Henry Ford West Bloomfield Hospital
6777 W Maple Road, West Bloomfield, MI · Henry Ford Health · · NPI 1407867559
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 |
|---|---|---|---|---|
| Unlisted resp px dx nuc med CPT 78599 | $549.70 | $2,278.00 | $208.33 – $1,756.34 | 20 |
| Unlisted spec derm svc/px CPT 96999 | $275.88 | $498.00 | $104.55 – $459.79 | 21 |
| Unlisted special svc px/rprt CPT 99199 | not published | not published | $23.10 – $23.10 | 1 |
| Unlisted surgical path px CPT 88399 | $71.65 | not published | $13.10 – $119.42 | 18 |
| Unlisted transfusion med px CPT 86999 | $39.77 | not published | $10.83 – $66.29 | 18 |
| Unlisted ultrasound procedure CPT 76999 | $119.66 | $1,301.00 | $45.35 – $316.88 | 22 |
| Unlisted urinalysis px CPT 81099 | not published | not published | $4.22 – $40.34 | 3 |
| Unlisted vasc endoscopy px CPT 37501 | $862.57 | $1,900.00 | $326.90 – $1,437.62 | 19 |
| Unlstd hematop ret/endo lymp CPT 78199 | $549.70 | not published | $208.33 – $916.16 | 17 |
| Unlstd laps px mat care&dlvr CPT 59898 | $8,312.83 | not published | $3,150.44 – $13,854.72 | 18 |
| Unlstd laps px sprmatic cord CPT 55559 | $8,312.83 | $960.00 | $384.00 – $13,854.72 | 19 |
| Unsched dialysis esrd pt hos HCPCS G0257 | $943.71 | $1,392.00 | $201.31 – $1,572.86 | 20 |
| Upgrade pm system CPT 33214 | $14,371.89 | $13,491.00 | $271.36 – $23,953.14 | 21 |
| Upper Arm (Humerus) X-ray (left side) CPT 73060 | $119.66 | $267.00 | $5.11 – $145.39 | 22 |
| Upper Back (Thoracic Spine) CT Scan (with contrast) CPT 72129 | $241.18 | $2,278.00 | $35.78 – $1,526.26 | 22 |
| Upper Back (Thoracic Spine) CT Scan (without contrast) CPT 72128 | $143.75 | $1,575.00 | $29.61 – $1,055.25 | 22 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $479.72 | $4,202.00 | $67.31 – $2,815.34 | 22 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $479.72 | $4,436.00 | $52.40 – $2,972.12 | 22 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $328.08 | $2,849.00 | $43.45 – $1,908.83 | 22 |
| Upper Back (Thoracic Spine) X-ray (2 views) CPT 72070 | $143.75 | $290.00 | $6.18 – $239.59 | 22 |
| Upper Back (Thoracic Spine) X-ray (3 views) CPT 72072 | $143.75 | $301.00 | $6.60 – $239.59 | 22 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | $1,247.13 | $2,148.00 | $70.50 – $2,078.56 | 22 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | $1,247.13 | $2,016.00 | $78.81 – $2,078.56 | 22 |
| Upper ext fx orthosis rad/ul HCPCS L3982 | $606.30 | not published | $404.20 – $868.50 | 16 |
| Upper ext harvest for cabg1 seg 35600 CPT 35600 | $259.30 | $890.00 | $107.78 – $1,569.19 | 19 |
| Upper GI Barium X-ray (barium and gas) CPT 74246 | $241.18 | $674.00 | $26.63 – $451.58 | 22 |
| Upper GI Barium X-ray (barium only) CPT 74240 | $241.18 | $572.00 | $24.07 – $401.97 | 22 |
| Uppr gi scope w/submuc inj CPT 43236 | $1,247.13 | $2,148.00 | $78.81 – $2,148.00 | 22 |
| Urachal cyst/sinus excision 51500 CPT 51500 | $8,312.83 | $2,070.00 | $369.98 – $13,854.72 | 20 |
| Urea nitrogen CPT 84520 | $5.45 | $25.00 | $0.74 – $16.75 | 20 |
| Urea nitrogen 24 hour urine CPT 84540 | $7.67 | $32.00 | $2.91 – $21.44 | 21 |
| Urea nitrogen clearance CPT 84545 | $9.94 | not published | $3.77 – $17.08 | 17 |
| Urea nitrogen semi-quant CPT 84525 | $7.08 | not published | $2.38 – $8.36 | 15 |
| Ureteral embolization/occl CPT 50705 | $235.23 | $3,175.00 | $101.81 – $3,175.00 | 22 |
| Ureteral reflux study CPT 78740 | $549.70 | $1,301.00 | $17.25 – $916.16 | 22 |
| Ureter endoscopy CPT 50970 | $4,846.99 | $1,210.00 | $207.25 – $8,078.31 | 20 |
| Ureter endoscopy & biopsy CPT 50955 | $7,372.68 | $1,150.00 | $197.45 – $12,287.80 | 20 |
| Ureter endoscopy & biopsy CPT 50974 | $7,372.68 | $1,550.00 | $246.15 – $12,287.80 | 20 |
| Ureter endoscopy & catheter CPT 50972 | $4,846.99 | $1,170.00 | $158.74 – $8,078.31 | 20 |
| Ureter endoscopy & treatment CPT 50957 | $7,372.68 | $1,160.00 | $198.52 – $12,287.80 | 20 |
| Ureter endoscopy & treatment CPT 50961 | $7,372.68 | $1,040.00 | $178.07 – $12,287.80 | 20 |
| Ureter endoscopy & treatment CPT 50976 | $7,372.68 | $1,530.00 | $256.10 – $12,287.80 | 20 |
| Ureter endoscopy & treatment CPT 50980 | $7,372.68 | $1,170.00 | $199.16 – $12,287.80 | 20 |
| Ureteroneocystostomy 50780 CPT 50780 | $1,473.37 | $3,640.00 | $641.98 – $6,760.34 | 19 |
| Ureteroureterostomy 50760 CPT 50760 | $1,509.66 | $3,740.00 | $654.98 – $6,868.09 | 19 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $328.08 | $499.00 | $9.80 – $546.80 | 22 |
| Urethrlys transvag with scope CPT 53500 | $4,846.99 | $2,430.00 | $428.98 – $8,078.31 | 19 |
| Urethrocystography void s&i CPT 74455 | $328.08 | $551.00 | $10.01 – $546.80 | 22 |
| Uric acid blood CPT 84550 | $6.24 | $30.00 | $2.36 – $20.10 | 20 |
| Uric acid urine CPT 84560 | $7.01 | $32.00 | $2.66 – $21.44 | 21 |
| Urinalysis glass test CPT 81020 | $6.49 | not published | $3.84 – $10.20 | 16 |
| Urinalysis microscopic only CPT 81015 | $4.21 | $21.00 | $1.60 – $14.07 | 21 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | $2.99 | $16.00 | $1.13 – $10.72 | 21 |
| Urinalysis (with microscopy) CPT 81001 | $4.37 | $21.00 | $1.66 – $14.07 | 21 |
| Urinalysis (without microscopy) CPT 81003 | $3.11 | $17.00 | $1.18 – $11.39 | 21 |
| Urinary bldr retent nuc study CPT 78730 | $87.52 | $575.00 | $4.90 – $385.25 | 22 |
| Urinary pouch on barr w/flng HCPCS A5073 | $6.25 | not published | $2.83 – $8.95 | 16 |
| Urinary pouch w/barrier HCPCS A5071 | $11.83 | not published | $5.42 – $16.94 | 16 |
| Urinary reflex study CPT 51792 | $81.77 | $178.00 | $30.74 – $135.19 | 20 |
| Urinary suspensory HCPCS A5105 | $80.19 | not published | $53.46 – $114.87 | 16 |
| Urine Culture Test CPT 87086 | $11.14 | $54.00 | $4.22 – $36.18 | 21 |
| Urine flow measurement 51736 CPT 51736 | $182.95 | $180.00 | $4.11 – $304.91 | 22 |
| Urine ost pouch w faucet/tap HCPCS A4428 | $12.82 | not published | $5.31 – $18.37 | 16 |
| Urine pregnancy test CPT 81025 | $11.88 | $43.00 | $4.50 – $28.81 | 21 |
| Urine screen for bacteria CPT 81007 | $41.37 | not published | $4.47 – $48.87 | 16 |
| Urine shunt to intestine CPT 50815 | $1,588.56 | $3,990.00 | $699.71 – $7,480.53 | 19 |
| Urine specimen collect mult HCPCS P9615 | $12.89 | not published | $3.60 – $12.61 | 13 |
| Urofollitropin, 75 iu HCPCS J3355 | not published | not published | $127.65 – $334.29 | 4 |
| Urography, antegrade CPT 74425 | $479.72 | $417.00 | $15.12 – $799.53 | 22 |
| Urography inf drip &/or bolus CPT 74410 | $241.18 | $906.00 | $14.70 – $607.02 | 22 |
| Urokinase 250,000 iu inj HCPCS J3365 | not published | not published | $440.45 – $1,123.88 | 3 |
| Urokinase 5000 iu injection HCPCS J3364 | not published | not published | $8.81 – $22.50 | 3 |
| Use 1st target lesion CPT 76982 | $143.75 | $703.00 | $17.89 – $542.01 | 22 |
| User adjustable heel height HCPCS L5990 | $3,082.74 | not published | $2,055.16 – $4,415.84 | 16 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | $17.24 | $6,408.95 | $6.53 – $5,524.51 | 22 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | not published | not published | $155.88 – $672.72 | 5 |
| U/s trtmt, not leiomyomata HCPCS C9734 | $17,653.66 | not published | $6,690.48 – $29,422.77 | 17 |
| Vaccine Administration (one shot) CPT 90471 | $29.00 | $43.00 | $6.91 – $132.00 | 22 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | $223.08 | not published | $91.30 – $449.79 | 12 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | $131.00 | not published | $83.06 – $409.19 | 9 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | $151.00 | not published | $95.09 – $468.49 | 12 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | $85.00 | not published | $53.54 – $263.78 | 9 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | $63.00 | not published | $60.31 – $182.39 | 8 |
| Vaccine dtap < 7 years im CPT 90700 | $22.00 | not published | $29.25 – $86.81 | 8 |
| Vaccine dtap-hep b-ipv im CPT 90723 | $67.00 | $327.38 | $98.21 – $282.20 | 14 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | $49.00 | not published | $62.12 – $185.20 | 8 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | not published | not published | $152.81 – $458.00 | 7 |
| Vaccine dtap-ipv/hib im CPT 90698 | $43.00 | not published | $117.09 – $354.91 | 8 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | $40.00 | $97.17 | $29.15 – $83.76 | 14 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | $17.00 | not published | $12.95 – $57.01 | 8 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $109.00 | $271.46 | $41.54 – $234.00 | 14 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | $166.00 | $425.29 | $127.59 – $366.60 | 14 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | $29.00 | $242.17 | $38.58 – $208.75 | 14 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | not published | not published | $29.80 – $85.56 | 5 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | $103.70 | not published | $42.44 – $209.10 | 10 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | not published | $228.05 | $63.85 – $196.58 | 18 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | not published | $472.25 | $132.23 – $407.08 | 18 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | not published | $93.08 | $26.06 – $80.23 | 18 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | $287.00 | not published | $320.93 – $933.67 | 7 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | $310.00 | $990.02 | $182.45 – $853.40 | 13 |
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.