CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: McLaren Macomb

Billing Code: 392 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$7,977

about 1.4× the $5,676 Medicare rate · typically $5,168–$12,788

modeled estimate · not a bill or quote

What this hospital charges insurers

$8,288

About the fair price

about $311 over the fair price · 1.5× Medicare

Medicare pays $5,676 Fair price $7,977 This hospital $8,288 Cash price $12,096 Hospital's list price $24,191

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 $5,277 Priciest $8,288

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

A fair price for a Digestive disorders treatment (inpatient stay) is about $7,977 (about 1.4× the $5,676 Medicare rate). McLaren Macomb charges insurers about $8,288, or about $12,096 in cash — about the fair price. Located in Mount Clemens, 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	$10,715	189%
Blue Cross Blue Shieldmajor	$9,448 - $15,060	166%
Aetnamajor	$3,509 - $9,766	62%
Humanamajor	$5,395 - $5,408	95%
Priority Health	$5,024 - $7,227	89%
+ 1 smaller / regional plan	$8,080 - $8,497

Government programs also on file: Medicare, Military & VA.

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 (about 12,096), 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: 392.

Insurance Before you use insurance

Call your insurance company to confirm McLaren Macomb is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 392.
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 McLaren Macomb

Compare: Digestive disorders treatment (inpatient stay) at other MI hospitals

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