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 |
|---|---|---|---|---|
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $412.72 | $737.00 | $49.41 – $378.63 | 21 |
| Initial hosp neonate 28 d/less than not critically ill 99477 CPT 99477 | not published | not published | $382.90 – $382.90 | 3 |
| Initial nursing facility care/day 35 minutes CPT 99305 | not published | not published | $131.77 – $145.51 | 4 |
| Initial nursing facility care/day 45 minutes CPT 99306 | not published | not published | $145.00 – $183.82 | 4 |
| Initial nursing facility care/day low severity 99304 CPT 99304 | not published | not published | $94.90 – $102.94 | 4 |
| Initiation & management bipap/cpap initial day CPT 94660 | $266.00 | $475.00 | $67.52 – $378.63 | 21 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | $973.93 | $1,739.17 | $2.16 – $6.24 | 5 |
| Inj ceftolozane tazobactam HCPCS J0695 | $0.28 | $0.50 | $0.22 – $0.50 | 2 |
| Inj, clevidipine butyrate HCPCS C9248 | $3.39 | $6.06 | $2.27 – $6.06 | 9 |
| Inj disk cerv-thor ea lev CPT 62291 | not published | not published | $281.71 – $935.87 | 4 |
| Inj dupuytren cord w/enzyme CPT 20527 | not published | not published | $45.60 – $549.52 | 20 |
| Inj, durolane 1 mg HCPCS J7318 | $678.16 | $1,211.00 | $22.33 – $22.33 | 3 |
| Inj dx for sinogram CPT 20501 | $754.88 | $1,348.00 | $62.73 – $970.56 | 6 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | not published | not published | $644.59 – $1,289.19 | 16 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $1,221.36 | $2,181.00 | $125.41 – $1,570.32 | 6 |
| Injection, cangrelor HCPCS C9460 | $10.61 | $18.94 | $8.35 – $18.94 | 2 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | not published | not published | $41.12 – $549.52 | 21 |
| Injection, daratumumab 10 mg HCPCS J9145 | $25.49 | $45.52 | $12.76 – $12.76 | 1 |
| Injection during cath supravalvular aortography CPT 93567 | $3,022.88 | $5,398.00 | $161.94 – $3,497.90 | 4 |
| Injection epidural blood patch or clot CPT 62273 | not published | not published | $169.18 – $1,289.19 | 24 |
| Injection eye drug CPT 67028 | not published | not published | $50.09 – $617.46 | 21 |
| Injection for arthrography wrist (both sides) CPT 25246 | $1,011.92 | $1,807.00 | $104.66 – $1,301.04 | 6 |
| Injection for bladder x-ray CPT 51600 | $597.52 | $1,067.00 | $59.65 – $768.24 | 7 |
| Injection for hip x-ray CPT 27095 | not published | not published | $156.44 – $687.23 | 4 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $353.92 | $632.00 | $85.28 – $455.04 | 6 |
| Injection for spleen x-ray CPT 38200 | $745.36 | $1,331.00 | $189.28 – $958.32 | 6 |
| Injection for tear sac x-ray CPT 68850 | not published | not published | $174.05 – $649.71 | 4 |
| Injection for ureter x-ray CPT 50684 | not published | not published | $66.19 – $813.00 | 7 |
| Injection for ureter x-ray CPT 50690 | $636.16 | $1,136.00 | $95.72 – $817.92 | 7 |
| Injection, fulvestrant HCPCS J9395 | $32.80 | $58.56 | $49.15 – $49.15 | 1 |
| Injection glatiramer acetate HCPCS J1595 | $171.93 | $307.02 | $102.18 – $201.61 | 5 |
| Injection into brain canal CPT 61026 | not published | not published | $117.70 – $1,289.19 | 24 |
| Injection into brain canal CPT 61055 | $765.52 | $1,367.00 | $274.76 – $984.24 | 24 |
| Injection into hemorrhoid(s) CPT 46500 | not published | not published | $138.67 – $1,697.23 | 21 |
| Injection into spinal artery CPT 62294 | not published | not published | $270.80 – $1,738.00 | 24 |
| Injection into vocal cord CPT 31513 | not published | not published | $181.28 – $1,381.00 | 24 |
| Injection jugular CPT 36299 | $789.60 | $1,410.00 | $487.09 – $913.68 | 4 |
| Injection of sinus tract CPT 20500 | not published | not published | $57.20 – $362.75 | 5 |
| Injection,onabotulinumtoxina HCPCS J0585 | $415.49 | $741.95 | $3.01 – $7.67 | 5 |
| Injection px peyronie ds CPT 54200 | not published | not published | $68.41 – $452.75 | 21 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $607.04 | $1,084.00 | $60.53 – $780.48 | 23 |
| Injection, renflexis HCPCS Q5104 | $51.35 | $91.69 | $62.57 – $62.57 | 3 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | $1,044.40 | $1,865.00 | $68.83 – $1,865.00 | 7 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $786.80 | $1,405.00 | $65.78 – $1,289.19 | 23 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $786.80 | $1,405.00 | $54.20 – $1,289.19 | 23 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | not published | not published | $292.73 – $1,657.35 | 21 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $1,271.20 | $2,270.00 | $233.90 – $1,634.40 | 6 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $2,257.92 | $4,032.00 | $279.51 – $2,903.04 | 23 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $1,271.20 | $2,270.00 | $234.25 – $1,634.40 | 6 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $2,257.92 | $4,032.00 | $247.51 – $2,903.04 | 23 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | not published | not published | $392.02 – $1,289.19 | 19 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $1,317.12 | $2,352.00 | $392.02 – $1,524.10 | 20 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $303.52 | $542.00 | $24.67 – $549.52 | 23 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | not published | not published | $31.40 – $549.52 | 21 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | not published | not published | $36.62 – $549.52 | 21 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $89.60 | $160.00 | $22.26 – $85.90 | 27 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $89.60 | $160.00 | $11.35 – $103.68 | 10 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $89.60 | $160.00 | $48.60 – $392.22 | 27 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $44.80 | $80.00 | $18.87 – $132.49 | 27 |
| Injection treatment of eye CPT 66020 | not published | not published | $224.38 – $1,198.62 | 8 |
| Injection treatment of eye CPT 66030 | not published | not published | $164.35 – $1,198.62 | 8 |
| Injection treatment of nerve CPT 64605 | not published | not published | $243.03 – $1,128.40 | 8 |
| Injection treatment of nerve CPT 64610 | not published | not published | $585.69 – $1,128.40 | 8 |
| Injection treatment of nerve CPT 64681 | not published | not published | $325.02 – $1,657.35 | 21 |
| Injection treatment of nose CPT 30200 | not published | not published | $80.09 – $948.00 | 21 |
| Inject sacroiliac joint CPT 27096 | not published | not published | $449.55 – $581.15 | 4 |
| Inject/treat eye socket CPT 67500 | not published | not published | $114.73 – $556.49 | 21 |
| Inject/treat eye socket CPT 67505 | not published | not published | $42.98 – $556.49 | 21 |
| Inject/treat eye socket CPT 67515 | not published | not published | $46.72 – $556.49 | 21 |
| Inj epidural sgl cerv-thor without img CPT 62320 | not published | not published | $392.02 – $1,289.19 | 19 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $1,366.96 | $2,441.00 | $392.02 – $1,657.35 | 20 |
| Inj for ext venography CPT 36005 | $1,651.44 | $2,949.00 | $81.42 – $1,062.00 | 6 |
| Inj for mammo ductogram CPT 19030 | $813.68 | $1,453.00 | $79.88 – $1,046.16 | 7 |
| Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 | $2,013.76 | $3,596.00 | $181.44 – $2,330.21 | 4 |
| Inj hrt cath w/s&i sel hrt ang CPT 93563 | not published | not published | $63.57 – $63.57 | 3 |
| Inj hrt cath w/s&i sel hrt art CPT 93564 | not published | not published | $65.37 – $65.37 | 3 |
| Inj hrt cath w/s&i sel left vent CPT 93565 | not published | not published | $49.51 – $49.51 | 3 |
| Inj hrt cath w/s&i sel right vent CPT 93566 | not published | not published | $200.17 – $200.17 | 3 |
| Inj/inf neurolyt sbst spinal canal lesion 62282 CPT 62282 | not published | not published | $226.17 – $1,657.35 | 24 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | not published | not published | $48.24 – $369.89 | 21 |
| Inj intralesional > 7 lsns CPT 11901 | not published | not published | $61.98 – $369.89 | 21 |
| Inj ivig privigen 500 mg HCPCS J1459 | $57.52 | $102.71 | $20.01 – $81.00 | 5 |
| Inj melpha hydroch nos 50 mg HCPCS J9245 | $1,279.49 | $2,284.81 | $676.12 – $2,085.26 | 6 |
| Inj nephrosto/ureterogram w/img exstng access CPT 50431 | $2,582.72 | $4,612.00 | $275.88 – $3,320.64 | 23 |
| Inj non-compmd foam sclrsnt mlt trncl veins same leg CPT 36466 | not published | not published | $1,167.97 – $1,167.97 | 3 |
| Inj non-compmd foam sclrsnt sgl trncl vein CPT 36465 | not published | not published | $1,167.97 – $1,167.97 | 3 |
| Inj peritoneal venous shunt CPT 49427 | not published | not published | $74.06 – $132.27 | 4 |
| Inj proc ankle arthr CPT 27648 | $927.36 | $1,656.00 | $81.54 – $1,192.32 | 6 |
| Inj proc elbow arthro CPT 24220 | $1,034.32 | $1,847.00 | $95.87 – $1,329.84 | 6 |
| Inj proc for lymphang CPT 38790 | $382.48 | $683.00 | $156.44 – $698.00 | 7 |
| Inj proc lumbr disk ea lvl CPT 62290 | $1,979.60 | $3,535.00 | $296.94 – $2,545.20 | 6 |
| Inj proc myelogram lumbar CPT 62284 | $1,180.48 | $2,108.00 | $286.86 – $1,517.76 | 6 |
| Inj proc sialogram CPT 42550 | not published | not published | $90.13 – $384.90 | 4 |
| Inj retro urethrocysto CPT 51610 | $691.60 | $1,235.00 | $89.89 – $889.20 | 7 |
| Inj scleros sol mult veins CPT 36471 | not published | not published | $112.88 – $813.00 | 24 |
| Inj scleros sol sgl vein CPT 36470 | not published | not published | $100.59 – $743.75 | 21 |
| Inj secretin synthetic human HCPCS J2850 | $238.14 | $425.25 | $18.29 – $45.09 | 5 |
| Inj(s) sclerosant spider veins limb/trunk CPT 36468 | not published | not published | $61.98 – $743.75 | 21 |
| Inj w/fluor eval cv device CPT 36598 | $266.56 | $476.00 | $87.47 – $392.22 | 23 |
| Ins cath ren art 1st bi CPT 36252 | $9,990.40 | $17,840.00 | $1,430.10 – $12,844.80 | 7 |
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.