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 |
|---|---|---|---|---|
| Wound therapy negative pressure per session <= 50 sq cm dme CPT 97605 | $147.84 | $264.00 | $47.27 – $369.89 | 21 |
| Wound therapy negative pressure per session > 50 sq cm dme CPT 97606 | $178.08 | $318.00 | $50.85 – $743.75 | 21 |
| Wrist arthroscopy CPT 29840 | not published | not published | $638.91 – $1,743.38 | 8 |
| Wrist arthroscopy/surgery CPT 29843 | not published | not published | $655.45 – $1,738.00 | 8 |
| Wrist arthroscopy/surgery CPT 29844 | not published | not published | $746.33 – $1,743.38 | 8 |
| Wrist arthroscopy/surgery CPT 29845 | not published | not published | $894.50 – $1,743.38 | 8 |
| Wrist arthroscopy/surgery CPT 29846 | not published | not published | $941.55 – $1,743.38 | 8 |
| Wrist arthroscopy/surgery CPT 29847 | not published | not published | $933.04 – $3,248.44 | 8 |
| Wrist endoscopy/surgery CPT 29848 | not published | not published | $692.84 – $1,346.10 | 5 |
| Wrist X-ray CPT 73110 | $180.88 | $323.00 | $26.60 – $163.91 | 26 |
| Xcapsl ctrc rmvl cplx wo ecp CPT 66982 | not published | not published | $918.24 – $1,815.93 | 5 |
| Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/< CPT 14040 | not published | not published | $742.30 – $1,381.00 | 8 |
| Xfer tis s/a/l 10 sq cm/< CPT 14020 | not published | not published | $742.30 – $1,738.00 | 8 |
| X-linked intellectual dblt CPT 81470 | not published | not published | $868.30 – $4,668.11 | 19 |
| X-linked intellectual dblt CPT 81471 | not published | not published | $0.01 – $1,736.60 | 19 |
| Xm archive tissue molec anal CPT 88363 | $28.56 | $51.00 | $6.68 – $45.58 | 26 |
| Xpos opn axillary/sbclvn art w/cndt crtn CPT 34716 | $2,342.48 | $4,183.00 | $1,083.07 – $2,710.58 | 4 |
| Xpos opn fmrl eprst aor uni add-on CPT 34812 | $1,633.52 | $2,917.00 | $566.92 – $2,100.24 | 6 |
| X-ray abdomen 1 view CPT 74018 | $87.92 | $157.00 | $15.70 – $163.91 | 22 |
| X-ray abdomen 2 views CPT 74019 | $127.12 | $227.00 | $18.73 – $197.96 | 22 |
| X-ray abdomen >=3 views CPT 74021 | $62.16 | $111.00 | $21.78 – $197.96 | 22 |
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $104.72 | $187.00 | $30.23 – $197.96 | 26 |
| X-ray acromioclavicular joints without or w/weighted distraction bilateral CPT 73050 | $104.16 | $186.00 | $26.90 – $163.91 | 26 |
| X-ray ankle 2 views (both sides) CPT 73600 | $119.28 | $213.00 | $19.33 – $163.91 | 26 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | $281.68 | $503.00 | $74.47 – $664.83 | 26 |
| X-ray assay calculus CPT 82370 | not published | not published | $10.20 – $23.79 | 25 |
| X-ray bone age studies CPT 77072 | $90.16 | $161.00 | $12.96 – $197.96 | 26 |
| X-ray bone length studies CPT 77073 | $156.24 | $279.00 | $22.35 – $197.96 | 26 |
| X-ray bone survey complete CPT 77075 | $117.04 | $209.00 | $52.96 – $197.96 | 26 |
| X-ray bone survey infant CPT 77076 | $87.92 | $157.00 | $52.96 – $197.96 | 26 |
| X-ray cervical spine 2-3 views CPT 72040 | $141.68 | $253.00 | $25.62 – $163.91 | 26 |
| X-ray cervical spine 4-5 views CPT 72050 | $182.00 | $325.00 | $34.77 – $197.96 | 26 |
| X-ray cervical spine >= 6 views CPT 72052 | $186.48 | $333.00 | $44.37 – $197.96 | 26 |
| X-ray clavicle complete (both sides) CPT 73000 | $112.00 | $200.00 | $19.33 – $163.91 | 26 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $287.84 | $514.00 | $52.96 – $331.40 | 26 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $281.68 | $503.00 | $100.98 – $331.40 | 26 |
| X-ray consultation CPT 76140 | not published | not published | $16.65 – $42.41 | 6 |
| X-ray elbow 2 views (both sides) CPT 73070 | $116.48 | $208.00 | $19.33 – $163.91 | 26 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $172.48 | $308.00 | $23.56 – $163.91 | 26 |
| Xray endovasc thor ao repr CPT 75956 | $542.64 | $969.00 | $235.65 – $684.33 | 8 |
| Xray endovasc thor ao repr CPT 75957 | $369.04 | $659.00 | $242.58 – $584.97 | 8 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $151.76 | $271.00 | $52.96 – $331.40 | 26 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $246.96 | $441.00 | $42.62 – $285.77 | 26 |
| X-ray exam entire spi 6/> vw CPT 72084 | $326.48 | $583.00 | $51.12 – $377.78 | 26 |
| X-ray exam of arm infant CPT 73092 | $92.40 | $165.00 | $18.72 – $197.96 | 26 |
| X-ray exam of eye sockets CPT 70200 | $174.72 | $312.00 | $27.81 – $197.96 | 26 |
| X-ray exam of femur 1 CPT 73551 | $86.24 | $154.00 | $16.50 – $163.91 | 26 |
| X-ray exam of jaw joint CPT 70328 | not published | not published | $20.54 – $163.91 | 26 |
| X-ray exam of jaw joint CPT 70332 | not published | not published | $45.08 – $449.98 | 26 |
| X-ray exam of mastoids CPT 70120 | $220.08 | $393.00 | $25.08 – $197.96 | 26 |
| X-ray exam of middle ear CPT 70134 | not published | not published | $35.38 – $1,020.70 | 26 |
| X-ray exam of penis CPT 74445 | not published | not published | $39.89 – $448.65 | 26 |
| X-ray exam of perineum CPT 74775 | not published | not published | $50.36 – $449.98 | 26 |
| X-ray exam of salivary gland CPT 70380 | not published | not published | $28.72 – $163.91 | 26 |
| X-ray exam of sinuses CPT 70210 | $50.40 | $90.00 | $21.15 – $163.91 | 26 |
| X-ray exam of tear duct CPT 70170 | not published | not published | $33.89 – $553.39 | 26 |
| X-ray exam of teeth CPT 70300 | not published | not published | $8.42 – $163.91 | 24 |
| X-ray exam of teeth CPT 70310 | not published | not published | $27.21 – $449.98 | 24 |
| X-ray exam si joints CPT 72200 | not published | not published | $19.92 – $197.96 | 26 |
| X-ray exam thorac spine4/>vw CPT 72074 | $182.00 | $325.00 | $31.14 – $197.96 | 26 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $147.28 | $263.00 | $19.02 – $163.91 | 26 |
| X-ray facial bones complete > 3 views CPT 70150 | $186.48 | $333.00 | $27.81 – $197.96 | 26 |
| X-ray fallopian tube CPT 74742 | not published | not published | $52.48 – $208.29 | 9 |
| X-ray femur >=2 views (both sides) CPT 73552 | $151.76 | $271.00 | $19.53 – $175.61 | 26 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $62.16 | $111.00 | $24.17 – $163.91 | 26 |
| X-ray foot 2 views (both sides) CPT 73620 | $103.04 | $184.00 | $18.41 – $163.91 | 26 |
| X-ray forearm 2 views (both sides) CPT 73090 | $120.40 | $215.00 | $18.41 – $163.91 | 26 |
| X-ray hand 2 views (both sides) CPT 73120 | $75.04 | $134.00 | $18.41 – $197.96 | 26 |
| X-ray head for orthodontia CPT 70350 | not published | not published | $11.14 – $163.91 | 26 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $119.28 | $213.00 | $19.02 – $163.91 | 26 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $268.80 | $480.00 | $31.68 – $311.04 | 26 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $211.12 | $377.00 | $24.09 – $244.30 | 26 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $268.80 | $480.00 | $28.65 – $311.04 | 26 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $281.68 | $503.00 | $34.42 – $325.94 | 26 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $103.60 | $185.00 | $17.42 – $163.91 | 26 |
| X-ray humerus >= 2 views left CPT 73060 | $122.08 | $218.00 | $19.33 – $163.91 | 26 |
| X-ray joint survey 1 view CPT 77077 | $174.72 | $312.00 | $23.25 – $197.96 | 26 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $136.08 | $243.00 | $20.23 – $163.91 | 26 |
| X-ray knee 3 views (both sides) CPT 73562 | $143.92 | $257.00 | $25.38 – $163.91 | 26 |
| X-ray knee ap standing bilateral CPT 73565 | $109.20 | $195.00 | $23.87 – $163.91 | 26 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $134.40 | $240.00 | $22.35 – $163.91 | 26 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $75.60 | $135.00 | $29.63 – $197.96 | 26 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $210.56 | $376.00 | $32.05 – $197.96 | 26 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $166.32 | $297.00 | $45.08 – $197.96 | 26 |
| X-ray male genital tract CPT 74440 | not published | not published | $59.01 – $449.98 | 26 |
| X-ray mandible complete > 4 views CPT 70110 | $182.56 | $326.00 | $25.38 – $197.96 | 26 |
| X-ray mandible ltd <4 views CPT 70100 | $123.20 | $220.00 | $23.56 – $163.91 | 26 |
| X-ray measurement of pelvis CPT 74710 | not published | not published | $19.92 – $82.98 | 10 |
| X-ray nasal bones complete > 3 views CPT 70160 | $116.48 | $208.00 | $22.96 – $163.91 | 26 |
| X-ray neck soft tissue CPT 70360 | $99.12 | $177.00 | $17.51 – $163.91 | 26 |
| X-ray nose to rectum for foreign body child CPT 76010 | $32.48 | $58.00 | $16.90 – $163.91 | 26 |
| X-ray of mammary ducts CPT 77054 | $223.44 | $399.00 | $51.36 – $449.98 | 27 |
| X-ray optic foramina CPT 70190 | not published | not published | $23.56 – $163.91 | 26 |
| X-ray pelvis 1-2 views CPT 72170 | $77.84 | $139.00 | $16.29 – $197.96 | 26 |
| X-ray pelvis complete > 3 views CPT 72190 | $140.00 | $250.00 | $29.32 – $197.96 | 26 |
| Xray place dist ext thor ao CPT 75959 | $350.56 | $626.00 | $78.91 – $405.65 | 8 |
| Xray place prox ext thor ao CPT 75958 | $350.56 | $626.00 | $74.64 – $405.65 | 8 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $226.80 | $405.00 | $94.42 – $664.83 | 26 |
| X-ray ribs 2 views left CPT 71100 | $86.80 | $155.00 | $20.23 – $163.91 | 26 |
| X-ray ribs 3 views bilateral CPT 71110 | $137.20 | $245.00 | $25.38 – $197.96 | 26 |
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.