OSF St Mary Medical Center
3333 North Seminary, Galesburg, IL · Osfhealthcare · · NPI 1164485363
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 |
|---|---|---|---|---|
| Clot factor fletcher fact CPT 85292 | not published | not published | $18.93 – $19.31 | 3 |
| Clot factor viii reltd antgn CPT 85244 | not published | not published | $20.42 – $20.83 | 3 |
| Clot factor wght kininogen CPT 85293 | not published | not published | $18.93 – $19.31 | 3 |
| Clot factor xii hageman CPT 85280 | $382.20 | $637.00 | $19.35 – $19.74 | 3 |
| Clot factor xiii fibrin scrn CPT 85291 | $382.20 | $637.00 | $9.11 – $9.29 | 3 |
| Clot factor xiii fibrin stab CPT 85290 | $519.00 | $865.00 | $16.34 – $16.67 | 3 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | $594.00 | $990.00 | $264.33 – $1,586.00 | 5 |
| Clsd tx bimalleol ank fx without manip 27808 CPT 27808 | not published | not published | $264.33 – $1,586.00 | 5 |
| Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 | $310.80 | $518.00 | $264.33 – $1,586.00 | 5 |
| Clsd tx clav dislc without manip 23520 CPT 23520 | not published | not published | $1,723.15 – $5,339.00 | 5 |
| Clsd tx clavicle dislocation without manip 23540 CPT 23540 | not published | not published | $264.33 – $1,586.00 | 5 |
| Clsd tx clavicle fracture w/manip 23505 CPT 23505 | not published | not published | $1,723.15 – $3,176.00 | 5 |
| Clsd tx/clavicular fx without manip 23500 CPT 23500 | $306.00 | $510.00 | $264.33 – $1,586.00 | 5 |
| Clsd tx coccygeal fracture 27200 CPT 27200 | not published | not published | $264.33 – $1,586.00 | 5 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | not published | not published | $264.33 – $1,586.00 | 5 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | $290.40 | $484.00 | $264.33 – $1,586.00 | 5 |
| Clsd tx/dis tib/wt bear no manip 27824 CPT 27824 | not published | not published | $264.33 – $1,586.00 | 5 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | $683.40 | $1,139.00 | $264.33 – $1,586.00 | 5 |
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | $2,247.00 | $3,745.00 | $1,723.15 – $5,339.00 | 5 |
| Clsd tx finger tendon w/wo perq pin 26432 CPT 26432 | not published | not published | $1,723.15 – $5,339.00 | 5 |
| Clsd tx fracture of radius 25500 CPT 25500 | not published | not published | $264.33 – $1,586.00 | 5 |
| Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 | $322.20 | $537.00 | $264.33 – $1,586.00 | 5 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $683.40 | $1,139.00 | $264.33 – $1,586.00 | 5 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | $470.40 | $784.00 | $264.33 – $1,586.00 | 5 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $1,926.00 | $3,210.00 | $1,723.15 – $3,176.00 | 5 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | $306.00 | $510.00 | $264.33 – $1,586.00 | 5 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $1,494.60 | $2,491.00 | $693.00 – $1,757.62 | 5 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | $448.80 | $748.00 | $264.33 – $1,586.00 | 5 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $524.40 | $874.00 | $264.33 – $1,586.00 | 5 |
| Clsd tx humeral fract without manip 24530 CPT 24530 | not published | not published | $264.33 – $1,586.00 | 5 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | $683.40 | $1,139.00 | $264.33 – $1,586.00 | 5 |
| Clsd tx iphal jnt disl w/manip req anes CPT 26775 | not published | not published | $299.72 – $1,586.00 | 5 |
| Clsd tx mandibular fx without manip 21450 CPT 21450 | not published | not published | $577.95 – $1,586.00 | 5 |
| Clsd tx/metacar/interphal artic fx 26740 CPT 26740 | not published | not published | $264.33 – $1,586.00 | 5 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $683.40 | $1,139.00 | $264.33 – $1,586.00 | 5 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $683.40 | $1,139.00 | $264.33 – $1,586.00 | 5 |
| Clsd tx metacarp fx w/manip&ext fix ea bone 26607 CPT 26607 | not published | not published | $3,506.34 – $5,339.00 | 5 |
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | not published | not published | $264.33 – $1,586.00 | 5 |
| Clsd tx/metatarsal fx without manip 28470 CPT 28470 | $288.00 | $480.00 | $264.33 – $1,586.00 | 5 |
| Clsd tx/nasal bone fx/stabilize 21320 CPT 21320 | $4,008.60 | $6,681.00 | $3,552.91 – $5,339.00 | 5 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | $2,064.60 | $3,441.00 | $1,723.15 – $5,339.00 | 5 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $683.40 | $1,139.00 | $264.33 – $1,586.00 | 5 |
| Clsd tx/patellar fx without manip 27520 CPT 27520 | not published | not published | $264.33 – $1,586.00 | 5 |
| Clsd tx pelvic ring fx CPT 27197 | not published | not published | $264.33 – $1,586.00 | 5 |
| Clsd tx pelvic ring fx CPT 27198 | not published | not published | $264.33 – $1,586.00 | 5 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $1,008.00 | $1,680.00 | $1,723.15 – $3,176.00 | 5 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | not published | not published | $264.33 – $1,586.00 | 5 |
| Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 | $683.40 | $1,139.00 | $264.33 – $1,586.00 | 5 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | $1,594.20 | $2,657.00 | $693.00 – $1,757.62 | 5 |
| Clsd tx/scapular fx without manip 23570 CPT 23570 | not published | not published | $264.33 – $1,586.00 | 5 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $2,061.00 | $3,435.00 | $1,723.15 – $3,176.00 | 5 |
| Clsd tx shoulder disloc w/anatom neck fx w/manip 23675 CPT 23675 | $2,020.20 | $3,367.00 | $693.00 – $1,757.62 | 5 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | $2,274.60 | $3,791.00 | $1,723.15 – $5,339.00 | 5 |
| Clsd tx/talotarsal dislocat/anes 28575 CPT 28575 | not published | not published | $3,506.34 – $5,339.00 | 5 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $555.00 | $925.00 | $264.33 – $1,586.00 | 5 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $646.20 | $1,077.00 | $264.33 – $1,586.00 | 5 |
| Clsd tx trimall ankle fx without manip 27816 CPT 27816 | $294.60 | $491.00 | $264.33 – $1,586.00 | 5 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $1,008.00 | $1,680.00 | $1,723.15 – $3,176.00 | 5 |
| Clsd tx/ulnar shaft fx without manip 25530 CPT 25530 | $322.20 | $537.00 | $264.33 – $1,586.00 | 5 |
| Clsd tx vert body fx without manip req &w/csting/bracing CPT 22310 | not published | not published | $264.33 – $1,586.00 | 5 |
| Clsd tx wrist carpal fx without manip 25630 CPT 25630 | not published | not published | $264.33 – $1,586.00 | 5 |
| Clsd tx wrist scaphoid fx without manip 25622 CPT 25622 | not published | not published | $264.33 – $1,586.00 | 5 |
| Clsd tx wrist trans-scaph fx w/manip 25680 CPT 25680 | not published | not published | $264.33 – $1,586.00 | 5 |
| Clsd tx wrist ulnar styloid fx 25650 CPT 25650 | not published | not published | $264.33 – $1,586.00 | 5 |
| Clsd/ulnar fx/prox end without manip 24670 CPT 24670 | not published | not published | $264.33 – $1,586.00 | 5 |
| Clsr 1 vsd w/wo patch w/vlvt CPT 33684 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Clsr 1vsd w/wo ptch rmvl bnd CPT 33688 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Cls tx of heel fracture w/manip 28405 CPT 28405 | not published | not published | $264.33 – $1,586.00 | 5 |
| Cltx carpl scphd fx w/mnpj CPT 25624 | not published | not published | $1,723.15 – $3,176.00 | 5 |
| Cltx craniofacial separation CPT 21431 | not published | not published | $6,343.80 – $12,241.00 | 5 |
| Cltx gr hmrl tbrs fx w/mnpj CPT 23625 | not published | not published | $1,723.15 – $5,339.00 | 5 |
| Cltx hum epcndylr fx wo mnpj CPT 24560 | not published | not published | $264.33 – $1,586.00 | 5 |
| Cltx humrl cndylr fx w/mnpj CPT 24577 | $1,887.00 | $3,145.00 | $693.00 – $1,757.62 | 5 |
| Cltx humrl cndylr fx wo mnpj CPT 24576 | not published | not published | $264.33 – $1,586.00 | 5 |
| Cltx lunate dislc w/mnpj CPT 25690 | not published | not published | $1,723.15 – $5,339.00 | 5 |
| Cltx mndblr fx ntrdntl fixj CPT 21453 | not published | not published | $6,343.80 – $12,241.00 | 5 |
| Cltx mndblr fx w/mnpj CPT 21451 | $1,930.80 | $3,218.00 | $1,662.71 – $5,339.00 | 5 |
| Cltx mndblr/max alv ridge fx CPT 21440 | $3,892.20 | $6,487.00 | $3,552.91 – $5,672.00 | 5 |
| Cltx palatal/max fx wire fix CPT 21421 | not published | not published | $3,552.91 – $5,672.00 | 5 |
| Cltx post ankle fx CPT 27767 | not published | not published | $264.33 – $1,586.00 | 5 |
| Cltx post ankle fx w/mnpj CPT 27768 | $1,981.80 | $3,303.00 | $693.00 – $1,757.62 | 5 |
| Cltx scap fx w/mnpj +-tractj CPT 23575 | $1,887.00 | $3,145.00 | $693.00 – $1,757.62 | 5 |
| Cltx strnclav dislc w/mnpj CPT 23525 | not published | not published | $264.33 – $1,586.00 | 5 |
| Cltx thigh fx CPT 27267 | not published | not published | $3,506.34 – $5,339.00 | 5 |
| Cltx thigh fx w/mnpj CPT 27268 | not published | not published | $1,723.15 – $6,675.00 | 5 |
| Cltx tmprmand dislc comp CPT 21485 | not published | not published | $1,662.71 – $5,339.00 | 5 |
| Cmbn ant pst colprhy CPT 57260 | not published | not published | $5,360.72 – $6,675.00 | 5 |
| C motor evoked uppr limbs CPT 95928 | not published | not published | $920.24 – $938.65 | 3 |
| C motor evoked upr&lwr limbs CPT 95939 | not published | not published | $920.24 – $938.65 | 3 |
| Cmp rpr tof wo plm atrs ptch CPT 33694 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Cmptr ophth dx img ant segmt CPT 92132 | not published | not published | $63.22 – $64.48 | 3 |
| Cmptr ophth img optic nerve CPT 92133 | not published | not published | $63.22 – $64.48 | 3 |
| #cms hgb-carboxyhemoglobin CPT 82376 | not published | not published | $14.07 – $14.35 | 3 |
| #cms hgb-sulfhemoglobin CPT 83060 | not published | not published | $8.80 – $8.98 | 3 |
| #cmvcul-virus inoculation shell CPT 87254 | $405.00 | $675.00 | $19.56 – $19.95 | 3 |
| Cmv pcr-sendout CPT 87496 | $385.80 | $643.00 | $35.09 – $35.79 | 3 |
| Cnbp gene detc abnor allele CPT 81187 | not published | not published | $137.00 – $139.74 | 3 |
| Cntct lens hydrophil photoch HCPCS V2524 | not published | not published | $171.49 – $174.92 | 3 |
| Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 | not published | not published | $2.64 – $3.98 | 4 |
| Coagulation time activated teg CPT 85347 | $110.40 | $184.00 | $4.28 – $4.37 | 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.