CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Henry Ford Macomb Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $83
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.71x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Henry Ford Macomb Hospital is $83. 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 $117.57, this hospital’s rate is 0.71x 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
$83

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)
Insurance Median: $83 (71%)
Ins. Median: $83 (71% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $117.57 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
Molina $32 - $123 27%
Molina Mi Health Link $32 27%
Cofinity Group Health $39 - $78 33%
Aetna $44 - $112 37%
Blue Cross Blue Shield $44 - $117 37%
Hap $44 - $169 37%
Mclaren $44 37%
Meridian Health Plan Of Mi $44 37%
Priority Health $44 - $105 37%
Amerihealth Michigan $52 - $110 44%
Hap Caresource $52 - $72 44%
Mclaren Health Plan Inc. $52 - $112 44%
Meridian $52 - $112 44%
Vitalcore Physicians Group Of Mi $52 - $146 44%
UnitedHealthcare $53 - $112 45%
Mclaren Health $55 47%
Priority $55 - $112 47%
Humana $63 - $114 54%
Multiplan, Inc. $69 59%
Pace Se Mi $79 - $107 67%
Bcn $83 - $112 71%
Cca Health Mi $83 - $112 71%
Health Alliance Plan Of Michigan $83 - $112 71%
Mount Carmel Health Plan $83 - $112 71%
United Behavioral Health, Inc. $83 - $112 71%
Wellcare Ma $83 71%
Cigna $84 - $152 71%
University Of Michigan $84 71%
Wellcare $84 71%
Bc3Np $107 - $115 91%

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