CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Henry Ford Macomb Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $5,805
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.02x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Henry Ford Macomb Hospital is $5,805. 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 $5,675.87, this hospital’s rate is 1.02x the Medicare baseline. Located in 15855 Nineteen Mile Rd, Clinton Township, MI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,805

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$5,675.87

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $5,675.87 (100%)
Insurance Median: $5,805 (102%)
Ins. Median: $5,805 (102% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $5,675.87 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
Humana $5,277 - $5,921 93%
Pace Of Se Mi $5,515 97%
Amerihealth Michigan $5,689 100%
Aetna $5,805 - $9,850 102%
Bcn $5,805 102%
Blue Cross Blue Shield $5,805 - $12,777 102%
Cca Health Michigan $5,805 102%
Hap $5,805 - $11,517 102%
Hap Caresource $5,805 102%
Mclaren Health $5,805 102%
Molina Mi Health Link $5,805 102%
Mount Carmel Health Plan $5,805 102%
Priority Health $5,805 - $11,005 102%
UnitedHealthcare $5,805 - $9,190 102%
Wellcare $5,805 102%
Meridian Health Plan Of Mi $7,837 138%
Molina $7,837 138%
Cofinity Group Health $8,100 143%
Vitalcore Physicians Group Of Mi $10,739 189%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15855 Nineteen Mile Rd, Clinton Township, MI 48038
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals