Henry Ford Providence Novi Hospital
47601 Grand River Ave, Novi, MI · Henry Ford Health · · NPI 1144210253
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 |
|---|---|---|---|---|
| Ghs phenylketonurid CPT 84030 | not published | not published | $3.19 – $9.88 | 35 |
| Ghs picc line insert < 5 CPT 36568 | not published | not published | $329.32 – $711.66 | 12 |
| Ghs plngl fx pm cl CPT 26725 | not published | not published | $124.92 – $457.39 | 31 |
| Ghs plt ct-manual CPT 85032 | not published | not published | $2.50 – $7.72 | 35 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | not published | not published | $450.49 – $1,375.61 | 32 |
| Ghs pos nystagmus CPT 92542 | $76.72 | $137.00 | $21.27 – $4,697.97 | 31 |
| Ghs ppd (tb intradermal) CPT 86580 | not published | not published | $6.68 – $33.11 | 35 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $4.48 | $8.00 | $5.60 – $17.05 | 35 |
| Ghs protein, misc fluid CPT 84160 | not published | not published | $3.25 – $7.74 | 35 |
| Ghs protoporphyrins fract CPT 84202 | $18.48 | $33.00 | $8.32 – $25.79 | 35 |
| Ghs pr without cont pulse ox CPT 94625 | $77.28 | $138.00 | $33.76 – $86.86 | 25 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | not published | not published | $7.11 – $22.02 | 35 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | not published | not published | $125.94 – $171.42 | 4 |
| Ghs quinidine CPT 80194 | $5.60 | $10.00 | $8.47 – $26.24 | 35 |
| Ghs refill of implantable pump CPT 95990 | not published | not published | $95.32 – $448.47 | 31 |
| Ghs removal intranasal foreign body CPT 30300 | not published | not published | $47.96 – $311.84 | 31 |
| Ghs removal pharyngeal foreign body CPT 42809 | not published | not published | $47.96 – $539.54 | 31 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | not published | not published | $644.17 – $2,011.09 | 12 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | not published | not published | $592.93 – $2,597.68 | 12 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | not published | not published | $9.22 – $23.17 | 35 |
| Ghs reticulocyte count CPT 85044 | $19.60 | $35.00 | $2.50 – $7.38 | 35 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $32.48 | $58.00 | $8.07 – $21.56 | 35 |
| Ghs sedimentation rate CPT 85651 | $11.76 | $21.00 | $2.48 – $6.37 | 35 |
| Ghs semen analysis fert CPT 89320 | $43.68 | $78.00 | $7.14 – $21.67 | 35 |
| Ghs semen analysis, post-vas CPT 89300 | not published | not published | $5.71 – $13.58 | 35 |
| Ghs sensitivity (per antimicro) CPT 87184 | $47.60 | $85.00 | $4.34 – $12.41 | 35 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | not published | not published | $61.98 – $540.20 | 31 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | not published | not published | $61.98 – $540.20 | 31 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | not published | not published | $61.98 – $540.20 | 31 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | not published | not published | $61.98 – $540.20 | 31 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | not published | not published | $61.98 – $268.66 | 31 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | not published | not published | $61.98 – $268.66 | 31 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | not published | not published | $61.98 – $268.66 | 31 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | not published | not published | $112.91 – $326.27 | 31 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | not published | not published | $61.98 – $268.66 | 31 |
| Ghs sleep study unattended CPT 95800 | not published | not published | $65.91 – $211.55 | 32 |
| Ghs somatosensory testing lower extremit CPT 95926 | $381.36 | $681.00 | $115.90 – $421.04 | 31 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $686.56 | $1,226.00 | $163.41 – $717.42 | 31 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | not published | not published | $26.39 – $3,635.22 | 31 |
| Ghs sphenopalatine ganglion block CPT 64505 | not published | not published | $66.82 – $399.12 | 31 |
| Ghs spont nystagmus CPT 92541 | $76.72 | $137.00 | $19.41 – $3,998.15 | 31 |
| Ghs sp train/fitting sp device - kx CPT 92609 | not published | not published | $56.03 – $3,430.82 | 31 |
| Ghs st - eval for alt comm CPT 92567 | $68.32 | $122.00 | $16.05 – $3,993.80 | 31 |
| Ghs strapping shoulder - 29240 CPT 29240 | not published | not published | $29.42 – $214.65 | 31 |
| Ghs st - re-eval for alt comm CPT 92597 | not published | not published | $39.90 – $696.53 | 31 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | not published | not published | $16.24 – $475.79 | 31 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | not published | not published | $91.09 – $515.37 | 31 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $512.40 | $915.00 | $225.48 – $827.65 | 32 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | not published | not published | $191.05 – $540.20 | 31 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | not published | not published | $268.32 – $926.01 | 12 |
| Ghs trypsin (fecal) CPT 84488 | not published | not published | $4.23 – $13.12 | 35 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | not published | not published | $124.92 – $425.22 | 31 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $90.65 – $413.40 | 31 |
| Ghs urine, hydroxproline total CPT 83505 | $30.28 | $54.08 | $14.09 – $43.69 | 35 |
| Ghs urine, porphyrins quant CPT 84120 | $25.76 | $46.00 | $8.53 – $26.43 | 35 |
| Ghs vaginal delivery only CPT 59409 | not published | not published | $978.98 – $2,063.45 | 12 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | not published | not published | $75.31 – $810.00 | 31 |
| Ghs windowing of cast CPT 29730 | not published | not published | $52.49 – $3,671.87 | 31 |
| Giardia lamblia antibody CPT 86674 | not published | not published | $8.54 – $23.89 | 35 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $57.56 – $629.48 | 34 |
| Gi inhouse confirmation CPT 87045 | $38.08 | $68.00 | $5.48 – $16.96 | 35 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $336.34 – $2,080.85 | 12 |
| Gi protein loss CPT 78282 | not published | not published | $51.87 – $1,030.95 | 34 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | not published | not published | $392.06 – $3,602.95 | 31 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | $518.10 – $1,232.73 | 25 |
| Gi trc img intral esophagus CPT 91111 | not published | not published | $392.06 – $3,602.95 | 31 |
| Gi wireless capsule measure CPT 91112 | not published | not published | $392.06 – $23,436.39 | 31 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $58.65 – $264.87 | 35 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $35.68 – $84.90 | 35 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $16.20 – $48.30 | 35 |
| Glaucoma surgery CPT 66150 | not published | not published | $944.20 – $2,885.87 | 12 |
| Glaucoma surgery CPT 66155 | not published | not published | $918.24 – $2,885.87 | 12 |
| Glaucoma surgery CPT 66160 | not published | not published | $918.24 – $2,150.83 | 12 |
| Glaucoma surgery CPT 66170 | not published | not published | $918.24 – $2,150.83 | 12 |
| Glucagon plasma - sendout CPT 82943 | $22.40 | $40.00 | $8.29 – $25.69 | 35 |
| Glucose 1 hr post dose CPT 82950 | $11.76 | $21.00 | $2.76 – $7.51 | 35 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | $28.56 | $51.00 | $3.51 – $10.88 | 35 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $9.52 | $17.00 | $1.90 – $4.53 | 35 |
| Glucose blood quantitative CPT 82947 | $9.52 | $17.00 | $1.04 – $6.75 | 29 |
| Glucose body fluid CPT 82945 | $8.96 | $16.00 | $2.28 – $6.75 | 35 |
| Glucose monitoring continual min 72hr pt CPT 95249 | not published | not published | $33.76 – $80.32 | 25 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $36.96 | $66.00 | $7.46 – $23.14 | 35 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $12.32 | $22.00 | $2.27 – $7.05 | 35 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $108.08 | $193.00 | $10.78 – $33.40 | 35 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $103.04 | $184.00 | $10.74 – $33.29 | 35 |
| Gonioscopy CPT 92020 | not published | not published | $15.54 – $68,979.80 | 31 |
| Goniotomy CPT 65820 | not published | not published | $808.70 – $2,465.21 | 12 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $48.72 | $87.00 | $41.07 – $41.07 | 1 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $108.64 | $194.00 | $114.93 – $128.05 | 6 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $992.19 – $2,513.88 | 12 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $5,169.92 | $9,232.00 | $41.16 – $1,537.43 | 7 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $2,687.44 | $4,799.00 | $54.45 – $1,617.93 | 7 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $1,935.36 | $3,456.00 | $105.04 – $146.25 | 9 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $1,365.77 – $4,212.24 | 9 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $1,904.00 | $3,400.00 | $176.90 – $295.03 | 7 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $196.00 | $350.00 | $18.94 – $62.17 | 10 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $58.80 | $105.00 | $92.04 – $102.56 | 6 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $443.52 | $792.00 | $157.40 – $328.25 | 7 |
| Granulocyte pheresis ea unit HCPCS P9050 | $1,121.68 | $2,003.00 | $112.49 – $798.72 | 9 |
| Great toe with reduction 28495 CPT 28495 | not published | not published | $90.65 – $324.34 | 31 |
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.