Henry Ford Allegiance Health

205 N East Ave, Jackson, MI 49201 · (517) 788-4800

Acute Care HospitalsVoluntary non-profit - OtherCMS rating 3/5Jackson, MI metro Part of Henry Ford Health System · 8 hospitals Website ↗

Price file

Prices published

File dated 2026-06-28

29,659 price rows for 68 procedures

Published prices

cash · negotiated range · list

Basic metabolic panel (blood test)

CPT 80048

—

cash

$4 to $92

131 negotiated rates

$102

list

CT scan of the abdomen and pelvis, with contrast

CPT 74177

—

cash

$183 to $3,962

131 negotiated rates

$4,402

list

CT scan of the head, no contrast

CPT 70450

—

cash

$56 to $2,089

132 negotiated rates

$2,321

list

CT scan of the pelvis, with contrast

CPT 72193

—

cash

$94 to $2,364

132 negotiated rates

$2,627

list

Cataract surgery with lens implant

CPT 66984 · lowest of 3 lines · metro median $617

$617

cash

$295 to $6,861

287 negotiated rates

$2,000

list

Cesarean delivery with prenatal and postpartum care

CPT 59510 · lowest of 3 lines · metro median $3,410

$3,410

cash

$1,999 to $17,862

211 negotiated rates

$5,520

list

Cesarean section hospital stay, no complications

MS-DRG 788

—

cash

$7,881 to $17,819

83 negotiated rates

—

list

Chlamydia test (DNA)

CPT 87491

—

cash

$6 to $213

500 negotiated rates

$12

list

Colonoscopy (diagnostic)

CPT 45378 · lowest of 3 lines · metro median $224

$224

cash

$105 to $4,029

356 negotiated rates

$620

list

Colonoscopy with biopsy

CPT 45380 · lowest of 3 lines · metro median $242

$242

cash

$113 to $4,029

356 negotiated rates

$670

list

Colonoscopy with polyp removal

CPT 45385 · lowest of 3 lines · metro median $305

$305

cash

$143 to $4,029

356 negotiated rates

$850

list

Complete blood count (CBC) with differential

CPT 85025

—

cash

$4 to $57

131 negotiated rates

$63

list

Comprehensive metabolic panel (blood test)

CPT 80053

—

cash

$6 to $111

131 negotiated rates

$123

list

Diagnostic mammogram (both breasts)

CPT 77066

—

cash

$53 to $614

128 negotiated rates

$682

list

Electrocardiogram (ECG) with interpretation

CPT 93000

—

cash

$13 to $61

28 negotiated rates

—

list

Established patient office visit (about 40 minutes)

CPT 99215 · lowest of 15 lines · metro median $172

$172

cash

$40 to $258

1313 negotiated rates

$99

list

Family psychotherapy with the patient

CPT 90847 · lowest of 12 lines · metro median $141

$141

cash

$43 to $409

1632 negotiated rates

$85

list

Family psychotherapy without the patient

CPT 90846 · lowest of 9 lines · metro median $136

$136

cash

$66 to $409

954 negotiated rates

$143

list

Gallbladder removal (laparoscopic)

CPT 47562 · lowest of 3 lines · metro median $864

$864

cash

$403 to $13,919

290 negotiated rates

$2,240

list

Gonorrhea test (DNA)

CPT 87591

—

cash

$6 to $213

377 negotiated rates

$12

list

Group psychotherapy

CPT 90853 · lowest of 9 lines · metro median $34

$34

cash

$16 to $256

1368 negotiated rates

$68

list

Hip or knee replacement, no major complications

MS-DRG 470

—

cash

$8,400 to $45,848

83 negotiated rates

—

list

Hospital stay for digestive disorders, no complications

MS-DRG 392

—

cash

$5,761 to $16,416

83 negotiated rates

—

list

Hysterectomy for non-cancer reasons, no complications

MS-DRG 743

—

cash

$8,400 to $28,885

83 negotiated rates

—

list

Inguinal hernia repair (age 5 and up)

CPT 49505 · lowest of 3 lines · metro median $692

$692

cash

$324 to $8,243

293 negotiated rates

$1,760

list

Knee arthroscopy with meniscus repair

CPT 29881 · lowest of 3 lines · metro median $691

$691

cash

$329 to $7,533

290 negotiated rates

$1,780

list

Laser treatment after cataract surgery (YAG)

CPT 66821

—

cash

$232 to $4,029

128 negotiated rates

$2,211

list

Left heart catheterization

CPT 93452

—

cash

$526 to $7,464

128 negotiated rates

$6,388

list

Lipid panel (cholesterol test)

CPT 80061

—

cash

$7 to $89

131 negotiated rates

$99

list

Liver function panel

CPT 80076

—

cash

$4 to $104

131 negotiated rates

$116

list

MRI of the brain, with and without contrast

CPT 70553

—

cash

$181 to $4,484

132 negotiated rates

$4,982

list

MRI of the knee or other lower joint, no contrast

CPT 73721

—

cash

$120 to $3,798

132 negotiated rates

$4,220

list

MRI of the lower back (lumbar spine), no contrast

CPT 72148

—

cash

$105 to $2,880

132 negotiated rates

$3,200

list

MRI of the neck (cervical spine), no contrast

CPT 72141

—

cash

$104 to $2,978

132 negotiated rates

$3,309

list

Neck (cervical) spinal fusion, no complications

MS-DRG 473

—

cash

$8,400 to $51,406

83 negotiated rates

—

list

Nerve block injection, lower back, with imaging guidance

CPT 64483 · lowest of 3 lines · metro median $135

$135

cash

$63 to $3,717

353 negotiated rates

$350

list

New patient office visit (about 30 minutes)

CPT 99203 · lowest of 18 lines · metro median $98

$98

cash

$35 to $188

1500 negotiated rates

$99

list

New patient office visit (about 45 minutes)

CPT 99204 · lowest of 18 lines · metro median $160

$160

cash

$41 to $255

1500 negotiated rates

$99

list

New patient office visit (about 60 minutes)

CPT 99205 · lowest of 15 lines · metro median $220

$220

cash

$50 to $331

1260 negotiated rates

$99

list

PSA test (prostate)

CPT 84153

—

cash

$9 to $117

254 negotiated rates

$18

list

Partial thromboplastin time (blood clotting test)

CPT 85730

—

cash

$3 to $78

131 negotiated rates

$87

list

Physical therapy, therapeutic exercise (15 minutes)

CPT 97110 · lowest of 5 lines · metro median $39

$39

cash

$15 to $163

695 negotiated rates

$74

list

Pregnancy ultrasound (after first trimester)

CPT 76805

—

cash

$56 to $744

132 negotiated rates

$827

list

Preventive visit, new patient age 18 to 39

CPT 99385 · lowest of 3 lines · metro median $154

$154

cash

$40 to $223

219 negotiated rates

$133

list

Preventive visit, new patient age 40 to 64

CPT 99386 · lowest of 3 lines · metro median $172

$172

cash

$51 to $257

216 negotiated rates

$171

list

Prostate biopsy

CPT 55700

—

cash

$117 to $3,281

26 negotiated rates

—

list

Prostate removal (laparoscopic)

CPT 55866 · lowest of 3 lines · metro median $1,479

$1,479

cash

$690 to $29,623

286 negotiated rates

$16,000

list

Prothrombin time (blood clotting test)

CPT 85610 · lowest of 3 lines · metro median $6

cash

$2 to $35

323 negotiated rates

$35

list

Psychotherapy, 30 minutes

CPT 90832 · lowest of 12 lines · metro median $95

$95

cash

$37 to $409

1733 negotiated rates

$131

list

Psychotherapy, 45 minutes

CPT 90834 · lowest of 15 lines · metro median $126

$126

cash

$59 to $409

2012 negotiated rates

$184

list

Psychotherapy, 60 minutes

CPT 90837 · lowest of 12 lines · metro median $186

$186

cash

$66 to $409

1505 negotiated rates

$225

list

Removal of a breast lump (biopsy by excision)

CPT 19120 · lowest of 3 lines · metro median $551

$551

cash

$260 to $9,015

357 negotiated rates

$1,390

list

Screening mammogram (both breasts)

CPT 77067

—

cash

$44 to $447

248 negotiated rates

$374

list

Shoulder arthroscopy with decompression

CPT 29826 · lowest of 3 lines · metro median $204

$204

cash

$94 to $6,749

217 negotiated rates

$590

list

Sleep study (overnight, attended)

CPT 95810

—

cash

$431 to $4,728

131 negotiated rates

$5,253

list

Spinal injection, lower back, no imaging guidance

CPT 62322 · lowest of 3 lines · metro median $101

$101

cash

$47 to $2,878

348 negotiated rates

$276

list

Spinal injection, lower back, with imaging guidance

CPT 62323 · lowest of 3 lines · metro median $121

$121

cash

$57 to $2,878

348 negotiated rates

$320

list

TSH test (thyroid)

CPT 84443

—

cash

$9 to $102

131 negotiated rates

$113

list

Tonsils and adenoids removal (under age 12)

CPT 42820 · lowest of 3 lines · metro median $351

$351

cash

$166 to $13,629

290 negotiated rates

$940

list

Transvaginal ultrasound

CPT 76830

—

cash

$56 to $708

132 negotiated rates

$787

list

Ultrasound of the abdomen (complete)

CPT 76700

—

cash

$56 to $1,022

132 negotiated rates

$1,136

list

Upper endoscopy (EGD)

CPT 43235 · lowest of 3 lines · metro median $150

$150

cash

$71 to $2,878

356 negotiated rates

$410

list

Upper endoscopy with biopsy

CPT 43239 · lowest of 3 lines · metro median $168

$168

cash

$79 to $4,029

356 negotiated rates

$460

list

Urinalysis with microscope

CPT 81001

—

cash

$2 to $48

131 negotiated rates

$53

list

Vaginal delivery after a previous cesarean

CPT 59610 · lowest of 3 lines · metro median $3,216

$3,216

cash

$1,886 to $16,938

211 negotiated rates

$5,720

list

Vaginal delivery hospital stay, no complications

MS-DRG 807

—

cash

$3,790 to $12,031

83 negotiated rates

—

list

Vaginal delivery with prenatal and postpartum care

CPT 59400 · lowest of 3 lines · metro median $3,043

$3,043

cash

$1,793 to $16,092

211 negotiated rates

$5,120

list

X-ray of the lower spine (4 or more views)

CPT 72110 · lowest of 2 lines · metro median $269

$269

cash

$28 to $313

136 negotiated rates

$348

list

Source files

The machine-readable files this hospital lists in its cms-hpt.txt. Every price above comes from one of them.

https://www.henryford.com/-/media/files/henry-ford/patients-visitors/price-transparency-06-26/382027689_wa-foote-memorial-hospital_standardcharges.csv
Henry Ford Jackson Hospital · discovered · tall v3.0.0 · file dated 2026-06-28 · 787.7 MB · 9636 price rows read · read Oct 2026
https://www.henryford.com/-/media/files/henry-ford/patients-visitors/price-transparency-06-26/382027689_wa-foote-memorial-hospital_standardcharges.csv
Henry Ford Jackson Hospital · discovered · tall v3.0.0 · file dated 2026-06-28 · 787.7 MB · 9636 price rows read · read Oct 2026
https://www.henryford.com/-/media/files/henry-ford/patients-visitors/price-transparency-06-26/382027689_wa-foote-memorial-hospital_standardcharges.csv
Henry Ford Jackson Hospital · parsed · tall v3.0.0 · file dated 2026-06-28 · 787.7 MB · 9636 price rows read · read Nov 2026
https://www.henryford.com/-/media/files/henry-ford/patients-visitors/price-transparency-2026/legacy-ascension/383322109-1215139233_henry-ford-madison-heights-hospital_standardcharges.csv
Henry Ford Madison Heights Hospital · parsed · tall v3.0.0 · file dated 2026-01-01 · 123.1 MB · 751 price rows read · read Nov 2026
https://www.henryford.com/-/media/files/henry-ford/patients-visitors/price-transparency-2026/legacy-ascension/381358212-1144210253_henry-ford-providence-novi-hospital_standardcharges.csv
Henry Ford Providence Novi Hospital · discovered
https://www.henryford.com/-/media/files/henry-ford/patients-visitors/price-transparency-2026/legacy-ascension/381358212-1144210253_henry-ford-providence-southfield-hospital_standardcharges.csv
Henry Ford Providence Southfield Hospital · discovered
https://www.henryford.com/-/media/files/henry-ford/patients-visitors/price-transparency-2026/legacy-ascension/383160564_henry-ford-river-district-hospital_standardcharges.csv
Henry Ford River District Hospital · discovered