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 |
|---|---|---|---|---|
| Cta neck without &/or w/contrast CPT 70498 | $2,446.80 | $4,078.00 | $187.96 – $191.72 | 3 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $3,609.60 | $6,016.00 | $373.86 – $381.34 | 3 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $2,478.60 | $4,131.00 | $187.96 – $191.72 | 3 |
| CT Angiogram of the Head CPT 70496 | $2,508.00 | $4,180.00 | $187.96 – $191.72 | 3 |
| CT angio hrt w/3d image CPT 75574 | not published | not published | $373.86 – $381.34 | 3 |
| CT angio pelvis CPT 72191 | $2,785.20 | $4,642.00 | $187.96 – $191.72 | 3 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $3,670.80 | $6,118.00 | $187.96 – $191.72 | 3 |
| CT bone density axial CPT 77078 | not published | not published | $93.26 – $95.12 | 3 |
| CT cerebral perf w cont & prcssng CPT 70473 | $2,362.80 | $3,938.00 | $187.96 – $191.72 | 3 |
| CT colonography dx CPT 74261 | not published | not published | $112.03 – $114.27 | 3 |
| CT colonography dx w/dye CPT 74262 | not published | not published | $187.96 – $191.72 | 3 |
| CT colonography screening CPT 74263 | not published | not published | $255.69 – $260.80 | 3 |
| CT guidance for needle placement CPT 77012 | $2,502.00 | $4,170.00 | not published | 0 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $2,595.60 | $4,326.00 | not published | 0 |
| CT guid cryo ablat intramuscular CPT 20999 | not published | not published | $264.33 – $1,586.00 | 5 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $117.00 | $195.00 | $93.26 – $95.12 | 3 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | not published | not published | $373.86 – $381.34 | 3 |
| CT hrt w/3d image CPT 75572 | not published | not published | $373.86 – $381.34 | 3 |
| CT limited or localized follow-up study CPT 76380 | $2,446.80 | $4,078.00 | $93.26 – $95.12 | 3 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $3,736.20 | $6,227.00 | $187.96 – $191.72 | 3 |
| CT lower extremity without contrast (both sides) CPT 73700 | $3,670.80 | $6,118.00 | $112.03 – $114.27 | 3 |
| CT lwr extremity w/o&w/dye CPT 73702 | $3,670.80 | $6,118.00 | $187.96 – $191.72 | 3 |
| CT neck soft tissue w/contrast CPT 70491 | $2,446.80 | $4,078.00 | $187.96 – $191.72 | 3 |
| CT neck soft tissue without contrast CPT 70490 | $2,446.80 | $4,078.00 | $112.03 – $114.27 | 3 |
| CT neck soft tissue without & w/contrast CPT 70492 | $2,550.60 | $4,251.00 | $187.96 – $191.72 | 3 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $2,446.80 | $4,078.00 | $187.96 – $191.72 | 3 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $2,446.80 | $4,078.00 | $187.96 – $191.72 | 3 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $2,446.80 | $4,078.00 | $112.03 – $114.27 | 3 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | not published | not published | $253.81 – $1,586.00 | 5 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $4,243.20 | $7,072.00 | $373.86 – $381.34 | 3 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $3,534.00 | $5,890.00 | $373.86 – $381.34 | 3 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $3,307.20 | $5,512.00 | $255.69 – $260.80 | 3 |
| CT thoracic spine w/contrast CPT 72129 | $2,606.40 | $4,344.00 | $187.96 – $191.72 | 3 |
| CT thoracic spine without contrast CPT 72128 | $2,446.80 | $4,078.00 | $112.03 – $114.27 | 3 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $176.40 | $294.00 | $112.03 – $114.27 | 3 |
| CT t-spine w /wo contrast CPT 72130 | $2,610.60 | $4,351.00 | $187.96 – $191.72 | 3 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $3,670.80 | $6,118.00 | $373.86 – $381.34 | 3 |
| CT upper extremity without contrast (both sides) CPT 73200 | $3,670.80 | $6,118.00 | $112.03 – $114.27 | 3 |
| CT uppr extremity w/o&w/dye CPT 73202 | $3,670.80 | $6,118.00 | $187.96 – $191.72 | 3 |
| Cultr oocyte/embryo <4 days CPT 89250 | not published | not published | $182.57 – $186.22 | 3 |
| Cultr oocyte/embryo <4 days CPT 89251 | not published | not published | $182.57 – $186.22 | 3 |
| Cult skin graft fnhfg 15155 CPT 15155 | not published | not published | $3,797.52 – $6,675.00 | 5 |
| Cult skin grft t/arm/leg CPT 15150 | not published | not published | $2,211.05 – $5,339.00 | 5 |
| Culture aerobic additional method definitive id each CPT 87077 | $63.00 | $105.00 | $8.08 – $8.24 | 3 |
| Culture afb any source CPT 87116 | $243.60 | $406.00 | $10.80 – $11.02 | 3 |
| Culture anaerobic additional method definitive id each CPT 87076 | $180.60 | $301.00 | $8.08 – $8.24 | 3 |
| Culture anaerobic except blood CPT 87075 | $217.20 | $362.00 | $9.47 – $9.66 | 3 |
| Culture bacteria anaerobic CPT 87073 | $217.20 | $362.00 | $9.66 – $9.85 | 3 |
| Culture bact stool aero addl path ea CPT 87046 | $88.20 | $147.00 | $9.44 – $9.63 | 3 |
| Culture body fluid CPT 87070 | $213.60 | $356.00 | $8.62 – $8.79 | 3 |
| Culture fungi definitive id mold CPT 87107 | $117.60 | $196.00 | $10.32 – $10.53 | 3 |
| Culture fungi definitive id yeast CPT 87106 | $117.00 | $195.00 | $10.32 – $10.53 | 3 |
| Culture fungi other (except blood) CPT 87102 | $186.60 | $311.00 | $8.41 – $8.58 | 3 |
| Culture fungi skin/hair/nail CPT 87101 | $183.60 | $306.00 | $7.71 – $7.86 | 3 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $268.20 | $447.00 | $14.61 – $14.90 | 3 |
| Culture mycoplasma any source CPT 87109 | not published | not published | $15.39 – $15.70 | 3 |
| Culture of specimen by kit CPT 87084 | not published | not published | $27.07 – $27.61 | 3 |
| Culture quantitative aerobic other source CPT 87071 | $217.20 | $362.00 | $9.89 – $10.09 | 3 |
| Culture screening strep group a CPT 87081 | $115.80 | $193.00 | $6.63 – $6.76 | 3 |
| Culture type pulse field gel CPT 87152 | $355.20 | $592.00 | $7.74 – $7.89 | 3 |
| Culture typing added method CPT 87158 | not published | not published | $7.74 – $7.89 | 3 |
| Culture typing glc/hplc CPT 87143 | not published | not published | $12.52 – $12.77 | 3 |
| Culture typing immunologic CPT 87147 | $66.60 | $111.00 | $5.18 – $5.28 | 3 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | $625.20 | $1,042.00 | $218.06 – $222.42 | 3 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $471.00 | $785.00 | $35.09 – $35.79 | 3 |
| Culture urine each isolate CPT 87088 | $124.80 | $208.00 | $8.09 – $8.25 | 3 |
| Culture virus isolation CPT 87250 | not published | not published | $19.56 – $19.95 | 3 |
| Curette/treat cornea CPT 65435 | not published | not published | $1,068.27 – $5,339.00 | 5 |
| Curette/treat cornea CPT 65436 | not published | not published | $2,547.76 – $5,672.00 | 5 |
| Cv line/pic reposition CPT 36597 | not published | not published | $1,686.89 – $3,176.00 | 5 |
| Cyanocobalamin unsat binding capacity CPT 82608 | not published | not published | $14.32 – $14.61 | 3 |
| Cyclic citrullinated peptide antibody CPT 86200 | $143.40 | $239.00 | $12.95 – $13.21 | 3 |
| Cyclophosphamide 100 mg inj HCPCS J9070 | not published | not published | $28.20 – $28.20 | 1 |
| Cyclosporine 2 hour CPT 80158 | $361.20 | $602.00 | $18.05 – $18.41 | 3 |
| Cyp2c19 gene com variants CPT 81225 | $1,609.80 | $2,683.00 | $291.36 – $297.19 | 3 |
| Cyp2c9 gene com variants CPT 81227 | not published | not published | $174.81 – $178.31 | 3 |
| Cyp2d6 gene com variants CPT 81226 | $2,238.60 | $3,731.00 | $450.91 – $459.93 | 3 |
| Cyp3a4 gene common variants CPT 81230 | not published | not published | $174.81 – $178.31 | 3 |
| Cyp3a5 gene common variants CPT 81231 | not published | not published | $174.81 – $178.31 | 3 |
| Cystatin c CPT 82610 | $102.60 | $171.00 | $18.52 – $18.89 | 3 |
| Cystic fibrosis cftr CPT 81223 | $3,138.00 | $5,230.00 | $499.00 – $508.98 | 3 |
| Cystine urine quantitative CPT 82131 | $813.60 | $1,356.00 | $22.98 – $23.44 | 3 |
| Cysto cgen post urtl valves CPT 52400 | not published | not published | $3,777.44 – $5,672.00 | 5 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $1,233.00 | $2,055.00 | $373.86 – $381.34 | 3 |
| Cysto impl 4 or more HCPCS C9740 | not published | not published | $7,993.00 – $17,033.00 | 5 |
| Cysto, litho, vacuum kidney HCPCS C9761 | not published | not published | $5,543.00 – $10,347.33 | 5 |
| Cystometrogram w/up 51727 CPT 51727 | not published | not published | $747.24 – $3,176.00 | 5 |
| Cystorrhaphy wound comp 51865 CPT 51865 | not published | not published | $6,223.00 – $6,675.00 | 2 |
| Cystorrhaphy wound simple 51860 CPT 51860 | not published | not published | $5,543.00 – $10,347.33 | 5 |
| Cysto rx balo cath urtl strx CPT 52284 | not published | not published | $5,745.80 – $5,860.72 | 3 |
| Cystoscopy and biopsy CPT 52007 | not published | not published | $3,777.44 – $5,672.00 | 5 |
| Cystoscopy and radiotracer CPT 52250 | not published | not published | $3,777.44 – $5,672.00 | 5 |
| Cystoscopy and treatment CPT 52214 | not published | not published | $3,777.44 – $5,672.00 | 5 |
| Cystoscopy and treatment CPT 52224 | not published | not published | $3,777.44 – $5,672.00 | 5 |
| Cystoscopy and treatment CPT 52234 | not published | not published | $3,777.44 – $5,672.00 | 5 |
| Cystoscopy and treatment CPT 52235 | not published | not published | $3,777.44 – $5,672.00 | 5 |
| Cystoscopy and treatment CPT 52240 | not published | not published | $5,543.00 – $5,860.72 | 5 |
| Cystoscopy and treatment CPT 52260 | not published | not published | $2,240.09 – $5,339.00 | 5 |
| Cystoscopy and treatment CPT 52265 | not published | not published | $1,963.00 – $3,176.00 | 5 |
| Cystoscopy and treatment CPT 52276 | not published | not published | $2,240.09 – $5,672.00 | 5 |
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.