CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Henry Ford Macomb Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $14,203
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Henry Ford Macomb Hospital is $14,203. 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 $14,116.91, this hospital’s rate is 1.01x 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
$14,203

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$14,116.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $14,116.91 (100%)
Insurance Median: $14,203 (101%)
Ins. Median: $14,203 (101% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $14,116.91 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 $13,399 - $14,487 95%
Pace Of Se Mi $13,493 96%
Amerihealth Michigan $13,919 99%
Aetna $14,203 - $24,768 101%
Bcn $14,203 101%
Blue Cross Blue Shield $14,203 - $32,191 101%
Cca Health Michigan $14,203 101%
Hap $14,203 - $28,961 101%
Hap Caresource $14,203 101%
Mclaren Health $14,203 101%
Molina Mi Health Link $14,203 101%
Mount Carmel Health Plan $14,203 101%
Priority Health $14,203 - $27,676 101%
UnitedHealthcare $14,203 - $23,108 101%
Wellcare $14,203 101%
Meridian Health Plan Of Mi $19,175 136%
Molina $19,175 136%
Cofinity Group Health $20,369 144%
Vitalcore Physicians Group Of Mi $26,276 186%

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