Henry Ford St John Hospital
22101 Moross Rd, Detroit, MI · Henry Ford Health · · NPI 1023088168
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Closure of eyelid by suture CPT 67875 | not published | not published | $198.33 – $1,803.02 | 21 |
| Closure of salivary fistula CPT 42600 | not published | not published | $606.85 – $1,152.96 | 8 |
| Closure of windpipe lesion 31820 CPT 31820 | not published | not published | $446.49 – $1,345.11 | 8 |
| Closure paravalvlr leak pq CPT 33999 | $776.16 | $1,386.00 | $253.97 – $1,150.94 | 21 |
| Clot factor fletcher fact CPT 85292 | $22.40 | $40.00 | $15.42 – $35.97 | 25 |
| Clot factor viii reltd antgn CPT 85244 | $70.56 | $126.00 | $16.64 – $38.80 | 25 |
| Clot factor wght kininogen CPT 85293 | $22.40 | $40.00 | $15.42 – $35.97 | 25 |
| Clot factor xii hageman CPT 85280 | $22.96 | $41.00 | $15.77 – $36.77 | 25 |
| Clot factor xiii fibrin scrn CPT 85291 | $112.56 | $201.00 | $7.25 – $24.76 | 25 |
| Clot factor xiii fibrin stab CPT 85290 | not published | not published | $13.31 – $31.05 | 25 |
| Clotting assay whole blood CPT 85396 | not published | not published | $20.76 – $25.13 | 8 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | not published | not published | $90.65 – $813.00 | 24 |
| Clsd tx bimalleol ank fx without manip 27808 CPT 27808 | not published | not published | $90.65 – $813.00 | 24 |
| Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 | not published | not published | $112.53 – $517.16 | 21 |
| Clsd tx clav dislc without manip 23520 CPT 23520 | not published | not published | $281.38 – $852.69 | 8 |
| Clsd tx clavicle dislocation without manip 23540 CPT 23540 | not published | not published | $90.65 – $813.00 | 24 |
| Clsd tx clavicle fracture w/manip 23505 CPT 23505 | not published | not published | $446.55 – $852.69 | 8 |
| Clsd tx/clavicular fx without manip 23500 CPT 23500 | not published | not published | $90.65 – $813.00 | 24 |
| Clsd tx coccygeal fracture 27200 CPT 27200 | not published | not published | $90.65 – $446.56 | 21 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | not published | not published | $90.65 – $446.56 | 21 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | not published | not published | $124.92 – $813.00 | 24 |
| Clsd tx/dis tib/wt bear no manip 27824 CPT 27824 | not published | not published | $124.92 – $813.00 | 24 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | not published | not published | $71.78 – $446.56 | 21 |
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | not published | not published | $576.73 – $1,381.00 | 8 |
| Clsd tx finger tendon w/wo perq pin 26432 CPT 26432 | not published | not published | $765.47 – $1,738.00 | 8 |
| Clsd tx fracture of radius 25500 CPT 25500 | not published | not published | $90.65 – $446.56 | 21 |
| Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 | not published | not published | $90.65 – $446.56 | 21 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $480.48 | $858.00 | $108.78 – $617.76 | 23 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | not published | not published | $112.53 – $446.56 | 21 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | not published | not published | $576.73 – $1,738.00 | 8 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | not published | not published | $90.65 – $446.56 | 21 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | not published | not published | $576.73 – $1,381.00 | 8 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | not published | not published | $112.53 – $813.00 | 24 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | not published | not published | $124.92 – $813.00 | 24 |
| Clsd tx humeral fract without manip 24530 CPT 24530 | not published | not published | $124.92 – $813.00 | 24 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | not published | not published | $124.92 – $813.00 | 24 |
| Clsd tx iphal jnt disl w/manip req anes CPT 26775 | not published | not published | $109.34 – $494.40 | 21 |
| Clsd tx mandibular fx without manip 21450 CPT 21450 | not published | not published | $164.60 – $1,738.00 | 24 |
| Clsd tx/metacar/interphal artic fx 26740 CPT 26740 | not published | not published | $112.53 – $446.56 | 21 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | not published | not published | $90.65 – $446.56 | 21 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | not published | not published | $124.92 – $1,381.00 | 24 |
| Clsd tx metacarp fx w/manip&ext fix ea bone 26607 CPT 26607 | not published | not published | $576.73 – $1,494.33 | 8 |
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | not published | not published | $90.65 – $446.56 | 21 |
| Clsd tx/metatarsal fx without manip 28470 CPT 28470 | not published | not published | $90.65 – $446.56 | 21 |
| Clsd tx/nasal bone fx/stabilize 21320 CPT 21320 | not published | not published | $286.49 – $1,381.00 | 8 |
| Clsd tx nose fx without manip 21310 CPT 21310 | not published | not published | $68.01 – $1,381.00 | 8 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | not published | not published | $440.76 – $1,381.00 | 8 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | not published | not published | $90.65 – $813.00 | 24 |
| Clsd tx/patellar fx without manip 27520 CPT 27520 | not published | not published | $90.65 – $813.00 | 24 |
| Clsd tx pelvic ring fx CPT 27197 | not published | not published | $208.25 – $446.56 | 19 |
| Clsd tx pelvic ring fx CPT 27198 | not published | not published | $208.25 – $446.56 | 19 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | not published | not published | $504.62 – $852.69 | 8 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | not published | not published | $90.65 – $446.56 | 21 |
| Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 | not published | not published | $90.65 – $446.56 | 21 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | not published | not published | $570.96 – $813.00 | 8 |
| Clsd tx/scapular fx without manip 23570 CPT 23570 | not published | not published | $90.65 – $813.00 | 24 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | not published | not published | $444.05 – $1,381.00 | 8 |
| Clsd tx shoulder disloc w/anatom neck fx w/manip 23675 CPT 23675 | not published | not published | $576.73 – $1,381.00 | 8 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | not published | not published | $492.66 – $994.79 | 8 |
| Clsd tx/talotarsal dislocat/anes 28575 CPT 28575 | not published | not published | $442.16 – $1,494.33 | 8 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | not published | not published | $68.01 – $813.00 | 24 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | not published | not published | $71.02 – $446.56 | 21 |
| Clsd tx trimall ankle fx without manip 27816 CPT 27816 | not published | not published | $124.92 – $813.00 | 24 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | not published | not published | $576.73 – $852.69 | 8 |
| Clsd tx/ulnar shaft fx without manip 25530 CPT 25530 | not published | not published | $90.65 – $446.56 | 21 |
| Clsd tx vert body fx without manip req &w/csting/bracing CPT 22310 | not published | not published | $124.92 – $813.00 | 24 |
| Clsd tx wrist carpal fx without manip 25630 CPT 25630 | not published | not published | $90.65 – $446.56 | 21 |
| Clsd tx wrist scaphoid fx without manip 25622 CPT 25622 | not published | not published | $90.65 – $446.56 | 21 |
| Clsd tx wrist trans-scaph fx w/manip 25680 CPT 25680 | not published | not published | $124.92 – $1,381.00 | 24 |
| Clsd tx wrist ulnar styloid fx 25650 CPT 25650 | not published | not published | $112.53 – $446.56 | 21 |
| Clsd/ulnar fx/prox end without manip 24670 CPT 24670 | not published | not published | $90.65 – $813.00 | 24 |
| Cls tx of heel fracture w/manip 28405 CPT 28405 | not published | not published | $124.92 – $1,381.00 | 24 |
| Cltx carpl scphd fx w/mnpj CPT 25624 | not published | not published | $574.68 – $1,381.00 | 8 |
| Cltx gr hmrl tbrs fx w/mnpj CPT 23625 | not published | not published | $522.80 – $1,381.00 | 8 |
| Cltx hum epcndylr fx wo mnpj CPT 24560 | not published | not published | $90.65 – $813.00 | 24 |
| Cltx humrl cndylr fx w/mnpj CPT 24577 | not published | not published | $576.73 – $852.69 | 8 |
| Cltx humrl cndylr fx wo mnpj CPT 24576 | not published | not published | $124.92 – $813.00 | 24 |
| Cltx lunate dislc w/mnpj CPT 25690 | not published | not published | $576.73 – $852.69 | 8 |
| Cltx mndblr fx ntrdntl fixj CPT 21453 | not published | not published | $850.61 – $2,499.06 | 8 |
| Cltx mndblr fx w/mnpj CPT 21451 | not published | not published | $739.35 – $2,380.00 | 8 |
| Cltx mndblr/max alv ridge fx CPT 21440 | not published | not published | $471.35 – $1,738.00 | 8 |
| Cltx palatal/max fx wire fix CPT 21421 | not published | not published | $709.50 – $2,921.83 | 8 |
| Cltx post ankle fx CPT 27767 | not published | not published | $112.53 – $446.56 | 20 |
| Cltx post ankle fx w/mnpj CPT 27768 | not published | not published | $576.73 – $852.69 | 4 |
| Cltx scap fx w/mnpj +-tractj CPT 23575 | not published | not published | $390.54 – $852.69 | 8 |
| Cltx strnclav dislc w/mnpj CPT 23525 | not published | not published | $90.65 – $813.00 | 24 |
| Cltx thigh fx CPT 27267 | not published | not published | $576.73 – $1,494.33 | 4 |
| Cltx tmprmand dislc comp CPT 21485 | not published | not published | $192.52 – $1,381.00 | 8 |
| Cmbn ant pst colprhy CPT 57260 | not published | not published | $1,056.23 – $2,202.64 | 5 |
| C motor evoked lwr limbs CPT 95929 | $837.76 | $1,496.00 | $202.49 – $987.75 | 21 |
| C motor evoked uppr limbs CPT 95928 | $837.76 | $1,496.00 | $197.99 – $1,893.96 | 21 |
| C motor evoked upr&lwr limbs CPT 95939 | not published | not published | $384.55 – $1,893.96 | 20 |
| Cmptr ophth dx img ant segmt CPT 92132 | not published | not published | $18.65 – $110.58 | 20 |
| Cmptr ophth img optic nerve CPT 92133 | not published | not published | $18.27 – $110.58 | 20 |
| #cms hgb-carboxyhemoglobin CPT 82376 | not published | not published | $5.71 – $26.73 | 25 |
| #cms hgb-sulfhemoglobin CPT 83060 | $11.11 | $19.84 | $5.49 – $16.72 | 25 |
| #cmvcul-virus inoculation shell CPT 87254 | $133.28 | $238.00 | $11.16 – $37.16 | 25 |
| Cmv pcr-sendout CPT 87496 | $42.00 | $75.00 | $22.15 – $66.67 | 25 |
| Co2 monitor per day CPT 94681 | not published | not published | $49.38 – $579.69 | 21 |
| Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 | $2.18 | $3.90 | $1.09 – $2.44 | 5 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.