Physical therapy evaluation, low complexity at Mercy Health Lakeshore Campus

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HC Pt Evaluation Low Complexity Patient/Family

Shelby, MI

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How this price compares nationally

Mercy Health Lakeshore Campus’s median price of $268 is 79% above the median hospital's median price ($150), higher than 85% of the 2,543 hospitals reporting CPT 97161. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 97161 at Mercy Health Lakeshore Campus

Negotiated rates from the hospital’s own file: 21 payers, 27 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Blue Cross Blue Shield blue cross complete medicaid facility · fee schedule · both	$69.25	$69.25	$69.25 – $69.25
2	Molina molina medicaid facility · fee schedule · both	$70.60	$70.60	$70.60 – $70.60
3	Blue Cross Blue Shield bcbs medicare advantage facility · percent of total billed charges · bothfrom % of charges	$76.93	$76.93	$76.93 – $76.93
4	Molina molina medicare advantage facility · percent of total billed charges · bothfrom % of charges	$76.93	$76.93	$76.93 – $76.93
5	Aetna aetna medicare advantage facility · percent of total billed charges · bothfrom % of charges	$78.50	$78.50	$78.50 – $78.50
6	Oscar oscar epo facility · percent of total billed charges · bothfrom % of charges	$96.46	$96.46	$96.46 – $96.46
7	UnitedHealthcare united healthcare medicare advantage facility · percent of total billed charges · bothfrom % of charges	$109.96	$109.96	$109.96 – $109.96
8	Molina molina hmo marketplace facility · percent of total billed charges · bothfrom % of charges	$130.62	$130.62	$130.62 – $130.62
9	Aetna aetna ppo and preferred facility · percent of total billed charges · bothfrom % of charges	$249.94	$249.94	$249.94 – $249.94
10	Anthem bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges	$268.38	$268.38	$268.38 – $268.38
11	Blue Cross Blue Shield bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges	$268.38	$268.38	$268.38 – $268.38
12	Carefirst bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges	$268.38	$268.38	$268.38 – $268.38
13	Excellus bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges	$268.38	$268.38	$268.38 – $268.38
14	Highmark bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges	$268.38	$268.38	$268.38 – $268.38
15	Kaiser bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges	$268.38	$268.38	$268.38 – $268.38
16	Premera bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges	$268.38	$268.38	$268.38 – $268.38
17	Regence bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges	$268.38	$268.38	$268.38 – $268.38
18	Wellmark bcbs trad / trust facility · percent of total billed charges · bothfrom % of charges	$268.38	$268.38	$268.38 – $268.38
19	MultiPlan multiplan facility · percent of total billed charges · bothfrom % of charges	$270.04	$270.04	$270.04 – $270.04
20	Phcs multiplan facility · percent of total billed charges · bothfrom % of charges	$270.04	$270.04	$270.04 – $270.04
21	Cigna priority health cigna ppo facility · percent of total billed charges · bothfrom % of charges	$272.52	$272.52	$272.52 – $272.52
22	Caresource hap hmo facility · percent of total billed charges · bothfrom % of charges	$280.15	$280.15	$280.15 – $280.15
23	Humana cofinity ppo facility · percent of total billed charges · bothfrom % of charges	$281.03	$281.03	$281.03 – $281.03
24	Medcost cofinity ppo facility · percent of total billed charges · bothfrom % of charges	$281.03	$281.03	$281.03 – $281.03
25	Medical Mutual cofinity ppo facility · percent of total billed charges · bothfrom % of charges	$281.03	$281.03	$281.03 – $281.03

Page 1 of 2 · 27 rates

Last updated: Mar 31, 2026

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