OSF Little Company of Mary Medical Center
2800 W 95Th St, Evergreen Park, IL · Osfhealthcare · · NPI 1215572045
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 |
|---|---|---|---|---|
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $510.60 | $851.00 | $19.99 – $208.38 | 6 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $464.40 | $774.00 | $26.07 – $208.38 | 6 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $534.00 | $890.00 | $28.44 – $208.38 | 6 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $295.80 | $493.00 | $16.95 – $173.46 | 6 |
| X-ray humerus >= 2 views left CPT 73060 | $409.20 | $682.00 | $15.13 – $173.46 | 6 |
| X-ray joint survey 1 view CPT 77077 | $214.80 | $358.00 | $30.87 – $208.38 | 6 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $403.80 | $673.00 | $15.13 – $173.46 | 6 |
| X-ray knee 3 views (both sides) CPT 73562 | $592.80 | $988.00 | $16.95 – $173.46 | 6 |
| X-ray knee ap standing bilateral CPT 73565 | $207.00 | $345.00 | $15.76 – $173.46 | 6 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $1,179.60 | $1,966.00 | $14.52 – $173.46 | 6 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $415.80 | $693.00 | $19.99 – $208.38 | 6 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $478.20 | $797.00 | $23.01 – $208.38 | 6 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $540.60 | $901.00 | $27.83 – $208.38 | 6 |
| X-ray male genital tract CPT 74440 | not published | not published | $32.10 – $475.58 | 6 |
| X-ray mandible complete > 4 views CPT 70110 | $405.00 | $675.00 | $21.80 – $208.38 | 6 |
| X-ray mandible ltd <4 views CPT 70100 | $580.80 | $968.00 | $16.35 – $173.46 | 6 |
| X-ray nasal bones complete > 3 views CPT 70160 | $259.80 | $433.00 | $15.74 – $173.46 | 6 |
| X-ray neck soft tissue CPT 70360 | $326.40 | $544.00 | $16.35 – $173.46 | 6 |
| X-ray nose to rectum for foreign body child CPT 76010 | $316.80 | $528.00 | $16.35 – $173.46 | 6 |
| X-ray of mammary ducts CPT 77054 | $885.00 | $1,475.00 | $39.36 – $475.58 | 6 |
| X-ray optic foramina CPT 70190 | not published | not published | $20.01 – $173.46 | 6 |
| X-ray pelvis 1-2 views CPT 72170 | $266.40 | $444.00 | $15.74 – $208.38 | 6 |
| X-ray pelvis complete > 3 views CPT 72190 | $587.40 | $979.00 | $22.42 – $208.38 | 6 |
| Xray place dist ext thor ao CPT 75959 | not published | not published | $331.14 – $331.14 | 1 |
| Xray place prox ext thor ao CPT 75958 | not published | not published | $378.48 – $378.48 | 1 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $739.20 | $1,232.00 | $44.81 – $695.38 | 6 |
| X-ray ribs 2 views left CPT 71100 | $435.00 | $725.00 | $19.99 – $173.46 | 6 |
| X-ray ribs 3 views bilateral CPT 71110 | $552.60 | $921.00 | $25.44 – $208.38 | 6 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $557.40 | $929.00 | $23.62 – $208.38 | 6 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $681.60 | $1,136.00 | $29.03 – $208.38 | 6 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $297.60 | $496.00 | $19.97 – $208.38 | 6 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $289.20 | $482.00 | $15.74 – $173.46 | 6 |
| X-ray scapula complete (both sides) CPT 73010 | $526.20 | $877.00 | $16.35 – $208.38 | 6 |
| X-ray sella turcica CPT 70240 | not published | not published | $16.95 – $173.46 | 6 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $388.80 | $648.00 | $13.92 – $173.46 | 6 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $373.20 | $622.00 | $19.36 – $173.46 | 6 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $1,021.80 | $1,703.00 | $47.10 – $1,089.12 | 6 |
| X-ray skull < 4 views CPT 70250 | $334.20 | $557.00 | $16.35 – $208.38 | 6 |
| X-ray skull > 4 views complete CPT 70260 | $456.00 | $760.00 | $24.85 – $208.38 | 6 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $2,298.00 | $3,830.00 | $53.21 – $208.38 | 6 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $601.20 | $1,002.00 | $71.42 – $349.61 | 6 |
| X-ray small intestine follow-through study CPT 74248 | $501.60 | $836.00 | $62.31 – $62.31 | 1 |
| X-ray spine single view CPT 72020 | $324.00 | $540.00 | $14.52 – $173.46 | 6 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $546.00 | $910.00 | $19.36 – $173.46 | 6 |
| X-ray sternum > 2 views CPT 71120 | $289.20 | $482.00 | $17.54 – $173.46 | 6 |
| X-ray surgical specimen CPT 76098 | $799.20 | $1,332.00 | $28.44 – $1,089.12 | 6 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $436.20 | $727.00 | $48.35 – $349.61 | 6 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $516.60 | $861.00 | $21.19 – $173.46 | 6 |
| X-ray thoracic spine 2 views CPT 72070 | $405.00 | $675.00 | $18.17 – $208.38 | 6 |
| X-ray thoracic spine 3 views CPT 72072 | $465.60 | $776.00 | $19.97 – $208.38 | 6 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $198.00 | $330.00 | $18.78 – $173.46 | 6 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $260.40 | $434.00 | $23.01 – $173.46 | 6 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $301.80 | $503.00 | $28.44 – $208.38 | 6 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $426.60 | $711.00 | $14.52 – $173.46 | 6 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $303.00 | $505.00 | $12.09 – $173.46 | 6 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $901.80 | $1,503.00 | $78.69 – $349.61 | 6 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $751.20 | $1,252.00 | $71.42 – $349.61 | 6 |
| X-ray wrist 2 views (both sides) CPT 73100 | $397.80 | $663.00 | $15.13 – $173.46 | 6 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | $577.80 | $963.00 | $53.19 – $349.61 | 6 |
| Xylose absorption test blood &/or urine CPT 84620 | $237.60 | $396.00 | $12.91 – $24.01 | 7 |
| Xyntha inj HCPCS J7185 | not published | not published | $1.49 – $2.77 | 7 |
| Yersinia antibody CPT 86793 | not published | not published | $13.19 – $24.53 | 7 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | not published | not published | $56,824.55 – $105,693.66 | 7 |
| Ziconotide injection HCPCS J2278 | not published | not published | $9.70 – $19.46 | 7 |
| Zika virus dna/rna amp probe CPT 87662 | $570.00 | $950.00 | $51.31 – $95.44 | 7 |
| Zika virus igm antibody CPT 86794 | $427.80 | $713.00 | $16.85 – $31.34 | 7 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | not published | not published | $8.30 – $16.01 | 7 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $173.93 – $359.44 | 7 |
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.