Ot evaluation high complexity patient/family at Henry Ford Macomb Hospital
15855 19 Mile Rd, Clinton Twp, MI · Henry Ford Health · · NPI 1023114634
$136.70
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.
$377.00
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.
$51.81 with Meridian vs $293.87 with Priority Health — 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 |
|---|---|---|---|
| Meridian | Medicaid HMO | $51.81 | ↓ -62% |
| Priority Health | Medicaid HMO | $51.81 | ↓ -62% |
| McLaren | Medicaid HMO | $51.81 | ↓ -62% |
| HAP | HAP Caresource Medicaid | $51.81 | ↓ -62% |
| Aetna Better Health | Medicaid HMO | $52.85 | ↓ -61% |
| Molina | Medicaid HMO | $55.95 | ↓ -59% |
| ScriptGuideRX | All Products | $67.35 | ↓ -51% |
| Humana Military | Tricare | $92.91 | ↓ -32% |
| WellCare | Medicare Advantage | $99.06 | ↓ -28% |
| Blue Cross | Medicare Plus Blue | $99.06 | ↓ -28% |
| Pace SE MI | Medicare Advantage | $122.82 | ↓ -10% |
| HAP | HAP HMO_AHL_Fully Insured | $126.96 | ↓ -7% |
| HAP | HAP Dual Products | $128.99 | ↓ -6% |
| HAP | Medicare Advantage | $129.28 | ↓ -5% |
| Molina | Dual MI Coordinated Health | $129.28 | ↓ -5% |
| Blue Cross | BCN Advantage | $129.28 | ↓ -5% |
| Aetna | Medicare Advantage | $129.28 | ↓ -5% |
| United Healthcare | VACCN | $129.28 | ↓ -5% |
| Trinity Health Plan | Medicare Advantage | $129.28 | ↓ -5% |
| Priority Health | Medicare Advantage | $129.28 | ↓ -5% |
| McLaren | Medicare Advantage | $129.28 | ↓ -5% |
| Priority Health | Dual Premier_HIDE-SNP | $129.28 | ↓ -5% |
| Humana | Medicare Advantage | $130.57 | ↓ -4% |
| HAP | Self-Funded | $134.39 | ↓ -2% |
| Blue Cross | BCBSM GM Connected Care | $140.52 | ↑ +3% |
| Aetna | Dual Products | $142.21 | ↑ +4% |
| Amerihealth Caritas | Dual Products | $150.80 | ↑ +10% |
| BCN | HMO | $151.03 | ↑ +10% |
| Blue Cross | BCBSM Commercial | $151.03 | ↑ +10% |
| Blue Cross | BCN Commercial | $151.03 | ↑ +10% |
| HAP | Henry Ford Select -HPN commercial | $155.14 | ↑ +13% |
| Nomi | All Products | $163.00 | ↑ +19% |
| Priority Health | Commercial | $167.28 | ↑ +22% |
| United Healthcare | UHC Commercial | $186.99 | ↑ +37% |
| Vitalcore | All Products | $188.50 | ↑ +38% |
| Aetna | Commercial | $241.09 | ↑ +76% |
| Multiplan | All Products | $248.82 | ↑ +82% |
| Cofinity | Commercial | $266.54 | ↑ +95% |
| United Healthcare | Baseline Benefit Plan | $274.83 | ↑ +101% |
| Priority Health | Priority Cigna | $293.87 | ↑ +115% |
| Detroit Wayne Integrated Health | Medicaid HMO | not published by hospital | — |
| Carelon Behavioral Health | Behavioral Health | not published by hospital | — |
| Meridian | Ambetter From Meridian | not published by hospital | — |
| WellCare | Wellcare Meridian Dual Align (HMO D-SNP) | not published by hospital | — |
Visitor-reported prices
Comments
Ot evaluation high complexity patient/family at other Michigan hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Corewell Health Big Rapids | Big Rapids | $255.00 | $99.06 – $178.31 |
| Corewell Health Gerber | Fremont | $255.00 | $120.64 – $120.64 |
| Corewell Health Lakeland Watervliet | Watervliet | $380.00 | $99.06 – $148.59 |
| Corewell Health Lakeland St. Joseph | St Joseph | $380.00 | $99.06 – $260.12 |
| Corewell Health Butterworth Hospital | Grand Rapids | $255.00 | $58.45 – $178.31 |
| Corewell Health Blodgett Hospital | East Grand Rapids | $255.00 | $58.45 – $178.31 |
| Corewell Health Reed City | Po Box 75 | $255.00 | $120.64 – $120.64 |
| Corewell Health Greenville | Greenville | $255.00 | $99.06 – $178.31 |