CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Mercy Health Lakeshore Campus

Billing Code: 99214 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$93
about 0.7× the $136 Medicare rate · typically $73–$131
modeled estimate · not a bill or quote
What this hospital charges insurers
$119
Above the fair price
about $26 over the fair price · 0.9× Medicare
Medicare pays $136 Fair price $93 This hospital $119 Hospital's list price $205

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 $45 Priciest $119

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

A fair price for a Office visit, established patient (30-39 min) is about $93 (about 0.7× the $136 Medicare rate). Mercy Health Lakeshore Campus charges insurers about $119 — 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 $93. 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 $89 - $123 66%
Blue Cross Blue Shieldmajor $86 - $125 63%
Aetnamajor $86 - $190 63%
Cignamajor $86 - $128 63%
Humanamajor $86 - $119 63%
Ambetter (Centene) $86 - $119 63%
AmeriHealth $119 88%
Dean Health Plan $176 130%
GEHA $111 82%
Health Net $86 - $190 63%
HealthPartners $86 - $119 63%
MagnaCare $119 88%
Medical Mutual $119 88%
Meridian $86 - $119 63%
Molina $86 - $176 63%
MVP Health Care $176 130%
Oscar Health $176 130%
Paramount $86 - $119 63%
Presbyterian $86 - $119 63%
Priority Health $136 100%
Tufts Health Plan $86 - $119 63%
UniCare $119 88%
WellSense $86 - $119 63%
+ 350 smaller / regional plans $86 - $202
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.

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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