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 |
|---|---|---|---|---|
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $466.60 | $833.22 | $60.46 – $60.46 | 1 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $1,616.87 | $2,887.26 | $1,263.93 – $1,388.25 | 2 |
| Digoxin total therapeutic drug level CPT 80162 | $63.28 | $113.00 | $10.82 – $25.23 | 25 |
| Dilate biliary duct/ampulla CPT 47542 | $3,708.88 | $6,623.00 | $1,302.86 – $4,768.56 | 6 |
| Dilate esophagus CPT 43453 | not published | not published | $160.22 – $813.00 | 8 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $135.69 – $1,745.34 | 24 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | $3,183.60 | $5,685.00 | $3,683.88 – $4,093.20 | 3 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | $3,183.60 | $5,685.00 | $3,683.88 – $4,093.20 | 3 |
| Dilate ic vasospasm init CPT 61640 | $3,723.44 | $6,649.00 | $4,308.55 – $4,787.28 | 3 |
| Dilate tear duct opening CPT 68801 | not published | not published | $47.96 – $742.84 | 21 |
| Dilate urethra stricture CPT 53600 | not published | not published | $38.87 – $813.00 | 24 |
| Dilate urethra stricture CPT 53601 | not published | not published | $47.96 – $813.00 | 24 |
| Dilate urethra stricture CPT 53605 | not published | not published | $90.51 – $1,381.00 | 8 |
| Dilate urethra stricture CPT 53621 | not published | not published | $60.56 – $813.00 | 24 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $45.60 – $813.00 | 24 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $194.13 – $873.95 | 8 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $31.77 – $978.98 | 8 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $207.35 – $873.95 | 8 |
| Dilation of salivary duct CPT 42660 | not published | not published | $83.35 – $948.00 | 21 |
| Dilation of urethra CPT 53661 | not published | not published | $47.96 – $813.00 | 24 |
| Dilation of urethra CPT 53665 | not published | not published | $68.60 – $971.43 | 8 |
| Dilation of vagina CPT 57400 | not published | not published | $185.64 – $1,381.00 | 8 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $56.82 – $362.75 | 5 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $57.20 – $1,242.54 | 24 |
| Dilator fascial 10fx20cm HCPCS C2627 | $120.96 | $216.00 | $109.56 – $130.00 | 3 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | not published | not published | $49.25 – $74.67 | 4 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $10.00 – $73.07 | 20 |
| Disability dlco CPT 94727 | not published | not published | $68.25 – $291.27 | 17 |
| Disaccharidases CPT 82657 | $231.67 | $413.70 | $14.71 – $43.78 | 25 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $437.42 – $1,738.00 | 8 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | not published | not published | $2,713.83 – $4,316.36 | 4 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $370.25 – $563.92 | 4 |
| Discography cerv/thor spine CPT 72285 | not published | not published | $61.45 – $1,430.10 | 10 |
| Dissolve clot heart vessel CPT 92975 | not published | not published | $492.25 – $648.37 | 4 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $1,996.32 – $2,885.11 | 4 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $1,311.84 – $2,499.06 | 5 |
| Division of fallopian tube 58605 CPT 58605 | not published | not published | $676.87 – $927.91 | 4 |
| #d/lmeth-l-methamphetamine CPT 80374 | not published | not published | $10.49 – $28.75 | 8 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | $386.96 | $691.00 | $447.77 – $861.28 | 4 |
| Dmd dup/delet analysis CPT 81161 | $359.52 | $642.00 | $149.32 – $1,031.25 | 25 |
| Dmpk gene detc abnor allele CPT 81234 | not published | not published | $130.15 – $260.30 | 16 |
| Dna antibody native/double stranded CPT 86225 | $57.68 | $103.00 | $11.20 – $26.11 | 25 |
| Dna gardnerella CPT 87510 | $68.32 | $122.00 | $16.34 – $38.09 | 25 |
| Dna probe chlamydia CPT 87490 | $22.40 | $40.00 | $16.34 – $43.23 | 25 |
| Dna probe gc CPT 87590 | $34.16 | $61.00 | $17.74 – $51.07 | 25 |
| Dna trichomonas CPT 87660 | $68.32 | $122.00 | $16.34 – $81.99 | 25 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $10.24 | $18.29 | $1.84 – $3.58 | 3 |
| Doppler echo complete CPT 93320 | $1,020.88 | $1,823.00 | $39.26 – $161.43 | 6 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $3,334.80 | $5,955.00 | $193.88 – $415.86 | 4 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $735.84 | $1,314.00 | $68.25 – $291.27 | 23 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $681.52 | $1,217.00 | $47.96 – $239.95 | 23 |
| Dornhoffer fixed part w/window HCPCS L8614 | $19,600.00 | $35,000.00 | $108.00 – $19,558.02 | 4 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $20.58 | $36.74 | $4.28 – $4.28 | 2 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $321.70 | $574.46 | $233.45 – $574.46 | 5 |
| Dpyd gene common variants CPT 81232 | not published | not published | $166.07 – $332.14 | 16 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | not published | not published | $120.07 – $1,309.78 | 21 |
| Drainage ext aud canal abscess 69020 CPT 69020 | not published | not published | $120.07 – $1,309.78 | 21 |
| Drainage external ear complex 69005 CPT 69005 | not published | not published | $135.69 – $743.91 | 5 |
| Drainage external ear simple 69000 CPT 69000 | not published | not published | $120.07 – $1,309.78 | 21 |
| Drainage lymph node lesion 38300 CPT 38300 | not published | not published | $222.38 – $813.00 | 8 |
| Drainage lymph node lesion 38305 CPT 38305 | not published | not published | $206.65 – $1,381.00 | 8 |
| Drainage mouth roof lesion CPT 42000 | not published | not published | $164.60 – $1,381.00 | 24 |
| Drainage of arm bursa 23931 CPT 23931 | not published | not published | $283.02 – $1,381.00 | 8 |
| Drainage of bladder abscess CPT 51080 | not published | not published | $495.48 – $1,264.58 | 5 |
| Drainage of eye CPT 65800 | not published | not published | $142.48 – $1,198.62 | 8 |
| Drainage of eye CPT 65810 | not published | not published | $462.36 – $1,738.00 | 8 |
| Drainage of eye CPT 65815 | not published | not published | $497.62 – $1,448.33 | 8 |
| Drainage of forearm bursa CPT 25031 | not published | not published | $168.02 – $1,381.00 | 8 |
| Drainage of kidney lesion CPT 50390 | $1,268.96 | $2,266.00 | $193.43 – $1,631.52 | 24 |
| Drainage of mouth lesion CPT 41005 | not published | not published | $162.58 – $813.00 | 24 |
| Drainage of mouth lesion CPT 41006 | not published | not published | $298.10 – $813.00 | 8 |
| Drainage of mouth lesion CPT 41007 | not published | not published | $117.84 – $813.00 | 8 |
| Drainage of mouth lesion CPT 41008 | not published | not published | $366.54 – $1,152.96 | 8 |
| Drainage of mouth lesion CPT 41009 | not published | not published | $164.60 – $948.00 | 24 |
| Drainage of mouth lesion CPT 41015 | not published | not published | $164.60 – $948.00 | 24 |
| Drainage of mouth lesion CPT 41016 | not published | not published | $463.01 – $2,499.06 | 8 |
| Drainage of mouth lesion CPT 41017 | not published | not published | $436.03 – $1,152.96 | 8 |
| Drainage of mouth lesion CPT 41018 | not published | not published | $362.75 – $813.00 | 8 |
| Drainage of nose lesion int 30000 CPT 30000 | not published | not published | $68.01 – $432.29 | 21 |
| Drainage of nose lesion sept 30020 CPT 30020 | not published | not published | $146.64 – $948.00 | 21 |
| Drainage of pelvis bursa CPT 26991 | not published | not published | $698.00 – $1,743.38 | 8 |
| Drainage of pelvis lesion 26990 CPT 26990 | not published | not published | $698.00 – $1,743.38 | 8 |
| Drainage of prostate abscess CPT 52700 | not published | not published | $488.72 – $2,133.60 | 8 |
| Drainage of prostate abscess CPT 55720 | not published | not published | $476.87 – $1,307.42 | 8 |
| Drainage of prostate abscess CPT 55725 | not published | not published | $638.79 – $1,383.49 | 5 |
| Drainage of rectal abscess CPT 45005 | not published | not published | $198.50 – $1,381.00 | 8 |
| Drainage of rectal abscess 45020 CPT 45020 | not published | not published | $582.02 – $1,381.00 | 8 |
| Drainage of salivary gland CPT 42305 | not published | not published | $509.88 – $1,489.24 | 8 |
| Drainage of salivary gland CPT 42320 | not published | not published | $164.60 – $948.00 | 24 |
| Drainage of throat abscess CPT 42725 | not published | not published | $804.63 – $2,499.06 | 8 |
| Drainage of urethra abscess CPT 53040 | not published | not published | $715.85 – $2,133.60 | 8 |
| Drainage of urethra abscess 53060 CPT 53060 | not published | not published | $84.86 – $792.38 | 5 |
| Drainage of urinary leakage CPT 53080 | not published | not published | $319.40 – $1,242.54 | 21 |
| Drainage of urinary leakage CPT 53085 | not published | not published | $710.31 – $1,348.27 | 5 |
| Drain bladder by trocar/cath CPT 51101 | not published | not published | $78.56 – $1,893.96 | 21 |
| Drain blood from under nail 11740 CPT 11740 | $98.56 | $176.00 | $29.42 – $239.95 | 23 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | not published | not published | $495.48 – $745.71 | 4 |
| Drain cath image guided visceral pq CPT 49405 | $6,010.48 | $10,733.00 | $495.48 – $7,727.76 | 7 |
| Drain cerebro spinal fluid 62272 CPT 62272 | $1,228.08 | $2,193.00 | $137.05 – $1,578.96 | 24 |
| Drain chest lesion CPT 21502 | not published | not published | $567.97 – $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.