Henry Ford Health West Bloomfield Hospital
6777 West Maple Road, W Bloomfield, MI 48322 · Acute care hospital · Emergency room
These are Henry Ford Health West Bloomfield Hospital's own posted figures from its standard-charges file dated June 28, 2026. They are not a quote. Source: the hospital's file · its price transparency page.
234 of the services we track have a posted price here; 196 of them have a discounted cash price. Tap a service to compare it with nearby hospitals. How to read these numbers.
Emergency room
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Critical care, first 30 to 74 minutes CPT 99291 | $1,135.82 | $4,510.00 | $198.47 – $1,893.04 |
| Emergency room visit, level 1 (minor) CPT 99281 | $115.95 | $227.00 | $10.75 – $1,478.00 |
| Emergency room visit, level 2 CPT 99282 | $211.13 | $553.00 | $39.32 – $1,478.00 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $375.36 | $1,068.00 | $66.20 – $1,478.00 |
| Emergency room visit, level 4 CPT 99284 | $573.75 | $1,731.00 | $113.33 – $1,478.00 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $818.88 | $2,639.00 | $164.56 – $1,478.00 |
| Simple wound repair (stitches), 2.5 cm or less CPT 12001 | $275.88 | $180.00 | $43.22 – $2,056.00 |
Office visits
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $31.13 | $133.00 | $11.80 – $88.73 |
| Abdominal X-ray, 1 view CPT 74018 | $119.66 | $261.00 | $18.99 – $199.43 |
| Ankle X-ray, 3 or more views CPT 73610 | $119.66 | $290.00 | $19.01 – $159.55 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $143.75 | $338.00 | $19.89 – $259.03 |
| Breast ultrasound, one breast, complete CPT 76641 | $143.75 | $1,552.00 | $58.84 – $239.59 |
| Breast ultrasound, one breast, limited CPT 76642 | $119.66 | $623.00 | $46.29 – $199.43 |
| Chest X-ray, 1 view CPT 71045 | $119.66 | $229.00 | $15.47 – $199.43 |
| Chest X-ray, 2 views CPT 71046 | $119.66 | $308.00 | $20.76 – $199.43 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $241.18 | $3,147.00 | $93.72 – $1,592.00 |
| CT angiogram of the head CPT 70496 | $241.18 | $3,095.00 | $93.72 – $1,592.00 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $479.72 | $3,981.00 | $194.39 – $799.53 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $479.72 | $4,501.00 | $196.34 – $799.53 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $328.08 | $2,732.00 | $92.57 – $546.80 |
| CT scan of the abdomen, without contrast CPT 74150 | $143.75 | $1,353.00 | $58.84 – $239.59 |
| CT scan of the chest, with contrast CPT 71260 | $241.18 | $2,016.00 | $74.40 – $1,592.00 |
| CT scan of the chest, without contrast CPT 71250 | $143.75 | $1,418.00 | $54.73 – $1,592.00 |
| CT scan of the head, without contrast CPT 70450 | $143.75 | $1,327.00 | $44.21 – $1,592.00 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $143.75 | $1,575.00 | $55.39 – $1,592.00 |
| CT scan of the pelvis, with contrast CPT 72193 | $241.18 | $2,278.00 | $93.72 – $1,592.00 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $143.75 | $1,458.00 | $55.86 – $1,592.00 |
| Diagnostic mammogram, both breasts CPT 77066 | $147.89 | $469.00 | $56.05 – $423.30 |
| Diagnostic mammogram, one breast CPT 77065 | $115.09 | $410.00 | $43.62 – $332.03 |
| Foot X-ray, 3 or more views CPT 73630 | $119.66 | $272.00 | $17.25 – $159.55 |
| Hand X-ray, 3 or more views CPT 73130 | $119.66 | $293.00 | $19.45 – $159.55 |
| Knee X-ray, 3 views CPT 73562 | $119.66 | $328.00 | $21.85 – $159.55 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $328.08 | $1,319.00 | $100.20 – $675.78 |
| Leg or arm vein ultrasound, one side CPT 93971 | $143.75 | $941.00 | $55.86 – $431.79 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $143.75 | $301.00 | $19.67 – $191.67 |
| MRI of both breasts, without and with contrast CPT 77049 | $312.36 | $6,830.00 | |
| MRI of the abdomen, without and with contrast CPT 74183 | $479.72 | $4,996.00 | $154.34 – $2,418.59 |
| MRI of the brain, without and with contrast CPT 70553 | $479.72 | $4,982.00 | $139.43 – $2,304.00 |
| MRI of the brain, without contrast CPT 70551 | $328.08 | $2,953.00 | $84.05 – $2,304.00 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $328.08 | $2,940.00 | $93.24 – $2,304.00 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $328.08 | $2,834.00 | $109.89 – $546.80 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $328.08 | $2,849.00 | $80.54 – $2,304.00 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $328.08 | $2,719.00 | $80.76 – $2,304.00 |
| MRI of the pelvis, without and with contrast CPT 72197 | $479.72 | $4,475.00 | $196.34 – $799.53 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $328.08 | $2,940.00 | $126.54 – $546.80 |
| Neck X-ray, 2 or 3 views CPT 72040 | $119.66 | $282.00 | $19.45 – $159.55 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $143.75 | $852.00 | $58.84 – $239.59 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $143.75 | $877.00 | $58.84 – $239.59 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $143.75 | $673.00 | $58.84 – $239.59 |
| Screening mammogram, both breasts CPT 77067 | $121.76 | $393.00 | $46.14 – $351.06 |
| Shoulder X-ray, 2 or more views CPT 73030 | $119.66 | $261.00 | $17.69 – $159.55 |
| Transvaginal pregnancy ultrasound CPT 76817 | $143.75 | $536.00 | $49.80 – $239.59 |
| Transvaginal ultrasound CPT 76830 | $143.75 | $739.00 | $58.84 – $239.59 |
| Ultrasound of the abdomen, complete CPT 76700 | $143.75 | $833.00 | $58.84 – $239.59 |
| Ultrasound of the neck or thyroid CPT 76536 | $143.75 | $847.00 | $54.07 – $313.05 |
| Wrist X-ray, 3 or more views CPT 73110 | $119.66 | $328.00 | $22.52 – $159.55 |
| X-ray of the lower back, 4 or more views CPT 72110 | $143.75 | $398.00 | $26.90 – $191.67 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $11.67 | $56.00 | $4.42 – $29.75 |
| Blood culture CPT 87040 | $14.24 | $110.00 | $5.40 – $36.29 |
| Blood draw (venipuncture) CPT 36415 | $12.89 | $17.00 | $6.80 – $13.41 |
| BNP test (heart failure) CPT 83880 | $54.18 | $229.00 | $20.53 – $138.07 |
| C-reactive protein (CRP) test CPT 86140 | $7.15 | $34.00 | $2.71 – $18.21 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $48.42 | $237.00 | $18.35 – $123.39 |
| Complete blood count (CBC) with differential CPT 85025 | $10.72 | $52.00 | $4.06 – $27.33 |
| Complete blood count (CBC), automated CPT 85027 | $8.93 | $43.00 | $3.38 – $22.75 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $14.57 | $72.00 | $5.52 – $37.14 |
| COVID-19 PCR test CPT 87635 | $70.81 | $137.00 | $26.84 – $114.79 |
| D-dimer test (blood clots) CPT 85379 | $14.05 | $70.00 | $5.32 – $35.81 |
| Drug screen, instrument chemistry CPT 80307 | $85.75 | $377.00 | $32.50 – $218.52 |
| Ferritin (iron stores) test CPT 82728 | $18.81 | $93.00 | $7.13 – $47.93 |
| Free T4 (thyroid) test CPT 84439 | $12.45 | $60.00 | $4.72 – $31.71 |
| General health panel (blood tests) CPT 80050 | not posted | $151.00 | $49.42 – $151.00 |
| Glucose (blood sugar) test CPT 82947 | $5.42 | $25.00 | $2.06 – $13.82 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $48.42 | $237.00 | $18.35 – $123.39 |
| Hemoglobin A1c test CPT 83036 | $13.40 | $67.00 | $5.08 – $34.15 |
| Hepatitis C antibody test CPT 86803 | $19.69 | $96.00 | $7.46 – $50.17 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $33.23 | $163.00 | $12.59 – $84.68 |
| Iron test CPT 83540 | $8.93 | $52.45 | $3.38 – $22.75 |
| Kidney function panel CPT 80069 | $11.98 | $57.00 | $4.54 – $30.53 |
| Lipase test (pancreas) CPT 83690 | $9.51 | $48.00 | $3.60 – $24.22 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $18.48 | $81.00 | $7.00 – $47.08 |
| Liver function panel CPT 80076 | $11.27 | $54.00 | $4.27 – $28.74 |
| Magnesium test CPT 83735 | $9.25 | $46.00 | $3.50 – $23.56 |
| Obstetric blood test panel CPT 80055 | $65.98 | $45.42 – $65.98 | |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $8.29 | $57.00 | $3.14 – $22.54 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $20.77 | $154.00 | $7.87 – $52.93 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $5.92 | $25.00 | $2.24 – $15.41 |
| PSA (prostate specific antigen), free CPT 84154 | $25.38 | $8.20 | $8.20 – $54.81 |
| PSA (prostate specific antigen), total CPT 84153 | $25.38 | $124.00 | $9.62 – $64.68 |
| Rapid strep test CPT 87880 | $22.81 | $81.00 | $8.65 – $58.13 |
| Sed rate (ESR) test CPT 85652 | $3.73 | $19.00 | $1.41 – $9.50 |
| TB skin test CPT 86580 | $39.77 | $86.00 | $7.40 – $53.03 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $23.18 | $113.00 | $8.79 – $59.08 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $71.65 | $243.00 | $23.17 – $219.39 |
| Troponin test (heart damage) CPT 84484 | $17.21 | $68.00 | $6.52 – $43.85 |
| Urinalysis, automated, with microscope CPT 81001 | $4.37 | $21.00 | $1.66 – $11.14 |
| Urinalysis, automated, without microscope CPT 81003 | $3.11 | $17.00 | $1.18 – $7.92 |
| Urinalysis, manual, with microscope CPT 81000 | $5.55 | $21.00 | $2.10 – $14.14 |
| Urinalysis, manual, without microscope CPT 81002 | $4.80 | $18.00 | $1.82 – $12.22 |
| Urine culture, colony count CPT 87086 | $11.14 | $54.00 | $4.22 – $28.39 |
| Urine pregnancy test CPT 81025 | $11.88 | $43.00 | $4.50 – $30.27 |
| Vitamin B12 test CPT 82607 | $20.81 | $101.00 | $7.89 – $53.03 |
| Vitamin D test CPT 82306 | $40.85 | $190.00 | $15.48 – $104.09 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $328.08 | $1,220.00 | $99.98 – $665.42 |
| ECG tracing only (no interpretation) CPT 93005 | $81.12 | $110.00 | $5.80 – $135.19 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $751.34 | $2,364.00 | $111.85 – $1,252.24 |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 | $21.40 | $20.32 – $60.83 | |
| Holter monitor, up to 48 hours CPT 93224 | $95.47 | $363.00 | $44.94 – $290.25 |
| Left heart catheterization CPT 93452 | $4,457.77 | $6,388.00 | $551.61 – $10,648.00 |
| Left heart catheterization with coronary angiogram CPT 93458 | $4,457.77 | $8,805.00 | $622.86 – $10,648.00 |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $1,780.19 | $4,032.00 | $233.00 – $2,373.58 |
| Treadmill stress test, complete CPT 93015 | $100.37 | $292.00 | $46.86 – $195.11 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| ACL reconstruction, arthroscopic CPT 29888 | $9,977.57 | $935.24 – $16,629.28 | |
| Appendix removal, laparoscopic CPT 44970 | $8,312.83 | $591.77 – $13,854.72 | |
| Breast biopsy with ultrasound guidance CPT 19083 | $2,271.01 | $1,201.00 | $141.03 – $3,785.02 |
| Carpal tunnel release CPT 64721 | $2,685.07 | $3,543.00 | $419.90 – $4,475.11 |
| Colonoscopy with biopsy CPT 45380 | $1,645.43 | $2,184.00 | $186.93 – $2,877.00 |
| Colonoscopy with polyp removal (snare) CPT 45385 | $1,645.43 | $2,204.00 | $234.87 – $2,877.00 |
| Colonoscopy, diagnostic CPT 45378 | $1,278.72 | $1,756.00 | $171.81 – $2,877.00 |
| Colposcopy with biopsy CPT 57454 | $175.30 | $430.00 | $75.83 – $349.45 |
| Cystoscopy (bladder scope) CPT 52000 | $958.81 | $1,503.00 | $74.82 – $2,056.00 |
| Ear tubes, under general anesthesia CPT 69436 | $2,133.48 | $149.65 – $6,029.00 | |
| Flexible sigmoidoscopy, diagnostic CPT 45330 | $1,278.72 | $716.00 | $53.43 – $2,131.20 |
| Gallbladder removal, laparoscopic CPT 47562 | $8,312.83 | $650.97 – $13,854.72 | |
| Gastric bypass (weight loss surgery), laparoscopic CPT 43644 | $2,455.21 | $5,930.00 | $1,031.99 – $5,161.49 |
| Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571 | $14,616.42 | $865.22 – $24,360.70 | |
| Hysteroscopy with biopsy or polyp removal CPT 58558 | $4,451.18 | $2,385.00 | $221.20 – $7,418.63 |
| Inguinal (groin) hernia repair, laparoscopic CPT 49650 | $8,312.83 | $425.76 – $13,854.72 | |
| Inguinal (groin) hernia repair, open, age 5 or older CPT 49505 | $4,923.19 | $515.09 – $8,514.00 | |
| Kidney stone shock-wave lithotripsy CPT 50590 | $4,846.99 | $536.58 – $8,078.31 | |
| Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881 | $4,499.12 | $522.09 – $8,514.00 | |
| Lower colon endoscopy with ultrasound CPT 45391 | $1,645.43 | $2,446.00 | $237.41 – $6,624.00 |
| Nasal endoscopy, diagnostic CPT 31231 | $79.98 | $210.00 | $34.93 – $304.15 |
| Prostate biopsy CPT 55700 | not posted | $342.21 – $2,791.55 | |
| Prostate removal, laparoscopic or robotic CPT 55866 | $1,570.08 | $16,000.00 | $689.91 – $11,108.71 |
| Removal of a breast lump, open surgery CPT 19120 | $5,383.86 | $3,528.00 | $409.21 – $8,973.11 |
| Rotator cuff repair, arthroscopic CPT 29827 | $9,977.57 | $1,026.63 – $16,629.28 | |
| Screening colonoscopy, average risk HCPCS G0121 | $1,278.72 | $1,392.00 | $117.66 – $1,704.96 |
| Screening colonoscopy, high risk HCPCS G0105 | $1,278.72 | $975.00 | $171.81 – $2,877.00 |
| Septoplasty (nasal septum repair) CPT 30520 | $4,558.89 | $618.76 – $7,598.14 | |
| Shoulder arthroscopy, bone shaving (decompression) CPT 29826 | $220.61 | $590.00 | $94.15 – $1,424.81 |
| Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775 | $1,538.59 | $3,840.00 | $637.72 – $3,311.24 |
| Tonsil and adenoid removal, under age 12 CPT 42820 | $8,139.99 | $276.28 – $13,566.64 | |
| Total hip replacement CPT 27130 | $17,653.66 | $1,239.12 – $29,422.77 | |
| Total knee replacement CPT 27447 | $17,653.66 | $1,237.44 – $29,422.77 | |
| Upper endoscopy (EGD) with biopsy CPT 43239 | $1,247.13 | $2,016.00 | $127.82 – $2,877.00 |
| Upper endoscopy (EGD), diagnostic CPT 43235 | $1,247.13 | $2,148.00 | $114.03 – $2,078.56 |
| Vasectomy CPT 55250 | $2,874.36 | $2,655.00 | $152.59 – $3,832.48 |
Pregnancy and birth
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| C-section delivery, routine care including prenatal and postpartum CPT 59510 | $3,792.01 | $5,520.00 | $2,262.86 – $5,044.10 |
| Fetal non-stress test CPT 59025 | $277.99 | $186.00 | $8.80 – $463.31 |
| IUD insertion CPT 58300 | $175.00 | $451.00 | |
| Vaginal birth after a prior C-section (VBAC), routine care CPT 59610 | $3,579.68 | $5,720.00 | $2,136.51 – $4,778.66 |
| Vaginal delivery, routine care including prenatal and postpartum CPT 59400 | $3,358.99 | $5,120.00 | $2,018.37 – $4,519.83 |
Hospital stays
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897 | not posted | $6,360.02 – $17,948.20 | |
| C-section, without complications MS-DRG 788 | not posted | $6,880.99 – $19,493.36 | |
| Chest pain MS-DRG 313 | not posted | $5,244.04 – $17,274.21 | |
| COPD flare-up, with major complications MS-DRG 190 | not posted | $7,901.69 – $21,842.14 | |
| COPD flare-up, without complications MS-DRG 192 | not posted | $4,709.35 – $25,116.91 | |
| Fainting (syncope) MS-DRG 312 | not posted | $5,959.29 – $20,463.26 | |
| Gastrointestinal bleeding, with complications MS-DRG 378 | not posted | $7,031.11 – $24,592.37 | |
| Heart failure, with major complications MS-DRG 291 | not posted | $8,701.17 – $55,019.75 | |
| Heart failure, without complications MS-DRG 293 | not posted | $3,098.32 – $18,901.73 | |
| Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216 | not posted | $67,368.96 – $240,750.56 | |
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 | not posted | $13,530.96 – $71,699.30 | |
| Irregular heartbeat, without complications MS-DRG 310 | not posted | $3,994.57 – $18,566.26 | |
| Kidney failure, with complications MS-DRG 683 | not posted | $5,828.20 – $17,805.88 | |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | not posted | $5,097.32 – $16,457.94 | |
| Neck (cervical) spinal fusion, without complications MS-DRG 473 | not posted | $17,043.44 – $46,811.71 | |
| Normal newborn care MS-DRG 795 | not posted | $1,161.87 – $4,062.13 | |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | not posted | $5,114.45 – $18,220.64 | |
| Pneumonia, with complications MS-DRG 194 | not posted | $5,832.88 – $17,139.03 | |
| Pneumonia, with major complications MS-DRG 193 | not posted | $8,498.10 – $22,534.52 | |
| Pneumonia, without complications MS-DRG 195 | not posted | $4,278.18 – $13,052.50 | |
| Psychoses (inpatient psychiatric stay) MS-DRG 885 | not posted | $5,133.30 – $28,398.34 | |
| Sepsis, with major complications MS-DRG 871 | not posted | $13,125.87 – $39,492.96 | |
| Sepsis, without major complications MS-DRG 872 | not posted | $6,626.77 – $20,804.71 | |
| Skin infection (cellulitis), without major complications MS-DRG 603 | not posted | $5,088.75 – $21,176.76 | |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | not posted | $5,620.84 – $16,057.42 | |
| Stroke, with complications or clot-busting drug MS-DRG 65 | not posted | $7,234.02 – $35,725.63 | |
| Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743 | not posted | $8,813.40 – $27,612.93 | |
| Vaginal delivery, without complications MS-DRG 807 | not posted | $3,698.10 – $13,707.16 | |
| Weight loss surgery, without complications MS-DRG 621 | not posted | $10,648.46 – $33,539.20 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | $422.07 | $306.00 | $43.14 – $2,056.00 |
| Lower back nerve root injection with imaging guidance CPT 64483 | $1,216.18 | $991.00 | $69.56 – $1,621.57 |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | $970.61 | $1,186.00 | $91.76 – $2,056.00 |
| Lower back spinal injection (epidural), without imaging CPT 62322 | $1,216.18 | $1,143.00 | $72.93 – $2,056.00 |
Eye
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Cataract removal with lens implant CPT 66984 | $3,173.34 | $488.99 – $7,103.00 | |
| Eye exam, new patient, comprehensive CPT 92004 | $107.90 | $237.00 | $49.63 – $221.45 |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 | $756.27 | $1,107.00 | $187.32 – $1,008.36 |
Eye and ear
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Hearing test, comprehensive CPT 92557 | $176.93 | $157.00 | $28.61 – $294.88 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Home sleep apnea test CPT 95806 | $140.91 | $1,043.00 | $65.82 – $278.55 |
| Sleep study with CPAP titration CPT 95811 | $1,180.80 | $3,983.00 | $385.85 – $1,875.07 |
| Sleep study, overnight in a sleep lab CPT 95810 | $1,180.80 | $3,173.00 | $366.02 – $1,788.78 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $296.91 | $208.00 | $107.81 – $164.13 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $37.95 | $118.00 | $47.20 – $93.11 |
| Physical therapy evaluation, low complexity CPT 97161 | $133.14 | $300.00 | $120.00 – $236.73 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $133.14 | $338.00 | $90.56 – $151.72 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $39.76 | $118.00 | $47.20 – $93.11 |
| Therapeutic activities, 15 minutes CPT 97530 | $47.75 | $118.00 | $47.20 – $93.11 |
Mental health
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Family psychotherapy, with the patient, 50 minutes CPT 90847 | $244.07 | $195.00 | $95.71 – $406.78 |
| Family psychotherapy, without the patient, 50 minutes CPT 90846 | $244.07 | $193.00 | $91.83 – $406.78 |
| Group psychotherapy CPT 90853 | $139.68 | $68.00 | $22.77 – $232.81 |
| Psychiatric diagnostic evaluation CPT 90791 | $244.07 | $351.00 | $99.89 – $406.78 |
| Psychotherapy, 30 minutes CPT 90832 | $244.07 | $112.00 | $64.32 – $406.78 |
| Psychotherapy, 45 minutes CPT 90834 | $244.07 | $205.00 | $84.78 – $406.78 |
| Psychotherapy, 60 minutes CPT 90837 | $244.07 | $306.00 | $158.60 – $241.46 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $99.00 | $76.00 | $10.39 – $132.00 |
| IV hydration, each additional hour CPT 96361 | $64.39 | $170.00 | $88.11 – $134.15 |
| IV hydration, first hour CPT 96360 | $292.48 | $396.00 | $205.25 – $312.48 |
| IV push injection of a drug, first CPT 96374 | $292.48 | $300.00 | $155.49 – $236.73 |
| IV push injection, each additional drug CPT 96375 | $64.39 | $176.00 | $13.17 – $107.32 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | not posted | $14.00 | |
| Dexamethasone injection, per 1 mg HCPCS J1100 | not posted | $9.29 | |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $1.64 | $17.55 | |
| Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170 | not posted | $16.11 | $4.83 – $13.89 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | not posted | $8.76 | ? – $2.14 |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | not posted | $16.00 | |
| Morphine injection, up to 10 mg HCPCS J2270 | $4.19 | $35.00 | |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | not posted | $8.86 | |
| Propofol injection, per 10 mg HCPCS J2704 | not posted | $37.40 | |
| Saline IV solution, 1000 ml HCPCS J7030 | $2.74 | $1.12 – $7.18 |
Cash price: the hospital's posted discounted price for people paying themselves. Gross charge: its list price before any discount. Insurer rates: the lowest and highest rates it says it negotiated with any insurer. When the file lists a service on several rows, this page shows one (the facility row for the usual setting); the service's own page lists every row.