Excision addl breast lesion 19126 at Henry Ford Macomb Hospital
15855 19 Mile Rd, Clinton Twp, MI · Henry Ford Health · · NPI 1023114634
$220.58
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$560.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$91.80 with United Healthcare vs $990.94 with BCN — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| United Healthcare | Medicaid-Behavioral Health-Adult-FAC | $91.80 | ↓ -58% |
| Meridian | Medicaid HMO-Child-FAC | $91.80 | ↓ -58% |
| Meridian | Medicaid HMO-Adult-FAC | $91.80 | ↓ -58% |
| McLaren | Medicaid HMO-Adult-FAC | $91.80 | ↓ -58% |
| McLaren | Medicaid HMO-Child-FAC | $91.80 | ↓ -58% |
| HAP | HAP Caresource Medicaid-FAC | $91.80 | ↓ -58% |
| United Healthcare | Medicaid-Behavioral Health-Child-FAC | $91.80 | ↓ -58% |
| Aetna Better Health | Medicaid HMO-Child-FAC | $93.64 | ↓ -58% |
| Aetna Better Health | Medicaid HMO-Adult-FAC | $93.64 | ↓ -58% |
| Molina | Medicaid HMO-Adult-FAC | $95.47 | ↓ -57% |
| Molina | Medicaid HMO-Child-FAC | $95.47 | ↓ -57% |
| Priority Health | Medicaid HMO-Adult-FAC | $96.39 | ↓ -56% |
| Priority Health | Medicaid HMO-Child-FAC | $96.39 | ↓ -56% |
| ScriptGuideRX | All Products | $119.34 | ↓ -46% |
| Humana Military | Tricare-NonPhysician-FAC | $133.81 | ↓ -39% |
| Priority Health | Commercial | $135.60 | ↓ -39% |
| HAP | Medicare Advantage HMO/PPO-NonPhysician-NONFAC | $135.86 | ↓ -38% |
| HAP | Medicare Advantage HMO/PPO-NonPhysician-FAC | $135.86 | ↓ -38% |
| Pace SE MI | Medicare Advantage-NONFAC | $151.85 | ↓ -31% |
| Pace SE MI | Medicare Advantage-FAC | $151.85 | ↓ -31% |
| BC3NP | Medicaid HMO | $152.43 | ↓ -31% |
| Amerihealth Caritas | Dual Products-FAC | $156.64 | ↓ -29% |
| Amerihealth Caritas | Dual Products-NONFAC | $156.64 | ↓ -29% |
| Humana Military | Tricare-Physician-FAC | $157.42 | ↓ -29% |
| Humana Military | Tricare | $157.42 | ↓ -29% |
| Priority Health | Medicare Advantage-NONFAC | $159.84 | ↓ -28% |
| Aetna | Medicare Advantage-FAC | $159.84 | ↓ -28% |
| Aetna | Medicare Advantage-NONFAC | $159.84 | ↓ -28% |
| Blue Cross | BCN Medicare Advantage -FAC | $159.84 | ↓ -28% |
| Blue Cross | BCN Medicare Advantage -NONFAC | $159.84 | ↓ -28% |
| Blue Cross | Medicare Plus Blue-FAC | $159.84 | ↓ -28% |
| Blue Cross | Medicare Plus Blue-NONFAC | $159.84 | ↓ -28% |
| HAP | HAP Dual Products-FAC | $159.84 | ↓ -28% |
| HAP | HAP Dual Products-NONFAC | $159.84 | ↓ -28% |
| HAP | Medicare Advantage-FAC | $159.84 | ↓ -28% |
| HAP | Medicare Advantage-NONFAC | $159.84 | ↓ -28% |
| HAP | Medicare Advantage-Physician-FAC | $159.84 | ↓ -28% |
| HAP | Medicare Advantage-Physician-NONFAC | $159.84 | ↓ -28% |
| Humana | Medicare Advantage-FAC | $159.84 | ↓ -28% |
| McLaren | Medicare Advantage-FAC | $159.84 | ↓ -28% |
| McLaren | Medicare Advantage-NONFAC | $159.84 | ↓ -28% |
| Meridian | Ambetter From Meridian-FAC | $159.84 | ↓ -28% |
| Meridian | Ambetter From Meridian-NONFAC | $159.84 | ↓ -28% |
| Molina | Dual Product-FAC | $159.84 | ↓ -28% |
| Molina | Dual Product-NONFAC | $159.84 | ↓ -28% |
| Molina | Medicare Advantage-FAC | $159.84 | ↓ -28% |
| Molina | Medicare Advantage-NONFAC | $159.84 | ↓ -28% |
| Priority Health | Medicare Advantage-FAC | $159.84 | ↓ -28% |
| Trinity Health Plan | Medicare Advantage-FAC | $159.84 | ↓ -28% |
| Trinity Health Plan | Medicare Advantage-NONFAC | $159.84 | ↓ -28% |
| United Healthcare | Medicare Advantage-FAC | $159.84 | ↓ -28% |
| United Healthcare | Medicare Advantage-NONFAC | $159.84 | ↓ -28% |
| United Healthcare | Medicare-Behavioral Health-FAC | $159.84 | ↓ -28% |
| WellCare | Medicare Advantage-FAC | $159.84 | ↓ -28% |
| WellCare | Medicare Advantage-NONFAC | $159.84 | ↓ -28% |
| WellCare | Wellcare Meridian Dual Align (HMO D-SNP)-FAC | $159.84 | ↓ -28% |
| WellCare | Wellcare Meridian Dual Align (HMO D-SNP)-NONFAC | $159.84 | ↓ -28% |
| Humana | Medicare Advantage-NONFAC | $163.04 | ↓ -26% |
| United Healthcare | Medicare-Behavioral Health-NONFAC | $171.11 | ↓ -22% |
| Humana | Medicare Advantage-Physician-FAC | $172.82 | ↓ -22% |
| Priority Health | All Products | $217.87 | ↓ -1% |
| Nomi | All Products | $223.78 | ↑ +1% |
| HAP | HAP HMO_AHL_Fully-Insured | $226.57 | ↑ +3% |
| Blue Cross | GM Connected Care | $229.12 | ↑ +4% |
| Aetna | All Products-NONFAC | $239.25 | ↑ +8% |
| Priority Health | Priority Cigna | $239.66 | ↑ +9% |
| Blue Cross | BCBSM Commercial | $254.05 | ↑ +15% |
| Blue Cross | BCN Commercial-NONFAC | $254.58 | ↑ +15% |
| Blue Cross | BCN Commercial-FAC | $254.58 | ↑ +15% |
| HAP | HAP HMO_AHL_Fully Insured | $261.34 | ↑ +18% |
| HAP | Self-Funded | $264.58 | ↑ +20% |
| United Healthcare | All Products-Prof | $274.24 | ↑ +24% |
| United Healthcare | All Products-Midlevel | $355.47 | ↑ +61% |
| Blue Cross | BCBSM GM Connected Care | $967.16 | ↑ +338% |
| Blue Cross | BCN Commercial | $990.94 | ↑ +349% |
| BCN | HMO | $990.94 | ↑ +349% |
| United Healthcare | Commercial-Behavioral Health-RN | not published by hospital | — |
| United Healthcare | Commercial-Behavioral Health-PhD | not published by hospital | — |
| United Healthcare | Commercial-Behavioral Health-MD | not published by hospital | — |
| United Healthcare | Commercial-Behavioral Health-MA | not published by hospital | — |
Visitor-reported prices
Comments
Excision addl breast lesion 19126 at other Michigan hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Henry Ford Hospital | Detroit MI 48202 | 19401 Hubbard Dr. | $220.58 | $91.80 – $1,335.24 |
| Henry Ford West Bloomfield Hospital | West Bloomfield | $220.58 | $91.80 – $988.36 |
| Henry Ford Wyandotte Hospital: | Wyandotte | $220.58 | $91.80 – $996.00 |
| Corewell Health Lakeland St. Joseph | St Joseph | not published | $118.18 – $118.18 |
| Corewell Health Gross Pointe | Grosse Pointe | not published | $239.89 – $2,724.47 |
| Corewell Health Taylor | Taylor | not published | $325.23 – $2,724.47 |
| Corewell Health Trenton | Trenton | not published | $323.42 – $2,724.47 |
| Corewell Health Troy | Troy | not published | $238.74 – $2,724.47 |