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 |
|---|---|---|---|---|
| Destruction 2-14 lesions 17003 CPT 17003 | $49.80 | $83.00 | $308.00 – $1,094.00 | 2 |
| Destruction anal lesion(s) CPT 46910 | $4,429.80 | $7,383.00 | $1,471.00 – $4,112.55 | 7 |
| Destruction anal lesion(s) CPT 46924 | not published | not published | $1,094.00 – $5,532.48 | 8 |
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | $220.80 | $368.00 | $308.00 – $810.27 | 7 |
| Destruction benign lesions < 14 lesions CPT 17110 | $169.20 | $282.00 | $215.00 – $399.91 | 7 |
| Destruction by injection tx of nerve 64630 CPT 64630 | not published | not published | $947.82 – $2,825.00 | 8 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | $2,139.00 | $3,565.00 | $308.00 – $1,094.00 | 2 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | $4,481.40 | $7,469.00 | $1,094.00 – $4,100.00 | 7 |
| Destruction ciliary body CPT 66700 | not published | not published | $1,471.00 – $4,599.98 | 8 |
| Destruction ciliary body CPT 66720 | not published | not published | $1,471.00 – $4,738.83 | 8 |
| Destruction ciliary body CPT 66740 | not published | not published | $1,471.00 – $4,738.83 | 8 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | not published | not published | $215.00 – $399.91 | 7 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | not published | not published | $1,094.00 – $5,532.48 | 8 |
| Destruction les conjunctiva CPT 68135 | not published | not published | $1,094.00 – $4,738.83 | 7 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | $308.00 – $810.27 | 7 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | $308.00 – $810.27 | 7 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | not published | not published | $308.00 – $810.27 | 7 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | not published | not published | $308.00 – $810.27 | 7 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | $220.80 | $368.00 | $308.00 – $810.27 | 7 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | $1,094.00 – $4,112.55 | 8 |
| Destruction premal lesions 15/> 17004 CPT 17004 | $220.80 | $368.00 | $308.00 – $810.27 | 7 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $1,471.00 – $8,800.00 | 8 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $1,094.00 – $6,452.27 | 8 |
| Destruction vag lesions simple 57061 CPT 57061 | $231.00 | $385.00 | $1,094.00 – $6,452.27 | 7 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $2,211.05 – $4,112.55 | 7 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $24.59 – $55.86 | 7 |
| Detect agnt mult dna direc CPT 87800 | not published | not published | $43.67 – $81.23 | 7 |
| Developmental screen/score/document 96110 CPT 96110 | $164.40 | $274.00 | not published | 0 |
| Devel tst phys/qhp 1st hr CPT 96112 | $371.40 | $619.00 | $137.89 – $256.47 | 6 |
| Devise bowel pouch CPT 44316 | not published | not published | $785.00 – $785.00 | 1 |
| Devlopment test interpt&rep HCPCS G0451 | not published | not published | $108.87 – $202.49 | 6 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | $208.80 | $348.00 | not published | 0 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $240.60 | $401.00 | $18.17 – $173.46 | 6 |
| Dexamethasone 4 mg tablet HCPCS J8540 | not published | not published | $0.03 – $0.03 | 1 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $203.79 – $379.05 | 7 |
| Dexamethasone panel CPT 80420 | not published | not published | $88.33 – $301.10 | 7 |
| Dexmedetomidine film, 1 mcg HCPCS J1105 | not published | not published | $0.64 – $0.64 | 1 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | not published | not published | $46.53 – $92.51 | 7 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $321.00 | $535.00 | $22.23 – $41.35 | 7 |
| Diabetes (HbA1c) Test CPT 83036 | $69.60 | $116.00 | $9.71 – $18.06 | 7 |
| Diab manage trn ind/group HCPCS G0109 | $163.80 | $273.00 | $15.78 – $29.35 | 6 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $1,471.00 – $3,547.71 | 8 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $1,678.00 – $12,050.01 | 8 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $308.00 – $890.42 | 7 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $1,094.00 – $3,533.00 | 7 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $299.40 | $499.00 | $142.58 – $308.00 | 7 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | not published | not published | $87.20 – $87.20 | 1 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | not published | not published | $71.42 – $71.42 | 1 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $122.40 | $204.00 | $213.90 – $397.86 | 7 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $466.80 | $778.00 | $213.90 – $397.86 | 7 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $469.80 | $783.00 | $87.20 – $208.26 | 6 |
| Diagnostic Mammogram (one breast) CPT 77065 | $331.20 | $552.00 | $71.42 – $165.08 | 6 |
| Diagnostic radio unlisted proc CPT 76499 | $123.00 | $205.00 | $93.26 – $173.46 | 6 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $24,345.60 | $40,576.00 | $308.00 – $1,094.00 | 2 |
| Dialysis one evaluation CPT 90945 | $1,929.60 | $3,216.00 | $447.15 – $831.69 | 6 |
| Diathermy eg microwave CPT 97024 | not published | not published | $7.82 – $14.55 | 6 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $3.60 | $6.00 | not published | 0 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.09 – $0.09 | 1 |
| Diffusing capacity CPT 94729 | $398.40 | $664.00 | not published | 0 |
| Digital analysis of eeg CPT 95957 | $924.00 | $1,540.00 | not published | 0 |
| Digit nerve surgery add-on CPT 64778 | not published | not published | $308.00 – $1,600.00 | 3 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | not published | not published | $4,968.58 – $9,610.60 | 7 |
| Digoxin total therapeutic drug level CPT 80162 | $188.40 | $314.00 | $13.28 – $24.70 | 7 |
| Dilate biliary duct/ampulla CPT 47542 | $4,296.00 | $7,160.00 | $308.00 – $1,094.00 | 2 |
| Dilate esophagus CPT 43453 | $2,958.60 | $4,931.00 | $1,094.00 – $3,824.79 | 8 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $971.94 – $3,533.00 | 8 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | $1,161.00 | $1,935.00 | $785.00 – $785.00 | 1 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | $1,161.00 | $1,935.00 | $785.00 – $785.00 | 1 |
| Dilate ic vasospasm init CPT 61640 | $1,161.00 | $1,935.00 | $785.00 – $785.00 | 1 |
| Dilate tear duct opening CPT 68801 | not published | not published | $308.00 – $890.42 | 7 |
| Dilate urethra stricture CPT 53600 | not published | not published | $267.74 – $498.00 | 7 |
| Dilate urethra stricture CPT 53601 | not published | not published | $142.58 – $308.00 | 7 |
| Dilate urethra stricture CPT 53605 | not published | not published | $1,471.00 – $7,026.03 | 8 |
| Dilate urethra stricture CPT 53621 | not published | not published | $267.74 – $498.00 | 7 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $137.89 – $308.00 | 7 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $1,094.00 – $3,533.00 | 8 |
| Dilation of cervical canal 57800 CPT 57800 | $5,294.40 | $8,824.00 | $1,094.00 – $6,452.27 | 7 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $1,094.00 – $3,533.00 | 8 |
| Dilation of salivary duct CPT 42660 | $1,245.60 | $2,076.00 | $308.00 – $1,075.00 | 7 |
| Dilation of urethra CPT 53661 | not published | not published | $142.58 – $308.00 | 7 |
| Dilation of urethra CPT 53665 | not published | not published | $1,094.00 – $4,166.57 | 8 |
| Dilation of vagina CPT 57400 | not published | not published | $1,471.00 – $6,452.27 | 8 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $1,094.00 – $3,533.00 | 7 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $747.24 – $2,825.00 | 7 |
| Dilat xst trc ndurlgc px CPT 50436 | $2,724.00 | $4,540.00 | $1,094.00 – $7,026.03 | 7 |
| Dilat xst trc new access rcs CPT 50437 | $2,724.00 | $4,540.00 | $1,471.00 – $7,026.03 | 7 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | not published | not published | $714.72 – $1,393.09 | 7 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $40.03 – $74.45 | 6 |
| Disability dlco CPT 94727 | $516.60 | $861.00 | $231.39 – $430.38 | 6 |
| Disaccharidases CPT 82657 | $1,390.20 | $2,317.00 | $22.14 – $41.24 | 7 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $1,678.00 – $4,112.55 | 8 |
| Disarticulation shoulder CPT 23920 | not published | not published | $6,885.00 – $25,590.20 | 7 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | not published | not published | $785.00 – $785.00 | 1 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $785.00 – $785.00 | 1 |
| Discography cerv/thor spine CPT 72285 | $2,127.00 | $3,545.00 | $102.41 – $3,892.19 | 6 |
| Dise eval slp do brth flx dx CPT 42975 | not published | not published | $308.00 – $3,547.71 | 7 |
| Dissect brain w/scope CPT 62161 | not published | not published | $785.00 – $785.00 | 1 |
| Dissolve clot heart vessel CPT 92975 | not published | not published | $785.00 – $785.00 | 1 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $2,074.00 – $11,091.19 | 7 |
| Div aberrant vsl w/reanast CPT 33803 | not published | not published | $785.00 – $785.00 | 1 |
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.