CMS Price Transparency Data

Inguinal hernia repair

Facility: Henry Ford Macomb Hospital

Billing Code: 49505 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 49505
  • Insurance Median: $560
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.15x Medicare
The contracted insurance negotiated median rate for a Inguinal hernia repair at Henry Ford Macomb Hospital is $560. 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 $3,657.95, this hospital’s rate is 0.15x 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
$560

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$3,657.95

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $3,657.95 (100%)
Insurance Median: $560 (15%)
Ins. Median: $560 (15% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $3,657.95 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
Aetna $300 - $3,803 8%
Blue Cross Blue Shield $300 - $6,014 8%
Hap $300 - $3,458 8%
Mclaren $300 8%
Meridian Health Plan Of Mi $300 - $4,668 8%
Priority Health $300 - $4,843 8%
Amerihealth Michigan $340 - $3,389 9%
Hap Caresource $340 - $3,458 9%
Mclaren Health Plan Inc. $340 - $560 9%
Meridian $340 - $560 9%
Molina $353 - $4,668 10%
Priority $356 - $560 10%
Humana $448 - $3,527 12%
Pace Se Mi $532 15%
Bcn $560 - $3,458 15%
Cca Health Mi $560 15%
Health Alliance Plan Of Michigan $560 15%
Mount Carmel Health Plan $560 - $3,458 15%
United Behavioral Health, Inc. $560 15%
UnitedHealthcare $560 - $3,458 15%
Wellcare Ma $560 15%
Vitalcore Physicians Group Of Mi $728 - $7,953 20%
Cigna $771 21%
Pace Of Se Mi $3,285 90%
Cca Health Michigan $3,458 95%
Mclaren Health $3,458 95%
Molina Mi Health Link $3,458 95%
Wellcare $3,492 95%

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