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 |
|---|---|---|---|---|
| Prq card revasc mi 1 vsl drug-eluting HCPCS C9606 | $25,386.90 | $46,158.00 | not published | 0 |
| Prq card stent/ath/angio CPT 92934 | $9,721.80 | $17,676.00 | not published | 0 |
| Prq card stent w/angio addl CPT 92929 | $9,721.80 | $17,676.00 | not published | 0 |
| Prq revasc byp graft 1 art and/or branches CPT 92937 | $11,818.40 | $21,488.00 | not published | 0 |
| Prq revasc byp graft addl CPT 92938 | $8,329.20 | $15,144.00 | not published | 0 |
| Prq skel fix clcnl fx w/mnpj CPT 28406 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Prq skel fix epcndylr hum fx CPT 24566 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Prq skel fix sprcndlr hum fx CPT 24538 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Prq skel fix talus fx w/mnpj CPT 28436 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Prq skel fix tarsl fx w/mnpj CPT 28456 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Prq tcat plmt ntrac st 1 les CPT 92928 | $15,936.80 | $28,976.00 | not published | 0 |
| Prq trlml c athrc st angiop1 CPT 92933 | $20,326.90 | $36,958.00 | not published | 0 |
| Prq trluml c angiop 1art&/br CPT 92920 | $11,829.95 | $21,509.00 | not published | 0 |
| Prq trluml c athrc 1 art&/br CPT 92924 | $13,410.10 | $24,382.00 | not published | 0 |
| Prq trluml revsc ch occ ant CPT 92943 | $11,485.10 | $20,882.00 | not published | 0 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $146.85 | $267.00 | $142.58 – $149.71 | 3 |
| Pr removal intrauterine device CPT 58301 | $330.55 | $601.00 | $326.55 – $342.88 | 3 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $583.00 | $1,060.00 | $435.63 – $457.41 | 3 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $243.65 | $443.00 | $215.00 – $225.75 | 3 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $552.20 | $1,004.00 | $215.00 – $225.75 | 3 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $309.65 | $563.00 | $215.00 – $225.75 | 3 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $432.85 | $787.00 | $215.00 – $225.75 | 3 |
| Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child CPT 15100 | $3,087.15 | $5,613.00 | $2,211.05 – $2,321.60 | 3 |
| Prtl exc bone olecrn process CPT 24147 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Prtl exc bone radial h/n CPT 24145 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Prtl exchange transfuse nb CPT 36456 | not published | not published | $472.77 – $496.41 | 3 |
| Prtl excision bone clavicle CPT 23180 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Prtl excision bone scapula CPT 23182 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $1,302.95 | $2,369.00 | $1,686.89 – $1,771.24 | 3 |
| PSA (Prostate) Test CPT 84153 | $246.40 | $448.00 | $18.39 – $19.31 | 3 |
| Psychoanalysis CPT 90845 | not published | not published | $190.21 – $199.72 | 3 |
| Psychotherapy group therapy CPT 90853 | $283.80 | $516.00 | $108.87 – $114.31 | 3 |
| Psychotherapy patient individual therapy 30 minutes CPT 90832 | $265.10 | $482.00 | $190.21 – $199.72 | 3 |
| Psychotherapy patient individual therapy 45 minutes CPT 90834 | $265.10 | $482.00 | $190.21 – $199.72 | 3 |
| Psychotherapy patient individual therapy 60 minutes CPT 90837 | $366.30 | $666.00 | $190.21 – $199.72 | 3 |
| Psych test eval svc phys/qhp 1st hr CPT 96130 | not published | not published | $231.39 – $242.96 | 3 |
| Psy/npsy phys/qhp 2> tst 1st 30 min CPT 96136 | not published | not published | $142.58 – $149.71 | 3 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $133.65 | $243.00 | $15.18 – $15.94 | 3 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $122.65 | $223.00 | $18.35 – $19.27 | 3 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $161.15 | $293.00 | $13.94 – $14.64 | 3 |
| Pt application of modality traction mechanical CPT 97012 | $132.55 | $241.00 | $14.22 – $14.93 | 3 |
| Pten gene dup/delet variant CPT 81323 | $270.60 | $492.00 | $300.00 – $315.00 | 3 |
| Pten gene full sequence CPT 81321 | $541.75 | $985.00 | $600.00 – $630.00 | 3 |
| Pten gene known fam variant CPT 81322 | not published | not published | $46.60 – $48.93 | 3 |
| Pt evaluation high complexity patient/family CPT 97163 | $345.40 | $628.00 | $94.04 – $98.74 | 3 |
| Pt evaluation low complexity patient/family CPT 97161 | $228.80 | $416.00 | $98.89 – $103.83 | 3 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $250.25 | $455.00 | $99.73 – $104.72 | 3 |
| Pt re-evaluation patient/family CPT 97164 | $185.35 | $337.00 | $68.90 – $72.34 | 3 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $71.50 | $130.00 | not published | 0 |
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | $121.55 | $221.00 | $12.33 – $12.95 | 3 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $92.95 | $169.00 | $28.06 – $29.46 | 3 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $94.05 | $171.00 | $30.54 – $32.07 | 3 |
| Pt wheelchair management each 15 minutes CPT 97542 | $97.35 | $177.00 | $31.68 – $33.26 | 3 |
| Pulm ds ipf mrna 190 gen alg CPT 81554 | not published | not published | $5,409.60 – $5,680.08 | 3 |
| Pulmonary vent imaging CPT 78579 | not published | not published | $428.40 – $449.82 | 3 |
| Pulse ox continuous overnight monitoring CPT 94762 | $448.25 | $815.00 | $137.89 – $144.78 | 3 |
| Pulse ox multiple CPT 94761 | $117.70 | $214.00 | not published | 0 |
| Pulse ox single CPT 94760 | $112.75 | $205.00 | not published | 0 |
| Punc of shunt for asp or inj CPT 61070 | not published | not published | $756.44 – $794.26 | 3 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $69.30 | $126.00 | $142.58 – $149.71 | 3 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $638.55 | $1,161.00 | $435.63 – $457.41 | 3 |
| Puncture spinal lumbar diagnostic CPT 62270 | $1,275.45 | $2,319.00 | $756.44 – $794.26 | 3 |
| Pvb thoracic cont infusion CPT 64463 | not published | not published | $756.44 – $794.26 | 3 |
| Pvb thoracic single inj site CPT 64461 | $675.95 | $1,229.00 | $756.44 – $794.26 | 3 |
| Pyruvate CPT 84210 | $68.20 | $124.00 | $14.48 – $15.20 | 3 |
| Pyruvate kinase CPT 84220 | $111.65 | $203.00 | $9.44 – $9.91 | 3 |
| Quan puplmtry phy/qhp uni/bi CPT 95919 | not published | not published | $142.58 – $149.71 | 3 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $583.55 | $1,061.00 | $581.86 – $610.95 | 3 |
| Quant diff pulm perf w/imaging CPT 78597 | $1,058.75 | $1,925.00 | $428.40 – $449.82 | 3 |
| Quest t3 uptake CPT 84479 | $16.50 | $30.00 | $6.47 – $6.79 | 3 |
| Radiation physics consult CPT 77336 | $775.50 | $1,410.00 | not published | 0 |
| Radiation therapy dose plan CPT 77300 | $821.15 | $1,493.00 | not published | 0 |
| Radiation treatment aid(s) CPT 77332 | $264.00 | $480.00 | not published | 0 |
| Radiation treatment aid(s) CPT 77334 | $1,213.30 | $2,206.00 | $401.25 – $421.31 | 3 |
| Radiation treatment delivery CPT 77402 | $332.20 | $604.00 | not published | 0 |
| Radiation treatment delivery CPT 77412 | $877.25 | $1,595.00 | $592.11 – $621.72 | 3 |
| Radical rescj tumor clavicle CPT 23200 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Radical rescj tumor prox hum CPT 23220 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Radical rescj tumor scapula CPT 23210 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Radical resection of elbow CPT 24149 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Radical resection sternum 21630 CPT 21630 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Radic resect abd tumor<5cm 22904 CPT 22904 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Radic resect shoulder tumor 5cm/> 23078 CPT 23078 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Radiology port images(s) CPT 77417 | $268.40 | $488.00 | not published | 0 |
| Radiotherapy dose plan imrt CPT 77301 | $7,157.15 | $13,013.00 | $1,483.26 – $1,557.42 | 3 |
| Radium ra223 dichl ther/uci HCPCS A9606 | $371.80 | $676.00 | not published | 0 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $2,552.55 | $4,641.00 | $581.86 – $610.95 | 3 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $3,365.45 | $6,119.00 | $581.86 – $610.95 | 3 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | not published | not published | $1,387.37 – $1,456.74 | 3 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $2,968.35 | $5,397.00 | $581.86 – $610.95 | 3 |
| Radphm lcl tumor plr sgl day CPT 78800 | $1,763.30 | $3,206.00 | $428.40 – $449.82 | 3 |
| Rad rescj tum dstl/shft hum CPT 24150 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Rad rescj tum shoulder<5 cm CPT 23077 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Rad rescj tum tiss a/e 5 cm+ CPT 24079 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Rad rescj tum tiss a/e <5cm CPT 24077 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Rad resec soft tis tum/ft/toe/<3cm 28046 CPT 28046 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Rad resect abd tumor 5 cm/> CPT 22905 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Rad resect hand tumor < 3 cm CPT 26117 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Rad resect hand tumor 3 cm/> CPT 26118 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Rad resection tum radial h/n CPT 24152 | not published | not published | $7,775.89 – $8,164.69 | 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.