health $105 110%
Family Life Insurance Company $105 110%
International Benefit Administrators $105 110%
Lifetime Benefit Solutions $105 110%
Manhattan Life $105 110%
Molina Marketplace $105 110%
Multiplan $105 110%
Mvp $105 110%
Oscar $105 110%
Pai $105 110%
Pan-American Life $105 110%
Phcs $105 110%
Trinity Health Share $105 110%
Wellpath $105 110%
Wc Accident Fund $109 115%
Wc Advantage $109 115%
Wc Aig $109 115%
Wc Allied $109 115%
Wc Amerisure $109 115%
Wc Amtrust $109 115%
Wc Asu Risk Mgt $109 115%
Wc Berkley Admin $109 115%
Wc Broadspire $109 115%
Wc Bunch & Associates $109 115%
Wc Ccmsi $109 115%
Wc Emc Insurance Company $109 115%
Wc Esis $109 115%
Wc Fcci $109 115%
Wc Federated $109 115%
Wc Gallagher Bassett $109 115%
Wc Genex Care For Ohio $109 115%
Wc Guard Insurance Company $109 115%
Wc Hartford $109 115%
Wc Liberty Mutual $109 115%
Wc Meijers $109 115%
Wc Michigan $109 115%
Wc Mitchell Frankenmuth $109 115%
Wc Pma $109 115%
Wc Sedgwick $109 115%
Wc Sentry $109 115%
Wc Travelers $109 115%
Wc Tristar $109 115%
Wc Walmart $109 115%
Wc Zurich $109 115%
Partners Direct Health - Brio $113 119%
Andrie Inc $114 120%
East Greenbush Central School District $114 120%
Genex Wc $114 120%
Healthsmart Workers Comp $114 120%
Jag Source $114 120%
New York State Insurance Fund $114 120%
Njm Insurance Group $114 120%
Rx Heatlhcomp $114 120%
Rx Restat $114 120%
Rx Saif Opdp Wc $114 120%
Rx Worker'S Comp $114 120%
Wc Ace $114 120%
Wc Acs Federal Employees $114 120%
Wc Acuity $114 120%
Wc Aegis $114 120%
Wc Aims $114 120%
Wc Alaska National Ins $114 120%
Wc Align Network $114 120%
Wc Am Trust N America $114 120%
Wc American Claims Mgmt $114 120%
Wc Benetech $114 120%
Wc Broward County $114 120%
Wc California State Comp Ins $114 120%
Wc California State Ins Fund $114 120%
Wc Capitol Area Health Consortium $114 120%
Wc Chartis $114 120%
Wc Chubb $114 120%
Wc Cirma $114 120%
Wc City Of Albany $114 120%
Wc City Of Sioux City $114 120%
Wc Claims Mgmt Inc $114 120%
Wc Cna $114 120%
Wc Comp One Admin C/O Manageability $114 120%
Wc Compone Admin $114 120%
Wc Corvel $114 120%
Wc Ct Healthcare Trust $114 120%
Wc Donegal Insurance Group $114 120%
Wc Employee Mutual $114 120%
Wc Enablecomp $114 120%
Wc Encore Health Network $114 120%
Wc Erie $114 120%
Wc Evolutions $114 120%
Wc Fed Ex $114 120%
Wc Federal Black Lung $114 120%
Wc Finley Occupational Health $114 120%
Wc First Agency/Occunet $114 120%
Wc Ford Motor $114 120%
Wc Fresno Unified Emp $114 120%
Wc General Motors $114 120%
Wc Generic $114 120%
Wc Great West Casualty $114 120%
Wc Guarantee Insurance $114 120%
Wc Hab $114 120%
Wc Hastings $114 120%
Wc Health Management $114 120%
Wc Heritage Summit $114 120%
Wc Hireright $114 120%
Wc Horizon $114 120%
Wc Icw Group $114 120%
Wc Idaho State Ins Fund $114 120%
Wc Intercare Insurance $114 120%
Wc Intermountain $114 120%
Wc Johns Eastern $114 120%
Wc Kemberton $114 120%
Wc Key Ins & Benefit Solutions $114 120%
Wc Mac Risk Management $114 120%
Wc Massachusetts $114 120%
Wc Mdia $114 120%
Wc Meadowbrook Claim $114 120%
Wc Medical Administrators $114 120%
Wc Memic $114 120%
Wc Mercy Workcare $114 120%
Wc Michigan Millers Mutual $114 120%
Wc Mra $114 120%
Wc Nationwide $114 120%
Wc Nca Comp $114 120%
Wc New York $114 120%
Wc New York Special Funds $114 120%
Wc North American Rishces $114 120%
Wc Northeast Health $114 120%
Wc Notre Dame $114 120%
Wc Novanet $114 120%
Wc O'Hara Corp $114 120%
Wc Occ Health Allen $114 120%
Wc Ohio Bureau $114 120%
Wc One Call Medical $114 120%
Wc Paradigm $114 120%
Wc Peerless $114 120%
Wc Praxis Health Network $114 120%
Wc Price Chopper $114 120%
Wc Procura Management $114 120%
Wc Qualcare $114 120%
Wc Quiktrip $114 120%
Wc Reny Company $114 120%
Wc Rev Claims $114 120%
Wc Risico $114 120%
Wc Rural Mutual $114 120%
Wc Saif Oregon $114 120%
Wc Secura $114 120%
Wc Sheakley Unicomp $114 120%
Wc Smile Lodge $114 120%
Wc Society $114 120%
Wc Srs $114 120%
Wc Taconic (Mro) $114 120%
Wc Taconic Farms $114 120%
Wc Triad Group $114 120%
Wc Troy Ny $114 120%
Wc Tyson $114 120%
Wc Unified Health Services $114 120%
Wc United Heartland $114 120%
Wc Us Dept Of Labor $114 120%
Wc Velocity $114 120%
Wc West Bend $114 120%
Wc West Bend Mutual/Argent $114 120%
Wc Winnebago Industries $114 120%
Wc Yankee Trails $114 120%
Wc York Risk $114 120%
Wc Zenith $114 120%
U Of M Health Plan $117 123%
Claimdoc $120 126%
Kent County Jail $120 126%
Muskegon County Jail $120 126%
Nomi Health $120 126%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

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