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 |
|---|---|---|---|---|
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $153.44 | $274.00 | $28.67 – $143.78 | 34 |
| X-ray acromioclavicular joints without or w/weighted distraction bilateral CPT 73050 | $119.28 | $213.00 | $25.11 – $119.05 | 34 |
| X-ray ankle 2 views (both sides) CPT 73600 | $194.88 | $348.00 | $19.33 – $119.05 | 34 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | $702.24 | $1,254.00 | $72.81 – $482.88 | 34 |
| X-ray assay calculus CPT 82370 | not published | not published | $7.26 – $22.53 | 35 |
| X-ray bone age studies CPT 77072 | $119.28 | $213.00 | $12.96 – $143.78 | 34 |
| X-ray bone length studies CPT 77073 | $98.00 | $175.00 | $21.55 – $143.78 | 34 |
| X-ray bone survey complete CPT 77075 | $313.04 | $559.00 | $52.96 – $200.32 | 34 |
| X-ray bone survey infant CPT 77076 | $78.96 | $141.00 | $52.96 – $143.78 | 34 |
| X-ray cervical spine 2-3 views CPT 72040 | $119.28 | $213.00 | $21.90 – $119.05 | 34 |
| X-ray cervical spine 4-5 views CPT 72050 | $171.92 | $307.00 | $29.74 – $143.78 | 34 |
| X-ray cervical spine >= 6 views CPT 72052 | $188.72 | $337.00 | $37.92 – $143.78 | 34 |
| X-ray clavicle complete (both sides) CPT 73000 | $205.52 | $367.00 | $19.33 – $119.05 | 34 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $259.28 | $463.00 | $52.96 – $305.23 | 34 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $356.16 | $636.00 | $100.98 – $474.02 | 34 |
| X-ray consultation CPT 76140 | not published | not published | $16.65 – $158.70 | 4 |
| X-ray elbow 2 views (both sides) CPT 73070 | $194.88 | $348.00 | $19.33 – $119.05 | 34 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $235.76 | $421.00 | $22.61 – $119.05 | 34 |
| Xray endovasc thor ao repr CPT 75956 | not published | not published | $261.88 – $1,007.73 | 10 |
| Xray endovasc thor ao repr CPT 75957 | not published | not published | $239.75 – $863.83 | 10 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $269.92 | $482.00 | $52.96 – $240.70 | 34 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $282.24 | $504.00 | $42.62 – $171.72 | 34 |
| X-ray exam entire spi 6/> vw CPT 72084 | not published | not published | $51.12 – $215.60 | 34 |
| X-ray exam of arm infant CPT 73092 | $154.00 | $275.00 | $18.72 – $143.78 | 34 |
| X-ray exam of eye sockets CPT 70200 | $139.44 | $249.00 | $27.81 – $143.78 | 34 |
| X-ray exam of femur 1 CPT 73551 | $115.36 | $206.00 | $16.50 – $119.05 | 34 |
| X-ray exam of jaw joint CPT 70328 | not published | not published | $20.54 – $119.05 | 34 |
| X-ray exam of jaw joint CPT 70332 | not published | not published | $45.08 – $326.83 | 34 |
| X-ray exam of mastoids CPT 70120 | not published | not published | $24.75 – $143.78 | 34 |
| X-ray exam of middle ear CPT 70134 | not published | not published | $34.36 – $741.35 | 34 |
| X-ray exam of penis CPT 74445 | not published | not published | $39.89 – $297.60 | 34 |
| X-ray exam of perineum CPT 74775 | not published | not published | $50.36 – $629.48 | 34 |
| X-ray exam of salivary gland CPT 70380 | not published | not published | $26.89 – $119.05 | 34 |
| X-ray exam of sinuses CPT 70210 | $119.28 | $213.00 | $21.15 – $119.05 | 34 |
| X-ray exam of tear duct CPT 70170 | not published | not published | $33.89 – $629.48 | 34 |
| X-ray exam of teeth CPT 70300 | not published | not published | $8.42 – $119.05 | 28 |
| X-ray exam of teeth CPT 70310 | not published | not published | $27.21 – $326.83 | 28 |
| X-ray exam si joints CPT 72200 | $62.72 | $112.00 | $19.77 – $143.78 | 34 |
| X-ray exam thorac spine4/>vw CPT 72074 | $153.44 | $274.00 | $28.31 – $143.78 | 34 |
| X-ray eye detection foreign body (both sides) CPT 70030 | not published | not published | $19.02 – $119.05 | 34 |
| X-ray facial bones complete > 3 views CPT 70150 | $161.84 | $289.00 | $27.81 – $143.78 | 34 |
| X-ray fallopian tube CPT 74742 | not published | not published | $52.48 – $232.37 | 12 |
| X-ray femur >=2 views (both sides) CPT 73552 | $202.16 | $361.00 | $19.53 – $119.05 | 34 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $80.64 | $144.00 | $24.17 – $119.05 | 34 |
| X-ray foot 2 views (both sides) CPT 73620 | $194.88 | $348.00 | $18.34 – $119.05 | 34 |
| X-ray forearm 2 views (both sides) CPT 73090 | $205.52 | $367.00 | $17.63 – $119.05 | 34 |
| X-ray hand 2 views (both sides) CPT 73120 | $194.88 | $348.00 | $17.99 – $143.78 | 34 |
| X-ray head for orthodontia CPT 70350 | not published | not published | $9.80 – $119.05 | 34 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $194.88 | $348.00 | $19.02 – $119.05 | 34 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $277.20 | $495.00 | $31.68 – $143.78 | 34 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $224.00 | $400.00 | $23.77 – $143.78 | 34 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $337.12 | $602.00 | $28.65 – $143.78 | 34 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $381.92 | $682.00 | $34.42 – $143.78 | 34 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $150.08 | $268.00 | $17.09 – $119.05 | 34 |
| X-ray humerus >= 2 views left CPT 73060 | $299.60 | $535.00 | $19.33 – $119.05 | 34 |
| X-ray joint survey 1 view CPT 77077 | not published | not published | $21.19 – $143.78 | 34 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $205.52 | $367.00 | $20.23 – $119.05 | 34 |
| X-ray knee 3 views (both sides) CPT 73562 | $103.04 | $184.00 | $25.38 – $119.05 | 34 |
| X-ray knee ap standing bilateral CPT 73565 | $139.44 | $249.00 | $23.87 – $119.05 | 34 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $194.88 | $348.00 | $19.77 – $119.05 | 34 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $100.24 | $179.00 | $29.38 – $143.78 | 34 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $183.12 | $327.00 | $32.05 – $143.78 | 34 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $205.52 | $367.00 | $45.08 – $143.78 | 34 |
| X-ray male genital tract CPT 74440 | not published | not published | $59.01 – $326.83 | 34 |
| X-ray mandible complete > 4 views CPT 70110 | $139.44 | $249.00 | $25.38 – $143.78 | 34 |
| X-ray mandible ltd <4 views CPT 70100 | $164.08 | $293.00 | $23.56 – $119.05 | 34 |
| X-ray measurement of pelvis CPT 74710 | not published | not published | $19.77 – $65.88 | 15 |
| X-ray nasal bones complete > 3 views CPT 70160 | $116.48 | $208.00 | $22.96 – $119.05 | 34 |
| X-ray neck soft tissue CPT 70360 | $93.52 | $167.00 | $17.51 – $119.05 | 34 |
| X-ray nose to rectum for foreign body child CPT 76010 | $78.96 | $141.00 | $16.90 – $119.05 | 34 |
| X-ray of mammary ducts CPT 77054 | $654.08 | $1,168.00 | $51.36 – $326.83 | 35 |
| X-ray optic foramina CPT 70190 | not published | not published | $23.56 – $119.05 | 34 |
| X-ray pelvis 1-2 views CPT 72170 | $104.72 | $187.00 | $16.29 – $143.78 | 34 |
| X-ray pelvis complete > 3 views CPT 72190 | $124.88 | $223.00 | $27.24 – $143.78 | 34 |
| Xray place dist ext thor ao CPT 75959 | not published | not published | $96.82 – $501.57 | 10 |
| Xray place prox ext thor ao CPT 75958 | not published | not published | $82.94 – $572.52 | 10 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $399.28 | $713.00 | $94.42 – $482.88 | 34 |
| X-ray ribs 2 views left CPT 71100 | $108.64 | $194.00 | $20.23 – $119.05 | 34 |
| X-ray ribs 3 views bilateral CPT 71110 | $146.16 | $261.00 | $24.04 – $143.78 | 34 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $139.44 | $249.00 | $22.97 – $143.78 | 34 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $214.48 | $383.00 | $31.87 – $143.78 | 34 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $139.44 | $249.00 | $23.56 – $143.78 | 34 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $139.44 | $249.00 | $19.02 – $119.05 | 34 |
| X-ray scapula complete (both sides) CPT 73010 | $214.48 | $383.00 | $20.54 – $143.78 | 34 |
| X-ray sella turcica CPT 70240 | not published | not published | $19.02 – $119.05 | 34 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $188.72 | $337.00 | $15.14 – $119.05 | 34 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $171.92 | $307.00 | $25.08 – $119.05 | 34 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $209.44 | $374.00 | $29.02 – $741.35 | 34 |
| X-ray skull < 4 views CPT 70250 | $116.48 | $208.00 | $23.25 – $143.78 | 34 |
| X-ray skull > 4 views complete CPT 70260 | $176.96 | $316.00 | $28.31 – $143.78 | 34 |
| X-ray slg plne bdy sect without urogr CPT 76100 | not published | not published | $52.96 – $181.25 | 34 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $224.00 | $400.00 | $52.96 – $242.30 | 34 |
| X-ray small intestine follow-through study CPT 74248 | $97.44 | $174.00 | $41.47 – $143.05 | 10 |
| X-ray spine single view CPT 72020 | $93.52 | $167.00 | $14.43 – $119.05 | 34 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $119.28 | $213.00 | $24.48 – $119.05 | 34 |
| X-ray sternum > 2 views CPT 71120 | $113.12 | $202.00 | $19.41 – $119.05 | 34 |
| X-ray surgical specimen CPT 76098 | $365.12 | $652.00 | $8.73 – $741.35 | 35 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $228.48 | $408.00 | $52.96 – $300.48 | 34 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $139.44 | $249.00 | $31.98 – $119.05 | 34 |
| X-ray thoracic spine 2 views CPT 72070 | $110.88 | $198.00 | $21.15 – $143.78 | 34 |
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.