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 |
|---|---|---|---|---|
| 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 |
| Tcd vasoreactivity study CPT 93890 | not published | not published | $80.78 – $210.22 | 6 |
| 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 |
| T cells absolute cd 4 count CPT 86361 | $38.64 | $69.00 | $16.12 – $50.88 | 25 |
| T cells total count CPT 86359 | $85.68 | $153.00 | $10.08 – $71.69 | 25 |
| Tcranial magn stim tx deli CPT 90868 | not published | not published | $115.90 – $579.69 | 20 |
| Tcranial magn stim tx plan CPT 90867 | not published | not published | $115.90 – $579.69 | 20 |
| Tcran magn stim redetemine CPT 90869 | not published | not published | $115.90 – $579.69 | 20 |
| Tdh sdrl/ventr pnxr CPT 61105 | not published | not published | $929.90 – $1,284.97 | 4 |
| Teaec w/wo patch graft iliofemoral CPT 35355 | not published | not published | $2,120.62 – $3,015.49 | 4 |
| Team conf without pat by hc pro CPT 99368 | not published | not published | $40.48 – $40.48 | 3 |
| Team conf without pat by phys CPT 99367 | not published | not published | $62.70 – $62.70 | 3 |
| Team conf w/pat by hc prof CPT 99366 | not published | not published | $47.52 – $47.52 | 3 |
| Telethx isodose plan cplx CPT 77307 | $1,392.72 | $2,487.00 | $114.27 – $1,611.58 | 24 |
| Telethx isodose plan simple CPT 77306 | $1,052.24 | $1,879.00 | $62.24 – $1,217.59 | 24 |
| Temozolomide HCPCS J8700 | $6.74 | $12.03 | $0.88 – $12.03 | 7 |
| Temperature gradient studies CPT 93740 | not published | not published | $2.16 – $291.27 | 21 |
| Temple bne implnt w/stimulat CPT 69715 | not published | not published | $1,458.55 – $14,295.43 | 5 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | $34.07 | $60.84 | $32.88 – $32.88 | 1 |
| Tendon lengthening CPT 26476 | not published | not published | $451.31 – $1,494.33 | 8 |
| Tendon lngth upr a/e ea tdn CPT 24305 | not published | not published | $667.54 – $1,743.38 | 5 |
| Tendon shortening CPT 26477 | not published | not published | $698.00 – $1,494.33 | 8 |
| Tendon transfer with graft CPT 26492 | not published | not published | $1,191.46 – $1,930.18 | 8 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $97.25 | $173.66 | $49.42 – $139.45 | 5 |
| Tenodesis biceps tdn at elbw CPT 24340 | not published | not published | $1,177.42 – $3,248.44 | 8 |
| Tenolysis extensor tendon hand/finger each CPT 26445 | not published | not published | $765.47 – $1,738.00 | 8 |
| Tenolysis triceps CPT 24332 | not published | not published | $765.47 – $1,743.38 | 5 |
| Tenoplasty elbow to sho 1 CPT 24320 | not published | not published | $1,117.88 – $1,983.38 | 8 |
| Tenosynovectomy radic 26145 CPT 26145 | not published | not published | $765.47 – $1,738.00 | 8 |
| Tenotomy hip flexor open CPT 27005 | not published | not published | $1,049.28 – $2,067.68 | 4 |
| Tenotomy length/rls abductor hallucis musc 28240 CPT 28240 | not published | not published | $511.13 – $1,494.33 | 8 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | not published | not published | $276.23 – $1,381.00 | 8 |
| Tert gene targeted seq alys CPT 81345 | not published | not published | $175.94 – $351.88 | 16 |
| Test for chlorohydrocarbons CPT 82441 | not published | not published | $4.90 – $24.24 | 25 |
| Test for porphobilinogen CPT 84106 | $34.72 | $62.00 | $3.84 – $11.06 | 25 |
| Test for urine cystines CPT 82615 | not published | not published | $6.65 – $18.14 | 25 |
| Testicular imaging w/vasc flow CPT 78761 | not published | not published | $163.12 – $748.03 | 26 |
| Testosterone response panel CPT 80414 | not published | not published | $42.08 – $98.12 | 25 |
| Test stress cardiovascular tracing only CPT 93017 | $1,020.88 | $1,823.00 | $74.25 – $579.69 | 20 |
| Test urine for lactose CPT 83633 | not published | not published | $3.48 – $21.38 | 25 |
| Test urine for porphyrins CPT 84119 | $38.08 | $68.00 | $6.60 – $25.38 | 25 |
| Test urine urobilinogen CPT 84578 | not published | not published | $2.95 – $8.49 | 25 |
| Tetanus ig im CPT 90389 | not published | not published | $477.15 – $728.08 | 4 |
| Tetanus immune globulin inj HCPCS J1670 | $168.18 | $300.33 | $134.24 – $134.24 | 1 |
| Tgfbi gene common variants CPT 81333 | not published | not published | $130.15 – $260.30 | 16 |
| Tgsap hl neo 5-50 rna alys CPT 81451 | not published | not published | $721.55 – $1,443.11 | 16 |
| Tgsap so neo 5-50 rna alys CPT 81449 | not published | not published | $568.01 – $1,136.03 | 16 |
| Thaw cryoprsvrd reprod tiss CPT 89354 | not published | not published | $13.23 – $319.01 | 19 |
| Thawing cryopresrved embryo CPT 89352 | not published | not published | $13.23 – $319.01 | 22 |
| Thawing cryopresrved oocyte CPT 89356 | not published | not published | $11.79 – $319.01 | 19 |
| Thawing cryopresrved sperm CPT 89353 | not published | not published | $12.00 – $99.47 | 21 |
| Thaw preserved stem cells CPT 38208 | not published | not published | $183.65 – $813.85 | 20 |
| Theophylline therapeutic drug level CPT 80198 | $63.28 | $113.00 | $11.52 – $26.87 | 25 |
| Therapy activation ipnss CPT 93150 | not published | not published | $85.43 – $170.87 | 16 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | not published | not published | $17.43 – $64.64 | 20 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | not published | not published | $14.69 – $56.37 | 20 |
| Therapy photodnmc lght dstr lsn skn by staff rx per day CPT 96567 | not published | not published | $61.98 – $369.89 | 21 |
| Ther fx nasal inf turbinate CPT 30930 | not published | not published | $166.37 – $1,345.11 | 5 |
| Ther nma rdctj intus/obstrcj CPT 74283 | not published | not published | $98.41 – $331.40 | 26 |
| Ther/proph/diag inj ia CPT 96373 | $84.00 | $150.00 | $22.02 – $392.22 | 27 |
| Ther radiology tx plng cplx CPT 77263 | not published | not published | $146.90 – $324.80 | 6 |
| Ther radiology tx plng intrm CPT 77262 | not published | not published | $99.29 – $220.03 | 6 |
| Ther radiology tx plng smpl CPT 77261 | not published | not published | $65.63 – $146.19 | 6 |
| Thorabd diaphr hern repair CPT 43336 | not published | not published | $4,351.18 – $4,351.18 | 3 |
| Thorabd diaphr hern repair CPT 43337 | not published | not published | $4,690.31 – $4,690.31 | 3 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | $1,769.04 | $3,159.00 | $253.97 – $2,274.48 | 23 |
| Thoracic aortic graft 33875 CPT 33875 | not published | not published | $3,612.28 – $7,918.63 | 4 |
| Thoracic duct procedure CPT 38380 | not published | not published | $656.38 – $1,606.20 | 4 |
| Thoracic duct procedure CPT 38381 | not published | not published | $1,240.46 – $2,315.32 | 4 |
| Thoracic duct procedure CPT 38382 | not published | not published | $888.76 – $1,931.42 | 4 |
| Thoracic lymphadenect/thoracotomy 38746 CPT 38746 | not published | not published | $429.42 – $621.59 | 4 |
| Thoracoabdominal graft 33877 CPT 33877 | not published | not published | $4,977.69 – $10,519.39 | 4 |
| Thoracoscop w/esoph musc exc CPT 32665 | not published | not published | $1,482.85 – $3,554.54 | 4 |
| Thoracoscopy bilobectomy 32670 CPT 32670 | not published | not published | $4,616.72 – $4,616.72 | 3 |
| Thoracoscopy diagnostic 32601 CPT 32601 | not published | not published | $637.75 – $3,087.17 | 5 |
| Thoracoscopy for lvrs CPT 32672 | not published | not published | $4,388.96 – $4,388.96 | 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.