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 |
|---|---|---|---|---|
| Subsequent intensive care infant 2501-5000 grams 99480 CPT 99480 | not published | not published | $133.09 – $273.75 | 4 |
| Subtalar arthro w/deb CPT 29906 | not published | not published | $765.47 – $1,743.38 | 4 |
| Subtalar arthro w/exc CPT 29905 | not published | not published | $1,260.08 – $1,743.38 | 4 |
| Subtalar arthro w/fb rmvl CPT 29904 | not published | not published | $1,260.08 – $1,743.38 | 4 |
| Subtalar arthro w/fusion CPT 29907 | not published | not published | $3,715.70 – $6,103.84 | 4 |
| Suction lipectomy head&neck CPT 15876 | not published | not published | $1,001.44 – $1,659.41 | 5 |
| Suction lipectomy lwr extrem CPT 15879 | not published | not published | $768.68 – $1,935.97 | 5 |
| Suction lipectomy trunk CPT 15877 | not published | not published | $1,059.92 – $1,935.97 | 5 |
| Suction lipectomy upr extrem CPT 15878 | not published | not published | $768.68 – $1,275.41 | 5 |
| Sugars multiple quant CPT 84379 | not published | not published | $9.39 – $30.94 | 25 |
| Sugars single quant CPT 84378 | $13.44 | $24.00 | $9.39 – $32.45 | 25 |
| Sulfonylurea screen qn-sendout CPT 80377 | not published | not published | $11.77 – $28.75 | 8 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $48.72 | $87.00 | $26.28 – $75.79 | 4 |
| Sup of prep of antigen # of vials 95144 CPT 95144 | not published | not published | $9.36 – $85.90 | 21 |
| Supprelin la implant HCPCS J9226 | $23,946.72 | $42,762.00 | $11,661.86 – $11,661.86 | 1 |
| Surg dx exam anorectal CPT 45990 | not published | not published | $147.94 – $1,365.86 | 5 |
| Surg ect salp-oophorectomy 59120 CPT 59120 | not published | not published | $1,194.75 – $2,272.56 | 4 |
| Surg ect without salp-oophorectomy 59121 CPT 59121 | not published | not published | $1,090.49 – $2,279.52 | 4 |
| Surgery for urethra pouch CPT 53240 | not published | not published | $643.22 – $2,133.60 | 8 |
| Surgery to stop leg growth CPT 27475 | not published | not published | $1,212.96 – $1,914.98 | 5 |
| Surgery to stop leg growth CPT 27477 | not published | not published | $1,260.08 – $1,792.65 | 5 |
| Surgery to stop leg growth CPT 27479 | not published | not published | $1,260.08 – $1,983.38 | 5 |
| Surgery to stop leg growth CPT 27485 | not published | not published | $802.66 – $1,792.65 | 5 |
| Surgical exposure prostate 55860 CPT 55860 | not published | not published | $1,180.08 – $2,133.60 | 5 |
| Surgical opening of stomach CPT 43510 | not published | not published | $392.06 – $1,745.34 | 21 |
| Surgical opening of stomach 43500 CPT 43500 | not published | not published | $925.29 – $2,263.60 | 4 |
| Surgical opening of throat CPT 42955 | not published | not published | $362.75 – $1,381.00 | 8 |
| Surgical pathology level 1 gross examination only CPT 88300 | $16.80 | $30.00 | $11.97 – $45.58 | 26 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $34.72 | $62.00 | $16.05 – $73.07 | 26 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $42.00 | $75.00 | $25.12 – $99.47 | 26 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $74.48 | $133.00 | $25.12 – $170.02 | 27 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $105.84 | $189.00 | $110.15 – $669.65 | 27 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $153.44 | $274.00 | $231.72 – $1,520.72 | 26 |
| Surgical repair stomach bleedin ulcer 43501 CPT 43501 | not published | not published | $1,404.63 – $3,879.75 | 4 |
| Surgical repair stomach gastric lac 43502 CPT 43502 | not published | not published | $1,420.77 – $4,337.24 | 4 |
| Surg tx anal fistula 2nd stage 46285 CPT 46285 | not published | not published | $415.61 – $1,365.86 | 8 |
| Susceptibility agar dilution per agent CPT 87181 | $10.08 | $18.00 | $2.02 – $9.03 | 25 |
| Susceptibility enzyme detection per enzyme CPT 87185 | not published | not published | $3.30 – $9.03 | 25 |
| Susceptibility mic per plate CPT 87186 | $19.04 | $34.00 | $7.04 – $16.43 | 25 |
| Suscept studies macrobroth dilution ea CPT 87188 | not published | not published | $5.41 – $12.62 | 25 |
| Suspension of testis CPT 54620 | not published | not published | $387.70 – $1,738.00 | 8 |
| Suspension of uterus 58400 CPT 58400 | not published | not published | $761.23 – $1,245.18 | 4 |
| Sutr lg intestine 1/mult perf without colostomy 44604 CPT 44604 | not published | not published | $1,425.79 – $3,051.29 | 4 |
| Suture bile duct injury 47900 CPT 47900 | not published | not published | $1,519.79 – $3,952.36 | 4 |
| Svc venogram s&i CPT 75827 | $1,127.28 | $2,013.00 | $96.44 – $482.57 | 10 |
| Sweat collection by iontophoresis CPT 89230 | $51.52 | $92.00 | $3.25 – $99.47 | 26 |
| Sympathectomy cervical CPT 64802 | not published | not published | $732.49 – $1,381.00 | 8 |
| Sympathectomy digital artery CPT 64820 | not published | not published | $732.49 – $1,249.29 | 5 |
| Sympathectomy supfc palmar CPT 64823 | not published | not published | $765.47 – $1,346.10 | 5 |
| Synthetic sentence id test CPT 92576 | not published | not published | $16.05 – $73.07 | 18 |
| Synvisc or synvisc-one HCPCS J7325 | $1,053.54 | $1,881.32 | $6.77 – $20.27 | 5 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $21.84 | $39.00 | $3.59 – $8.36 | 25 |
| System cardiomems hosp electronics HCPCS C2624 | $25,200.00 | $45,000.00 | $45,000.00 – $45,000.00 | 1 |
| System pacing micra av HCPCS C1786 | $15,288.00 | $27,300.00 | $1,675.04 – $5,372.00 | 3 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $5,851.44 | $10,449.00 | $375.00 – $5,960.00 | 3 |
| T3 (triiodothyronine) free CPT 84481 | $29.68 | $53.00 | $10.07 – $32.19 | 25 |
| T3 (triiodothyronine) total CPT 84480 | $56.00 | $100.00 | $11.56 – $26.94 | 25 |
| T4 (thyroxine) free CPT 84439 | $38.08 | $68.00 | $7.35 – $18.06 | 25 |
| T4 (thyroxine) total CPT 84436 | $42.00 | $75.00 | $5.60 – $13.05 | 25 |
| Tacrol astagraf ex rel oral HCPCS J7508 | $0.50 | $0.90 | $0.21 – $0.69 | 7 |
| Tacrol envarsus ex rel oral HCPCS J7503 | $1.21 | $2.16 | $1.50 – $1.51 | 4 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $4.10 | $7.31 | $0.14 – $0.54 | 4 |
| Tacrolimus therapeutic drug level CPT 80197 | $63.28 | $113.00 | $11.19 – $26.09 | 25 |
| Tah rad debulk/lymph remove 58954 CPT 58954 | not published | not published | $3,150.60 – $6,339.28 | 4 |
| Tah rad dissect for debulk 58953 CPT 58953 | not published | not published | $2,912.72 – $5,835.04 | 4 |
| Tah w/mmk 58152 CPT 58152 | not published | not published | $1,935.50 – $3,534.64 | 4 |
| Tap block bilat cont infusion 64489 CPT 64489 | not published | not published | $503.24 – $503.24 | 3 |
| Tap block uni by cont infusion 64487 CPT 64487 | not published | not published | $379.92 – $379.92 | 3 |
| Target gsa panel hmtlmph neop CPT 81450 | not published | not published | $690.84 – $1,443.11 | 22 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | not published | not published | $898.84 – $5,368.33 | 3 |
| Target gsa panel organ neop CPT 81445 | not published | not published | $568.01 – $1,136.03 | 22 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | not published | not published | $125.96 – $1,139.52 | 21 |
| Tavr perq femoral CPT 33361 | $5,152.56 | $9,201.00 | $3,937.44 – $6,624.72 | 6 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $1.34 | $2.39 | $0.66 – $2.03 | 5 |
| Tbs techl calculation only CPT 77091 | not published | not published | $81.96 – $163.91 | 16 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $81.96 – $163.91 | 16 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | not published | not published | $66.01 – $190.00 | 24 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $72.80 | $130.00 | $50.51 – $117.76 | 25 |
| Tc-99m bicisate HCPCS A9557 | $665.28 | $1,188.00 | $311.93 – $511.25 | 6 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | $1,337.84 | $2,389.00 | $3.24 – $2,389.00 | 6 |
| Tc-99m exametazime diag HCPCS A9521 | $850.08 | $1,518.00 | $497.34 – $1,124.12 | 3 |
| Tc-99m labeled rbc HCPCS A9560 | $202.16 | $361.00 | $112.09 – $150.96 | 6 |
| Tc-99m maa HCPCS A9540 | $46.48 | $83.00 | $41.22 – $63.12 | 6 |
| Tc-99m mebrofenin HCPCS A9537 | $82.88 | $148.00 | $69.80 – $120.40 | 6 |
| Tc-99m medronate HCPCS A9503 | $54.32 | $97.00 | $17.86 – $37.31 | 6 |
| Tc-99m mertiatide HCPCS A9562 | $220.64 | $394.00 | $322.50 – $322.50 | 1 |
| Tc-99m oxidronate HCPCS A9561 | $72.80 | $130.00 | $37.61 – $60.46 | 6 |
| Tc-99m pentetate dtpa HCPCS A9539 | $36.96 | $66.00 | $22.25 – $57.28 | 6 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $36.96 | $66.00 | $64.28 – $64.28 | 2 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $3.36 | $6.00 | $2.20 – $3.00 | 5 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $56.00 | $100.00 | $34.53 – $46.19 | 6 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $192.08 | $343.00 | $111.11 – $143.80 | 6 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $149.52 | $267.00 | $156.51 – $233.30 | 3 |
| Tc-99m sulfur colloid HCPCS A9541 | $67.76 | $121.00 | $73.47 – $98.70 | 6 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $192.08 | $343.00 | $111.11 – $133.91 | 6 |
| Tca peel dermal 15789 CPT 15789 | not published | not published | $118.64 – $1,139.52 | 21 |
| Tcd emboli detect w/inj CPT 93893 | $173.04 | $309.00 | $48.43 – $264.82 | 23 |
| Tcd emboli detect without inj CPT 93892 | $173.04 | $309.00 | $48.43 – $241.13 | 23 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $260.66 – $813.85 | 20 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $108.64 | $194.00 | $38.29 – $89.26 | 25 |
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.