Henry Ford Providence Southfield Hospital — price list
← Hospital overviewVerified from Henry Ford Providence Southfield 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.
243 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| ACETAZOLAMIDE(DIAMOX) 500MG IV Outpatient | 71997639 CDM | $44.00 | $24.64 | $11.44 – $44.00 | — | |
| ADENOSINE 6MG INJ Outpatient | 71750145 CDM | $70.00 | $39.20 | $18.20 – $70.00 | — | |
| ALBUTEROL INHALER (VENTOLIN) Outpatient | 71713325 CDM | $41.00 | $22.96 | $10.66 – $41.00 | — | |
| AMINOPHYLLINE 20ML VIAL Outpatient | 71713291 CDM | $12.00 | $6.72 | $3.12 – $12.00 | — | |
| ARTERIAL BLOOD DRAW Outpatient | 72830342 CDM | $35.00 | $19.60 | $9.10 – $35.00 | — | |
| ARTERIAL BLOOD DRAW Outpatient | 73630345 CDM | $35.00 | $19.60 | $9.10 – $35.00 | — | |
| ARTERIAL PUNCTURE*36600 Outpatient | 67879635 CDM | $35.00 | $19.60 | $9.10 – $35.00 | — | |
| ASP/INJ RENAL CYST OR PELVIS Outpatient | 72176571 CDM | $1,424 | $797 | $370 – $1,424 | — | |
| ASPIRATE/INJ THYROID CYST Outpatient | 72102346 CDM | $904 | $506 | $235 – $904 | — | |
| ASPIRIN-BABY 81 MG TAB Outpatient | 72350176 CDM | $17.00 | $9.52 | $4.42 – $17.00 | — | |
| ATROPINE 1MG INJ VIAL Outpatient | 71713028 CDM | $23.00 | $12.88 | $5.98 – $23.00 | — | |
| BI-VENT LEAD REPOSITION*33226 Outpatient | 72710643 CDM | $3,421 | $1,916 | $889 – $3,421 | — | |
| BRACHY NONSTRAND Y90/SOURCE Outpatient | 71906481 CDM | $35,053 | $19,630 | $9,114 – $35,053 | — | |
| CALCIUM CHLORIDE 1GM/10ML SYR Outpatient | 33049610 CDM | $0.05 | $0.03 | $0.01 – $0.05 | — | |
| CALCIUM CHLORIDE 1GM/10ML VIAL Outpatient | 33049602 CDM | $0.05 | $0.03 | $0.01 – $0.05 | — | |
| CARDIZEM 125MG IVPB Outpatient | 67816223 CDM | $156 | $87.36 | $40.56 – $156 | — | |
| CARDIZEM 25MG INJ VIAL Outpatient | 67816215 CDM | $32.00 | $17.92 | $8.32 – $32.00 | — | |
| CAROTID STENT W/O PROTEC*37216 Outpatient | 72360332 CDM | $5,128 | $2,872 | $1,333 – $5,128 | — | |
| CAROTID STENT W/PROTECT*37215 Outpatient | 72360324 CDM | $6,689 | $3,746 | $1,739 – $6,689 | — | |
| CAROTID STENT W/PROTECT*37215 Outpatient | 74660325 CDM | $6,689 | $3,746 | $1,739 – $6,689 | — | |
| CHOLANGIOPANCREAT(MRCP)-MRI Outpatient | 72639040 CDM | $737 | $413 | $192 – $737 | — | |
| CLARSCN 10ML VL/0.1ML#1692762 Outpatient | 72686132 CDM | $1.00 | $0.56 | $0.26 – $1.00 | — | |
| CLARSCN 10MLSYR/0.1 ML#1540102 Outpatient | 72686157 CDM | $1.00 | $0.56 | $0.26 – $1.00 | — | |
| CLARSCN 15ML SYR/0.1ML#1468567 Outpatient | 72686165 CDM | $1.00 | $0.56 | $0.26 – $1.00 | — | |
| CLARSCN 15ML VL/0.1ML#1473983 Outpatient | 72686124 CDM | $1.00 | $0.56 | $0.26 – $1.00 | — | |
| CLARSCN 20ML SYR/0.1ML#1468568 Outpatient | 72686173 CDM | $1.00 | $0.56 | $0.26 – $1.00 | — | |
| CLARSCN 20ML VL/0.1ML#1474177 Outpatient | 72686140 CDM | $1.00 | $0.56 | $0.26 – $1.00 | — | |
| CLARSCN 5ML VL/0.1ML#1468569 Outpatient | 72686181 CDM | $1.00 | $0.56 | $0.26 – $1.00 | — | |
| CONT OMNI 350 100ML/ML#592740 Outpatient | 72370562 CDM | $4.00 | $2.24 | $1.04 – $4.00 | — | |
| CONT OMNI 350 150ML/ML#580691 Outpatient | 72384118 CDM | $4.00 | $2.24 | $1.04 – $4.00 | — |