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 |
|---|---|---|---|---|
| Unlstd laps px mat care&dlvr CPT 59898 | not published | not published | $2,104.60 – $3,087.17 | 4 |
| Unlstd laps px sprmatic cord CPT 55559 | not published | not published | $2,104.60 – $3,087.17 | 4 |
| Unsched dialysis esrd pt hos HCPCS G0257 | $426.72 | $762.00 | $8.71 – $287.55 | 3 |
| Upgrade pm system CPT 33214 | $14,580.72 | $26,037.00 | $808.48 – $18,746.64 | 7 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $1,312.08 | $2,343.00 | $238.97 – $1,302.22 | 26 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $1,148.00 | $2,050.00 | $238.97 – $1,045.45 | 26 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $983.92 | $1,757.00 | $143.88 – $779.32 | 26 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | not published | not published | $378.05 – $1,745.34 | 24 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | not published | not published | $392.06 – $1,745.34 | 24 |
| Upper ext harvest for cabg1 seg 35600 CPT 35600 | not published | not published | $421.20 – $738.95 | 4 |
| Uppr gi scope w/submuc inj CPT 43236 | not published | not published | $375.65 – $1,745.34 | 21 |
| Urachal cyst/sinus excision 51500 CPT 51500 | not published | not published | $1,027.88 – $2,380.00 | 8 |
| Urea nitrogen CPT 84520 | $19.04 | $34.00 | $3.75 – $7.50 | 23 |
| Urea nitrogen 24 hour urine CPT 84540 | $19.04 | $34.00 | $3.87 – $10.56 | 25 |
| Urea nitrogen clearance CPT 84545 | $27.44 | $49.00 | $5.39 – $13.68 | 25 |
| Urea nitrogen semi-quant CPT 84525 | not published | not published | $1.82 – $9.75 | 23 |
| Ureteral embolization/occl CPT 50705 | $497.28 | $888.00 | $575.42 – $5,464.08 | 6 |
| Ureteral reflux study CPT 78740 | $497.28 | $888.00 | $146.77 – $748.03 | 26 |
| Ureter endoscopy CPT 50970 | not published | not published | $275.88 – $813.00 | 8 |
| Ureter endoscopy & biopsy CPT 50955 | not published | not published | $224.97 – $2,133.60 | 8 |
| Ureter endoscopy & biopsy CPT 50974 | not published | not published | $234.71 – $2,133.60 | 8 |
| Ureter endoscopy & catheter CPT 50972 | not published | not published | $151.36 – $813.00 | 8 |
| Ureter endoscopy & treatment CPT 50957 | not published | not published | $234.71 – $2,133.60 | 8 |
| Ureter endoscopy & treatment CPT 50961 | not published | not published | $462.33 – $2,133.60 | 8 |
| Ureter endoscopy & treatment CPT 50976 | not published | not published | $244.20 – $2,133.60 | 8 |
| Ureter endoscopy & treatment CPT 50980 | not published | not published | $234.71 – $2,133.60 | 8 |
| Ureteroneocystostomy 50780 CPT 50780 | not published | not published | $1,728.65 – $3,183.56 | 4 |
| Ureteroureterostomy 50760 CPT 50760 | not published | not published | $1,753.02 – $3,234.29 | 4 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $174.72 | $312.00 | $51.57 – $449.98 | 26 |
| Urethrlys transvag with scope CPT 53500 | not published | not published | $1,180.08 – $1,869.27 | 4 |
| Urethrocystography void s&i CPT 74455 | $194.88 | $348.00 | $66.30 – $449.98 | 26 |
| Uric acid blood CPT 84550 | $21.84 | $39.00 | $4.29 – $8.59 | 23 |
| Uric acid urine CPT 84560 | $19.04 | $34.00 | $3.87 – $9.65 | 25 |
| Urinalysis glass test CPT 81020 | not published | not published | $3.10 – $8.93 | 25 |
| Urinalysis microscopic only CPT 81015 | $11.76 | $21.00 | $2.48 – $5.79 | 25 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | $12.32 | $22.00 | $1.76 – $4.12 | 25 |
| Urinalysis (with microscopy) CPT 81001 | $25.76 | $46.00 | $2.59 – $6.02 | 25 |
| Urinalysis (without microscopy) CPT 81003 | $11.76 | $21.00 | $1.83 – $4.27 | 25 |
| Urinary bldr retent nuc study CPT 78730 | not published | not published | $62.65 – $121.31 | 9 |
| Urinary reflex study CPT 51792 | not published | not published | $29.42 – $343.62 | 21 |
| Urine Culture Test CPT 87086 | $42.56 | $76.00 | $6.57 – $15.33 | 25 |
| Urine flow measurement 51736 CPT 51736 | not published | not published | $47.96 – $239.95 | 21 |
| Urine pregnancy test CPT 81025 | $33.60 | $60.00 | $5.68 – $16.36 | 26 |
| Urine screen for bacteria CPT 81007 | not published | not published | $2.98 – $56.96 | 25 |
| Urine shunt to intestine CPT 50815 | not published | not published | $2,110.76 – $3,522.71 | 4 |
| Urography, antegrade CPT 74425 | $301.28 | $538.00 | $44.36 – $664.83 | 26 |
| Urography inf drip &/or bolus CPT 74410 | not published | not published | $82.04 – $331.40 | 26 |
| Use 1st target lesion CPT 76982 | not published | not published | $58.21 – $197.96 | 20 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | $9.48 | $16.93 | $13.74 – $16.93 | 4 |
| Vaccine dtap < 7 years im CPT 90700 | not published | not published | $30.02 – $33.95 | 4 |
| Vaccine dtap-hep b-ipv im CPT 90723 | not published | not published | $67.37 – $107.89 | 4 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | not published | not published | $69.33 – $70.96 | 4 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | not published | not published | not published | 0 |
| Vaccine dtap-ipv/hib im CPT 90698 | not published | not published | $116.46 – $131.24 | 4 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | not published | not published | $33.23 – $35.87 | 4 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | not published | not published | $14.74 – $33.16 | 4 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | not published | not published | $68.28 – $91.91 | 4 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | not published | not published | $130.77 – $142.55 | 4 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | not published | not published | $41.76 – $44.70 | 4 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | not published | not published | $26.28 – $41.76 | 4 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $83.94 – $89.21 | 4 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | not published | not published | $76.44 – $76.78 | 4 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | not published | not published | $121.66 – $150.11 | 4 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | not published | not published | $30.80 – $31.00 | 4 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | not published | not published | $298.15 – $298.15 | 3 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | not published | not published | $189.95 – $219.90 | 4 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | not published | not published | $37.41 – $61.11 | 4 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | not published | not published | $62.60 – $62.60 | 3 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | not published | not published | $14.77 – $21.98 | 4 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | not published | not published | $17.93 – $22.64 | 4 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | not published | not published | $20.43 – $20.43 | 3 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | not published | not published | $24.97 – $28.48 | 4 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | not published | not published | $21.79 – $32.10 | 4 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | not published | not published | $10.76 – $10.76 | 3 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | not published | not published | $22.92 – $31.53 | 7 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | not published | not published | $61.11 – $61.11 | 3 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | not published | not published | $25.01 – $25.01 | 3 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | not published | not published | $6.74 – $16.14 | 4 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | not published | not published | $81.90 – $234.44 | 4 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | not published | not published | $64.54 – $191.70 | 4 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | $234.96 | $419.57 | $53.32 – $167.88 | 5 |
| Vaccine mmr live subcutaneous CPT 90707 | not published | not published | $75.46 – $102.59 | 4 |
| Vaccine mmrv live subcutaneous CPT 90710 | not published | not published | $202.37 – $293.85 | 4 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | not published | not published | $84.21 – $130.77 | 4 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | not published | not published | $175.41 – $246.55 | 4 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | not published | not published | $38.73 – $45.89 | 4 |
| Vaccine rabies im CPT 90675 | $221.47 | $395.49 | $138.62 – $603.57 | 21 |
| Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 | not published | not published | $155.36 – $166.01 | 4 |
| Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 | not published | not published | $105.40 – $113.72 | 4 |
| Vaccine tdap >=7 years im CPT 90715 | not published | not published | $37.60 – $54.27 | 4 |
| Vaccine td preservative free >= 7 years im CPT 90714 | not published | not published | $27.04 – $27.17 | 4 |
| Vaccine typhoid vicps im CPT 90691 | not published | not published | $81.91 – $102.74 | 4 |
| Vaccine varicella live subcutaneous CPT 90716 | not published | not published | $126.93 – $177.49 | 4 |
| Vaccine yellow fever live subcutaneous CPT 90717 | not published | not published | $104.34 – $193.26 | 4 |
| Vaccinia vrs vac 0.3 ml perq CPT 90622 | not published | not published | $0.01 – $0.02 | 16 |
| Vag hys/<250g/rmv tube/rpr entero 58263 CPT 58263 | not published | not published | $1,844.04 – $2,801.71 | 5 |
| Vag hyst incl t/o complex CPT 58291 | not published | not published | $1,865.41 – $2,801.71 | 5 |
| Vag hyst including t/o CPT 58262 | not published | not published | $1,645.15 – $2,896.87 | 5 |
| Vag hyst t/o & repair compl CPT 58292 | not published | not published | $1,851.13 – $4,312.69 | 5 |
| Vag hyst w/enterocele compl 58294 CPT 58294 | not published | not published | $1,716.88 – $2,801.71 | 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.