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 |
|---|---|---|---|---|
| Drain chst dry seal exp thorastat HCPCS A7041 | $45.36 | $81.00 | $81.00 – $81.00 | 1 |
| Drain finger abscess;simple 26010 CPT 26010 | not published | not published | $86.23 – $369.89 | 21 |
| Drain lower leg bursa CPT 27604 | not published | not published | $679.38 – $1,743.38 | 8 |
| Drain lower leg lesion 27603 CPT 27603 | $3,421.04 | $6,109.00 | $743.91 – $4,398.48 | 8 |
| Drain neck/chest lesion 21501 CPT 21501 | not published | not published | $444.06 – $1,381.00 | 8 |
| Drain open lung lesion 32200 CPT 32200 | not published | not published | $1,263.68 – $3,247.21 | 4 |
| Drain ovarn cyst abd CPT 58805 | not published | not published | $753.84 – $1,525.14 | 5 |
| Drain ovary abscess open CPT 58820 | not published | not published | $474.30 – $1,738.00 | 8 |
| Drain pancreatic pseudocyst 48510 CPT 48510 | not published | not published | $1,213.75 – $3,137.81 | 4 |
| Drain penis lesion CPT 54015 | not published | not published | $344.43 – $2,380.00 | 8 |
| Drain shoulder bone lesion CPT 23035 | not published | not published | $765.47 – $1,738.00 | 8 |
| Drain shoulder bursa 23031 CPT 23031 | not published | not published | $298.06 – $1,008.24 | 5 |
| Drain shoulder lesion CPT 23030 | not published | not published | $426.79 – $1,264.58 | 8 |
| Drain thigh/knee lesion 27301 CPT 27301 | not published | not published | $743.91 – $1,738.00 | 8 |
| Drain thyroid/tongue cyst CPT 60000 | not published | not published | $182.29 – $813.00 | 8 |
| Drain to peritoneal cavity CPT 49062 | not published | not published | $1,058.03 – $2,128.34 | 4 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $189.28 | $338.00 | $118.64 – $369.89 | 23 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $137.20 | $245.00 | $61.98 – $369.89 | 23 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $259.84 | $464.00 | $118.64 – $743.75 | 24 |
| Dressing change not for burn w/anes 15852 CPT 15852 | not published | not published | $47.96 – $1,139.52 | 21 |
| Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm HCPCS Q4108 | $2,099.44 | $3,749.00 | $53.45 – $966.60 | 3 |
| Drill hole evac+/drg subdural hematoma 61108 CPT 61108 | not published | not published | $1,206.20 – $2,632.58 | 4 |
| Drill hole implt ventricular cath/device 61107 CPT 61107 | $2,291.52 | $4,092.00 | $798.98 – $2,946.24 | 6 |
| Drng appendix abscess open 44900 CPT 44900 | not published | not published | $857.10 – $2,208.90 | 4 |
| Drng hand tendon sheath 26020 CPT 26020 | not published | not published | $551.21 – $1,494.33 | 8 |
| Drng of eyelid abscess 67700 CPT 67700 | not published | not published | $127.84 – $556.49 | 21 |
| Drng of finger abscess comp 26011 CPT 26011 | $2,511.04 | $4,484.00 | $251.07 – $3,228.48 | 8 |
| Drng of hydrocele 55000 CPT 55000 | not published | not published | $65.43 – $1,309.78 | 21 |
| Drng of mouth lesion 40801 CPT 40801 | not published | not published | $279.70 – $1,381.00 | 24 |
| Drng of ovarian cyst(s) 58800 CPT 58800 | not published | not published | $494.91 – $1,738.00 | 8 |
| Drng of palm multi bursas 26030 CPT 26030 | not published | not published | $735.46 – $1,494.33 | 8 |
| Drng of palm single bursa 26025 CPT 26025 | not published | not published | $576.10 – $1,494.33 | 8 |
| Drng of pelvic abscess transrectal 45000 CPT 45000 | not published | not published | $339.55 – $1,024.59 | 8 |
| Drng of salivary cyst 42409 CPT 42409 | not published | not published | $306.04 – $1,738.00 | 8 |
| Drng of scrotum abscess 55100 CPT 55100 | not published | not published | $258.82 – $813.00 | 8 |
| Drng open retroperitoneal abscess 49060 CPT 49060 | $5,189.52 | $9,267.00 | $1,372.17 – $6,672.24 | 6 |
| Drng open subdiaphragmatic/subphrenic absc 49040 CPT 49040 | not published | not published | $1,137.13 – $2,876.25 | 4 |
| Drng ovary abscess perqt 58822 CPT 58822 | not published | not published | $924.63 – $1,971.21 | 4 |
| Drng peritoneal abscess open 49020 CPT 49020 | $7,416.08 | $13,243.00 | $1,912.87 – $9,534.96 | 6 |
| Drng salivary gland simple 42300 CPT 42300 | not published | not published | $216.59 – $813.00 | 8 |
| Drng salivary gland submax/subling 42310 CPT 42310 | not published | not published | $138.68 – $948.00 | 24 |
| Dronabinol 2.5mg oral HCPCS Q0167 | $4.83 | $8.62 | $0.86 – $8.22 | 4 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $845.60 | $1,510.00 | $337.50 – $650.00 | 3 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $15.12 | $27.00 | $16.98 – $16.98 | 2 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | $21.84 | $39.00 | $9.23 – $17.61 | 3 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | $1,853.60 | $3,310.00 | $48.54 – $1,769.76 | 3 |
| Drug admin & hemodynmic meas CPT 93463 | $436.80 | $780.00 | $128.53 – $505.44 | 10 |
| Drug assay caffeine CPT 80155 | $16.67 | $29.76 | $12.94 – $73.28 | 25 |
| Drug assay posaconazole CPT 80187 | not published | not published | $25.75 – $51.51 | 16 |
| Drug assay rufinamide CPT 80210 | not published | not published | $25.75 – $51.51 | 16 |
| Drug assay vedolizumab CPT 80280 | not published | not published | $36.64 – $73.28 | 16 |
| Drug assay voriconazole CPT 80285 | not published | not published | $25.75 – $51.51 | 16 |
| Drug asy hydroxychloroquine CPT 80220 | not published | not published | $17.71 – $35.42 | 16 |
| Drug of abuse screen urine CPT 80305 | $33.60 | $60.00 | $8.88 – $48.60 | 23 |
| Drug screen quant tiagabine CPT 80199 | not published | not published | $15.89 – $51.51 | 24 |
| Drug test def 1-7 classes HCPCS G0480 | $196.00 | $350.00 | $9.35 – $88.81 | 4 |
| Drug test def 22+ classes HCPCS G0483 | $290.64 | $519.00 | $162.99 – $519.00 | 4 |
| Drug test def 8-14 classes HCPCS G0481 | $187.60 | $335.00 | $49.60 – $121.53 | 4 |
| Drug test prsmv instrmnt CPT 80306 | $15.12 | $27.00 | $11.85 – $32.57 | 23 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $72.80 | $130.00 | $7.00 – $118.07 | 23 |
| Drvvt confirm - quest CPT 85597 | $23.52 | $42.00 | $7.79 – $34.16 | 25 |
| Dstrj extensive retinopathy CPT 67227 | not published | not published | $698.00 – $1,599.39 | 8 |
| Dstr mal les s/n/h/f/g >4.0 CPT 17276 | not published | not published | $162.97 – $743.75 | 21 |
| Dstr mal ls f/e/e/n/l/m2.1-3 CPT 17283 | not published | not published | $118.64 – $743.75 | 21 |
| Dstr mal ls f/e/e/n/l/m3.1-4 CPT 17284 | not published | not published | $118.64 – $1,139.52 | 21 |
| Dstr mal ls f/e/e/n/l/m>4.0 CPT 17286 | not published | not published | $118.64 – $1,139.52 | 21 |
| Ductogram sgl duct CPT 77053 | $172.48 | $308.00 | $38.83 – $449.98 | 27 |
| Duodenal motility study CPT 91022 | not published | not published | $116.09 – $987.75 | 20 |
| Duplex scan bilateral study 93985 CPT 93985 | not published | not published | $224.99 – $449.98 | 16 |
| Duplex scan unilateral study 93986 CPT 93986 | not published | not published | $98.98 – $197.96 | 16 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $183.12 | $327.00 | $48.43 – $224.77 | 23 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | not published | not published | $68.25 – $291.27 | 23 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $908.88 | $1,623.00 | $80.78 – $449.98 | 23 |
| Dxa bone density axl vrt fx CPT 77085 | $126.56 | $226.00 | $34.96 – $197.96 | 24 |
| Dx aly aud oi snd prcsr 1st CPT 92622 | not published | not published | $145.63 – $291.27 | 16 |
| Dx bronchoscope/brush 31623 CPT 31623 | not published | not published | $451.52 – $710.87 | 5 |
| Dx bronchoscope/lavage 31624 CPT 31624 | not published | not published | $454.43 – $708.43 | 5 |
| Dx bronchoscope/wash 31622 CPT 31622 | not published | not published | $431.13 – $814.18 | 8 |
| Dx dark adaptation exam i&r CPT 92284 | not published | not published | $47.96 – $742.84 | 21 |
| Dx duod intub w/asp spec 43756 CPT 43756 | not published | not published | $52.96 – $1,745.34 | 20 |
| Dx duod intub w/asp specs CPT 43757 | not published | not published | $392.06 – $1,745.34 | 20 |
| Dx gastr intub w/asp spec CPT 43754 | not published | not published | $115.90 – $579.69 | 20 |
| Dx gastr intub w/asp specs CPT 43755 | not published | not published | $68.25 – $291.27 | 20 |
| Dx laryngoscopy newborn CPT 31520 | not published | not published | $197.32 – $722.87 | 21 |
| Dx laryngoscopy w/oper scope CPT 31526 | not published | not published | $303.00 – $1,381.00 | 8 |
| Dynamic cavernosometry CPT 54231 | not published | not published | $65.43 – $792.38 | 21 |
| Dynamic surface emg CPT 96002 | not published | not published | $24.09 – $579.69 | 21 |
| Ear and throat examination CPT 92502 | not published | not published | $109.15 – $948.00 | 21 |
| Ear canal biopsy 69105 CPT 69105 | not published | not published | $98.17 – $850.49 | 5 |
| Ear cartilage graft CPT 21235 | not published | not published | $850.49 – $2,499.06 | 5 |
| Ear irrigation 69209 CPT 69209 | not published | not published | $29.42 – $110.58 | 20 |
| Ear protector evaluation CPT 92596 | not published | not published | $16.05 – $73.07 | 21 |
| Ecg 12 lead tracing only CPT 93005 | $46.48 | $83.00 | $11.91 – $110.58 | 23 |
| Ecg/1-3 leads/interp & report only 93042 CPT 93042 | not published | not published | $8.16 – $13.94 | 6 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | not published | not published | $6.66 – $110.58 | 23 |
| Ecg < 30 days transmission & analysis CPT 93271 | $191.52 | $342.00 | $55.99 – $323.84 | 23 |
| Ecg external < 48 hours recording CPT 93225 | $141.12 | $252.00 | $32.52 – $239.95 | 23 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $191.52 | $342.00 | $47.88 – $132.01 | 23 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | not published | not published | $36.54 – $73.07 | 16 |
| Ecg external >7 days up to 15 days recording CPT 93246 | not published | not published | $36.54 – $73.07 | 16 |
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.