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 |
|---|---|---|---|---|
| Ghs plt ct-manual CPT 85032 | not published | not published | $3.51 – $8.19 | 25 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | not published | not published | $450.49 – $1,893.96 | 22 |
| Ghs pos nystagmus CPT 92542 | not published | not published | $47.96 – $239.95 | 18 |
| Ghs ppd (tb intradermal) CPT 86580 | not published | not published | $6.68 – $45.58 | 26 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $4.68 | $8.36 | $7.87 – $18.35 | 25 |
| Ghs protein, misc fluid CPT 84160 | not published | not published | $4.22 – $10.66 | 25 |
| Ghs protoporphyrins fract CPT 84202 | $16.80 | $30.00 | $11.69 – $27.26 | 25 |
| Ghs pr without cont pulse ox CPT 94625 | not published | not published | $55.29 – $110.58 | 16 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | $7.17 | $12.80 | $9.61 – $23.27 | 25 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | not published | not published | $130.79 – $221.68 | 6 |
| Ghs quinidine CPT 80194 | $49.84 | $89.00 | $11.90 – $27.74 | 25 |
| Ghs refill of implantable pump CPT 95990 | not published | not published | $77.41 – $617.46 | 27 |
| Ghs removal intranasal foreign body CPT 30300 | not published | not published | $47.96 – $239.95 | 21 |
| Ghs removal pharyngeal foreign body CPT 42809 | not published | not published | $47.96 – $742.84 | 21 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | not published | not published | $765.47 – $1,738.00 | 8 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | not published | not published | $1,017.03 – $2,380.00 | 8 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | not published | not published | $7.96 – $30.19 | 25 |
| Ghs reticulocyte count CPT 85044 | $21.84 | $39.00 | $3.51 – $8.19 | 25 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $49.28 | $88.00 | $9.77 – $26.43 | 25 |
| Ghs sedimentation rate CPT 85651 | $21.84 | $39.00 | $2.89 – $8.11 | 25 |
| Ghs semen analysis fert CPT 89320 | $27.44 | $49.00 | $9.82 – $31.90 | 25 |
| Ghs semen analysis, post-vas CPT 89300 | not published | not published | $7.28 – $18.70 | 25 |
| Ghs sensitivity (per antimicro) CPT 87184 | $43.68 | $78.00 | $5.62 – $14.21 | 25 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | not published | not published | $61.98 – $1,381.00 | 24 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | not published | not published | $61.98 – $1,381.00 | 24 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | not published | not published | $61.98 – $1,381.00 | 24 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | not published | not published | $61.98 – $1,381.00 | 24 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | not published | not published | $61.98 – $369.89 | 21 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | not published | not published | $61.98 – $369.89 | 21 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | not published | not published | $61.98 – $369.89 | 21 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | not published | not published | $118.64 – $1,381.00 | 24 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | not published | not published | $61.98 – $1,381.00 | 24 |
| Ghs sleep study unattended CPT 95800 | not published | not published | $68.25 – $291.27 | 22 |
| Ghs somatosensory testing lower extremit CPT 95926 | $336.00 | $600.00 | $115.90 – $579.69 | 21 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $604.24 | $1,079.00 | $208.57 – $987.75 | 21 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $45.36 | $81.00 | $25.60 – $86.45 | 17 |
| Ghs sphenopalatine ganglion block CPT 64505 | not published | not published | $55.33 – $549.52 | 21 |
| Ghs spont nystagmus CPT 92541 | not published | not published | $47.96 – $239.95 | 18 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $120.40 | $215.00 | $77.73 – $183.54 | 17 |
| Ghs st - eval for alt comm CPT 92567 | $66.64 | $119.00 | $16.05 – $73.07 | 18 |
| Ghs strapping shoulder - 29240 CPT 29240 | not published | not published | $29.42 – $239.95 | 18 |
| Ghs st - re-eval for alt comm CPT 92597 | $170.80 | $305.00 | $65.36 – $138.09 | 17 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | not published | not published | $16.24 – $85.90 | 26 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | not published | not published | $91.09 – $392.22 | 26 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $422.80 | $755.00 | $225.48 – $1,139.52 | 24 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | not published | not published | $191.97 – $813.00 | 24 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | not published | not published | $362.75 – $688.06 | 5 |
| Ghs trypsin (fecal) CPT 84488 | $8.06 | $14.40 | $5.95 – $13.87 | 25 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | not published | not published | $124.92 – $446.56 | 21 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $90.65 – $621.32 | 21 |
| Ghs urine, hydroxproline total CPT 83505 | not published | not published | $19.81 – $46.59 | 25 |
| Ghs urine, porphyrins quant CPT 84120 | $16.80 | $30.00 | $11.99 – $27.95 | 25 |
| Ghs vaginal delivery only CPT 59409 | not published | not published | $978.98 – $1,652.02 | 5 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | not published | not published | $493.88 – $987.75 | 16 |
| Ghs windowing of cast CPT 29730 | not published | not published | $62.72 – $293.74 | 18 |
| Giardia lamblia antibody CPT 86674 | not published | not published | $11.99 – $27.97 | 25 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $57.56 – $449.98 | 26 |
| Gi inhouse confirmation CPT 87045 | $63.84 | $114.00 | $7.70 – $18.06 | 25 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $250.38 – $2,080.85 | 5 |
| Gi protein loss CPT 78282 | not published | not published | $51.87 – $748.03 | 26 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | not published | not published | $392.06 – $1,745.34 | 21 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | $848.62 – $1,697.23 | 16 |
| Gi trc img intral esophagus CPT 91111 | not published | not published | $392.06 – $1,745.34 | 20 |
| Gi wireless capsule measure CPT 91112 | not published | not published | $392.06 – $1,745.34 | 20 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $66.75 – $198.63 | 21 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $40.60 – $116.89 | 21 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $18.95 – $66.50 | 21 |
| Glaucoma surgery CPT 66150 | not published | not published | $1,187.30 – $2,380.00 | 8 |
| Glaucoma surgery CPT 66155 | not published | not published | $918.24 – $2,380.00 | 8 |
| Glaucoma surgery CPT 66160 | not published | not published | $918.24 – $1,598.17 | 8 |
| Glaucoma surgery CPT 66170 | not published | not published | $918.24 – $2,380.00 | 8 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $134.28 | $239.78 | $100.26 – $145.96 | 2 |
| Glucagon plasma - sendout CPT 82943 | $16.80 | $30.00 | $11.64 – $27.15 | 25 |
| Glucose 1 hr post dose CPT 82950 | $8.96 | $16.00 | $3.87 – $9.03 | 25 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | $25.76 | $46.00 | $4.93 – $11.49 | 25 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $19.04 | $34.00 | $2.16 – $6.23 | 25 |
| Glucose blood quantitative CPT 82947 | $19.04 | $34.00 | $3.73 – $7.47 | 23 |
| Glucose body fluid CPT 82945 | $19.04 | $34.00 | $3.20 – $8.37 | 25 |
| Glucose monitoring continual min 72hr pt CPT 95249 | not published | not published | $55.29 – $110.58 | 19 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $58.80 | $105.00 | $10.49 – $24.45 | 25 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $14.56 | $26.00 | $3.19 – $7.45 | 25 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $98.56 | $176.00 | $15.14 – $35.30 | 25 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $94.08 | $168.00 | $15.09 – $35.19 | 25 |
| Gonioscopy CPT 92020 | not published | not published | $30.09 – $239.95 | 21 |
| Goniotomy CPT 65820 | not published | not published | $913.91 – $1,831.75 | 5 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $48.72 | $87.00 | $49.62 – $49.62 | 2 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $108.64 | $194.00 | $95.16 – $143.00 | 4 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $1,260.08 – $1,867.92 | 8 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $5,169.92 | $9,232.00 | $34.91 – $1,142.37 | 7 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $14,674.24 | $26,204.00 | $561.00 – $3,000.00 | 3 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $19,883.36 | $35,506.00 | $127.00 – $484.15 | 3 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $2,687.44 | $4,799.00 | $55.92 – $1,202.19 | 7 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $554.40 | $990.00 | $119.63 – $119.63 | 3 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $2,092.88 – $3,129.86 | 4 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $1,904.00 | $3,400.00 | $192.51 – $219.22 | 3 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $196.00 | $350.00 | $18.94 – $61.17 | 4 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $58.80 | $105.00 | $76.17 – $76.21 | 3 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $443.52 | $792.00 | $192.51 – $243.90 | 3 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $20,497.12 | $36,602.00 | $42.00 – $267.00 | 3 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $17,094.56 | $30,526.00 | $115.50 – $225.00 | 3 |
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.