CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Henry Ford Macomb Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $22,190
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.94x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Henry Ford Macomb Hospital is $22,190. 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 $23,503.93, this hospital’s rate is 0.94x 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
$22,190

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$23,503.93

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $23,503.93 (100%)
Insurance Median: $22,190 (94%)
Ins. Median: $22,190 (94% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $23,503.93 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
Pace Of Se Mi $21,081 90%
Amerihealth Michigan $21,747 93%
Bcn $22,190 94%
Cca Health Michigan $22,190 94%
Hap $22,190 94%
Hap Caresource $22,190 94%
Mclaren Health $22,190 94%
Molina Mi Health Link $22,190 94%
Mount Carmel Health Plan $22,190 94%
Priority Health $22,190 - $43,522 94%
UnitedHealthcare $22,190 - $36,344 94%
Wellcare $22,190 94%
Humana $22,634 - $27,770 96%
Aetna $23,078 - $38,955 98%
Meridian Health Plan Of Mi $29,957 127%
Molina $29,957 127%
Vitalcore Physicians Group Of Mi $41,052 175%
Blue Cross Blue Shield $47,719 - $54,392 203%

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