Visits & medical services prices at Henry Ford Providence Southfield Hospital

Southfield, MI · every code in this section with a posted price and a Medicare benchmark.

239 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
Ablate Heart Dysrhythm Focus (93650) $5,651.52 $10,092 0.7×
Acoustic Immit Test Tympanometry/Acoust Reflex/Decay (92570) $143.92 $257 1.1×
Acoustic Reflex Testing (92568) $49.84 $89 1.3×
Aep Hearing Status Deter Broadband Stimuli I&R (92651) $164.08 $293 0.8×
Aep neurodiagnostic i&r (92653) $310.24 $554 1.4×
Aep threshold estimation mlt frequencies i&r (92652) $310.24 $554 1.4×
Airway Inhalation Treatment (94640) $222.88 $398 1.0×
Airway resistance by oscillometry (94728) $85.68 $153 0.7×
Analyze neurostim complex (95972) $184.24 $329 1.9×
Analyze Pacemaker System (93724) $1,740.48 $3,108 5.7×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $73.36 $131 5.1×
Arrhythmia Induction (93618) $4,487.28 $8,013 3.7×
Assessment of aphasia per hr (96105) $182.56 $326 1.9×
Audiometry Air & Bone (92553) $119.84 $214 0.9×
Basic vestibular evaluation (92540) $177.52 $317 0.8×
Behavral qualit analys voice (92524) $131.60 $235 1.2×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $341.60 $610 0.9×
Bundle of his recording (93600) $4,487.28 $8,013 0.6×
C motor evoked uppr limbs (95928) $921.76 $1,646 1.1×
C motor evoked upr&lwr limbs (95939) $1,333.36 $2,381 1.6×
Caloric vestibular test w/rec bi monothermal (92538) $315.28 $563 1.5×
Caloric Vstblr Test W/Rec (92537) $315.28 $563 2.5×
Cardiac Stress Tst,Tracing Only (93017) $625.52 $1,117 2.9×
Cardiopulmonary exercise testing (94621) $966 $1,725 2.6×
Cardiopulmonary resuscitation (92950) $1,124.48 $2,008 5.2×
Cardioversion (92960) $992.32 $1,772 1.5×
Cardioversion elective internal (92961) $1,031.52 $1,842 1.6×
Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) $16,386.72 $29,262 5.1×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $13,641.60 $24,360 4.2×
Cbt 1st hour (94644) $137.76 $246 1.0×
Chemo Anti-Neopl Sq/Im (96401) $107.52 $192 1.5×
Chemo IV infusion addl hr (96415) $84 $150 1.2×
Chemo IV push addl drug (96411) $100.24 $179 1.4×
Chemotherapy Into Cns (96450) $323.68 $578 1.0×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $239.68 $428 0.7×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $175.84 $314 0.5×
Chest Wall Manipulation (94668) $111.44 $199 0.8×
Color/duplex Doppler, complete (93975) $342.16 $611 1.4×
Color/duplex Doppler, limited (93976) $168 $300 1.6×
Comprehensive Hearing Test (92557) $180.88 $323 1.4×
Computerized dynamic posturography (92548) $150.08 $268 1.1×
Conditioning Play Audiometry (92582) $86.24 $154 0.7×
Continuous Pulse Ox (94762) $235.20 $420 1.8×
Coronary Art/Grft Angio S&I (93455) $7,465.92 $13,332 2.3×
Coronary Artery Angio S&I (93454) $6,823.04 $12,184 2.1×
Cpap Ventilation Cpap Initiation&Mgmt (94660)
range across 6 matching MRF lines		 $474.32–$1,650.32 $847–$2,947 varies
Cpt initial (94667) $141.12 $252 1.1×
Critical care first hour (99291) $2,493.68 $4,453 3.0×
Ctr Motor Ep Std Transcrnl Motor Stimj Lwr Limbs (95929) $921.76 $1,646 2.5×
Debridement Open Wound 20 Sq Cm< (97597) $502.32 $897 2.5×
Distrt prod evokd otoacoustic emsns comp/dx eval (92588) $127.68 $228 0.3×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $400.40 $715 1.7×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $241.92 $432 2.3×
Dup-Scan Artl Infl&Ven O/F Pen Vsl Compl (93980) $707.28 $1,263 6.8×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $851.20 $1,520 3.6×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $671.44 $1,199 6.4×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $906.08 $1,618 3.8×
Dup-scan xtr veins unilateral/limited study (93971) $627.76 $1,121 6.0×
Duplex Scan Artl Infl&Ven O/F Hemo Compl Uni Std (93986) $417.20 $745 4.0×
Duplex Scan Hemodialysis Access (93990) $417.20 $745 4.0×
Duplex up extrem art bilat (93930) $1,069.04 $1,909 4.5×
Duplex up extrem art unilat/ltd (93931) $532 $950 5.1×
ECG/monitoring and analysis (93271) $280.56 $501 3.0×
Echo Heart Xthoracic,Limited (93308)
range across 2 matching MRF lines		 $479.36–$506.80 $856–$905 varies
Echo r-t 2d w/probe placement only (93313) $1,097.60 $1,960 2.0×
Echo transesophageal (93312) $1,097.60 $1,960 2.0×
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $1,117.76 $1,996 2.1×
EEG awake and asleep (95819) $459.20 $820 2.1×
EEG awake drowsy (95816) $459.20 $820 2.1×
EEG cerebral death evaluation (95824) $459.20 $820 1.2×
EEG cont rec w/video by tech min 8 channels (95700) $846.16 $1,511 3.9×
EEG extended monitoring 61-119 minutes (95813) $794.08 $1,418 3.7×
Eeg Sleep Only (95822) $794.64 $1,419 3.7×
EKG signal averaged (93278) $338.24 $604 5.8×
Electrocardiogram Tracing (93005) $80.08 $143 1.4×
Electrophysiologic Follow-Up W/Pac/Rec W/Arrhyt (93624)
unusually low: confirm this is the full procedure		 $2,961.28 $5,288 0.4×
Electrophysiology Evaluation (93642) $3,757.60 $6,710 3.1×
Emergency Dept Visit Level 2 (99282) $421.12 $752 2.8×
Emergency Dept Visit Level 3 (99283) $711.76 $1,271 2.6×
Emergency Dept Visit Level 4 (99284) $1,235.92 $2,207 3.0×
Emg 3 Extremities (95863) $283.92 $507 2.2×
Emg 4 Extremities (95864) $341.60 $610 2.7×
Endomyocardial Biopsy (93505) $1,056.72 $1,887 0.3×
Ep & ablate supravent arrhyt (93653) $15,089.76 $26,946 0.6×
Ep & ablate ventric tachy (93654) $24,030.16 $42,911 0.9×
Ep Compre Electrophysiologic Arrhythmia Induction (93620) $8,542.24 $15,254 1.1×
Ep Compre Electrophysiologic W/O Arrhyt Induction (93619) $8,310.96 $14,841 1.1×
Er level 1 (99281) $188.16 $336 2.2×
Er level v (99285) $1,828.96 $3,266 3.1×
Esophgl funcj g-esop rflx impd eltrd prolng (91038) $451.92 $807 1.2×
Evaluate pt use of inhaler (94664) $386.96 $691 1.8×
Evaluate Speech Production (92522) $127.12 $227 1.1×
Evaluate Swallowing Function (92610) $182.56 $326 2.2×
Evaluation of speech fluency (92521) $145.60 $260 1.1×
Evoked Auditory Test,Limited (92587) $90.72 $162 0.4×
Exercise test for bronchospasm (94617) $142.80 $255 1.1×
External Ecg Scanning Analysis Report (93226) $554.96 $991 9.4×
Extracranial Bilat Study (93880) $747.60 $1,335 3.1×
Extracranial Uni/Ltd Study (93882) $502.32 $897 4.8×
Funcjal Cort&Subcort Mapg Phys/Qhp Attnd Init Hr (95961) $963.20 $1,720 1.1×
Gastroesophag Reflx Test W/Intrluml Imped Eltrd (91037) $242.48 $433 1.1×
Group Therapeutic Procedures (97150) $41.44 $74 2.3×
Heart catheterization, both sides, with coronary and bypass graft angiography (93461) $16,624.72 $29,687 5.1×
Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935) $1,257.76 $2,246 1.8×
Holter monitor recording (93225) $177.52 $317 1.3×
Icd Device Interrogate (93289) $206.64 $369 5.6×
Icd device progr eval dual (93283) $267.12 $477 7.2×
Icd Device Progr Eval Mult (93284) $267.12 $477 7.2×
Ilr Device Eval Progr (93285) $198.80 $355 5.3×
Ilr Device Interrogate (93291) $154.56 $276 5.4×
Immunization administration (90471) $42 $75 0.6×
Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) $597.52 $1,067 1.6×
Insert/Place Heart Catheter (93503) $1,630.16 $2,911 1.0×
Interrogation eval in person wr defibrillator (93292) $154.56 $276 4.2×
Intra-atrial pacing (93610) $4,487.28 $8,013 0.6×
Intra-atrial recording (93602) $4,487.28 $8,013 0.6×
Intracranial Complete Study (93886) $627.76 $1,121 2.6×
Intraventricular pacing (93612) $4,487.28 $8,013 0.6×
Iontophoresis 15 min (97033) $84.56 $151 4.4×
IV infusion hydration each additional hour (96361)
range across 4 matching MRF lines		 $98.56–$127.68 $176–$228 varies
IV infusion hydration initial 31 min-1 hour (96360) $272.72 $487 1.3×
IV infusion ther proph addl sequential to 1 hr (96367) $127.68 $228 1.8×
IV infusion therapy prophylaxis/dx ea hour (96366) $108.64 $194 2.3×
IV push initial (96374) $108.64 $194 0.5×
L Hrt Art/Grft Angio (93459) $14,278.88 $25,498 4.4×
Low frequency non-thermal us (97610) $187.04 $334 0.9×
Lwr Xtr Vasc Stdy Bilat (93924) $955.92 $1,707 4.4×
Methacholine challenge (94070) $252 $450 0.7×
Motility study esophagus (91010) $446.32 $797 1.2×
Motion Fluoroscopy/Swallow (92611) $243.60 $435 2.7×
Muscle Test 2 Limbs (95861) $227.92 $407 1.7×
Muscle Test Nonparaspinal (95870) $174.72 $312 1.3×
Muscle Test One Limb (95860) $179.20 $320 1.4×
Needle Electromyography Cranial Nrv Muscle Bi (95868) $336.56 $601 1.6×
Needle Electromyography Cranial Nrv Muscle Uni (95867) $224 $400 1.0×
Needle electromyography larynx (95865) $157.92 $282 1.2×
Needle Emg Thrc Paraspi Musc Excluding T1/T12 (95869) $224 $400 1.0×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $356.72 $637 0.9×
Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) $395.36 $706 1.0×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $187.04 $334 0.9×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $225.68 $403 0.6×
Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) $204.40 $365 1.6×
Neuromuscular Reeducation (97112) $61.04 $109 1.9×
Optokinetic Nystagmus Test (92544) $76.72 $137 0.6×
Oral Function Therapy (92526) $106.40 $190 1.3×
Orthc/Prostc Mgmt Sbsq Enc (97763) $30.24 $54 0.6×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $63.84 $114 1.4×
Oscillating Tracking Test (92545) $76.72 $137 0.4×
Ot eval high complexity (97167) $128.24 $229 1.3×
Ot Eval Low Complex (97165) $128.24 $229 1.3×
Ot Eval Moderate Complexity (97166) $128.24 $229 1.3×
Ot manual therapy 15 min (97140) $62.72 $112 2.3×
Ot Prosthetic Training, Each 15 Min (97761) $62.72 $112 1.6×
Ot Re-Eval Est Plan Care (97168) $79.52 $142 1.2×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $119.84 $214 0.9×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $152.88 $273 1.2×
Peripheral arterial disease rehab per session (93668) $76.16 $136 1.3×
Perq transcath closure pda (93582) $30,556.96 $54,566 1.7×
Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) $7,872.48 $14,058 1.4×
Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) $14,285.04 $25,509 1.2×
Phlebotomy therapeutic (99195) $180.88 $323 1.4×
Plethysmography (94726) $341.60 $610 0.9×
Pm device eval in person (93288) $380.24 $679 10.2×
Pm device progr eval dual (93280) $506.80 $905 13.6×
Pm device progr eval multi (93281) $267.12 $477 7.2×
Pm Device Progr Eval Sngl (93279) $506.80 $905 13.6×
Pm/Icd Remote Tech Serv (93296) $66.08 $118 1.8×
Positional nystagmus test (92542) $76.72 $137 0.6×
Prgrmng Dev Eval Implantable in Persn 1 Ld Dfb (93282) $267.12 $477 7.2×
Prq Card Angio/Athrect 1 Art (92924) $12,956.16 $23,136 1.1×
Prq Card Stent W/Angio 1 Vsl (92928) $8,709.68 $15,553 0.8×
Prq Card Stent/Ath/Angio (92933) $14,018.48 $25,033 0.8×
Prq Revasc Byp Graft 1 Vsl (92937) $9,548 $17,050 0.8×
Prq Tcat Clsr Cgen Ventr Septal Dfct W/Implt (93581) $33,806.64 $60,369 1.9×
Pt Eval High Complex (97163) $147.28 $263 1.5×
Pt eval low complex 20 min (97161) $147.28 $263 1.5×
Pt Eval Mod Complex (97162) $147.28 $263 1.5×
Pt gait training 15 min (97116) $62.72 $112 2.2×
Pt mechanical traction (97012) $73.36 $131 5.1×
Pt Re-Eval Est Plan Care (97164) $91.28 $163 1.4×
Pulm function test by gas (94727) $85.68 $153 0.4×
Pulmonary Stress Testing (94618) $255.92 $457 1.9×
Pure Tone Audiometry Air (92552) $50.96 $91 0.4×
R Hrt Art/Grft Angio (93457) $12,265.68 $21,903 3.8×
R hrt coronary artery angio (93456) $9,680.72 $17,287 3.0×
R&L Hrt Cath W/Ventriclgrphy (93453) $13,840.96 $24,716 4.3×
Refill/Maint Pump/Resvr Syst (96522) $191.52 $342 0.9×
Rem Interrog Scrms <30 D Phys/Qhp (93298) $154.56 $276 4.2×
Remote 30 Day Ecg Rev/Report (93270) $280.56 $501 7.5×
Right Heart Cath (93451) $5,560.24 $9,929 1.7×
Right ventricular recording (93603) $4,487.28 $8,013 3.7×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $262.08 $468 1.3×
Self Care Mngment Training (97535) $54.32 $97 1.7×
Short-latency somatosens ep std upr limbs (95925) $381.36 $681 1.8×
Sinusoidal Vertical Axis Rotational Testing (92546) $150.08 $268 1.2×
Somatosensory Testing (95938) $686.56 $1,226 0.8×
Speech audiometry threshold (92555) $41.44 $74 0.7×
Speech sound lang comprehen (92523) $215.04 $384 0.9×
Spirometry (94010) $152.88 $273 0.7×
Spontaneous Nystagmus Test (92541) $76.72 $137 0.6×
Ssep lower limbs (95926) $381.36 $681 1.8×
Stenger Test Speech (92577) $119.84 $214 0.3×
Stenger Test, Pure Tone (92565) $41.44 $74 0.7×
Surfactant Admin Thru Tube (94610) $296.24 $529 1.4×
Tcd std icr art ven-artl shnt detcj IV mbubb njx (93893) $328.72 $587 3.2×
Temp transcutaneous pacing (92953) $1,243.76 $2,221 1.9×
Tensilon Test (95857) $108.64 $194 0.5×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) $52.08 $93 2.3×
Ther Ivntj Ea Addl 15 Min (97130) $52.08 $93 2.5×
Ther/Proph/Diag Inj Sc/Im (96372) $47.60 $85 0.7×
Ther/Proph/Diag Iv Inf Init (96365) $272.72 $487 1.3×
Therapeutic Activities (97530) $60.48 $108 1.7×
Tilt table test with heart rhythm and blood pressure monitoring (93660) $1,728.72 $3,087 4.6×
Tobacco Use Cessation Intensive >10 Minutes (99407) $28 $50 0.8×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $22.40 $40 0.6×
Transcath Closure of Asd (93580) $33,806.64 $60,369 1.9×
Transcranial Doppler Stdy Intracranial Art Lmtd (93888) $250.32 $447 2.4×
Transtelephonic Rhythm Strip Pacemaker Eval (93293) $267.12 $477 7.2×
Tte w/doppler, complete (93306)
range across 2 matching MRF lines		 $2,065.84–$2,182.88 $3,689–$3,898 varies
Tte W/O Doppler Complete (93307) $877.52 $1,567 3.7×
Tx atrial fib pulm vein isol (93656) $26,716.48 $47,708 1.0×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $91.28 $163 1.2×
Tx/Pro/Dx Inj New Drug Addon (96375) $108.64 $194 2.3×
Tympanometry (92567) $68.32 $122 1.8×
Tympanometry and reflex threshold measurements (92550) $117.60 $210 0.5×
Unlisted cardiovascular service/procedure (93799) $2,461.76 $4,396 19.2×
Upr/L Xtremity Art 2 Levels (93922)
range across 2 matching MRF lines		 $158.48–$413.28 $283–$738 varies
Upr/Lxtr Art Stdy 3+ Lvls (93923)
range across 2 matching MRF lines		 $226.24–$801.36 $404–$1,431 varies
Valvuloplasty aortic valve (92986) $7,944.16 $14,186 1.4×
Valvuloplasty mitral valve (92987) $10,540.32 $18,822 0.9×
Veeg 2-12 Hr Cont Mntr (95713) $716.24 $1,279 1.9×
Veeg 2-12 hr unmonitored (95711) $422.24 $754 2.0×
Veeg Ea 12-26 Hr Unmntr (95714) $1,481.76 $2,646 4.0×
Vent Mgmt Inpat Init Day (94002)
range across 2 matching MRF lines		 $1,650.32–$1,882.72 $2,947–$3,362 varies
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003)
range across 2 matching MRF lines		 $1,491.28–$1,769.04 $2,663–$3,159 varies
Visual Evoked Potential Test (95930) $374.08 $668 1.7×
Visual reinforcement audiometry (vra) (92579) $86.24 $154 0.4×
Vital capacity, total (94150) $72.24 $129 0.6×
Wheelchair Mgmt Ea 15 Min (97542) $62.72 $112 2.0×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.