Summary: Spectrum Health, a Grand Rapids, Mich., nonprofit health care group, has been publishing price information for some time. Its web site offers a search that reveals charged price, average Medicare payment, average Medicaid payment and average private insurance company payment for a range of common procedures. It’s a lot of work, although it’s not directly actionable. Read on for details, or …

 

 


What Spectrum Health reveals is not cash or self-pay pricing information, and so it’s not that useful for shopping purposes. Yet there’s value here, and the site does list both inpatient and outpatient prices.

“These prices are for Spectrum Health services performed at hospitals and facilities within the Grand Rapids area, and DO NOT INCLUDE physicians’ fees,” the site says.  “If you would like an estimated average price for a specific location please call (616) 774-7595 or toll free at (866) 542-7909.
“The chart below includes the following information:

  • The average price for the procedure.
  • The average Medicare payment Spectrum Health receives for this procedure
  • The average Medicaid payment Spectrum Health receives for this procedure
  • The average payment Spectrum Health receives from health insurance companies

“If you have Medicare, your coinsurance will vary depending on the procedure. Please contact Medicare to determine this amount. If you have another insurer, please check your health plan policy or contact your insurer to determine your deductible.

  • Butterworth/Blodgett Charge $1,137.75
  • Average Medicare Payment $368.81
  • Average Medicaid Payment $208.01
  • Average Insurance Payment $836.41
  • Outpatient Charge $1,023.97
  • Average Medicare Payment $368.81
  • Average Medicaid Payment $208.01
  • Average Insurance Payment $752.77

Spectrum has 11 hospitals in western Michigan, 170 ambulatory and service sites; 1,080 employed physicians and advanced practice providers, and Priority Health, a 575,000-member health plan.

Jeanne Pinder

Jeanne Pinder  is the founder and CEO of ClearHealthCosts. She worked at The New York Times for almost 25 years as a reporter, editor and human resources executive, then volunteered for a buyout and founded...