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 |
|---|---|---|---|---|
| Radiation treatment delivery CPT 77402 | $305.20 | $545.00 | $58.04 – $265.37 | 26 |
| Radiation treatment delivery CPT 77412 | $576.80 | $1,030.00 | $102.23 – $489.55 | 26 |
| Radical abdominal hysterectomy 58210 CPT 58210 | not published | not published | $3,194.60 – $5,291.03 | 4 |
| Radical resection of elbow CPT 24149 | not published | not published | $1,260.08 – $3,248.44 | 5 |
| Radical resection sternum 21630 CPT 21630 | not published | not published | $1,377.37 – $3,481.93 | 4 |
| Radic resect abd tumor<5cm 22904 CPT 22904 | not published | not published | $743.91 – $1,264.58 | 4 |
| Radic resect shoulder tumor 5cm/> 23078 CPT 23078 | not published | not published | $743.91 – $1,475.33 | 4 |
| Radiology port images(s) CPT 77417 | $258.72 | $462.00 | $12.96 – $37.89 | 9 |
| Radiotherapy dose plan imrt CPT 77301 | $3,002.16 | $5,361.00 | $540.10 – $2,930.94 | 10 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $861.84 | $1,539.00 | $232.16 – $499.85 | 10 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $906.08 | $1,618.00 | $317.89 – $918.28 | 10 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $994.56 | $1,776.00 | $232.16 – $512.94 | 10 |
| Radphm lcl tumor plr sgl day CPT 78800 | $251.44 | $449.00 | $143.72 – $748.03 | 26 |
| Rad rescj tum dstl/shft hum CPT 24150 | not published | not published | $1,260.08 – $3,838.86 | 8 |
| Rad rescj tum shoulder<5 cm CPT 23077 | not published | not published | $743.91 – $1,738.00 | 8 |
| Rad rescj tum tiss a/e 5 cm+ CPT 24079 | not published | not published | $743.91 – $1,475.33 | 4 |
| Rad rescj tum tiss a/e <5cm CPT 24077 | not published | not published | $743.91 – $1,738.00 | 8 |
| Rad resec soft tis tum/ft/toe/<3cm 28046 CPT 28046 | not published | not published | $743.91 – $1,738.00 | 8 |
| Rad resect abd tumor 5 cm/> CPT 22905 | not published | not published | $743.91 – $1,475.33 | 4 |
| Rad resect hand tumor < 3 cm CPT 26117 | not published | not published | $686.36 – $1,738.00 | 8 |
| Rad resect hand tumor 3 cm/> CPT 26118 | not published | not published | $743.91 – $1,475.33 | 4 |
| Rad resection tum radial h/n CPT 24152 | not published | not published | $1,194.25 – $3,248.44 | 8 |
| Rad resect tumor/neck/ant thor/<5cm21557 CPT 21557 | not published | not published | $743.91 – $1,264.58 | 5 |
| Rapid desensitization CPT 95180 | not published | not published | $47.96 – $742.84 | 21 |
| Rapid Strep Test CPT 87880 | $49.84 | $89.00 | $10.91 – $31.41 | 25 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | $164.98 | $294.60 | $119.72 – $292.10 | 2 |
| Rbc count only automated CPT 85041 | $10.64 | $19.00 | $2.46 – $5.74 | 25 |
| Rbc deglycerolized each unit HCPCS P9039 | $582.40 | $1,040.00 | $200.05 – $558.00 | 5 |
| Rbc depletion of harvest CPT 38212 | not published | not published | $260.66 – $813.85 | 20 |
| Rbc serum pretx incubj drugs CPT 86975 | $15.68 | $28.00 | $9.19 – $742.84 | 26 |
| Rcnst bfrnt sp orb rm&lw fhd CPT 21175 | not published | not published | $2,080.85 – $3,356.50 | 5 |
| Rdctj forehead cntrg only CPT 21137 | not published | not published | $850.49 – $1,578.73 | 5 |
| Rdctj forehead cntrg&prostc CPT 21138 | not published | not published | $1,178.29 – $2,915.56 | 5 |
| Rdctj forehead cntrg&setback CPT 21139 | not published | not published | $1,238.48 – $2,915.56 | 5 |
| Realignment of knee CPT 27457 | not published | not published | $1,621.30 – $2,706.18 | 4 |
| Realignment of tendons CPT 26437 | not published | not published | $765.47 – $1,738.00 | 8 |
| Rebuild eardrum structures CPT 69632 | not published | not published | $1,899.70 – $2,915.56 | 5 |
| Rebuild eardrum structures CPT 69633 | not published | not published | $1,919.70 – $2,915.56 | 5 |
| Rebuild eardrum structures CPT 69636 | not published | not published | $2,029.86 – $3,123.82 | 5 |
| Rebuild outer ear canal CPT 69310 | not published | not published | $1,301.95 – $2,915.56 | 8 |
| Rebuild outer ear canal CPT 69320 | not published | not published | $1,925.34 – $2,915.56 | 5 |
| Rechanneling of artery CPT 35361 | not published | not published | $2,616.74 – $4,441.67 | 4 |
| Rechanneling of artery 35305 CPT 35305 | not published | not published | $3,589.35 – $3,589.35 | 3 |
| Rechanneling of artery 35341 CPT 35341 | not published | not published | $2,532.90 – $3,995.12 | 4 |
| Rechanneling w/graft tibioperoneal trunk artery 35304 CPT 35304 | not published | not published | $3,754.44 – $3,754.44 | 3 |
| Rechanneling w/wo patch graft abd aorta 35331 CPT 35331 | not published | not published | $2,351.99 – $4,231.82 | 4 |
| Rechanneling w/wo patch graft deep profunda fem art 35372 CPT 35372 | not published | not published | $1,829.08 – $2,861.34 | 4 |
| Rechanneling w/wo patch grf axillary-brachial 35321 CPT 35303 | not published | not published | $3,617.19 – $3,617.19 | 3 |
| Reconst lwr jaw w/fixation CPT 21196 | not published | not published | $2,604.78 – $4,269.62 | 4 |
| Reconst lwr jaw w/graft CPT 21194 | not published | not published | $2,770.39 – $4,249.72 | 4 |
| Reconst lwr jaw without fixation CPT 21195 | not published | not published | $2,080.85 – $3,037.04 | 5 |
| Reconst lwr jaw without graft CPT 21193 | not published | not published | $2,080.85 – $3,037.04 | 5 |
| Reconst major injured chest 32820 CPT 32820 | not published | not published | $2,043.09 – $4,048.82 | 4 |
| Reconst pectus excavatum/carinatum opn 21740 CPT 21740 | not published | not published | $2,220.08 – $2,953.83 | 4 |
| Reconstr lwr jaw segment CPT 21198 | not published | not published | $850.49 – $2,499.06 | 5 |
| Reconstr lwr jaw w/advance CPT 21199 | not published | not published | $1,428.72 – $2,915.56 | 5 |
| Reconstruct ankle joint CPT 27702 | not published | not published | $2,627.46 – $2,788.91 | 4 |
| Reconstruct cleft foot CPT 28360 | not published | not published | $1,398.78 – $3,838.86 | 5 |
| Reconstruct cleft palate CPT 42200 | not published | not published | $1,537.84 – $2,915.56 | 5 |
| Reconstruct cleft palate CPT 42205 | not published | not published | $1,487.83 – $2,490.65 | 5 |
| Reconstruct cleft palate CPT 42210 | not published | not published | $1,666.83 – $2,915.56 | 5 |
| Reconstruct cleft palate CPT 42215 | not published | not published | $1,502.14 – $2,499.06 | 5 |
| Reconstruct cleft palate CPT 42220 | not published | not published | $1,276.30 – $2,499.06 | 5 |
| Reconstruct cleft palate CPT 42225 | not published | not published | $1,402.40 – $2,499.06 | 5 |
| Reconstruct elbow joint CPT 24360 | not published | not published | $1,355.51 – $3,248.44 | 5 |
| Reconstruct elbow joint CPT 24361 | not published | not published | $1,640.02 – $15,334.01 | 5 |
| Reconstruct elbow joint CPT 24362 | not published | not published | $1,833.04 – $8,747.25 | 5 |
| Reconstruct elbow lat ligmnt CPT 24344 | not published | not published | $1,845.80 – $3,789.85 | 5 |
| Reconstruct elbow med ligmnt CPT 24346 | not published | not published | $1,845.80 – $6,103.84 | 5 |
| Reconstruct extra finger CPT 26587 | not published | not published | $1,006.08 – $1,494.33 | 5 |
| Reconstruct finger joint CPT 26545 | not published | not published | $1,041.34 – $2,380.00 | 8 |
| Reconstruct finger joint CPT 26548 | not published | not published | $866.10 – $2,380.00 | 8 |
| Reconstruct head of radius CPT 24365 | not published | not published | $902.64 – $8,912.67 | 5 |
| Reconstruct head of radius CPT 24366 | not published | not published | $1,125.14 – $10,411.94 | 5 |
| Reconstruction ankle joint CPT 27703 | not published | not published | $2,457.95 – $3,174.62 | 4 |
| Reconstruction knee CPT 27427 | not published | not published | $1,358.56 – $4,060.56 | 8 |
| Reconstruction knee CPT 27428 | not published | not published | $2,001.92 – $7,577.98 | 8 |
| Reconstruction knee CPT 27429 | not published | not published | $2,043.00 – $6,103.84 | 8 |
| Reconstruction of anus CPT 46753 | not published | not published | $476.84 – $1,738.00 | 8 |
| Reconstruction of bile ducts 47800 CPT 47800 | not published | not published | $1,659.45 – $4,543.11 | 4 |
| Reconstruction of eyelid CPT 67971 | not published | not published | $737.01 – $1,738.00 | 8 |
| Reconstruction of eyelid CPT 67973 | not published | not published | $737.01 – $1,738.00 | 8 |
| Reconstruction of eyelid CPT 67974 | not published | not published | $1,320.44 – $1,738.00 | 8 |
| Reconstruction of eyelid CPT 67975 | not published | not published | $657.44 – $1,738.00 | 8 |
| Reconstruction of jaw CPT 21245 | not published | not published | $1,094.00 – $2,080.85 | 2 |
| Reconstruction of jaw CPT 21246 | not published | not published | $1,402.54 – $2,080.85 | 2 |
| Reconstruction of jaw CPT 21248 | not published | not published | $1,472.88 – $2,080.85 | 2 |
| Reconstruction of jaw CPT 21249 | not published | not published | $2,080.85 – $2,499.06 | 5 |
| Reconstruction of jaw joint CPT 21240 | not published | not published | $1,372.66 – $2,915.56 | 8 |
| Reconstruction of jaw joint CPT 21242 | not published | not published | $2,039.96 – $2,915.56 | 5 |
| Reconstruction of jaw joint CPT 21243 | not published | not published | $1,976.13 – $13,882.47 | 5 |
| Reconstruction of lower jaw CPT 21244 | not published | not published | $1,801.44 – $2,915.56 | 5 |
| Reconstruction of mouth CPT 40840 | not published | not published | $850.49 – $2,499.06 | 8 |
| Reconstruction of mouth CPT 40842 | not published | not published | $710.91 – $2,499.06 | 8 |
| Reconstruction of mouth CPT 40843 | not published | not published | $833.20 – $2,499.06 | 8 |
| Reconstruction of mouth CPT 40844 | not published | not published | $1,349.38 – $2,915.56 | 5 |
| Reconstruction of mouth CPT 40845 | not published | not published | $1,567.52 – $2,915.56 | 5 |
| Reconstruction of nail bed CPT 11762 | not published | not published | $175.68 – $742.30 | 5 |
| Reconstruction of nose CPT 30410 | not published | not published | $2,058.76 – $3,123.82 | 5 |
| Reconstruction of nose CPT 30420 | not published | not published | $2,080.85 – $3,123.82 | 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.