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 |
|---|---|---|---|---|
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | not published | $261.44 | $73.20 – $225.36 | 18 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | $135.46 | not published | $55.44 – $273.13 | 12 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | $30.46 | not published | $12.46 – $61.41 | 13 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | not published | $64.22 | $17.98 – $55.36 | 18 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | $27.00 | not published | $20.88 – $51.98 | 9 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | not published | not published | $77.36 – $192.60 | 9 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | $32.00 | not published | $21.64 – $46.64 | 4 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | $24.00 | not published | $22.35 – $55.65 | 9 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | $17.00 | not published | $10.44 – $25.99 | 5 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | $25.00 | not published | $27.79 – $69.17 | 9 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | $62.00 | not published | $73.40 – $182.73 | 9 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | $68.30 | not published | $27.95 – $137.73 | 12 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | $15.23 | not published | $6.23 – $43.34 | 10 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | $295.00 | $756.68 | $227.00 – $652.26 | 14 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | not published | not published | $202.18 – $588.05 | 7 |
| Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 | not published | not published | $167.71 – $502.30 | 7 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | $112.00 | $532.88 | $159.86 – $459.34 | 14 |
| Vaccine mmr live subcutaneous CPT 90707 | $125.00 | $292.22 | $87.67 – $251.89 | 14 |
| Vaccine mmrv live subcutaneous CPT 90710 | $366.00 | $863.51 | $259.05 – $744.35 | 14 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $154.00 | not published | $68.22 – $371.38 | 13 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | $115.00 | not published | $237.35 – $642.28 | 12 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | $371.64 | not published | $152.10 – $749.36 | 12 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | not published | $928.64 | $260.02 – $800.49 | 18 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | $56.00 | $1,416.83 | $43.63 – $1,221.31 | 14 |
| Vaccine rabies im CPT 90675 | $324.00 | $1,308.83 | $167.23 – $1,126.14 | 22 |
| Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 | $300.00 | not published | $299.19 – $870.76 | 7 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 | $325.00 | $1,835.19 | $542.34 – $1,581.93 | 14 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im CPT 90381 | $525.00 | $1,835.19 | $542.34 – $1,581.93 | 14 |
| Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im CPT 90679 | not published | not published | $298.75 – $869.48 | 7 |
| Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 | $90.00 | $470.14 | $141.04 – $405.26 | 14 |
| Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 | $87.00 | not published | $100.20 – $291.24 | 8 |
| Vaccine tdap >=7 years im CPT 90715 | $62.00 | $374.79 | $22.42 – $90.31 | 14 |
| Vaccine td preservative free >= 7 years im CPT 90714 | $36.00 | $180.62 | $22.01 – $119.15 | 14 |
| Vaccine typhoid vicps im CPT 90691 | $184.00 | $489.80 | $146.94 – $422.21 | 13 |
| Vaccine varicella live subcutaneous CPT 90716 | $241.00 | $579.10 | $173.73 – $499.18 | 14 |
| Vaccine yellow fever live subcutaneous CPT 90717 | $211.00 | $1,777.31 | $255.32 – $1,532.04 | 13 |
| Vaccinia vrs vac 0.3 ml perq CPT 90622 | $0.01 | not published | $0.01 – $0.02 | 17 |
| Vacuum drain bottle/tube kit HCPCS A7048 | $83.26 | not published | $55.21 – $119.26 | 15 |
| Vad battery clip set hmii 14-v li-ion HCPCS Q0497 | $795.49 | not published | $530.32 – $1,139.49 | 15 |
| Vad cable power module dc input HCPCS Q0478 | $312.27 | not published | $195.74 – $447.30 | 15 |
| Vad univ batt charger hm 1440 HCPCS Q0495 | $7,097.99 | not published | $4,731.99 – $10,167.43 | 15 |
| Vag hys/<250g/rmv tube/rpr entero 58263 CPT 58263 | $6,878.55 | $7,459.00 | $559.55 – $11,464.26 | 22 |
| Vag hyst incl t/o complex CPT 58291 | $6,878.55 | $6,940.00 | $696.72 – $11,464.26 | 22 |
| Vag hyst including t/o CPT 58262 | $6,878.55 | $6,940.00 | $522.06 – $11,464.26 | 22 |
| Vag hyst t/o & repair compl CPT 58292 | $10,196.50 | $7,459.00 | $733.79 – $16,994.17 | 22 |
| Vag hyst w/enterocele compl 58294 CPT 58294 | $6,878.55 | $3,890.00 | $682.03 – $11,464.26 | 20 |
| Vag hyst w/enterocele repair CPT 58270 | $6,878.55 | $2,840.00 | $506.09 – $11,464.26 | 20 |
| Vag hyst w/uro repair compl 58293 CPT 58293 | not published | not published | $2,218.22 – $3,089.11 | 2 |
| Vaginal bx CPT 58999 | $277.99 | $3,130.00 | $60.40 – $1,075.00 | 22 |
| Vaginal delivery after cesarean delivery 59612 CPT 59612 | $4,451.18 | $3,550.00 | $793.18 – $7,418.63 | 20 |
| Vaginal Delivery (full care) CPT 59400 | $3,358.99 | $5,120.00 | $2,018.37 – $12,730.83 | 19 |
| Vaginal hysterectomy CPT 58260 | $6,878.55 | $6,419.00 | $473.07 – $11,464.26 | 22 |
| Vaginectomy partial w/nodes CPT 57109 | $4,451.18 | $5,980.00 | $1,036.25 – $7,418.63 | 20 |
| Vag inser rectal control sys HCPCS A4563 | $2,319.20 | not published | $127.86 – $2,268.78 | 14 |
| Vagnc compl rmvl paravag tis CPT 57111 | $2,421.98 | $6,000.00 | $1,036.25 – $9,763.55 | 19 |
| Vagnc compl rmvl vag wall CPT 57110 | $1,171.72 | $2,870.00 | $508.86 – $5,364.35 | 19 |
| Vagotomy pfrmd w/prtl dstl gstrct 43635 CPT 43635 | $155.18 | $387.00 | $64.33 – $692.70 | 19 |
| Vagotomy & pylorus repair CPT 43641 | $1,711.96 | $4,070.00 | $722.92 – $7,301.01 | 19 |
| Vagotomy & pylorus repair 43640 CPT 43640 | $1,693.56 | $4,030.00 | $715.25 – $7,212.30 | 19 |
| Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr HCPCS J3379 | $0.06 | $26.00 | $0.03 – $9.64 | 13 |
| Valproic acid total therapeutic drug level CPT 80164 | $18.69 | $92.00 | $7.08 – $61.64 | 21 |
| Valrubicin injection HCPCS J9357 | $1,798.61 | $5,600.75 | $681.65 – $4,784.75 | 22 |
| Valvuloplasty aortic CPT 92986 | $7,826.12 | $9,300.00 | $744.86 – $13,043.53 | 22 |
| Valvuloplasty aortic valve CPT 33390 | $2,691.33 | $6,610.00 | $1,130.18 – $11,693.86 | 18 |
| Valvuloplasty aortic valve CPT 33391 | $3,210.23 | $7,830.00 | $1,351.49 – $13,856.50 | 18 |
| Valvuloplasty mitral CPT 92987 | $15,873.70 | $10,380.00 | $768.50 – $26,456.16 | 22 |
| Valvuloplasty pulmonary CPT 92990 | $15,873.70 | $7,518.00 | $616.00 – $26,456.16 | 22 |
| Valvuloplasty/tv without ring insert 33463 CPT 33463 | $4,356.36 | $10,620.00 | $1,827.33 – $18,946.26 | 19 |
| Valvuloplasty/tv w/ring insertion 33464 CPT 33464 | $3,444.00 | $8,380.00 | $1,449.47 – $14,969.47 | 19 |
| Vancomycin 1,000 mg intravenous injection HCPCS J3373 | $0.04 | $275.78 | $0.02 – $9.48 | 14 |
| Vancomycin 750 mg intravenous solution HCPCS J3374 | $0.14 | $53.12 | $0.06 – $45.79 | 14 |
| Vancomycin hcl injection HCPCS J3370 | not published | $647.03 | $1.57 – $4.50 | 11 |
| Vancomycin peak therapeutic drug level CPT 80202 | $18.69 | $92.00 | $7.08 – $61.64 | 21 |
| Vanomycin dna amp probe CPT 87500 | $48.42 | not published | $18.35 – $57.20 | 16 |
| Vantas implant HCPCS J9225 | not published | not published | $4,971.34 – $13,019.04 | 7 |
| Variable concentration mask HCPCS A4620 | $1.26 | not published | $0.84 – $23.19 | 16 |
| Varicella zoster antibody igg CPT 86787 | $17.77 | $88.00 | $3.80 – $27.82 | 21 |
| Varicella-zoster immue globin im CPT 90396 | $3,261.48 | not published | $1,236.05 – $5,435.80 | 18 |
| Varus/valgus strap padded/li HCPCS L2270 | $104.55 | not published | $69.70 – $149.75 | 16 |
| Vasc emb/occ w/prs cath HCPCS C9797 | $25,206.69 | $25,440.00 | $9,552.97 – $42,011.16 | 21 |
| Vasc graft into carpal bone CPT 25430 | $4,499.12 | $2,410.00 | $443.47 – $7,498.53 | 20 |
| Vasectomy CPT 55250 | $2,874.36 | $2,655.00 | $139.09 – $4,790.60 | 22 |
| Vasopressin 20 unit/ml intravenous solution HCPCS J2598 | $0.72 | $479.15 | $0.30 – $29.96 | 14 |
| Vbac delivery 59610 CPT 59610 | $3,579.68 | $5,720.00 | $2,136.51 – $13,400.28 | 19 |
| Vbac/include postpartum care 59614 CPT 59614 | $1,671.62 | $3,900.00 | $997.42 – $6,988.43 | 19 |
| Vedolizumab 300 mg intravenous solution HCPCS J3380 | $29.49 | $30,331.10 | $11.18 – $26,141.10 | 22 |
| Veeg cont 2-12 hrs CPT 95713 | $513.11 | $3,150.00 | $194.46 – $2,428.65 | 22 |
| Veeg ea 12-26hr cont mntr CPT 95716 | $1,180.80 | $6,448.00 | $447.50 – $4,971.41 | 22 |
| Veeg intrmnt 2-12 hrs CPT 95712 | $513.11 | $2,250.00 | $194.46 – $1,734.75 | 22 |
| Veeg unmon 12-26 hrs CPT 95714 | $513.11 | $2,456.00 | $194.46 – $1,893.58 | 22 |
| Veeg unmon 2-12 hrs CPT 95711 | $296.91 | $1,531.00 | $112.52 – $1,180.40 | 21 |
| Vein bypass grft fem-popliteal 35583 CPT 35583 | $2,006.46 | $4,990.00 | $830.27 – $8,973.66 | 19 |
| Vein byp fem-tibial peroneal 35585 CPT 35585 | $2,327.01 | $5,780.00 | $961.70 – $10,403.45 | 19 |
| Vein byp pop-tibl peroneal CPT 35587 | $1,872.85 | $4,710.00 | $773.19 – $8,487.93 | 19 |
| Vein gft fem a/p tib/pero/dis art 35566 CPT 35566 | $2,318.57 | $5,770.00 | $957.65 – $10,357.01 | 19 |
| Vein x-ray adrenal gland CPT 75840 | $4,341.66 | $1,431.00 | $33.44 – $7,236.10 | 22 |
| Vein x-ray adrenal glands CPT 75842 | not published | not published | $78.49 – $343.48 | 7 |
| Vein x-ray eye socket CPT 75880 | $862.57 | $1,431.00 | $20.66 – $1,437.62 | 22 |
| Vein x-ray kidney CPT 75831 | $4,341.66 | $1,341.00 | $31.95 – $7,236.10 | 22 |
| Vein x-ray liver CPT 75891 | $4,341.66 | $1,406.00 | $32.16 – $7,236.10 | 22 |
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.