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 |
|---|---|---|---|---|
| Dilation of cervical canal 57800 CPT 57800 | $4,451.18 | $155.00 | $27.69 – $7,418.63 | 22 |
| Dilation of rectal stricture 45910 CPT 45910 | $1,645.43 | $630.00 | $119.92 – $2,742.38 | 20 |
| Dilation of salivary duct CPT 42660 | $741.60 | $301.00 | $44.73 – $1,236.00 | 22 |
| Dilation of urethra CPT 53661 | $182.95 | $180.00 | $23.00 – $304.91 | 22 |
| Dilation of urethra CPT 53665 | $2,874.36 | $128.00 | $21.09 – $4,790.60 | 20 |
| Dilation of vagina CPT 57400 | $4,451.18 | $434.00 | $73.70 – $7,418.63 | 20 |
| Dilation salivary duct 42650 CPT 42650 | $2,133.48 | $228.00 | $34.08 – $3,555.80 | 22 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $958.81 | $285.00 | $49.20 – $1,598.02 | 22 |
| Dilator fascial 10fx20cm HCPCS C2627 | not published | $138.27 | $22.00 – $63.20 | 11 |
| Dilat xst trc ndurlgc px CPT 50436 | $4,846.99 | $491.00 | $86.90 – $8,078.31 | 19 |
| Dilat xst trc new access rcs CPT 50437 | $4,846.99 | $820.00 | $142.92 – $8,078.31 | 19 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $0.04 | $72.88 | $0.02 – $11.58 | 14 |
| Dimecaprol injection HCPCS J0470 | not published | not published | $54.55 – $142.85 | 6 |
| Dimenhydrinate injection HCPCS J1240 | $1.26 | $40.92 | $0.52 – $35.27 | 14 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $1,033.94 | $2,264.25 | $391.85 – $1,891.44 | 22 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | not published | $14.00 | $0.03 – $12.07 | 13 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $0.98 | $39.50 | $0.40 – $6.43 | 14 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | $45.00 | not published | $30.31 – $139.79 | 6 |
| Dipyridamole injection HCPCS J1245 | $11.61 | $64.40 | $3.87 – $55.51 | 14 |
| Direct advanced life support CPT 99288 | not published | not published | $87.68 – $436.34 | 2 |
| Dir nsl mucous membrane test CPT 95065 | $51.36 | not published | $16.13 – $85.61 | 19 |
| Disability dlco CPT 94727 | $296.91 | $208.00 | $7.67 – $494.85 | 22 |
| Disaccharidases CPT 82657 | $30.59 | $352.00 | $18.09 – $81.07 | 20 |
| Disarticulation sho sec clsr CPT 23921 | $2,837.09 | $1,540.00 | $292.88 – $4,728.48 | 20 |
| Disarticulation shoulder CPT 23920 | $17,653.66 | $3,740.00 | $659.66 – $6,705.43 | 19 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | $1,940.58 | $5,280.00 | $836.45 – $9,165.86 | 19 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | $300.67 | $750.00 | $120.35 – $1,197.47 | 19 |
| Discography cerv/thor spine CPT 72285 | $2,685.07 | $547.00 | $36.42 – $4,475.11 | 22 |
| Disconnect insert locking wr HCPCS L6616 | $109.59 | not published | $73.06 – $156.97 | 16 |
| Disconnect locking wrist uni HCPCS L6615 | $364.04 | not published | $242.70 – $521.48 | 16 |
| Dise eval slp do brth flx dx CPT 42975 | $2,447.43 | $360.00 | $53.25 – $4,079.05 | 19 |
| Dissect brain w/scope CPT 62161 | $2,321.68 | $5,380.00 | $958.29 – $9,387.59 | 19 |
| Dis site tele svcs rhc/fqhc HCPCS G2025 | not published | not published | $88.59 – $88.59 | 1 |
| Dissolve clot heart vessel CPT 92975 | not published | not published | $258.81 – $662.10 | 5 |
| Dist revas ligation hemo CPT 36838 | $7,651.38 | $3,950.00 | $657.11 – $12,752.30 | 19 |
| Div aberrant vsl w/reanast CPT 33803 | $1,644.05 | $3,960.00 | $692.89 – $7,077.15 | 19 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | $8,139.99 | $2,600.00 | $455.61 – $13,566.64 | 20 |
| Division of fallopian tube 58605 CPT 58605 | $441.09 | $2,979.00 | $192.77 – $1,995.93 | 22 |
| #d/lmeth-l-methamphetamine CPT 80374 | not published | not published | $0.02 – $84.93 | 3 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | $409.79 | $1,030.00 | $164.77 – $1,828.92 | 18 |
| Dmd dup/delet analysis CPT 81161 | $385.02 | not published | $145.92 – $602.64 | 16 |
| Dmpk gene charac alleles CPT 81239 | $379.27 | not published | $143.74 – $593.63 | 16 |
| Dmpk gene detc abnor allele CPT 81234 | $189.06 | not published | $71.65 – $295.92 | 16 |
| Dna antibody native/double stranded CPT 86225 | $18.96 | $93.00 | $7.19 – $62.31 | 21 |
| Dna gardnerella CPT 87510 | $27.67 | not published | $10.49 – $32.68 | 17 |
| Dna probe chlamydia CPT 87490 | $31.40 | not published | $11.90 – $37.08 | 17 |
| Dna probe gc CPT 87590 | $37.09 | not published | $14.06 – $43.81 | 17 |
| Dna trichomonas CPT 87660 | $27.67 | not published | $10.49 – $105.80 | 17 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $11.07 | $114.75 | $4.53 – $17.28 | 14 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $0.90 | $1,560.32 | $0.37 – $112.92 | 14 |
| Docetaxel (docivyx), 1 mg HCPCS J9172 | $68.66 | not published | $0.06 – $114.44 | 19 |
| Dolasetron mesylate HCPCS J1260 | not published | not published | $5.98 – $18.63 | 7 |
| Dolasetron mesylate oral HCPCS Q0180 | not published | not published | $94.25 – $216.73 | 6 |
| Domicil/r-home visit est pat CPT 99334 | not published | not published | $74.33 – $89.39 | 2 |
| Domicil/r-home visit est pat CPT 99335 | not published | not published | $138.90 – $139.96 | 2 |
| Domicil/r-home visit est pat CPT 99336 | not published | not published | $196.39 – $216.93 | 2 |
| Domicil/r-home visit est pat CPT 99337 | not published | not published | $283.52 – $283.52 | 1 |
| Domicil/r-home visit new pat CPT 99324 | not published | not published | $83.84 – $83.84 | 1 |
| Domicil/r-home visit new pat CPT 99325 | not published | not published | $120.76 – $140.86 | 2 |
| Domicil/r-home visit new pat CPT 99326 | not published | not published | $203.51 – $206.23 | 2 |
| Domicil/r-home visit new pat CPT 99327 | not published | not published | $274.06 – $274.06 | 1 |
| Domicil/r-home visit new pat CPT 99328 | not published | not published | $317.02 – $317.65 | 2 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $1.11 | $74.25 | $0.45 – $4.47 | 14 |
| Doppler echo complete CPT 93320 | $45.71 | $348.00 | $11.08 – $233.16 | 22 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $138.46 | $1,081.00 | $50.48 – $724.27 | 22 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $296.91 | $846.00 | $13.63 – $566.82 | 22 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $182.95 | $586.00 | $7.46 – $392.62 | 22 |
| Doripenem 50 mg/ml inj 10 ml HCPCS J1267 | not published | not published | $0.81 – $2.11 | 4 |
| Dornase alfa non-comp unit HCPCS J7639 | $76.12 | not published | $31.15 – $153.59 | 7 |
| Dornhoffer fixed part w/window HCPCS L8614 | $33,271.54 | $73,668.00 | $190.84 – $31,342.75 | 18 |
| Dorsi & plantar flex ass/res HCPCS L2220 | $137.21 | not published | $91.48 – $196.55 | 16 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | $341.46 | $36,862.64 | $129.41 – $31,732.50 | 22 |
| Double transfer toe-hand CPT 26554 | $9,977.57 | $12,690.00 | $2,184.74 – $20,019.15 | 19 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $3.84 | $839.09 | $1.57 – $66.37 | 14 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $143.53 | $5,102.00 | $54.40 – $1,163.70 | 22 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $0.14 | $83.99 | $0.06 – $41.16 | 14 |
| Dpyd gene common variants CPT 81232 | $241.24 | $864.00 | $91.43 – $666.14 | 21 |
| Drainable plastic pch w fcpl HCPCS A4375 | $33.77 | not published | $17.71 – $48.37 | 16 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $973.71 | $423.00 | $73.91 – $1,622.86 | 22 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $973.71 | $450.00 | $84.77 – $1,622.86 | 22 |
| Drainage external ear complex 69005 CPT 69005 | $2,271.01 | $586.00 | $93.29 – $3,785.02 | 22 |
| Drainage external ear simple 69000 CPT 69000 | $973.71 | $380.00 | $74.98 – $1,622.86 | 22 |
| Drainage lymph node lesion 38300 CPT 38300 | $3,994.09 | $1,217.00 | $137.81 – $6,656.82 | 22 |
| Drainage lymph node lesion 38305 CPT 38305 | $3,994.09 | $1,630.00 | $216.70 – $6,656.82 | 20 |
| Drainage mouth roof lesion CPT 42000 | $325.68 | $538.00 | $63.26 – $542.80 | 22 |
| Drainage of abdomen CPT 48000 | $2,653.40 | $6,470.00 | $1,113.99 – $11,419.33 | 19 |
| Drainage of arm bursa 23931 CPT 23931 | $2,271.01 | $705.00 | $101.18 – $3,785.02 | 22 |
| Drainage of bladder abscess CPT 51080 | $3,994.09 | $1,330.00 | $241.54 – $6,656.82 | 20 |
| Drainage of bone lesion CPT 26992 | $4,499.12 | $3,200.00 | $602.58 – $5,820.52 | 19 |
| Drainage of bone lesion CPT 27303 | $4,499.12 | $2,110.00 | $385.10 – $3,883.87 | 19 |
| Drainage of eye CPT 65800 | $3,173.34 | $2,361.00 | $45.37 – $5,288.90 | 22 |
| Drainage of eye CPT 65810 | $3,173.34 | $1,450.00 | $255.60 – $5,288.90 | 20 |
| Drainage of eye CPT 65815 | $3,173.34 | $1,929.00 | $262.42 – $5,288.90 | 22 |
| Drainage of forearm bursa CPT 25031 | $2,211.05 | $1,130.00 | $176.21 – $3,685.08 | 20 |
| Drainage of kidney lesion CPT 50390 | $973.71 | $312.00 | $51.55 – $1,622.86 | 20 |
| Drainage of mouth lesion CPT 41005 | $325.68 | $400.00 | $71.36 – $542.80 | 22 |
| Drainage of mouth lesion CPT 41006 | $2,133.48 | $830.00 | $137.39 – $3,555.80 | 20 |
| Drainage of mouth lesion CPT 41007 | $2,133.48 | $1,931.00 | $123.57 – $3,555.80 | 22 |
| Drainage of mouth lesion CPT 41008 | $4,558.89 | $3,392.00 | $156.13 – $7,598.14 | 22 |
| Drainage of mouth lesion CPT 41009 | $741.60 | $960.00 | $168.48 – $1,236.00 | 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.