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 |
|---|---|---|---|---|
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $633.60 | $1,152.00 | $112.03 – $117.63 | 3 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | $662.75 | $1,205.00 | $112.03 – $117.63 | 3 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | $488.95 | $889.00 | $112.03 – $117.63 | 3 |
| Ultrasound prostate/transrectal CPT 76872 | $722.70 | $1,314.00 | $112.03 – $117.63 | 3 |
| Ultrasound retroperitoneal limited CPT 76775 | $628.10 | $1,142.00 | $112.03 – $117.63 | 3 |
| Ultrasound scrotum and contents CPT 76870 | $996.05 | $1,811.00 | $112.03 – $117.63 | 3 |
| Ultrasound spinal canal and contents CPT 76800 | $440.00 | $800.00 | $112.03 – $117.63 | 3 |
| Ultrasound transabd ea addl gest CPT 76812 | $534.05 | $971.00 | not published | 0 |
| Ultrasound transvaginal non obstetric CPT 76830 | $856.90 | $1,558.00 | $112.03 – $117.63 | 3 |
| Ultrasound trgt dyn mbubb 1st les CPT 76978 | not published | not published | $373.86 – $392.55 | 3 |
| Ultraviolet therapy CPT 97028 | not published | not published | $8.07 – $8.47 | 3 |
| Umbilical cord occlud w/us CPT 59072 | not published | not published | $326.55 – $342.88 | 3 |
| Unlisted chemotherapy px CPT 96549 | $75.90 | $138.00 | $50.18 – $52.69 | 3 |
| Unlisted cranfcl&maxlfcl px CPT 21299 | not published | not published | $253.81 – $266.50 | 3 |
| Unlisted CT procedure CPT 76497 | not published | not published | $93.26 – $97.92 | 3 |
| Unlisted cv px dx nuc med CPT 78499 | not published | not published | $428.40 – $449.82 | 3 |
| Unlisted cytogenetic study CPT 88299 | not published | not published | $55.84 – $58.64 | 3 |
| Unlisted cytopathology px CPT 88199 | not published | not published | $55.84 – $58.64 | 3 |
| Unlisted dx gi procedure CPT 91299 | not published | not published | $137.89 – $144.78 | 3 |
| Unlisted endocrine px dx nuc CPT 78099 | not published | not published | $428.40 – $449.82 | 3 |
| Unlisted fluoroscopic px CPT 76496 | not published | not published | $93.26 – $97.92 | 3 |
| Unlisted gi px dx nuc med CPT 78299 | not published | not published | $428.40 – $449.82 | 3 |
| Unlisted gu px dx nuc med CPT 78799 | not published | not published | $428.40 – $449.82 | 3 |
| Unlisted laparoscopic liver biopy 47379 CPT 47379 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Unlisted laparoscopic procedure 49659 CPT 49659 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Unlisted laparoscopic reduction intestine 44238 CPT 44238 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Unlisted laparoscopy procedure biliary tract 47579 CPT 47579 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Unlisted laps px appendix CPT 44979 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Unlisted laps px bladder CPT 51999 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Unlisted laps px endoc sys CPT 60659 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Unlisted laps px esoph CPT 43289 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Unlisted laps px lymphtc sys CPT 38589 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Unlisted laps px ovidct ovry CPT 58679 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Unlisted laps px renal CPT 50549 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Unlisted laps px spleen CPT 38129 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Unlisted laps px testis CPT 54699 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Unlisted laps px ureter CPT 50949 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Unlisted laps px uterus CPT 58578 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Unlisted maxlfcl prosth px CPT 21089 | not published | not published | $253.81 – $266.50 | 3 |
| Unlisted misc path test CPT 89240 | not published | not published | $55.84 – $58.64 | 3 |
| Unlisted mr procedure CPT 76498 | not published | not published | $93.26 – $97.92 | 3 |
| Unlisted muscskel px dx nuc CPT 78399 | not published | not published | $428.40 – $449.82 | 3 |
| Unlisted muscskel px head CPT 21499 | not published | not published | $253.81 – $266.50 | 3 |
| Unlisted neurological dx px CPT 95999 | not published | not published | $137.89 – $144.78 | 3 |
| Unlisted nrvs sys px dx nuc CPT 78699 | not published | not published | $428.40 – $449.82 | 3 |
| Unlisted procedure colon CPT 45399 | not published | not published | $996.56 – $1,046.39 | 3 |
| Unlisted procedure esophagus CPT 43499 | not published | not published | $971.94 – $1,020.54 | 3 |
| Unlisted procedure larynx CPT 31599 | not published | not published | $253.81 – $266.50 | 3 |
| Unlisted procedure liver CPT 47399 | not published | not published | $758.85 – $796.79 | 3 |
| Unlisted procedure microbiology CPT 87999 | $2,079.55 | $3,781.00 | not published | 0 |
| Unlisted procedure pancreas CPT 48999 | not published | not published | $758.85 – $796.79 | 3 |
| Unlisted procedure rectum CPT 45999 | not published | not published | $996.56 – $1,046.39 | 3 |
| Unlisted procedure spine CPT 22899 | not published | not published | $264.33 – $277.55 | 3 |
| Unlisted px abdomen muscskel CPT 22999 | not published | not published | $264.33 – $277.55 | 3 |
| Unlisted px accessory sinus CPT 31299 | not published | not published | $253.81 – $266.50 | 3 |
| Unlisted px arthroscopy CPT 29999 | not published | not published | $264.33 – $277.55 | 3 |
| Unlisted px biliary tract CPT 47999 | not published | not published | $971.94 – $1,020.54 | 3 |
| Unlisted px casting/strpg CPT 29799 | $239.80 | $436.00 | $174.14 – $182.85 | 3 |
| Unlisted px exc pressure ulc CPT 15999 | not published | not published | $758.85 – $796.79 | 3 |
| Unlisted px external ear CPT 69399 | not published | not published | $253.81 – $266.50 | 3 |
| Unlisted px foot/toes CPT 28899 | not published | not published | $264.33 – $277.55 | 3 |
| Unlisted px forearm/wrist CPT 25999 | not published | not published | $264.33 – $277.55 | 3 |
| Unlisted px hands/fingers CPT 26989 | not published | not published | $264.33 – $277.55 | 3 |
| Unlisted px inner ear CPT 69949 | not published | not published | $253.81 – $266.50 | 3 |
| Unlisted px leg/ankle CPT 27899 | not published | not published | $264.33 – $277.55 | 3 |
| Unlisted px male genital sys CPT 55899 | not published | not published | $267.74 – $281.13 | 3 |
| Unlisted px middle ear CPT 69799 | not published | not published | $253.81 – $266.50 | 3 |
| Unlisted px neck/thorax CPT 21899 | not published | not published | $253.81 – $266.50 | 3 |
| Unlisted px palate uvula CPT 42299 | not published | not published | $253.81 – $266.50 | 3 |
| Unlisted px pelvis/hip joint CPT 27299 | $5,963.65 | $10,843.00 | $264.33 – $277.55 | 3 |
| Unlisted px salivry glnd/dux CPT 42699 | not published | not published | $253.81 – $266.50 | 3 |
| Unlisted px small intestine CPT 44799 | $4,777.30 | $8,686.00 | $971.94 – $1,020.54 | 3 |
| Unlisted px temporal bone CPT 69979 | not published | not published | $253.81 – $266.50 | 3 |
| Unlisted px tongue flr mouth CPT 41599 | not published | not published | $253.81 – $266.50 | 3 |
| Unlisted px vestibule mouth CPT 40899 | not published | not published | $253.81 – $266.50 | 3 |
| Unlisted reprod med lab proc CPT 89398 | not published | not published | $55.84 – $58.64 | 3 |
| Unlisted resp px dx nuc med CPT 78599 | not published | not published | $428.40 – $449.82 | 3 |
| Unlisted spec derm svc/px CPT 96999 | not published | not published | $215.00 – $225.75 | 3 |
| Unlisted surgical path px CPT 88399 | $66.55 | $121.00 | $55.84 – $58.64 | 3 |
| Unlisted transfusion med px CPT 86999 | $36.85 | $67.00 | not published | 0 |
| Unlisted ultrasound procedure CPT 76999 | not published | not published | $93.26 – $97.92 | 3 |
| Unlstd hematop ret/endo lymp CPT 78199 | not published | not published | $428.40 – $449.82 | 3 |
| Unlstd laps px mat care&dlvr CPT 59898 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Unlstd laps px sprmatic cord CPT 55559 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Unsched dialysis esrd pt hos HCPCS G0257 | $733.15 | $1,333.00 | not published | 0 |
| Upgrade pm system CPT 33214 | $13,920.50 | $25,310.00 | not published | 0 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $4,352.15 | $7,913.00 | $373.86 – $392.55 | 3 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $3,239.50 | $5,890.00 | $373.86 – $392.55 | 3 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $3,092.65 | $5,623.00 | $255.69 – $268.47 | 3 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | $1,151.70 | $2,094.00 | $971.94 – $1,020.54 | 3 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | not published | not published | $971.94 – $1,020.54 | 3 |
| Uppr gi scope w/submuc inj CPT 43236 | not published | not published | $971.94 – $1,020.54 | 3 |
| Urachal cyst/sinus excision 51500 CPT 51500 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Urea nitrogen CPT 84520 | $82.50 | $150.00 | $3.95 – $4.15 | 3 |
| Urea nitrogen 24 hour urine CPT 84540 | $113.30 | $206.00 | $5.56 – $5.84 | 3 |
| Urea nitrogen clearance CPT 84545 | $104.50 | $190.00 | $7.20 – $7.56 | 3 |
| Urea nitrogen semi-quant CPT 84525 | not published | not published | $5.13 – $5.39 | 3 |
| Ureteral reflux study CPT 78740 | $694.10 | $1,262.00 | $428.40 – $449.82 | 3 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $1,093.95 | $1,989.00 | $255.69 – $268.47 | 3 |
| Urethrocystography void s&i CPT 74455 | $1,093.95 | $1,989.00 | $255.69 – $268.47 | 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.