ASCENSION PROVIDENCE HOSPITAL - SOUTHFIELD CAMPUS ★★★★☆

Legal name: ASCENSION PROVIDENCE HOSPITAL

SOUTHFIELD, MI 480754818 (866) 501-3627 101Y00000X

Published Procedure Prices

Procedure	CPT	Cash Price	Insurance Range
HC MRA W/O CONT, LWR EXT	00001	$1,256	N/A
HC MRA W/O FOL W/CONT, LWR EXT	00002	$1,362	N/A
HC MRA CHEST W/O CONTRAST	00003	$1,260	N/A
HC MRA CHEST W/WO CONTRAST	00004	$1,366	N/A
HC MRA PELVIS W/WO CONTRAST	00005	$1,366	N/A
HC MRA ABDOMEN WO CONTRAST	00006	$1,321	N/A
HC MRA ABDOMEN W/WO CONTRAST	00007	$1,427	N/A
HC MRA PELVIS WO CONTRAST	00012	$1,260	N/A
HC MRA SPINAL CANAL & CONTENTS W/CONTRAST	00013	$516	N/A
HC MRA SPINAL CANAL W/O CONTRAST	00014	$386	N/A
HC MRA SPINAL CANAL W&W/O CONTRAST	00015	$646	N/A
ADM SARSCOV2 30MCG/0.3ML 1ST	0001A	N/A	N/A
RBC DNA HEA 35 AG 11 BLD GRP	0001U	N/A	N/A
ADM SARSCOV2 30MCG/0.3ML 2ND	0002A	N/A	N/A
LIVER DIS 10 ASSAYS W/ASH	0002M	N/A	N/A
ONC CLRCT 3 UR METAB ALG PLP	0002U	N/A	N/A
LIVER DIS 10 ASSAYS W/NASH	0003M	N/A	N/A
ONC OVAR 5 PRTN SER ALG SCOR	0003U	N/A	N/A
SCOLIOSIS DNA ALYS	0004M	N/A	N/A
ONCO PRST8 3 GENE UR ALG	0005U	N/A	N/A
ONC HEP GENE RISK CLASSIFIER	0006M	N/A	N/A
ONC GASTRO 51 GENE NOMOGRAM	0007M	N/A	N/A
RX TEST PRSMV UR W/DEF CONF	0007U	N/A	N/A
HPYLORI DETCJ ABX RSTNC DNA	0008U	N/A	N/A
ONC BRST CA ERBB2 AMP/NONAMP	0009U	N/A	N/A

Prices shown are published rates from hospital chargemaster files and insurer rate data. Your actual cost depends on your insurance plan, deductible status, and services rendered.