McLaren Port Huron
1221 Pine Grove Ave, Port Huron, MI 48061 · 118 Priced Procedures · 63% Patient Recommendation
Typical commercial prices here are 12% below the fair benchmark (0.88×) after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 0.88× fair market pricing.
Loss-Leader / Captive Ancillary Cross-Subsidizer
McLaren Port Huron prices routine shoppable procedures near 0.7× Medicare (p50 0.90×) while skewing captive emergency, lab, and upper-quartile codes to 1.1× Medicare (p75 1.11×, +23% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.
Where They're Good (Patient & Payer Edge)
- Elective shoppable care is priced 12% below peer Fair BaseRate (0.88×)
- Self-pay cash beats commercial insurance on 31% of shoppable procedures (99/100 Cash Honesty)
- 2-Star CMS clinical rating with 63% patient recommendation (62/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (22.1% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (0.88× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
- Captive ER (0.7×) & laboratory (1.2×) services average 1.57× higher multiples than routine shoppable care (0.7×)
- Upper-quartile procedures (Q75 1.11×) jump +23% above the median procedure ratio (Q50 0.90×)
- Unnegotiated chargemaster list prices average 5.7× Medicare (18¢ true HCRIS cost per $1 gross)
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at McLaren Port Huron
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 118 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $35,710 | 1.2× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $24,534 | 1.4× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $22,944 | 1.2× |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $21,155 | 1.1× |
| Total hip replacement CPT Code: 27130 | $13,385 | 1.0× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $8,428 | 1.0× |
| Total knee replacement CPT Code: 27447 | $5,628 | 0.4× |
| C-section delivery (full package) CPT Code: 59510 | $2,842 | 1.0× |
| Vaginal delivery (full package) CPT Code: 59400 | $2,648 | 1.0× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $1,994 | 2.0× |
| Blood transfusion CPT Code: 36430 | $1,691 | 3.4× |
| Trauma team activation HCPCS Code: G0390 | $1,290 | 0.9× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $1,181 | 2.0× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $1,001 | 0.2× |
| Cataract surgery with lens implant CPT Code: 66984 | $800 | 0.3× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $820 | 0.2× |
| Inguinal hernia repair CPT Code: 49505 | $792 | 0.2× |
| Bunion correction surgery CPT Code: 28296 | $596 | 0.2× |
| Breast lump removal CPT Code: 19120 | $478 | 0.1× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $292 | 0.3× |
| Colonoscopy with biopsy CPT Code: 45380 | $317 | 0.3× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $267 | 1.0× |
| Upper endoscopy with biopsy CPT Code: 43239 | $218 | 0.2× |
| Speech therapy (language evaluation) CPT Code: 92507 | $165 | 1.9× |
| X-ray, lower back CPT Code: 72110 | $172 | 1.5× |
Audit a Bill or Quote at McLaren Port Huron (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $19,739
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (22.1% of gross = $19,739).
Self-Pay Cash Rate ($44,678) Beats Your Bill
McLaren Port Huron's published 45 CFR § 180 self-pay cash rate is $44,678 (vs. $35,710 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($89,356) is $58,581 above the denoised Fair BaseRate ($30,775) and 3.8× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (22.1% of gross charges)
Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)Source: CMS Hospital Care Compare (532 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for McLaren Port Huron.
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.