healthcosts.net
Incision of pyloric muscle 43520 at Henry Ford Macomb Hospital
15855 19 Mile Rd, Clinton Twp, MI · Henry Ford Health · · NPI 1023114634
$1,022.41
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.
$2,340.00
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.
$434.31 with McLaren vs $4,211.64 with Blue Cross — 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 |
|---|---|---|---|
| McLaren | Medicaid HMO-Adult-FAC | $434.31 | ↓ -58% |
| United Healthcare | Medicaid-Behavioral Health-Adult-FAC | $434.31 | ↓ -58% |
| Meridian | Medicaid HMO-Child-FAC | $434.31 | ↓ -58% |
| Meridian | Medicaid HMO-Adult-FAC | $434.31 | ↓ -58% |
| McLaren | Medicaid HMO-Child-FAC | $434.31 | ↓ -58% |
| United Healthcare | Medicaid-Behavioral Health-Child-FAC | $434.31 | ↓ -58% |
| HAP | HAP Caresource Medicaid-FAC | $434.31 | ↓ -58% |
| Aetna Better Health | Medicaid HMO-Adult-FAC | $443.00 | ↓ -57% |
| Aetna Better Health | Medicaid HMO-Child-FAC | $443.00 | ↓ -57% |
| Molina | Medicaid HMO-Adult-FAC | $451.68 | ↓ -56% |
| Molina | Medicaid HMO-Child-FAC | $451.68 | ↓ -56% |
| Priority Health | Medicaid HMO-Child-FAC | $456.03 | ↓ -55% |
| Priority Health | Medicaid HMO-Adult-FAC | $456.03 | ↓ -55% |
| ScriptGuideRX | All Products | $564.60 | ↓ -45% |
| Humana Military | Tricare-NonPhysician-FAC | $597.83 | ↓ -42% |
| HAP | Medicare Advantage HMO/PPO-NonPhysician-FAC | $629.75 | ↓ -38% |
| HAP | Medicare Advantage HMO/PPO-NonPhysician-NONFAC | $629.75 | ↓ -38% |
| Humana Military | Tricare | $703.33 | ↓ -31% |
| Humana Military | Tricare-Physician-FAC | $703.33 | ↓ -31% |
| Pace SE MI | Medicare Advantage-FAC | $703.84 | ↓ -31% |
| Pace SE MI | Medicare Advantage-NONFAC | $703.84 | ↓ -31% |
| Amerihealth Caritas | Dual Products-NONFAC | $726.06 | ↓ -29% |
| Amerihealth Caritas | Dual Products-FAC | $726.06 | ↓ -29% |
| Molina | Medicare Advantage-FAC | $740.88 | ↓ -28% |
| Aetna | Medicare Advantage-FAC | $740.88 | ↓ -28% |
| Aetna | Medicare Advantage-NONFAC | $740.88 | ↓ -28% |
| Blue Cross | BCN Medicare Advantage -FAC | $740.88 | ↓ -28% |
| Blue Cross | BCN Medicare Advantage -NONFAC | $740.88 | ↓ -28% |
| Blue Cross | Medicare Plus Blue-FAC | $740.88 | ↓ -28% |
| Blue Cross | Medicare Plus Blue-NONFAC | $740.88 | ↓ -28% |
| HAP | HAP Dual Products-FAC | $740.88 | ↓ -28% |
| HAP | HAP Dual Products-NONFAC | $740.88 | ↓ -28% |
| HAP | Medicare Advantage-FAC | $740.88 | ↓ -28% |
| HAP | Medicare Advantage-NONFAC | $740.88 | ↓ -28% |
| HAP | Medicare Advantage-Physician-FAC | $740.88 | ↓ -28% |
| HAP | Medicare Advantage-Physician-NONFAC | $740.88 | ↓ -28% |
| Humana | Medicare Advantage-FAC | $740.88 | ↓ -28% |
| McLaren | Medicare Advantage-FAC | $740.88 | ↓ -28% |
| McLaren | Medicare Advantage-NONFAC | $740.88 | ↓ -28% |
| Meridian | Ambetter From Meridian-FAC | $740.88 | ↓ -28% |
| Meridian | Ambetter From Meridian-NONFAC | $740.88 | ↓ -28% |
| Molina | Dual Product-FAC | $740.88 | ↓ -28% |
| Molina | Dual Product-NONFAC | $740.88 | ↓ -28% |
| Molina | Medicare Advantage-NONFAC | $740.88 | ↓ -28% |
| Priority Health | Medicare Advantage-FAC | $740.88 | ↓ -28% |
| Priority Health | Medicare Advantage-NONFAC | $740.88 | ↓ -28% |
| Trinity Health Plan | Medicare Advantage-FAC | $740.88 | ↓ -28% |
| Trinity Health Plan | Medicare Advantage-NONFAC | $740.88 | ↓ -28% |
| United Healthcare | Medicare Advantage-FAC | $740.88 | ↓ -28% |
| United Healthcare | Medicare Advantage-NONFAC | $740.88 | ↓ -28% |
| United Healthcare | Medicare-Behavioral Health-FAC | $740.88 | ↓ -28% |
| WellCare | Medicare Advantage-FAC | $740.88 | ↓ -28% |
| WellCare | Medicare Advantage-NONFAC | $740.88 | ↓ -28% |
| WellCare | Wellcare Meridian Dual Align (HMO D-SNP)-FAC | $740.88 | ↓ -28% |
| WellCare | Wellcare Meridian Dual Align (HMO D-SNP)-NONFAC | $740.88 | ↓ -28% |
| Humana | Medicare Advantage-NONFAC | $755.70 | ↓ -26% |
| United Healthcare | Medicare-Behavioral Health-NONFAC | $764.50 | ↓ -25% |
| Humana | Medicare Advantage-Physician-FAC | $772.15 | ↓ -24% |
| Priority Health | Commercial | $781.95 | ↓ -24% |
| HAP | HAP HMO_AHL_Fully-Insured | $971.60 | ↓ -5% |
| Blue Cross | GM Connected Care | $1,036.81 | ↑ +1% |
| Nomi | All Products | $1,037.23 | ↑ +1% |
| Blue Cross | BCBSM Commercial | $1,107.81 | ↑ +8% |
| Aetna | All Products-NONFAC | $1,112.55 | ↑ +9% |
| HAP | HAP HMO_AHL_Fully Insured | $1,120.70 | ↑ +10% |
| HAP | Self-Funded | $1,134.60 | ↑ +11% |
| Blue Cross | BCN Commercial-FAC | $1,152.01 | ↑ +13% |
| Blue Cross | BCN Commercial-NONFAC | $1,152.01 | ↑ +13% |
| United Healthcare | All Products-Midlevel | $1,293.60 | ↑ +27% |
| Priority Health | All Products | $1,312.41 | ↑ +28% |
| Priority Health | Priority Cigna | $1,443.65 | ↑ +41% |
| United Healthcare | All Products-Prof | $1,548.57 | ↑ +51% |
| Blue Cross | BCBSM GM Connected Care | $4,110.59 | ↑ +302% |
| BCN | HMO | $4,211.64 | ↑ +312% |
| Blue Cross | BCN Commercial | $4,211.64 | ↑ +312% |
| United Healthcare | Commercial-Behavioral Health-PhD | not published by hospital | — |
| United Healthcare | Commercial-Behavioral Health-RN | 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
Incision of pyloric muscle 43520 at other Michigan hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Henry Ford Hospital | Detroit MI 48202 | 19401 Hubbard Dr. | $1,022.41 | $434.31 – $5,674.97 |
| Henry Ford West Bloomfield Hospital | West Bloomfield | $1,022.41 | $434.31 – $4,200.66 |
| Henry Ford Wyandotte Hospital: | Wyandotte | $1,022.41 | $434.31 – $4,233.15 |
| Corewell Health Big Rapids | Big Rapids | not published | $7,441.54 – $7,441.54 |
| Corewell Health Gerber | Fremont | not published | $7,441.54 – $7,441.54 |
| Corewell Health Lakeland St. Joseph | St Joseph | not published | $11,371.71 – $11,371.71 |
| Corewell Health Greenville | Greenville | not published | $7,441.54 – $7,441.54 |
| Corewell Health Zeeland | Zeeland | not published | $7,441.54 – $7,441.54 |