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 |
|---|---|---|---|---|
| Adj gastric band via subq port CPT 43999 | not published | not published | $392.06 – $1,745.34 | 20 |
| Adjmt/revj ext fixj sys anes CPT 20693 | not published | not published | $840.49 – $1,778.20 | 5 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | not published | not published | $742.30 – $1,738.00 | 8 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $64.65 | $115.44 | $1.03 – $1.03 | 3 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $84.00 | $150.00 | $22.26 – $132.49 | 29 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $127.12 | $227.00 | $22.26 – $132.49 | 29 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $248.08 | $443.00 | $147.42 – $617.46 | 29 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $168.00 | $300.00 | $91.09 – $617.46 | 29 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $144.48 | $258.00 | $22.26 – $132.49 | 29 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $144.48 | $258.00 | $48.60 – $140.95 | 29 |
| Administration immunization 1 vaccine CPT 90471 | $84.00 | $150.00 | $22.26 – $132.49 | 27 |
| Administration immunization each additional component CPT 90461 | not published | not published | $13.89 – $16.94 | 9 |
| Administration immunization each additional vaccine CPT 90472 | $84.00 | $150.00 | $11.64 – $16.94 | 10 |
| Administration immunization first component each vaccine CPT 90460 | not published | not published | $22.38 – $28.17 | 9 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | not published | not published | $12.98 – $132.49 | 27 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | not published | not published | $7.79 – $16.94 | 10 |
| Administration vaccine hepatitis b HCPCS G0010 | $26.32 | $47.00 | $4.02 – $27.14 | 13 |
| Administration vaccine influenza virus HCPCS G0008 | $24.08 | $43.00 | $4.02 – $27.14 | 13 |
| Administration vaccine pneumococcal HCPCS G0009 | $24.08 | $43.00 | $4.02 – $27.14 | 13 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $25.25 | $45.09 | $15.36 – $45.09 | 7 |
| Adrenal cortex & medulla img CPT 78075 | not published | not published | $316.09 – $694.73 | 10 |
| Adrenalectomy expl w/exc retro tumor 60545 CPT 60545 | not published | not published | $2,084.27 – $3,502.82 | 4 |
| Advance care planning each additional 30 min 99498 CPT 99498 | not published | not published | $134.07 – $134.07 | 3 |
| Aep hearing status deter i&r CPT 92651 | not published | not published | $289.85 – $579.69 | 16 |
| Aep neurodiagnostic i&r CPT 92653 | not published | not published | $289.85 – $579.69 | 16 |
| Aep thrshld est mlt freq i&r CPT 92652 | not published | not published | $289.85 – $579.69 | 16 |
| _afb id by dna probe rflx ast CPT 87149 | $45.36 | $81.00 | $16.34 – $38.09 | 25 |
| #afb mycobacteria suscep. #1 CPT 87190 | $34.72 | $62.00 | $4.82 – $13.89 | 25 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | not published | not published | $94.01 – $219.18 | 24 |
| After cataract laser surgery CPT 66821 | not published | not published | $231.64 – $1,381.00 | 24 |
| Air conduction bilat CPT 92552 | $53.76 | $96.00 | $24.58 – $239.95 | 21 |
| Air injection into abdomen 49400 CPT 49400 | not published | not published | $120.13 – $813.00 | 7 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | not published | not published | $115.90 – $291.27 | 17 |
| Albumin body fluid quantitative each specimen CPT 82042 | $26.88 | $48.00 | $3.85 – $14.78 | 25 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $71.26 | $127.25 | $28.11 – $127.25 | 5 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $129.50 | $231.25 | $28.69 – $76.62 | 5 |
| Albumin ischemia modified CPT 82045 | not published | not published | $32.24 – $64.49 | 22 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $26.32 | $47.00 | $4.71 – $13.74 | 25 |
| Albumin serum plasma or whole blood CPT 82040 | $19.04 | $34.00 | $4.70 – $9.40 | 23 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | not published | not published | $16.41 – $32.81 | 16 |
| Alkaline phosphatase CPT 84075 | $19.04 | $34.00 | $4.92 – $9.84 | 23 |
| Allergen alpha lactalbumin ige CPT 86008 | $21.28 | $38.00 | $14.61 – $34.07 | 19 |
| Allergen egg white ige CPT 86003 | $21.84 | $39.00 | $4.25 – $11.95 | 25 |
| Allergen specific ige qual multi scrn ea CPT 86005 | not published | not published | $6.49 – $15.14 | 25 |
| Allergy injections; 2 or more 95117 CPT 95117 | not published | not published | $13.41 – $85.90 | 21 |
| Allergy injection; single 95115 CPT 95115 | not published | not published | $11.16 – $85.90 | 21 |
| Allergy Skin Testing CPT 95004 | not published | not published | $5.28 – $1,893.96 | 22 |
| Allg patch or app # of tests 95044 CPT 95044 | not published | not published | $5.63 – $1,893.96 | 22 |
| Allgrft implnt knee w/scope CPT 29867 | not published | not published | $1,792.04 – $7,029.36 | 5 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $1,377.04 | $2,459.00 | $22.14 – $221.10 | 3 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $135.52 | $242.00 | $208.38 – $208.38 | 2 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | $126.00 | $225.00 | $43.77 – $43.77 | 2 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $1,834.56 | $3,276.00 | $77.75 – $148.47 | 3 |
| Allograft membrn amnio 1x2cm hu ambriodry HCPCS V2790 | $4,704.00 | $8,400.00 | $627.00 – $627.00 | 1 |
| All tstg perq&iq drugs/biol CPT 95018 | not published | not published | $8.74 – $73.07 | 21 |
| All tstg perq&iq w/venoms CPT 95017 | not published | not published | $4.91 – $45.58 | 21 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | not published | not published | $52.49 – $122.38 | 24 |
| Alpha-fetoprotein amniotic CPT 82106 | $45.92 | $82.00 | $13.67 – $34.60 | 25 |
| Alpha-fetoprotein tumor marker CPT 82105 | $56.00 | $100.00 | $13.67 – $35.28 | 25 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $4,598.72 | $8,212.00 | $38.79 – $100.41 | 5 |
| Alt/sgpt CPT 84460 | $19.04 | $34.00 | $5.03 – $10.07 | 23 |
| Aluminum - quest CPT 82108 | $30.24 | $54.00 | $20.76 – $48.41 | 25 |
| Alveoloplasty each quadrant CPT 41874 | not published | not published | $273.25 – $850.49 | 5 |
| Alys cplx sp/pn npgt w/prgrm CPT 95972 | $162.40 | $290.00 | $55.99 – $170.87 | 21 |
| Amantadine (symmetrel)-sendout CPT 80375 | not published | not published | $11.77 – $28.75 | 8 |
| Ambl bp mntr w/sw a/r CPT 93788 | not published | not published | $10.03 – $239.95 | 21 |
| Amino acid screen, urine CPT 82128 | $25.20 | $45.00 | $11.31 – $26.35 | 25 |
| Amino acid single qual CPT 82127 | not published | not published | $11.31 – $29.42 | 25 |
| Amino acids quant 2-5 CPT 82136 | not published | not published | $13.75 – $66.62 | 25 |
| Aminolevulinic acid delta CPT 82135 | $19.60 | $35.00 | $13.40 – $31.25 | 25 |
| Amitriptyline (elavil) -sendout CPT 80335 | not published | not published | $10.65 – $28.75 | 8 |
| Ammonia CPT 82140 | $47.04 | $84.00 | $11.80 – $27.68 | 25 |
| Amniocentesisdiagnostic 59000 CPT 59000 | $320.32 | $572.00 | $73.63 – $1,620.95 | 24 |
| Amniocentesis therapeutic CPT 59001 | not published | not published | $131.97 – $566.28 | 21 |
| Amniotic fluid scan CPT 82143 | $33.04 | $59.00 | $6.17 – $17.76 | 25 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | not published | not published | $765.47 – $2,380.00 | 8 |
| Amphetamine confirm urine -sendout CPT 80324 | not published | not published | $10.65 – $28.75 | 8 |
| Amphetamines 5 or more CPT 80326 | not published | not published | $10.65 – $14.28 | 7 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $14.93 | $26.66 | $9.59 – $20.99 | 4 |
| Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 | not published | not published | $249.84 – $499.68 | 16 |
| Amp metatarsal w/toe single 28810 CPT 28810 | not published | not published | $703.54 – $1,494.33 | 8 |
| Amp thigh through femur re-amp 27596 CPT 27596 | not published | not published | $1,083.23 – $2,078.62 | 4 |
| Amputate hand at wrist CPT 25922 | not published | not published | $305.51 – $1,738.00 | 8 |
| Amputate metacarpal bone 26910 CPT 26910 | not published | not published | $884.98 – $1,867.92 | 8 |
| Amputate thigh through femur 27590 CPT 27590 | not published | not published | $1,379.35 – $2,308.35 | 4 |
| Amputation follow-up surgery CPT 24925 | not published | not published | $305.51 – $1,743.38 | 8 |
| Amputation follow-up surgery CPT 25907 | not published | not published | $305.51 – $1,743.38 | 8 |
| Amputation follow-up surgery CPT 25909 | not published | not published | $829.04 – $1,792.65 | 5 |
| Amputation follow-up surgery CPT 25929 | not published | not published | $308.55 – $1,738.00 | 8 |
| Amputation follow-up surgery CPT 25931 | not published | not published | $701.28 – $1,743.38 | 5 |
| Amputation follow-up surgery CPT 27594 | not published | not published | $748.01 – $1,494.33 | 5 |
| Amputation follow-up surgery CPT 27884 | not published | not published | $891.25 – $1,743.38 | 8 |
| Amputation leg thr tib/fib 27880 CPT 27880 | not published | not published | $1,376.64 – $2,645.51 | 4 |
| Amputation leg; tib/fib f/u 27886 CPT 27886 | not published | not published | $1,059.06 – $1,893.63 | 4 |
| Amputation of foot at ankle CPT 27889 | not published | not published | $1,016.99 – $3,248.44 | 5 |
| Amputation of lower leg CPT 27882 | not published | not published | $951.71 – $1,730.52 | 4 |
| Amputation of midtarsal 28800 CPT 28800 | not published | not published | $769.91 – $1,549.51 | 4 |
| Amputation thru metatarsal CPT 28805 | not published | not published | $910.94 – $1,792.65 | 5 |
| Amputation toe interphalangeal joint CPT 28825 | not published | not published | $546.23 – $1,494.33 | 8 |
| Amputation toe metatarsophalangeal joint CPT 28820 | not published | not published | $586.20 – $1,494.33 | 8 |
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.