CMS Price Transparency Data
Office visit, established patient (30-39 min)
Facility: Mercy Health Lakeshore Campus
Billing Code: 99214 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99214
- Insurance Median: $119
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.88x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Mercy Health Lakeshore Campus is $119. 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 $135.6, 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
$119
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$135.6
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $135.6 (100%)
Insurance Median: $119 (88%)
Ins. Median: $119 (88% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $135.6 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 | $75 - $125 | 55% |
| Aetna | $86 - $190 | 63% |
| Albany County Correctional Facility | $86 - $119 | 63% |
| Ambetter / Centene | $86 - $119 | 63% |
| Amish Mennonite | $86 - $119 | 63% |
| Ascension St. Vincent Public Safety Medical | $86 - $119 | 63% |
| Bccp | $86 - $119 | 63% |
| Blue Cross Blue Shield | $86 - $125 | 63% |
| Bmc Healthnet | $86 - $119 | 63% |
| Breast Grant-Connecticut | $86 - $119 | 63% |
| Broward County Dept Of Health | $86 - $119 | 63% |
| California Health And Wellness | $86 - $119 | 63% |
| Can Community Health Inc | $86 - $119 | 63% |
| Cardinal Innovations Lme | $86 - $119 | 63% |
| Care Connections Of Northern Iowa | $86 - $119 | 63% |
| Care Oregon Ohp | $86 - $119 | 63% |
| Cencal Health Plan | $86 - $119 | 63% |
| Cenpatico | $86 - $119 | 63% |
| Chhuny | $86 - $119 | 63% |
| Childrens Comm Health Plan | $86 - $119 | 63% |
| Childrens Medical Services Title 19 | $86 - $119 | 63% |
| Cigna | $86 - $128 | 63% |
| City Of Philadelphia | $86 - $119 | 63% |
| Cmh Allegan County | $86 - $119 | 63% |
| Cmh Ausable Valley | $86 - $119 | 63% |
| Cmh Barry County | $86 - $119 | 63% |
| Cmh Bay-Arenac County | $86 - $119 | 63% |
| Cmh Berrien County | $86 - $119 | 63% |
| Cmh Cass County | $86 - $119 | 63% |
| Cmh Central Mi County | $86 - $119 | 63% |
| Cmh Clinton-Eaton-Ingham County | $86 - $119 | 63% |
| Cmh Detroit Wayne Integrated Health Network | $86 - $119 | 63% |
| Cmh Genesee County | $86 - $119 | 63% |
| Cmh Ionia County | $86 - $119 | 63% |
| Cmh Jackson County/Lifeways | $86 - $119 | 63% |
| Cmh Kalamazoo | $86 - $119 | 63% |
| Cmh Kent County | $86 - $119 | 63% |
| Cmh Lenawee County | $86 - $119 | 63% |
| Cmh Livingston County | $86 - $119 | 63% |
| Cmh Macomb | $86 - $119 | 63% |
| Cmh Misc | $86 - $119 | 63% |
| Cmh Monroe County | $86 - $119 | 63% |
| Cmh Montcalm County | $86 - $119 | 63% |
| Cmh Muskegon County | $86 - $119 | 63% |
| Cmh Newaygo County | $86 - $119 | 63% |
| Cmh North Country | $86 - $119 | 63% |
| Cmh Northern Lakes County | $86 - $119 | 63% |
| Cmh Oakland County | $86 - $119 | 63% |
| Cmh Ottawa County | $86 - $119 | 63% |
| Cmh Van Buren County | $86 - $119 | 63% |
| Cmh Washtenaw County | $86 - $119 | 63% |
| Cmh Wayne County/Carelink | $86 - $119 | 63% |
| Cmh Wayne Cty/Com Liv Svcs | $86 - $119 | 63% |
| Cmh West Mi County | $86 - $119 | 63% |
| Community Benefit Health | $86 - $119 | 63% |
| Community Care Behavorial Health | $86 - $119 | 63% |
| Community Care Partners | $86 - $119 | 63% |
| Community Health Choice | $86 - $119 | 63% |
| Connections Csp | $86 - $119 | 63% |
| County Coroner | $86 - $119 | 63% |
| County Funding Generic | $86 - $119 | 63% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $86 - $119 | 63% |
| Dean Wi Badgercare | $86 - $119 | 63% |
| Delaware County Department Of Health | $86 - $119 | 63% |
| Delaware First Health | $86 - $119 | 63% |
| Delta Dental Nj | $86 - $119 | 63% |
| Dph Tb Program | $86 - $119 | 63% |
| Dscc | $86 - $119 | 63% |
| Eastpointe Lme | $86 - $119 | 63% |
| Family Health Network | $86 - $119 | 63% |
| Freedom First Healthcare | $86 - $119 | 63% |
| Fresno County Ccs | $86 - $119 | 63% |
| Ghc Scw Wi Badgercare | $86 - $119 | 63% |
| Harbor Health | $86 - $119 | 63% |
| Health Safety Net | $86 - $119 | 63% |
| Healthy Blue Ne | $86 - $119 | 63% |
| Hennepin Health | $86 - $119 | 63% |
| Humana | $86 - $119 | 63% |
| Id County Ada | $86 - $119 | 63% |
| Id County Canyon | $86 - $119 | 63% |
| Id County Cat Fund | $86 - $119 | 63% |
| Id County Other | $86 - $119 | 63% |
| Id County Payette | $86 - $119 | 63% |
| Idaho Dept Health And Wellfare | $86 - $119 | 63% |
| Idaho Womens Health Check | $86 - $119 | 63% |
| Indiana Breast Cervical Cancer | $86 - $119 | 63% |
| Inland Empire Health Plan | $86 - $119 | 63% |
| Intercommunity Health Ohp | $86 - $119 | 63% |
| Iowa Total Care | $86 - $119 | 63% |
| Jai Medical System | $86 - $119 | 63% |
| Kern Family Health Plan | $86 - $119 | 63% |
| Keystone First | $86 - $119 | 63% |
| Keystone First Chip | $86 - $119 | 63% |
| La Care Health Plan | $86 - $119 | 63% |
| Lakeland Care Inc | $86 - $119 | 63% |
| Managed Health Services - Indiana | $86 - $119 | 63% |
| Maryland Breast & Cervical Program | $86 - $119 | 63% |
| Maryland Healthy Smiles - Scion Dental | $86 - $119 | 63% |
| Maryland Physicians Care | $86 - $119 | 63% |
| Massachusetts Behavioral Health Partnership | $86 - $119 | 63% |
| Mdwise | $86 - $119 | 63% |
| Medi-Cal | $86 - $119 | 63% |
| Medi-Cal Healthnet | $86 - $119 | 63% |
| Medstar Dc Healthy Family | $86 - $119 | 63% |
| Medstar Md Health Choice | $86 - $119 | 63% |
| Mo Home State Health Plan | $86 - $119 | 63% |
| Molina Centennial Care | $86 - $119 | 63% |
| Nascentia Health Options | $86 - $119 | 63% |
| Nebraska Total Care | $86 - $119 | 63% |
| New York Cancer Services Program | $86 - $119 | 63% |
| Nextlevel Health | $86 - $119 | 63% |
| Oregon Screenwise | $86 - $119 | 63% |
| Pace Of Southwest Michigan | $86 - $119 | 63% |
| Paramount Advantage | $86 - $119 | 63% |
| Parkland Community Health Plan | $86 - $119 | 63% |
| Partners Behavioral Lme | $86 - $119 | 63% |
| Peach State Healthplan | $86 - $119 | 63% |
| Philadelphia County Funding | $86 - $119 | 63% |
| Presbyterian Centennial Care | $86 - $119 | 63% |
| Prestige Health Choice | $86 - $119 | 63% |
| Priority Partners | $86 - $119 | 63% |
| Robert F Sing Program | $86 - $119 | 63% |
| Rx 340B Pass Along | $86 - $119 | 63% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $86 - $119 | 63% |
| Rx Medi-Cal | $86 - $119 | 63% |
| Rx Meridian Rx | $86 - $119 | 63% |
| Ryan White Florida Mssrp | $86 - $119 | 63% |
| Sandhills Center Lme | $86 - $119 | 63% |
| Screening For Life | $86 - $119 | 63% |
| St Joseph County Hlth Dpt | $86 - $119 | 63% |
| Stephenson Cty Health | $86 - $119 | 63% |
| Sunshine State Health Plan | $86 - $119 | 63% |
| Superior Health | $86 - $119 | 63% |
| Tenncare | $86 - $119 | 63% |
| Texas Children'S Health Plan | $86 - $119 | 63% |
| Trillium Community Ohp | $86 - $119 | 63% |
| Tufts Health Public Plans | $86 - $119 | 63% |
| Vaya Health Lme | $86 - $119 | 63% |
| Washtenaw Health Plan | $86 - $119 | 63% |
| Wellsense Health Plan | $86 - $119 | 63% |
| Wi Womens Wellness | $86 - $119 | 63% |
| Bcccp-Michigan | $88 | 65% |
| UnitedHealthcare | $89 - $123 | 66% |
| Geha | $111 | 82% |
| Us Health And Life | $113 - $144 | 83% |
| Hap | $115 - $142 | 85% |
| Health Partners | $115 | 85% |
| Tufts Health Plan | $115 | 85% |
| Champva | $118 | 87% |
| Tricare | $118 | 87% |
| Triwest Health Alliance | $118 | 87% |
| Us Family Health Plan | $118 | 87% |
| Veterans Eval Services | $118 | 87% |
| Acclaim | $119 | 88% |
| Administrative Concepts | $119 | 88% |
| Allegeant | $119 | 88% |
| Allied Benefit Systems | $119 | 88% |
| Ameriben | $119 | 88% |
| American Family | $119 | 88% |
| American Healthcare Alliance | $119 | 88% |
| American National | $119 | 88% |
| American Republic | $119 | 88% |
| Amerihealth | $119 | 88% |
| Aultcare | $119 | 88% |
| Automated Benefit Services | $119 | 88% |
| Auxiant | $119 | 88% |
| Benefit Administrative Systems,Llc | $119 | 88% |
| Boon Chapman | $119 | 88% |
| Cam Administrative Services | $119 | 88% |
| Christian Brother Services | $119 | 88% |
| Christian Brothers Holy Cross | $119 | 88% |
| Claimchoice Adminstrators | $119 | 88% |
| Comprehensive Benefits | $119 | 88% |
| Consociate | $119 | 88% |
| Continental Life Insurance | $119 | 88% |
| Coventry | $119 | 88% |
| Custom Benefit Administrators | $119 | 88% |
| Cypress Benefit Administrators | $119 | 88% |
| Employee Benefit Concepts | $119 | 88% |
| Employee Benefit Management | $119 | 88% |
| Enterprise Group Planning | $119 | 88% |
| First Health | $119 | 88% |
| Forest County Potawatomi | $119 | 88% |
| Freedom Life Insurance Company | $119 | 88% |
| Group Administrators | $119 | 88% |
| Group Marketing Services | $119 | 88% |
| Group Pension Administrators | $119 | 88% |
| Guardian | $119 | 88% |
| Health America | $119 | 88% |
| Health Choices | $119 | 88% |
| Health Smart | $119 | 88% |
| Healthcare Management Admin | $119 | 88% |
| Healthez | $119 | 88% |
| Healthgram | $119 | 88% |
| Healthscope | $119 | 88% |
| Insight | $119 | 88% |
| Intercare | $119 | 88% |
| Jfp Benefit Management | $119 | 88% |
| Jp Farley Corporation | $119 | 88% |
| Key Benefit Administrator | $119 | 88% |
| Liberty Union Life Assurance Co | $119 | 88% |
| Lucent Health | $119 | 88% |
| Luminare Health | $119 | 88% |
| Luminare Health (Detroit) | $119 | 88% |
| Magnacare | $119 | 88% |
| Medben | $119 | 88% |
| Medcost | $119 | 88% |
| Medical Mutual | $119 | 88% |
| Mutual Health Services | $119 | 88% |
| Mutual Of Omaha | $119 | 88% |
| Ncas | $119 | 88% |
| Nippon Life Ins | $119 | 88% |
| Nova | $119 | 88% |
| Painters Union Insurance Fund | $119 | 88% |
| Physicians Mutual | $119 | 88% |
| Plumbers Local 98 Insurance Fund | $119 | 88% |
| Prairie States | $119 | 88% |
| Preferred One | $119 | 88% |
| Primary Physician Care | $119 | 88% |
| Professional Benefit Administrators | $119 | 88% |
| Secureone Preferred United Plans | $119 | 88% |
| Siho Insurance Services | $119 | 88% |
| Sisco Benefits | $119 | 88% |
| The Health Plan | $119 | 88% |
| The Loomis Company | $119 | 88% |
| Trustmark Small Business Benefits | $119 | 88% |
| Unicare | $119 | 88% |
| Unified Group Services | $119 | 88% |
| Valenz | $119 | 88% |
| Webtpa | $119 | 88% |
| Western & Southern Financial Group | $119 | 88% |
| Wps | $119 | 88% |
| Blue Care Network | $121 | 89% |
| Blue Benefit Administrators Of Massachusetts | $124 | 91% |
| Blue Distinction Transplant | $124 | 91% |
| Blue Shield - Ca | $124 | 91% |
| Blue Shield - Id (Regence) | $124 | 91% |
| Blue Shield - Ny Highmark Northeastern | $124 | 91% |
| Blue Shield - Ny Highmark Western | $124 | 91% |
| Blue Shield - Pa (Highmark) | $124 | 91% |
| Blue Shield - Wa (Regence) | $124 | 91% |
| American Postal Workers Secondary | $128 | 94% |
| Medicare (plans) | $128 - $134 | 94% |
| Align Senior Care | $130 | 96% |
| Veterans Administration | $130 | 96% |
| Asr Health Benefits | $133 | 98% |
| Priority Health | $136 | 100% |
| Cca - Zing Health | $141 | 104% |
| Varipro | $142 | 105% |
| Access Health | $146 | 108% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $147 | 108% |
| Meritain | $164 | 121% |
| 1199 National Benefit Fund | $176 | 130% |
| Allied National Global Care | $176 | 130% |
| Asrm - Reliance Standard Life Insurance | $176 | 130% |
| Christian Care Ministry | $176 | 130% |
| Dean Health | $176 | 130% |
| Fallon Health | $176 | 130% |
| Family Life Insurance Company | $176 | 130% |
| International Benefit Administrators | $176 | 130% |
| Lifetime Benefit Solutions | $176 | 130% |
| Manhattan Life | $176 | 130% |
| Molina Marketplace | $176 | 130% |
| Multiplan | $176 | 130% |
| Mvp | $176 | 130% |
| Oscar | $176 | 130% |
| Pai | $176 | 130% |
| Pan-American Life | $176 | 130% |
| Phcs | $176 | 130% |
| Trinity Health Share | $176 | 130% |
| Wellpath | $176 | 130% |
| Wc Accident Fund | $180 | 133% |
| Wc Advantage | $180 | 133% |
| Wc Aig | $180 | 133% |
| Wc Allied | $180 | 133% |
| Wc Amerisure | $180 | 133% |
| Wc Amtrust | $180 | 133% |
| Wc Asu Risk Mgt | $180 | 133% |
| Wc Berkley Admin | $180 | 133% |
| Wc Broadspire | $180 | 133% |
| Wc Bunch & Associates | $180 | 133% |
| Wc Ccmsi | $180 | 133% |
| Wc Emc Insurance Company | $180 | 133% |
| Wc Esis | $180 | 133% |
| Wc Fcci | $180 | 133% |
| Wc Federated | $180 | 133% |
| Wc Gallagher Bassett | $180 | 133% |
| Wc Genex Care For Ohio | $180 | 133% |
| Wc Guard Insurance Company | $180 | 133% |
| Wc Hartford | $180 | 133% |
| Wc Liberty Mutual | $180 | 133% |
| Wc Meijers | $180 | 133% |
| Wc Michigan | $180 | 133% |
| Wc Mitchell Frankenmuth | $180 | 133% |
| Wc Pma | $180 | 133% |
| Wc Sedgwick | $180 | 133% |
| Wc Sentry | $180 | 133% |
| Wc Travelers | $180 | 133% |
| Wc Tristar | $180 | 133% |
| Wc Walmart | $180 | 133% |
| Wc Zurich | $180 | 133% |
| Partners Direct Health - Brio | $189 | 139% |
| Andrie Inc | $190 | 140% |
| East Greenbush Central School District | $190 | 140% |
| Genex Wc | $190 | 140% |
| Healthsmart Workers Comp | $190 | 140% |
| Jag Source | $190 | 140% |
| New York State Insurance Fund | $190 | 140% |
| Njm Insurance Group | $190 | 140% |
| Rx Heatlhcomp | $190 | 140% |
| Rx Restat | $190 | 140% |
| Rx Saif Opdp Wc | $190 | 140% |
| Rx Worker'S Comp | $190 | 140% |
| Wc Ace | $190 | 140% |
| Wc Acs Federal Employees | $190 | 140% |
| Wc Acuity | $190 | 140% |
| Wc Aegis | $190 | 140% |
| Wc Aims | $190 | 140% |
| Wc Alaska National Ins | $190 | 140% |
| Wc Align Network | $190 | 140% |
| Wc Am Trust N America | $190 | 140% |
| Wc American Claims Mgmt | $190 | 140% |
| Wc Benetech | $190 | 140% |
| Wc Broward County | $190 | 140% |
| Wc California State Comp Ins | $190 | 140% |
| Wc California State Ins Fund | $190 | 140% |
| Wc Capitol Area Health Consortium | $190 | 140% |
| Wc Chartis | $190 | 140% |
| Wc Chubb | $190 | 140% |
| Wc Cirma | $190 | 140% |
| Wc City Of Albany | $190 | 140% |
| Wc City Of Sioux City | $190 | 140% |
| Wc Claims Mgmt Inc | $190 | 140% |
| Wc Cna | $190 | 140% |
| Wc Comp One Admin C/O Manageability | $190 | 140% |
| Wc Compone Admin | $190 | 140% |
| Wc Corvel | $190 | 140% |
| Wc Ct Healthcare Trust | $190 | 140% |
| Wc Donegal Insurance Group | $190 | 140% |
| Wc Employee Mutual | $190 | 140% |
| Wc Enablecomp | $190 | 140% |
| Wc Encore Health Network | $190 | 140% |
| Wc Erie | $190 | 140% |
| Wc Evolutions | $190 | 140% |
| Wc Fed Ex | $190 | 140% |
| Wc Federal Black Lung | $190 | 140% |
| Wc Finley Occupational Health | $190 | 140% |
| Wc First Agency/Occunet | $190 | 140% |
| Wc Ford Motor | $190 | 140% |
| Wc Fresno Unified Emp | $190 | 140% |
| Wc General Motors | $190 | 140% |
| Wc Generic | $190 | 140% |
| Wc Great West Casualty | $190 | 140% |
| Wc Guarantee Insurance | $190 | 140% |
| Wc Hab | $190 | 140% |
| Wc Hastings | $190 | 140% |
| Wc Health Management | $190 | 140% |
| Wc Heritage Summit | $190 | 140% |
| Wc Hireright | $190 | 140% |
| Wc Horizon | $190 | 140% |
| Wc Icw Group | $190 | 140% |
| Wc Idaho State Ins Fund | $190 | 140% |
| Wc Intercare Insurance | $190 | 140% |
| Wc Intermountain | $190 | 140% |
| Wc Johns Eastern | $190 | 140% |
| Wc Kemberton | $190 | 140% |
| Wc Key Ins & Benefit Solutions | $190 | 140% |
| Wc Mac Risk Management | $190 | 140% |
| Wc Massachusetts | $190 | 140% |
| Wc Mdia | $190 | 140% |
| Wc Meadowbrook Claim | $190 | 140% |
| Wc Medical Administrators | $190 | 140% |
| Wc Memic | $190 | 140% |
| Wc Mercy Workcare | $190 | 140% |
| Wc Michigan Millers Mutual | $190 | 140% |
| Wc Mra | $190 | 140% |
| Wc Nationwide | $190 | 140% |
| Wc Nca Comp | $190 | 140% |
| Wc New York | $190 | 140% |
| Wc New York Special Funds | $190 | 140% |
| Wc North American Rishces | $190 | 140% |
| Wc Northeast Health | $190 | 140% |
| Wc Notre Dame | $190 | 140% |
| Wc Novanet | $190 | 140% |
| Wc O'Hara Corp | $190 | 140% |
| Wc Occ Health Allen | $190 | 140% |
| Wc Ohio Bureau | $190 | 140% |
| Wc One Call Medical | $190 | 140% |
| Wc Paradigm | $190 | 140% |
| Wc Peerless | $190 | 140% |
| Wc Praxis Health Network | $190 | 140% |
| Wc Price Chopper | $190 | 140% |
| Wc Procura Management | $190 | 140% |
| Wc Qualcare | $190 | 140% |
| Wc Quiktrip | $190 | 140% |
| Wc Reny Company | $190 | 140% |
| Wc Rev Claims | $190 | 140% |
| Wc Risico | $190 | 140% |
| Wc Rural Mutual | $190 | 140% |
| Wc Saif Oregon | $190 | 140% |
| Wc Secura | $190 | 140% |
| Wc Sheakley Unicomp | $190 | 140% |
| Wc Smile Lodge | $190 | 140% |
| Wc Society | $190 | 140% |
| Wc Srs | $190 | 140% |
| Wc Taconic (Mro) | $190 | 140% |
| Wc Taconic Farms | $190 | 140% |
| Wc Triad Group | $190 | 140% |
| Wc Troy Ny | $190 | 140% |
| Wc Tyson | $190 | 140% |
| Wc Unified Health Services | $190 | 140% |
| Wc United Heartland | $190 | 140% |
| Wc Us Dept Of Labor | $190 | 140% |
| Wc Velocity | $190 | 140% |
| Wc West Bend | $190 | 140% |
| Wc West Bend Mutual/Argent | $190 | 140% |
| Wc Winnebago Industries | $190 | 140% |
| Wc Yankee Trails | $190 | 140% |
| Wc York Risk | $190 | 140% |
| Wc Zenith | $190 | 140% |
| U Of M Health Plan | $195 | 144% |
| Claimdoc | $202 | 149% |
| Kent County Jail | $202 | 149% |
| Muskegon County Jail | $202 | 149% |
| Nomi Health | $202 | 149% |