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 |
|---|---|---|---|---|
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $99.68 | $178.00 | $24.48 – $197.96 | 26 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $166.32 | $297.00 | $34.48 – $197.96 | 26 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $90.16 | $161.00 | $23.56 – $197.96 | 26 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $98.00 | $175.00 | $19.02 – $163.91 | 26 |
| X-ray scapula complete (both sides) CPT 73010 | $134.40 | $240.00 | $20.54 – $197.96 | 26 |
| X-ray sella turcica CPT 70240 | not published | not published | $19.02 – $163.91 | 26 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $106.96 | $191.00 | $15.39 – $163.91 | 26 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $186.48 | $333.00 | $25.08 – $163.91 | 26 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $124.32 | $222.00 | $32.05 – $1,020.70 | 26 |
| X-ray skull < 4 views CPT 70250 | $146.72 | $262.00 | $23.25 – $197.96 | 26 |
| X-ray skull > 4 views complete CPT 70260 | $201.04 | $359.00 | $28.41 – $197.96 | 26 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $248.08 | $443.00 | $52.96 – $197.96 | 26 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $186.48 | $333.00 | $52.96 – $331.40 | 26 |
| X-ray spine single view CPT 72020 | $49.84 | $89.00 | $15.08 – $163.91 | 26 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $90.16 | $161.00 | $24.48 – $163.91 | 26 |
| X-ray sternum > 2 views CPT 71120 | $90.16 | $161.00 | $20.23 – $163.91 | 26 |
| X-ray surgical specimen CPT 76098 | $222.32 | $397.00 | $9.93 – $1,020.70 | 27 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $125.44 | $224.00 | $52.96 – $331.40 | 26 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $84.56 | $151.00 | $31.98 – $163.91 | 26 |
| X-ray thoracic spine 2 views CPT 72070 | $102.48 | $183.00 | $21.15 – $197.96 | 26 |
| X-ray thoracic spine 3 views CPT 72072 | $145.60 | $260.00 | $24.78 – $197.96 | 26 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $87.92 | $157.00 | $23.13 – $163.91 | 26 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $134.40 | $240.00 | $21.66 – $163.91 | 26 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $166.88 | $298.00 | $39.28 – $197.96 | 26 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $119.28 | $213.00 | $17.82 – $163.91 | 26 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $56.00 | $100.00 | $21.74 – $163.91 | 26 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $374.64 | $669.00 | $52.96 – $331.40 | 26 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $64.96 | $116.00 | $52.96 – $331.40 | 26 |
| X-ray upper gi delay w/kub CPT 74241 | not published | not published | $52.96 – $152.47 | 10 |
| X-ray upper gi&small intest CPT 74245 | not published | not published | $100.98 – $237.90 | 10 |
| X-ray wrist 2 views (both sides) CPT 73100 | $115.36 | $206.00 | $21.15 – $163.91 | 26 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | not published | not published | $52.96 – $331.40 | 26 |
| Xtrnl ecg rec up to 48 hrs CPT 93224 | not published | not published | $109.91 – $276.73 | 6 |
| Xylose absorption test blood &/or urine CPT 84620 | $69.44 | $124.00 | $9.66 – $24.53 | 25 |
| Yersinia antibody CPT 86793 | not published | not published | $10.74 – $25.06 | 25 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | $50,918.56 | $90,926.00 | $24,356.12 – $90,926.00 | 7 |
| Zika virus dna/rna amp probe CPT 87662 | $84.00 | $150.00 | $41.81 – $121.50 | 19 |
| Zika virus igm antibody CPT 86794 | not published | not published | $13.73 – $32.02 | 18 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $51.71 | $92.34 | $18.39 – $18.39 | 1 |
| Zoster vaccine-live inj CPT 90736 | not published | not published | $232.52 – $292.20 | 4 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $183.59 – $367.17 | 16 |
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.