Henry Ford St John Hospital — price list
← Hospital overviewVerified from Henry Ford St John Hospital’s published price file
Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
252 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| ALGFTAMNALWRPQCF#1021651 Outpatient | 66227492 CDM | $481 | $269 | $130 – $481 | — | |
| ALGFTDERMLSHPDQCF#1035172 Outpatient | 66227694 CDM | $54.00 | $30.24 | $14.58 – $54.00 | — | |
| ALGFTHMNPLCNTAQCF#1032061 Outpatient | 66227919 CDM | $1,806 | $1,011 | $488 – $1,806 | — | |
| ALGFTWNDLYOPH UMB QCF Outpatient | 66228051 CDM | $23.00 | $12.88 | $6.21 – $23.00 | — | |
| ALGFTWNDLYOPHQCF#1034953 Outpatient | 66227794 CDM | $34.00 | $19.04 | $9.18 – $34.00 | — | |
| ALGFTWOUNDNEOXQCF#1036330 Outpatient | 66227721 CDM | $2,390 | $1,338 | $645 – $2,390 | — | |
| ALLGRFT DRML 1MM 16X20CM Outpatient | 66229330 CDM | $74.00 | $41.44 | $19.98 – $74.00 | — | |
| ALLODRM MTRX 1.6-0.4 QCF Outpatient | 66228563 CDM | $95.00 | $53.20 | $25.65 – $95.00 | — | |
| ALLOGRAFT AMNIOTC EPICRD 2X3CM Outpatient | 66143086 CDM | $528 | $296 | $143 – $528 | — | |
| ALLOGRAFT EPICORD 1.0X2.0CM Outpatient | 66143084 CDM | $1,040 | $582 | $281 – $1,040 | — | |
| ALLOGRAFT EPICORD 2.0X3.0CM Outpatient | 66143085 CDM | $495 | $277 | $134 – $495 | — | |
| ALLOGRAFT GRFIX PRME 3.0X3.0CM Outpatient | 66143087 CDM | $306 | $171 | $82.62 – $306 | — | |
| ALLOGRAFT MEMBRNE 200 4X8 Outpatient | 66228878 CDM | $169 | $94.64 | $45.63 – $169 | — | |
| ALLOGRAFT PLACENTAL 3X9CM Outpatient | 66229273 CDM | $220 | $123 | $59.40 – $220 | — | |
| ALLOGRAFTAMNTC ALWRAP QCF Outpatient | 66228050 CDM | $513 | $287 | $139 – $513 | — | |
| ANCHORSFTSNGLJUGGE#269818 Outpatient | 66226047 CDM | $582 | $326 | $157 – $582 | — | |
| ASP/INJ MED JNT W/O US*20605 Outpatient | 66141093 CDM | $633 | $354 | $171 – $633 | — | |
| ASP/INJ SMALL JNT W/O US*20600 Outpatient | 66141092 CDM | $413 | $231 | $112 – $413 | — | |
| AVUL NAIL PLATE EA ADDL*11732 Outpatient | 66141056 CDM | $193 | $108 | $52.11 – $193 | — | |
| AVUL NAIL PLATE SMPL*11730 Outpatient | 66141055 CDM | $406 | $227 | $110 – $406 | — | |
| BLOOD GLUCOSE (BGM)*82962 Outpatient | 66130010 CDM | $16.00 | $8.96 | $4.32 – $16.00 | — | |
| BONE BIOPSY,OPEN;SUPRFCL*20240 Outpatient | 66142088 CDM | $5,093 | $2,852 | $1,375 – $5,093 | — | |
| BURN DRSG/DEBRD LARGE*16030 Outpatient | 66141088 CDM | $464 | $260 | $125 – $464 | — | |
| BURN DRSG/DEBRD MED*16025 Outpatient | 66141087 CDM | $338 | $189 | $91.26 – $338 | — | |
| BURN DRSG/DEBRD SMALL*16020 Outpatient | 66141086 CDM | $245 | $137 | $66.15 – $245 | — | |
| BX BONE TROCAR/NDL DEEP*20225 Outpatient | 66141091 CDM | $9,617 | $5,386 | $2,597 – $9,617 | — | |
| BX BONE TROCAR/NDL SRFCL*20220 Outpatient | 66141090 CDM | $2,217 | $1,242 | $599 – $2,217 | — | |
| CHEM CAUTERY TISSUE*17250 Outpatient | 66141089 CDM | $510 | $286 | $138 – $510 | — | |
| CL TX MED MAL FX W/O MAN*27760 Outpatient | 66141100 CDM | $585 | $328 | $158 – $585 | — | |
| CL TX TOE FX W/ MANIP*28515 Outpatient | 66141116 CDM | $858 | $480 | $232 – $858 | — |