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 |
|---|---|---|---|---|
| Io radiation tx management CPT 77469 | $378.62 | $820.00 | $169.97 – $323.74 | 17 |
| Io rad tx deliver by elctrns CPT 77425 | $10,127.56 | $19,511.00 | $491.42 – $16,879.26 | 21 |
| Io rad tx delivery by x-ray CPT 77424 | $10,127.56 | $19,511.00 | $696.39 – $16,879.26 | 21 |
| Ioxaglate 39.3%-19.6% inj 200 ml HCPCS Q9964 | not published | not published | $0.47 – $0.66 | 3 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | $257.94 | $108,706.64 | $97.76 – $23,415.56 | 22 |
| Ip/obs cnsltj new/est low 45 CPT 99253 | $293.00 | $392.00 | $63.05 – $215.60 | 15 |
| Ip/obs cnsltj new/est mod 60 CPT 99254 | $293.00 | $563.00 | $87.76 – $309.65 | 15 |
| Ip/obs consltj new/est hi 80 CPT 99255 | $293.00 | $776.00 | $117.79 – $426.80 | 15 |
| Ip/obs consltj new/est sf 35 CPT 99252 | $201.00 | $287.00 | $44.73 – $157.85 | 15 |
| Ipratropium bromide comp HCPCS J7645 | not published | not published | $0.05 – $0.14 | 3 |
| Ipratropium bromide non-comp HCPCS J7644 | $0.55 | not published | $0.23 – $1.06 | 9 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | $2.48 | $152.00 | $1.01 – $38.79 | 14 |
| Irinotecan liposomal 4.3 mg/ml intravenous HCPCS J9205 | $91.02 | $9,209.00 | $34.49 – $7,895.06 | 22 |
| Iron CPT 83540 | $8.93 | $55.00 | $3.38 – $26.80 | 21 |
| Iron binding capacity CPT 83550 | $12.06 | $57.00 | $4.57 – $38.19 | 21 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | $24.95 | $116.86 | $9.46 – $96.42 | 22 |
| Iron stain peripheral blood CPT 85536 | $9.49 | not published | $5.61 – $15.36 | 16 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $0.33 | $225.80 | $0.13 – $99.47 | 14 |
| Irradiation of blood product each unit reference CPT 86945 | $51.36 | $157.00 | $10.25 – $109.90 | 22 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $81.12 | $195.00 | $17.29 – $150.35 | 22 |
| Irrigation sphenoid sinus CPT 31002 | $2,133.48 | $590.00 | $106.71 – $3,555.80 | 20 |
| Irrigation syringe HCPCS A4322 | $6.00 | not published | $2.36 – $8.59 | 16 |
| Irrigation tray HCPCS A4320 | $9.67 | not published | $3.84 – $13.85 | 16 |
| Irrigation vagina and/or appl medicament tx disease CPT 57150 | $81.12 | $180.00 | $16.21 – $156.15 | 22 |
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | $116.33 | $13,946.90 | $44.09 – $2,395.80 | 22 |
| Island pedicle flap graft CPT 15740 | $2,837.09 | $2,750.00 | $479.04 – $4,728.48 | 22 |
| IV cipaglucosidase alfa-atga HCPCS G0138 | $875.50 | not published | $157.07 – $1,459.17 | 17 |
| Ivc venogram s&i CPT 75825 | $4,341.66 | $1,236.00 | $33.23 – $7,236.10 | 22 |
| IV Fluids (each additional hour) CPT 96361 | $64.39 | $170.00 | $8.30 – $113.90 | 22 |
| IV Fluids (first hour) CPT 96360 | $292.48 | $396.00 | $21.30 – $487.46 | 22 |
| Ivig non-lyophilized, nos HCPCS J1599 | not published | not published | $151.98 – $398.01 | 5 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $28.18 | $195.00 | $13.13 – $130.65 | 22 |
| IV inj ra drug dx study CPT 78808 | $549.70 | $676.00 | $27.59 – $916.16 | 22 |
| IV Medicine Infusion (additional drug) CPT 96367 | $99.00 | $241.00 | $18.90 – $165.00 | 22 |
| IV Medicine Infusion (each additional hour) CPT 96366 | $64.39 | $195.00 | $13.63 – $130.65 | 22 |
| IV Medicine Infusion (first hour) CPT 96365 | $292.48 | $396.00 | $41.24 – $487.46 | 22 |
| IV njx tst vasc flo flap/grf CPT 15860 | $614.27 | $494.00 | $59.43 – $1,023.78 | 22 |
| IV Push Injection (each additional drug) CPT 96375 | $64.39 | $176.00 | $10.01 – $117.25 | 22 |
| IV Push Injection (first drug) CPT 96374 | $292.48 | $300.00 | $24.07 – $487.46 | 22 |
| Ivp w/nephrotomography CPT 74415 | $241.18 | $1,171.00 | $14.48 – $784.57 | 22 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $241.18 | $893.00 | $14.48 – $598.31 | 22 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | $193.17 | $18,181.04 | $73.21 – $15,628.96 | 22 |
| Jak2 targeted sequence analysis CPT 81279 | $255.58 | $1,008.00 | $96.86 – $777.17 | 21 |
| Jaw arthroscopy/surgery CPT 29800 | $4,499.12 | $1,740.00 | $324.40 – $7,498.53 | 20 |
| Jaw arthroscopy/surgery CPT 29804 | $4,499.12 | $2,100.00 | $470.04 – $7,498.53 | 20 |
| Jaw Joint (TMJ) X-ray (both sides, open and closed) CPT 70330 | $119.66 | $367.00 | $7.24 – $245.89 | 22 |
| Jaw (Mandible) X-ray (complete) CPT 70110 | $143.75 | $363.00 | $7.46 – $239.59 | 22 |
| Jejunstmy tube plcmt CPT 44372 | $2,638.57 | $2,016.00 | $135.26 – $4,397.62 | 22 |
| Jkt lso inter HCPCS L0560 | not published | not published | $2,292.81 – $2,292.81 | 1 |
| John cunningham antibody CPT 86711 | $23.31 | $1,363.00 | $8.83 – $1,050.87 | 21 |
| J-tube placement CPT 44015 | $193.30 | $492.00 | $80.73 – $874.37 | 19 |
| Kafo dbl solid stirrup band/ HCPCS L2020 | $1,868.98 | not published | $1,245.98 – $2,677.18 | 16 |
| Kafo dbl solid stirrup without j HCPCS L2030 | $1,837.04 | not published | $1,224.69 – $2,631.45 | 16 |
| Kafo fem fx cast molded to p HCPCS L2128 | $2,719.21 | not published | $1,812.80 – $3,895.09 | 16 |
| Kafo fem fx cast semi-rigid HCPCS L2134 | $1,954.41 | not published | $1,302.94 – $2,799.57 | 16 |
| Kafo fem fx cast thermoplas HCPCS L2126 | $2,165.55 | not published | $1,443.70 – $3,102.02 | 16 |
| Kafo femoral fx cast rigid HCPCS L2136 | $2,138.81 | $1,747.00 | $698.80 – $2,014.82 | 19 |
| Kafo femoral fx cast soft HCPCS L2132 | $1,650.51 | not published | $1,100.34 – $2,364.25 | 16 |
| Kafo pla sin up w/wo k/a cus HCPCS L2034 | $3,445.29 | not published | $2,296.86 – $4,935.18 | 15 |
| Kafo plas sing free knee mol HCPCS L2037 | $2,812.47 | not published | $1,874.98 – $4,028.69 | 16 |
| Kafo plastic pediatric size HCPCS L2035 | $293.82 | not published | $195.88 – $420.88 | 16 |
| Kafo sing fre stirr thi/calf HCPCS L2000 | $1,897.24 | not published | $1,264.83 – $2,717.67 | 16 |
| Kafo sng/dbl mechanical act HCPCS L2005 | $6,949.58 | not published | $4,633.06 – $9,954.86 | 15 |
| Kafo sng solid stirrup without j HCPCS L2010 | $1,479.83 | not published | $986.55 – $2,119.76 | 16 |
| Kafo without joint multi-axis an HCPCS L2038 | $2,267.26 | not published | $1,511.50 – $3,247.69 | 16 |
| Keratomileusis CPT 65760 | not published | $1,530.00 | $263.20 – $2,061.34 | 10 |
| Keratophakia CPT 65765 | not published | not published | $2,585.41 – $2,702.97 | 2 |
| Keratoprosthesis CPT 65770 | $19,946.44 | $4,370.00 | $754.02 – $33,244.06 | 20 |
| Kerecis marigen shld sq cm HCPCS A2019 | $171.12 | not published | $66.49 – $228.16 | 14 |
| Ketamine and metabolite screen - quest CPT 80357 | not published | not published | $0.02 – $318.03 | 4 |
| Ketogenic steroids fract CPT 83582 | $21.35 | not published | $8.09 – $28.37 | 17 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $11.27 | $54.00 | $4.27 – $36.18 | 21 |
| Ketorolac (Toradol) Pain Shot, 15 mg HCPCS J1885 | $0.46 | $24.59 | $0.17 – $1.81 | 22 |
| Kidney endoscopy CPT 50551 | $7,372.68 | $970.00 | $165.50 – $12,287.80 | 20 |
| Kidney endoscopy CPT 50553 | $7,372.68 | $1,030.00 | $176.36 – $12,287.80 | 20 |
| Kidney endoscopy CPT 50570 | $4,846.99 | $1,610.00 | $274.34 – $8,078.31 | 20 |
| Kidney endoscopy CPT 50575 | $7,372.68 | $2,340.00 | $396.61 – $12,287.80 | 20 |
| Kidney endoscopy & biopsy CPT 50555 | $13,016.74 | $1,120.00 | $191.27 – $21,694.57 | 20 |
| Kidney endoscopy & biopsy CPT 50574 | $4,846.99 | $1,860.00 | $314.60 – $8,078.31 | 20 |
| Kidney endoscopy & treatment CPT 50557 | $13,016.74 | $1,130.00 | $160.20 – $21,694.57 | 20 |
| Kidney endoscopy & treatment CPT 50561 | $7,372.68 | $1,290.00 | $220.88 – $12,287.80 | 20 |
| Kidney endoscopy & treatment CPT 50576 | $13,016.74 | $1,850.00 | $313.54 – $21,694.57 | 20 |
| Kidney endoscopy & treatment CPT 50580 | $7,372.68 | $1,990.00 | $337.82 – $12,287.80 | 20 |
| Kidney function study CPT 78725 | $549.70 | $683.00 | $10.86 – $916.16 | 22 |
| Kidney imaging (3d) CPT 78710 | not published | not published | $224.70 – $555.18 | 2 |
| Kidney imaging morphology CPT 78700 | $549.70 | $1,103.00 | $12.78 – $916.16 | 22 |
| Kidney imag w/bld flow multi CPT 78709 | $746.61 | $2,179.00 | $40.26 – $1,459.93 | 22 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $746.61 | $1,783.00 | $27.69 – $1,244.35 | 22 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $143.75 | $860.00 | $21.73 – $542.70 | 22 |
| Kidney (Retroperitoneal) Ultrasound (limited) CPT 76775 | $143.75 | $531.00 | $17.25 – $322.27 | 22 |
| Kit cast tcc 3in w/2reg boots total contact cast HCPCS Q4038 | $72.42 | not published | $21.60 – $103.74 | 16 |
| Kit cath f 8f w/glv + wipe ster HCPCS A4353 | $13.79 | not published | $5.45 – $19.74 | 16 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | not published | $14,100.00 | $2,475.00 – $6,360.75 | 11 |
| Kit gene analys d816 variant CPT 81273 | $172.32 | $618.00 | $65.31 – $476.48 | 21 |
| Kit hfx iq ipg bundle HCPCS C1822 | not published | $66,000.00 | $18,210.60 – $52,325.12 | 11 |
| Kit irrigator stoma cone 7721 HCPCS A4398 | $27.19 | not published | $14.35 – $38.93 | 16 |
| Kit lead specify 5-6-5 HCPCS C1778 | not published | $30,027.00 | $54.00 – $155.16 | 11 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | not published | $2,145.00 | $643.50 – $1,848.99 | 11 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | $171.12 | not published | $14.99 – $3,918.01 | 16 |
| Kit sound processor cochlear osia 2 HCPCS L8691 | $2,926.40 | not published | $1,950.93 – $7,258.68 | 15 |
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.