BC METRO DETROIT EPO: disclosed hospital rates

iDirect answer

Based on the published hospital price files, BC METRO DETROIT EPO appears in disclosed negotiated rates across 2 hospitals and 416 services. This is public hospital price transparency data, not a guaranteed estimate of your bill.

Actual patient responsibility may vary based on your insurance plan, deductible, coinsurance, network status, diagnosis, setting, bundled services, clinical circumstances, and hospital billing practices.

416 prices shown.

Service	Hospital	Code	List price	Cash price	Negotiated range	Allowed (median)
.9 NACL 1000ML Outpatient	Henry Ford Providence Novi Hospital	74699166 CDM	$23.00	$12.88	$5.98 – $23.00	—
.9 NACL 1000ML Outpatient	Henry Ford Providence Southfield Hospital	74699166 CDM	$23.00	$12.88	$5.98 – $23.00	—
ACETAZOLAMIDE(DIAMOX) 500MG IV Outpatient	Henry Ford Providence Novi Hospital	71997639 CDM	$44.00	$24.64	$11.44 – $44.00	—
ACETAZOLAMIDE(DIAMOX) 500MG IV Outpatient	Henry Ford Providence Southfield Hospital	71997639 CDM	$44.00	$24.64	$11.44 – $44.00	—
ADENOSINE 6MG INJ Outpatient	Henry Ford Providence Novi Hospital	71750145 CDM	$70.00	$39.20	$18.20 – $70.00	—
ADENOSINE 6MG INJ Outpatient	Henry Ford Providence Southfield Hospital	71750145 CDM	$70.00	$39.20	$18.20 – $70.00	—
ALBUMIN 25% 12.5GM 50ML VIAL Outpatient	Henry Ford Providence Novi Hospital	79412706 CDM	$97.00	$54.32	$25.22 – $97.00	—
ALBUTEROL INHALER (VENTOLIN) Outpatient	Henry Ford Providence Novi Hospital	71713325 CDM	$41.00	$22.96	$10.66 – $41.00	—
ALBUTEROL INHALER (VENTOLIN) Outpatient	Henry Ford Providence Southfield Hospital	71713325 CDM	$41.00	$22.96	$10.66 – $41.00	—
AMICAR 5GM 20ML VIAL Outpatient	Henry Ford Providence Novi Hospital	79412714 CDM	$15.00	$8.40	$3.90 – $15.00	—
AMINOPHYLLINE 20ML VIAL Outpatient	Henry Ford Providence Southfield Hospital	71713291 CDM	$12.00	$6.72	$3.12 – $12.00	—
ARTERIAL BLOOD DRAW Outpatient	Henry Ford Providence Novi Hospital	73630345 CDM	$35.00	$19.60	$9.10 – $35.00	—
ARTERIAL BLOOD DRAW Outpatient	Henry Ford Providence Southfield Hospital	72830342 CDM	$35.00	$19.60	$9.10 – $35.00	—
ARTERIAL BLOOD DRAW Outpatient	Henry Ford Providence Southfield Hospital	73630345 CDM	$35.00	$19.60	$9.10 – $35.00	—
ARTERIAL PUNCTURE*36600 Outpatient	Henry Ford Providence Novi Hospital	67879635 CDM	$35.00	$19.60	$9.10 – $35.00	—
ARTERIAL PUNCTURE*36600 Outpatient	Henry Ford Providence Southfield Hospital	67879635 CDM	$35.00	$19.60	$9.10 – $35.00	—
ASP/INJ RENAL CYST/PELV*50390 Outpatient	Henry Ford Providence Novi Hospital	72476575 CDM	$1,424	$797	$370 – $1,424	—
ASPIRIN-BABY 81 MG TAB Outpatient	Henry Ford Providence Novi Hospital	72350176 CDM	$17.00	$9.52	$4.42 – $17.00	—
ASPIRIN-BABY 81 MG TAB Outpatient	Henry Ford Providence Southfield Hospital	72350176 CDM	$17.00	$9.52	$4.42 – $17.00	—
ATROPINE 1MG INJ VIAL Outpatient	Henry Ford Providence Novi Hospital	71713028 CDM	$23.00	$12.88	$5.98 – $23.00	—
ATROPINE 1MG INJ VIAL Outpatient	Henry Ford Providence Southfield Hospital	71713028 CDM	$23.00	$12.88	$5.98 – $23.00	—
BRACHY NONSTRAND Y90/SOURCE Outpatient	Henry Ford Providence Novi Hospital	71906481 CDM	$35,053	$19,630	$9,114 – $35,053	—
BRACHY NONSTRAND Y90/SOURCE Outpatient	Henry Ford Providence Novi Hospital	74606484 CDM	$35,053	$19,630	$9,114 – $35,053	—
BRACHY NONSTRAND Y90/SOURCE Outpatient	Henry Ford Providence Southfield Hospital	71906481 CDM	$35,053	$19,630	$9,114 – $35,053	—
CALCIUM CHLORIDE 1GM/10ML SYR Outpatient	Henry Ford Providence Novi Hospital	33049610 CDM	$0.05	$0.03	$0.01 – $0.05	—