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 |
|---|---|---|---|---|
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $1,461.60 | $2,610.00 | $60.00 – $770.00 | 3 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $6,328.00 | $11,300.00 | $1,612.50 – $5,400.00 | 3 |
| Lefort i-1 piece without graft CPT 21141 | not published | not published | $2,351.10 – $3,863.84 | 4 |
| Lefort i-2 piece without graft CPT 21142 | not published | not published | $2,351.59 – $4,050.82 | 4 |
| Lefort i-3/> piece with graft CPT 21147 | not published | not published | $2,059.18 – $4,826.56 | 4 |
| Lefort i-3/> piece without graft CPT 21143 | not published | not published | $2,429.91 – $4,208.95 | 4 |
| Lefort ii anterior intrusion CPT 21150 | not published | not published | $2,058.08 – $3,123.82 | 5 |
| Leg vein fusion 34530 CPT 34530 | not published | not published | $1,182.10 – $1,735.49 | 5 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $489.44 | $874.00 | $80.78 – $449.98 | 23 |
| Leishmania antibody CPT 86717 | not published | not published | $9.98 – $23.27 | 25 |
| Lengthening of hand tendon CPT 26478 | not published | not published | $698.00 – $1,494.33 | 8 |
| Lengthening of palate CPT 42227 | not published | not published | $1,319.74 – $2,915.56 | 5 |
| Lengthening of palate+pharyngeal flap 42226 CPT 42226 | not published | not published | $1,300.41 – $2,915.56 | 5 |
| Lengthening of thigh tendon CPT 27393 | not published | not published | $631.85 – $1,743.38 | 8 |
| Lengthening of thigh tendons CPT 27394 | not published | not published | $845.28 – $3,248.44 | 8 |
| Lengthening of thigh tendons CPT 27395 | not published | not published | $1,220.96 – $2,215.91 | 8 |
| Lengthening or shortening - tibia and fibula 27715 CPT 27715 | not published | not published | $1,885.59 – $3,009.51 | 7 |
| Lengthen metacarpal/finger CPT 26568 | not published | not published | $1,253.10 – $4,651.94 | 8 |
| Lengthen radius or ulna CPT 25391 | not published | not published | $1,631.15 – $8,375.47 | 8 |
| Lengthen radius & ulna CPT 25393 | not published | not published | $1,260.08 – $2,380.00 | 8 |
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $831.60 | $1,485.00 | $315.00 – $315.00 | 1 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $1,170.40 | $2,090.00 | $75.00 – $111.89 | 4 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $162.96 | $291.00 | $232.00 – $232.00 | 1 |
| Leukacyte transfusion CPT 86950 | not published | not published | $5.63 – $319.01 | 26 |
| Leukocyte phagocytosis CPT 86344 | $49.28 | $88.00 | $5.79 – $19.74 | 23 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $488.37 | $872.08 | $127.71 – $599.85 | 7 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $476.58 | $851.04 | $473.86 – $473.86 | 1 |
| Levetiracetam therapeutic drug level CPT 80177 | $21.84 | $39.00 | $10.80 – $28.00 | 25 |
| Liberta rc ipg HCPCS C1820 | $20,160.00 | $36,000.00 | $2,258.00 – $23,996.43 | 3 |
| Lidocaine therapeutic drug level CPT 80176 | $29.68 | $53.00 | $11.97 – $27.91 | 25 |
| Ligate leg veins open CPT 37761 | not published | not published | $385.26 – $1,182.10 | 4 |
| Ligate leg veins radical 37760 CPT 37760 | not published | not published | $1,182.10 – $1,824.59 | 8 |
| Ligate oviduct(s) add-on 58611 CPT 58611 | not published | not published | $118.92 – $217.81 | 4 |
| Ligate/strip long leg vein CPT 37722 | not published | not published | $705.42 – $1,824.59 | 5 |
| Ligate/strip short leg vein CPT 37718 | not published | not published | $551.89 – $1,563.94 | 5 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | not published | not published | $767.78 – $1,738.00 | 8 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | not published | not published | $290.49 – $1,381.00 | 8 |
| Ligation/divis of long saph vein 37700 CPT 37700 | not published | not published | $465.63 – $1,563.94 | 8 |
| Ligation external carotid artery 37600 CPT 37600 | not published | not published | $901.25 – $1,735.49 | 5 |
| Ligation internal/common carotid artery 37605 CPT 37605 | not published | not published | $992.91 – $1,735.49 | 5 |
| Ligation internal jugular vein 37565 CPT 37565 | not published | not published | $502.96 – $1,182.10 | 5 |
| Ligation/major artery/extremity 37618 CPT 37618 | not published | not published | $827.51 – $1,107.94 | 4 |
| Ligation major artery neck CPT 37615 | not published | not published | $502.96 – $1,996.32 | 5 |
| Ligation nasal sinus artery CPT 30915 | not published | not published | $1,044.35 – $1,824.59 | 8 |
| Ligation of abdomen artery 37617 CPT 37617 | not published | not published | $1,794.33 – $3,876.77 | 4 |
| Ligation of femoral vein CPT 37650 | not published | not published | $635.75 – $1,563.94 | 5 |
| Ligation of inf vena cava CPT 37619 | $4,975.04 | $8,884.00 | $1,996.32 – $6,396.48 | 7 |
| Ligation of neck artery CPT 37606 | not published | not published | $812.39 – $1,735.49 | 5 |
| Ligation of salivary duct CPT 42665 | not published | not published | $305.32 – $2,080.85 | 5 |
| Ligation upper jaw artery CPT 30920 | not published | not published | $1,182.10 – $1,824.59 | 8 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | not published | not published | $380.73 – $1,738.00 | 8 |
| Lig/band angioaccess av fistula CPT 37607 | not published | not published | $570.33 – $1,563.94 | 5 |
| Lig&div&compl strpg saph vn CPT 37735 | not published | not published | $1,182.10 – $1,824.59 | 8 |
| Limb exercise test CPT 95875 | not published | not published | $62.13 – $291.27 | 21 |
| Limited visual field xm CPT 92081 | not published | not published | $35.90 – $110.58 | 21 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $27.12 | $48.43 | $16.63 – $16.63 | 1 |
| Lipase CPT 83690 | $39.76 | $71.00 | $5.62 – $13.09 | 25 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $520.15 – $1,381.00 | 8 |
| Lipoprotein blood high res frac & quant CPT 83701 | $30.46 | $54.40 | $19.80 – $64.33 | 23 |
| Lipoprotein blood quant CPT 83704 | $39.76 | $71.00 | $26.16 – $102.11 | 23 |
| Lipoprotein direct measurement hdl CPT 83718 | $42.00 | $75.00 | $6.68 – $15.56 | 25 |
| Lipoprotein direct measurement ldl CPT 83721 | $16.24 | $29.00 | $7.77 – $19.95 | 25 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $32.48 – $64.96 | 16 |
| Lip surgery procedure CPT 40799 | not published | not published | $68.01 – $432.29 | 20 |
| Listeria monocytogenes CPT 86723 | not published | not published | $10.74 – $25.06 | 25 |
| Lithium therapeutic drug level CPT 80178 | $33.04 | $59.00 | $5.39 – $12.56 | 25 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | $1,281.55 – $3,472.99 | 4 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | not published | not published | $167.38 – $334.76 | 16 |
| Liver elastography 91200 CPT 91200 | $219.52 | $392.00 | $22.61 – $291.27 | 24 |
| Liver Function Test CPT 80076 | $16.24 | $29.00 | $6.26 – $21.36 | 25 |
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | $1,025.90 – $4,180.11 | 4 |
| Liver imaging CPT 78201 | not published | not published | $136.90 – $1,002.04 | 26 |
| Liver imag w/vasclr flow CPT 78202 | not published | not published | $163.78 – $1,002.04 | 26 |
| Liver/spleen imag static only CPT 78215 | $660.24 | $1,179.00 | $155.24 – $748.03 | 26 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $468.16 | $836.00 | $89.79 – $748.03 | 26 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $68.76 – $737.01 | 5 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $868.82 – $1,743.38 | 8 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $2.80 | $5.00 | $0.91 – $0.91 | 1 |
| Loudness balance test CPT 92562 | not published | not published | $19.93 – $579.69 | 18 |
| Low back disk surgery CPT 63030 | not published | not published | $1,882.73 – $5,851.63 | 5 |
| Low cost skin substitute app HCPCS C5271 | $1,036.56 | $1,851.00 | $225.48 – $350.20 | 2 |
| Low cost skin substitute app HCPCS C5273 | $5,169.92 | $9,232.00 | $1,103.58 – $1,124.32 | 2 |
| Low cost skin substitute app HCPCS C5275 | $1,036.56 | $1,851.00 | $225.48 – $350.20 | 2 |
| Low cost skin substitute app HCPCS C5277 | $3,414.32 | $6,097.00 | $350.20 – $742.30 | 2 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $766.08 | $1,368.00 | $124.59 – $790.13 | 26 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $590.24 | $1,054.00 | $182.90 – $664.83 | 26 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $542.08 | $968.00 | $59.17 – $448.20 | 26 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $1,312.08 | $2,343.00 | $238.97 – $1,293.29 | 26 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $1,148.00 | $2,050.00 | $238.97 – $1,039.30 | 26 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $983.92 | $1,757.00 | $143.88 – $779.32 | 26 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $154.00 | $275.00 | $23.56 – $197.96 | 26 |
| Lower jaw bone graft CPT 21215 | not published | not published | $1,697.49 – $2,239.92 | 5 |
| Low frequency non-thermal Ultrasound CPT 97610 | $162.40 | $290.00 | $61.98 – $369.89 | 21 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $1,034.09 – $3,065.68 | 5 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $2,311.87 – $4,685.33 | 5 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $1,200.41 – $4,685.50 | 5 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $1,965.09 – $4,685.33 | 5 |
| L/s ratio fetal lung CPT 83661 | $51.58 | $92.10 | $17.91 – $41.78 | 25 |
| Lumbar diskogram s&i CPT 72295 | $494.48 | $883.00 | $63.95 – $1,430.10 | 10 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $2,563.07 – $17,387.50 | 5 |
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.