SSM Health St. Mary's Hospital - Centralia
400 North Pleasant Avenue, Centralia, IL · SSM Health · · NPI 1083617245
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Esoph endoscopy dilation CPT 43226 | not published | not published | $2,056.34 – $2,159.15 | 3 |
| Esoph imped function test CPT 91037 | $355.30 | $646.00 | $231.39 – $242.96 | 3 |
| Esoph imped funct test > 1hr CPT 91038 | not published | not published | $399.88 – $419.88 | 3 |
| Esoph optical endomicroscopy CPT 43206 | not published | not published | $2,056.34 – $2,159.15 | 3 |
| Esoph scope w/sclerosis inj CPT 43204 | not published | not published | $2,056.34 – $2,159.15 | 3 |
| Esoph scope w/submucous inj CPT 43201 | not published | not published | $2,056.34 – $2,159.15 | 3 |
| Essure 58565 CPT 58565 | not published | not published | $5,360.72 – $5,628.75 | 3 |
| Established Patient Office Visit (level 1) CPT 99211 | $129.80 | $236.00 | not published | 0 |
| Established Patient Office Visit (level 2) CPT 99212 | $119.90 | $218.00 | not published | 0 |
| Established Patient Office Visit (level 3) CPT 99213 | $137.50 | $250.00 | not published | 0 |
| Established Patient Office Visit (level 4) CPT 99214 | $161.70 | $294.00 | not published | 0 |
| Established Patient Office Visit (level 5) CPT 99215 | $212.30 | $386.00 | not published | 0 |
| Estradiol total CPT 82670 | $56.10 | $102.00 | $27.94 – $29.34 | 3 |
| Estrogens total-sendout CPT 82672 | $399.30 | $726.00 | $21.70 – $22.78 | 3 |
| Ethylene glycol -sendout CPT 82693 | $167.75 | $305.00 | $14.90 – $15.64 | 3 |
| Euglobulin lysis CPT 85360 | not published | not published | $8.41 – $8.83 | 3 |
| Evacuate mole of uterus CPT 59870 | not published | not published | $3,468.96 – $3,642.41 | 3 |
| Eval aud rehab status/first hr 92626 CPT 92626 | not published | not published | $137.89 – $144.78 | 3 |
| Eval/fit voice prosthesis iii, st CPT 92607 | $350.90 | $638.00 | $117.78 – $123.67 | 3 |
| Evaluation cervical mucus CPT 89330 | not published | not published | $10.38 – $10.90 | 3 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $234.30 | $426.00 | $98.11 – $103.02 | 3 |
| Evaluation of speech fluency 92521 CPT 92521 | $416.90 | $758.00 | $134.52 – $141.25 | 3 |
| Evaluation psychiatric diagnostic CPT 90791 | $293.70 | $534.00 | $190.21 – $199.72 | 3 |
| Evasc rpr a-ao ndgft 34701 CPT 34701 | $8,385.30 | $15,246.00 | not published | 0 |
| Evasc rpr a-unilac ndgft 34703 CPT 34703 | $9,220.75 | $16,765.00 | not published | 0 |
| Evasc rpr ilio-iliac ndgft CPT 34707 | $18,205.00 | $33,100.00 | not published | 0 |
| Event monitor CPT 93270 | $779.35 | $1,417.00 | $39.99 – $41.99 | 3 |
| Evoked auditory tst complete CPT 92588 | not published | not published | $399.88 – $419.88 | 3 |
| Evoked oa emissions ltd CPT 92587 | not published | not published | $231.39 – $242.96 | 3 |
| Evoked potentials auditory screening automated analysis CPT 92650 | $383.35 | $697.00 | not published | 0 |
| Evoked potentials upper limbs CPT 95925 | $691.90 | $1,258.00 | $231.39 – $242.96 | 3 |
| Evoked potential visual not glaucoma CPT 95930 | not published | not published | $231.39 – $242.96 | 3 |
| Exam of vagina w/scope 57420 CPT 57420 | not published | not published | $326.55 – $342.88 | 3 |
| Exam plvc w/anes othr thn lcl CPT 57410 | not published | not published | $3,468.96 – $3,642.41 | 3 |
| Ex arm/elbow tum deep < 5 cm CPT 24076 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Ex arm/elbow tum deep 5 cm/> CPT 24073 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc 1st&/crv rib w/sympth CPT 21616 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Exc abd les sc 3 cm/> CPT 22903 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc abdl tum deep < 5 cm CPT 22900 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc abdl tum deep 5 cm/> CPT 22901 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc arm/elbo les sc >=3cm 24071 CPT 24071 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc arm/elbo les sc <3cm 24075 CPT 24075 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc back les sbq <3 cm 21930 CPT 21930 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc back tum deep 5 cm/> CPT 21933 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc bartholins gland/cyst CPT 56740 | not published | not published | $3,468.96 – $3,642.41 | 3 |
| Exc benign feenlm 3.1-4.0cm 11444 CPT 11444 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc benign feenlm >4.0cm 11446 CPT 11446 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc benign snhfg 3.1-4.0cm 11424 CPT 11424 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc benign tal 0.5 < cm 11400 CPT 11400 | $674.30 | $1,226.00 | $758.85 – $796.79 | 3 |
| Exc ben+marg excep skin tag feenlm <0.5cm 11440 CPT 11440 | $653.40 | $1,188.00 | $758.85 – $796.79 | 3 |
| Exc ben+marg excep skin tag feenlm 1.1-2cm 11442 CPT 11442 | $1,207.80 | $2,196.00 | $758.85 – $796.79 | 3 |
| Exc ben+marg excep skin tag feenlm 2.1-3cm 11443 CPT 11443 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 CPT 11421 | $1,521.30 | $2,766.00 | $758.85 – $796.79 | 3 |
| Exc ben+marg excep skin tag snhfg 2.1-3cm 11423 CPT 11423 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc ben+marg excep skin tag snhfg >4cm 11426 CPT 11426 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | $849.75 | $1,545.00 | $435.63 – $457.41 | 3 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | $1,113.20 | $2,024.00 | $758.85 – $796.79 | 3 |
| Exc breast duct fistula 19112 CPT 19112 | not published | not published | $4,195.85 – $4,405.64 | 3 |
| Exc cervix repair bowel 57556 CPT 57556 | not published | not published | $5,360.72 – $5,628.75 | 3 |
| Exc cervix/repair vagina 57555 CPT 57555 | not published | not published | $5,360.72 – $5,628.75 | 3 |
| Exc chest wall tumor w/ribs 21601 CPT 21601 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc ch wal tum without lymphadec CPT 21602 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Exc ch wal tum w/lymphadec CPT 21603 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Exc coccygl pr ulc flap clsr CPT 15922 | not published | not published | $3,797.52 – $3,987.40 | 3 |
| Exc coccygl pr ulc prim sutr CPT 15920 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc constrict ring finger w/mlt z-plasties 26596 CPT 26596 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Exc/crtg b1 cst/b9 tum rds CPT 24120 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Exc/crtg b1 cst/tum hum agrf CPT 24115 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Exc/crtg b1 cst/tum hum algr CPT 24116 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Exc/crtg b1 cst/tum rds agrf CPT 24125 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Exc/crtg b1 cst/tum rds algr CPT 24126 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Exc/curetg cst/tum tarsal/metar w/iliac/agrf 28106 CPT 28106 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Exc/curtg b1 cst/b9 tum hum CPT 24110 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Exc excessive skin buttock CPT 15835 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc excessive skin hip CPT 15834 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc excessive skin leg CPT 15833 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc excessive skin thigh CPT 15832 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc excsv skin forearm/hand CPT 15837 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc excsv submental fat pad CPT 15838 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc ext ear/partial/simple repair 69110 CPT 69110 | $2,627.90 | $4,778.00 | $3,112.75 – $3,268.38 | 3 |
| Exc face tum deep < 2 cm CPT 21013 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc face tum deep 2cm/> 21014 CPT 21014 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc feenl mal+mrg 0.6-1 11641 CPT 11641 | $878.90 | $1,598.00 | $758.85 – $796.79 | 3 |
| Exc feenl mal+mrg 2.1-3 11643 CPT 11643 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc foot/toe tum dep 1.5cm/> CPT 28041 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc foot/toe tum subq < 1.5 cm 28043 CPT 28043 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc forearm les sc 3 cm/> CPT 25071 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc forearm tum deep < 3 cm CPT 25076 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc forearm tum deep 3 cm/> CPT 25073 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc hand les sc < 1.5 cm CPT 26115 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc hand tum deep 1.5 cm/> CPT 26113 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc hand tum deep < 1.5 cm 26116 CPT 26116 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exchange biliary drg cath CPT 47536 | $4,407.70 | $8,014.00 | $3,836.82 – $4,028.66 | 3 |
| Exchange blood transfusion newborn 36450 CPT 36450 | not published | not published | $472.77 – $496.41 | 3 |
| Exchange drainage catheter CPT 49423 | $2,122.45 | $3,859.00 | $2,056.34 – $2,159.15 | 3 |
| Exchange nephrostomy cath CPT 50435 | $1,244.65 | $2,263.00 | not published | 0 |
| Exc hidradenitis ing simpl 11462 CPT 11462 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc hidradenitis peri/umb comp 11471 CPT 11471 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc hidradenitis peri/umb int 11470 CPT 11470 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc hip/pelv tum deep < 5 cm CPT 27048 | not published | not published | $3,112.75 – $3,268.38 | 3 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.