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 |
|---|---|---|---|---|
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $1.43 | $195.15 | $0.01 – $8.62 | 14 |
| Lomustine 10 mg HCPCS S0178 | not published | not published | $72.23 – $280.39 | 5 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | $305.29 | $87,139.31 | $115.70 – $75,070.99 | 22 |
| Long tongue stirrup HCPCS L2265 | $227.99 | not published | $151.99 – $326.58 | 16 |
| Loop ostmy bridg ster HCPCS A4421 | not published | not published | $2.10 – $12.57 | 4 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $1.94 | $53.00 | $0.79 – $6.69 | 14 |
| Lo rig pos pnl l1-l5 pre ots HCPCS L0641 | $70.93 | not published | $47.29 – $100.92 | 15 |
| Lo sag rig pnl stays pre cst HCPCS L0626 | $132.19 | not published | $88.13 – $189.35 | 16 |
| Loudness balance test CPT 92562 | $296.91 | not published | $32.19 – $494.85 | 20 |
| Low back disk surgery CPT 63030 | $9,977.57 | $3,340.00 | $572.76 – $16,629.28 | 20 |
| Low cost skin substitute app HCPCS C5271 | not published | not published | $727.71 – $883.16 | 3 |
| Low cost skin substitute app HCPCS C5273 | not published | not published | $2,293.23 – $2,883.44 | 3 |
| Low cost skin substitute app HCPCS C5275 | not published | not published | $143.43 – $883.16 | 4 |
| Low cost skin substitute app HCPCS C5277 | not published | not published | $727.71 – $883.16 | 3 |
| Low cost skin substitute app HCPCS C5272 | not published | not published | $0.02 – $0.02 | 2 |
| Low cost skin substitute app HCPCS C5274 | not published | not published | $0.02 – $0.02 | 2 |
| Low cost skin substitute app HCPCS C5276 | not published | not published | $0.02 – $0.02 | 2 |
| Low cost skin substitute app HCPCS C5278 | not published | not published | $0.02 – $0.02 | 2 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $143.75 | $1,668.00 | $31.52 – $1,286.03 | 22 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $241.18 | $3,095.00 | $37.28 – $2,073.65 | 22 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $479.72 | $2,263.00 | $35.78 – $1,516.21 | 22 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $143.75 | $1,560.00 | $29.61 – $1,045.20 | 22 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $479.72 | $4,176.00 | $67.31 – $2,797.92 | 22 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $479.72 | $3,668.00 | $52.40 – $2,457.56 | 22 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $328.08 | $2,834.00 | $43.67 – $1,898.78 | 22 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $143.75 | $301.00 | $6.82 – $239.59 | 22 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $143.75 | $398.00 | $8.09 – $239.59 | 22 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $143.75 | $523.00 | $9.16 – $316.91 | 22 |
| Lower jaw bone graft CPT 21215 | $8,139.99 | $4,173.00 | $459.44 – $13,566.64 | 22 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $119.66 | $263.00 | $4.90 – $142.71 | 22 |
| Low frequency non-thermal Ultrasound CPT 97610 | $275.88 | not published | $15.97 – $459.79 | 17 |
| Loxapine for inhalation 1 mg HCPCS J2062 | $21.94 | not published | $8.32 – $34.34 | 14 |
| Lsh uterus 250 g or less CPT 58541 | $14,616.42 | $2,300.00 | $413.65 – $24,360.70 | 20 |
| Lsh uterus above 250 g CPT 58543 | $14,616.42 | $2,650.00 | $473.50 – $24,360.70 | 20 |
| Lsh w/t/o ut 250 g or less CPT 58542 | $14,616.42 | $2,640.00 | $467.75 – $24,360.70 | 20 |
| Lsh w/t/o uterus above 250 g CPT 58544 | $14,616.42 | $2,900.00 | $511.41 – $24,360.70 | 20 |
| Lso corset front HCPCS L0972 | $164.97 | not published | $109.98 – $236.31 | 16 |
| Lso flex no ri stays pre ots HCPCS L0628 | $76.34 | not published | $50.89 – $143.85 | 16 |
| Lso full corset HCPCS L0976 | $253.58 | not published | $169.05 – $363.22 | 16 |
| Lso r post pnl sj-t9 pre cst HCPCS L0630 | $274.69 | not published | $183.13 – $393.48 | 16 |
| Lso sag-coronal panel custom HCPCS L0638 | $2,236.86 | $1,827.00 | $730.80 – $2,107.18 | 19 |
| Lso sag-co shell pnl pre ots HCPCS L0651 | $1,080.97 | not published | $720.65 – $1,537.87 | 15 |
| Lso sag ctr rigi pos pre ots HCPCS L0643 | $147.38 | not published | $98.26 – $209.68 | 15 |
| Lso sagit rigid panel prefab HCPCS L0635 | $1,694.67 | not published | $1,129.78 – $2,427.50 | 15 |
| Lso sagittal rigid panel cus HCPCS L0636 | $2,299.38 | not published | $1,532.92 – $3,293.73 | 16 |
| Lso sc r pos/lat pnl pre cst HCPCS L0633 | $486.33 | not published | $324.22 – $696.63 | 16 |
| Lso sc r pos/lat pnl pre ots HCPCS L0649 | $260.97 | not published | $173.98 – $371.28 | 15 |
| Lso s/c shell/panel custom HCPCS L0640 | $1,774.64 | not published | $1,183.09 – $2,542.05 | 16 |
| Lso s/c shell/panel prefab HCPCS L0639 | $2,197.14 | not published | $1,464.76 – $3,147.26 | 16 |
| L/s ratio fetal lung CPT 83661 | $30.35 | $90.59 | $11.50 – $60.70 | 21 |
| Lubricant per ounce HCPCS A4402 | $3.13 | not published | $0.35 – $4.50 | 16 |
| Lumbar bolster pad HCPCS L1030 | $132.80 | not published | $88.53 – $190.22 | 16 |
| Lumbar derotation pad HCPCS L1240 | $154.24 | not published | $102.83 – $220.95 | 16 |
| Lumbar diskogram s&i CPT 72295 | $2,685.07 | $566.00 | $25.77 – $4,475.11 | 22 |
| Lumbar or lumbar rib pad HCPCS L1040 | $150.36 | not published | $100.24 – $215.38 | 16 |
| Lumbar sling HCPCS L1090 | $170.65 | not published | $113.77 – $244.46 | 16 |
| Lumbar Spinal Fusion (single level) CPT 22612 | $24,109.66 | $5,440.00 | $935.92 – $40,182.77 | 20 |
| Lumizyme injection HCPCS J0221 | $286.19 | not published | $108.46 – $476.99 | 19 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $513.11 | $357.00 | $6.60 – $855.19 | 22 |
| Lung function test (mbc/mvv) CPT 94200 | $81.12 | $175.00 | $1.70 – $135.19 | 22 |
| Lung Function Test (Spirometry) CPT 94010 | $296.91 | $208.00 | $5.33 – $494.85 | 22 |
| Lung perfusion imaging CPT 78580 | $549.70 | $1,743.00 | $21.51 – $1,167.81 | 22 |
| Lung transplant double CPT 32853 | $6,462.44 | $15,930.00 | $2,703.18 – $28,164.93 | 19 |
| Lung transplant single CPT 32851 | $4,639.04 | $11,340.00 | $1,944.05 – $20,196.58 | 19 |
| Lung transplant with bypass CPT 32852 | $5,044.02 | $12,340.00 | $2,122.12 – $22,063.53 | 19 |
| Lung transplant with bypass CPT 32854 | $6,858.37 | $16,920.00 | $2,866.34 – $29,900.98 | 19 |
| Lung volume reduction 32491 CPT 32491 | $2,120.14 | $5,003.00 | $897.58 – $9,001.12 | 19 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $290.88 | $24,800.00 | $110.24 – $21,334.50 | 22 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $59.03 | $37,068.11 | $22.37 – $10,636.58 | 22 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | $442.66 | $920.08 | $167.76 – $737.76 | 21 |
| Lutetium lu 177 vipivotide HCPCS A9607 | $357.85 | $676.00 | $135.62 – $596.42 | 21 |
| Lvad shower bag heartmate HCPCS Q0501 | $867.80 | not published | $578.53 – $1,243.07 | 15 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | $39.77 | $106.00 | $15.07 – $66.29 | 20 |
| Lwr ext dynamic prosth pylon HCPCS L5985 | $479.87 | not published | $319.91 – $687.38 | 16 |
| Lyme dis dna dir probe CPT 87475 | $27.67 | not published | $10.49 – $32.68 | 17 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | $11,238.72 | $2,370.00 | $427.07 – $4,302.01 | 19 |
| Lymphatics/lymph node imaging CPT 78195 | $746.61 | $2,849.00 | $34.08 – $1,908.83 | 22 |
| Lymphocyte culture mixed CPT 86821 | $50.45 | not published | $19.12 – $182.17 | 17 |
| Lymphocyte transformation mitogen CPT 86353 | $67.66 | $135.80 | $25.64 – $83.20 | 21 |
| Lymphocytotoxicity assay CPT 86805 | $261.52 | not published | $99.11 – $308.90 | 17 |
| Lymphocytotoxicity assay CPT 86806 | $65.67 | $320.00 | $24.89 – $214.40 | 21 |
| Lymph vessel x-ray arm/leg CPT 75801 | $862.57 | $875.00 | $27.90 – $1,437.62 | 22 |
| Lymph vessel x-ray arms/legs CPT 75803 | $2,164.52 | $1,118.00 | $34.51 – $3,607.53 | 22 |
| Lymph vessel x-ray trunk CPT 75805 | $4,341.66 | $1,001.00 | $24.07 – $7,236.10 | 22 |
| Lymph vessel x-ray trunk CPT 75807 | $4,341.66 | $1,431.00 | $32.59 – $7,236.10 | 22 |
| Lysis intranasal synechia 30560 CPT 30560 | $741.60 | $440.00 | $89.03 – $1,236.00 | 22 |
| Lysis of labial adhesions CPT 56441 | $4,451.18 | $3,252.00 | $89.67 – $7,418.63 | 22 |
| Lysis penil circumic lesion CPT 54162 | $2,874.36 | $1,072.00 | $117.58 – $4,790.60 | 22 |
| Lyumjev for insulin pump use HCPCS J1813 | $20.84 | not published | $8.53 – $44.35 | 9 |
| Macro exam dissect molec study ea CPT 88387 | $35.11 | $104.00 | $4.98 – $25.44 | 21 |
| Macroscopic exam arthropod CPT 87168 | $5.89 | not published | $2.23 – $11.97 | 17 |
| Macroscopic exam parasite CPT 87169 | $5.95 | not published | $2.25 – $11.97 | 17 |
| Magnesium CPT 83735 | $9.25 | $46.00 | $3.18 – $12.98 | 21 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $0.56 | $83.60 | $0.23 – $8.40 | 14 |
| Magnetic image bone marrow CPT 77084 | $328.08 | $3,890.00 | $46.86 – $2,999.19 | 22 |
| Makena, 10 mg HCPCS J1726 | not published | not published | $20.62 – $54.01 | 3 |
| Malaria antibody CPT 86750 | $18.20 | not published | $6.90 – $24.34 | 17 |
| Male sling procedure CPT 53440 | $18,141.49 | $2,460.00 | $434.52 – $30,235.82 | 20 |
| Mammosite ced HCPCS C1728 | not published | $11,550.00 | $3,465.00 – $9,956.10 | 11 |
| Management of liver hemorrhage 47361 CPT 47361 | $4,203.38 | $10,380.00 | $1,766.20 – $18,576.66 | 19 |
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.