CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Henry Ford Macomb Hospital

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$18,466

about 1.3× the $14,044 Medicare rate · typically $11,848–$25,146

modeled estimate · not a bill or quote

What this hospital charges insurers

$13,932

Below the fair price — a good deal

about $4,534 under the fair price · 1.0× Medicare

Medicare pays $14,044 Fair price $18,466 This hospital $13,932

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 $7,442 Priciest $13,932

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

A fair price for a Hip or knee replacement (inpatient stay) is about $18,466 (about 1.3× the $14,044 Medicare rate). Henry Ford Macomb Hospital charges insurers about $13,932 — below the fair price — a good deal. Located in Clinton Township, MI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser 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	$13,659 - $22,206	97%
Blue Cross Blue Shieldmajor	$13,659 - $37,249	97%
Aetnamajor	$13,659 - $23,801	97%
Humanamajor	$13,932 - $17,751	99%
AmeriHealth	$13,386	95%
CareSource	$13,659	97%
Meridian	$18,440	131%
Molina	$13,659 - $18,440	97%
Priority Health	$13,659 - $26,593	97%
WellCare	$13,659	97%
+ 6 smaller / regional plans	$12,976 - $27,830

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 470.

Insurance Before you use insurance

Call your insurance company to confirm Henry Ford Macomb Hospital is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 470.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Henry Ford Macomb Hospital

Compare: Hip or knee replacement (inpatient stay) at other MI hospitals

Insurance negotiated median for the same procedure, sorted lowest first.