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 |
|---|---|---|---|---|
| Adhesiolysis tube ovary 58740 CPT 58740 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Adh-sendout CPT 84588 | $318.60 | $531.00 | $33.94 – $34.62 | 3 |
| Adj gastric band via subq port CPT 43999 | not published | not published | $971.94 – $5,339.00 | 5 |
| Adjmt/revj ext fixj sys anes CPT 20693 | not published | not published | $6,223.00 – $7,931.41 | 5 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | not published | not published | $2,211.05 – $5,339.00 | 5 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $73.80 | $123.00 | $77.16 – $78.70 | 3 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $192.60 | $321.00 | $77.16 – $78.70 | 3 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $992.40 | $1,654.00 | $353.96 – $361.04 | 3 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $350.40 | $584.00 | $353.96 – $361.04 | 3 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $145.80 | $243.00 | $77.16 – $78.70 | 3 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $142.20 | $237.00 | $77.16 – $78.70 | 3 |
| Administration immunization 1 vaccine CPT 90471 | $91.80 | $153.00 | $77.16 – $78.70 | 3 |
| Administration immunization each additional vaccine CPT 90472 | $47.40 | $79.00 | not published | 0 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | not published | not published | $77.16 – $78.70 | 3 |
| Administration vaccine hepatitis b HCPCS G0010 | $48.60 | $81.00 | $50.18 – $51.18 | 3 |
| Administration vaccine influenza virus HCPCS G0008 | $57.00 | $95.00 | $50.18 – $51.18 | 3 |
| Administration vaccine pneumococcal HCPCS G0009 | $62.40 | $104.00 | $50.18 – $51.18 | 3 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | not published | not published | $42.20 – $63.24 | 4 |
| Adrenal cortex & medulla img CPT 78075 | not published | not published | $1,387.37 – $1,415.12 | 3 |
| Adrenalectomy expl w/exc retro tumor 60545 CPT 60545 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Aep hearing status deter i&r CPT 92651 | $368.40 | $614.00 | $231.39 – $236.02 | 3 |
| Aep neurodiagnostic i&r CPT 92653 | not published | not published | $231.39 – $236.02 | 3 |
| Aep thrshld est mlt freq i&r CPT 92652 | not published | not published | $231.39 – $236.02 | 3 |
| Afamelanotide implant, 1 mg HCPCS J7352 | not published | not published | $2,943.42 – $4,740.99 | 4 |
| _afb id by dna probe rflx ast CPT 87149 | $190.80 | $318.00 | $20.05 – $20.45 | 3 |
| #afb mycobacteria suscep. #1 CPT 87190 | not published | not published | $7.31 – $7.46 | 3 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $369.00 | $615.00 | $115.36 – $117.67 | 3 |
| Aff2 gen aly detc abnl allel CPT 81171 | not published | not published | $137.00 – $139.74 | 3 |
| Aff2 gen alys charac alleles CPT 81172 | not published | not published | $274.83 – $280.33 | 3 |
| Aflibercept injection HCPCS J0178 | not published | not published | $731.88 – $1,444.86 | 4 |
| Afluria vacc, 3 yrs & >, im HCPCS Q2035 | not published | not published | $19.57 – $19.57 | 1 |
| Afo molded ankle gauntlet HCPCS L1904 | $169.20 | $282.00 | not published | 0 |
| Afo rig ant tib tcf/= custom HCPCS L1932 | $3,423.00 | $5,705.00 | not published | 0 |
| After cataract laser surgery CPT 66821 | not published | not published | $589.39 – $3,176.00 | 5 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | not published | not published | $227.58 – $355.38 | 4 |
| Air conduction bilat CPT 92552 | not published | not published | $142.58 – $145.43 | 3 |
| Air injection into abdomen 49400 CPT 49400 | not published | not published | $693.00 – $1,586.00 | 2 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | not published | not published | $137.89 – $140.65 | 3 |
| Albumin body fluid quantitative each specimen CPT 82042 | $157.80 | $263.00 | $7.78 – $7.94 | 3 |
| Albumin (human), 25%, 50ml HCPCS P9047 | not published | not published | $53.08 – $87.58 | 4 |
| Albumin, human 25 % intravenous solution HCPCS P9046 | not published | not published | $21.23 – $35.03 | 4 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | not published | not published | $53.08 – $87.58 | 4 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | not published | not published | $10.62 – $17.52 | 4 |
| Albumin ischemia modified CPT 82045 | not published | not published | $33.94 – $34.62 | 3 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $61.80 | $103.00 | $5.78 – $5.90 | 3 |
| Albumin serum plasma or whole blood CPT 82040 | $124.20 | $207.00 | $4.95 – $5.05 | 3 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $285.00 | $475.00 | $17.27 – $17.62 | 3 |
| Alcohol/sub misuse assess HCPCS G2011 | not published | not published | $30.99 – $31.61 | 3 |
| Aldesleukin injection HCPCS J9015 | not published | not published | $3,338.87 – $5,986.63 | 4 |
| Aldosterone suppression eval CPT 80408 | not published | not published | $125.50 – $128.01 | 3 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | not published | not published | $2,440.42 – $3,768.15 | 4 |
| Alglucosidase alfa injection HCPCS J0220 | not published | not published | $202.22 – $202.22 | 1 |
| Alkaline phosphatase CPT 84075 | $75.60 | $126.00 | $5.18 – $5.28 | 3 |
| Allergen alpha lactalbumin ige CPT 86008 | $427.80 | $713.00 | $17.93 – $18.29 | 3 |
| Allergen egg white ige CPT 86003 | $174.60 | $291.00 | $5.22 – $5.32 | 3 |
| Allergen specific ige qual multi scrn ea CPT 86005 | not published | not published | $7.97 – $8.13 | 3 |
| Allergy injections; 2 or more 95117 CPT 95117 | not published | not published | $50.18 – $51.18 | 3 |
| Allergy injection; single 95115 CPT 95115 | not published | not published | $50.18 – $51.18 | 3 |
| Allergy Skin Testing CPT 95004 | $46.80 | $78.00 | $920.24 – $938.65 | 3 |
| Allg patch or app # of tests 95044 CPT 95044 | not published | not published | $920.24 – $938.65 | 3 |
| Allgrft implnt knee w/scope CPT 29867 | not published | not published | $7,993.00 – $17,033.00 | 5 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $691.80 | $1,153.00 | not published | 0 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $444.60 | $741.00 | not published | 0 |
| All tstg perq&iq drugs/biol CPT 95018 | not published | not published | $40.03 – $40.83 | 3 |
| All tstg perq&iq w/venoms CPT 95017 | not published | not published | $30.99 – $31.61 | 3 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | not published | not published | $5.14 – $8.05 | 4 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | not published | not published | $64.41 – $65.70 | 3 |
| Alpha-fetoprotein amniotic CPT 82106 | $153.00 | $255.00 | $17.00 – $17.34 | 3 |
| Alpha-fetoprotein tumor marker CPT 82105 | $244.20 | $407.00 | $16.77 – $17.11 | 3 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | not published | not published | $95.09 – $147.10 | 4 |
| Alt/sgpt CPT 84460 | $111.00 | $185.00 | $5.30 – $5.41 | 3 |
| Aluminum - quest CPT 82108 | $157.20 | $262.00 | $25.48 – $25.99 | 3 |
| Alveoloplasty each quadrant CPT 41874 | not published | not published | $3,552.91 – $5,339.00 | 5 |
| Ambl bp mntr w/sw a/r CPT 93788 | not published | not published | $142.58 – $145.43 | 3 |
| Amines vaginal fluid qual CPT 82120 | not published | not published | $5.99 – $6.11 | 3 |
| Amino acid screen, urine CPT 82128 | $601.20 | $1,002.00 | $13.87 – $14.15 | 3 |
| Amino acid single qual CPT 82127 | not published | not published | $14.18 – $14.46 | 3 |
| Amino acids quant 2-5 CPT 82136 | $235.80 | $393.00 | $19.61 – $20.00 | 3 |
| Aminolevulinic acid, 10% gel HCPCS J7345 | not published | not published | $1.77 – $2.72 | 4 |
| Aminolevulinic acid delta CPT 82135 | $229.80 | $383.00 | $16.45 – $16.78 | 3 |
| Aminolevulinic acid hcl top HCPCS J7308 | not published | not published | $390.02 – $645.53 | 4 |
| Amitriptyline (elavil) -sendout CPT 80335 | $128.40 | $214.00 | not published | 0 |
| Amivantamab-vmjw 50 mg/ml intravenous solution HCPCS J9061 | not published | not published | $22.63 – $32.39 | 4 |
| Ammonia CPT 82140 | $176.40 | $294.00 | $14.57 – $14.86 | 3 |
| Amniocentesisdiagnostic 59000 CPT 59000 | $1,044.60 | $1,741.00 | $987.01 – $3,176.00 | 5 |
| Amniocentesis therapeutic CPT 59001 | not published | not published | $326.55 – $1,586.00 | 5 |
| Amniotic fluid scan CPT 82143 | $168.60 | $281.00 | $9.35 – $9.54 | 3 |
| Amobarbital 125 mg inj HCPCS J0300 | not published | not published | $282.43 – $282.43 | 1 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | not published | not published | $3,506.34 – $5,339.00 | 5 |
| Amphetamine confirm urine -sendout CPT 80324 | $274.80 | $458.00 | not published | 0 |
| Amphetamines 5 or more CPT 80326 | $240.00 | $400.00 | not published | 0 |
| Amphotericin b lipid complex HCPCS J0287 | not published | not published | $18.36 – $18.36 | 1 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | not published | not published | $22.81 – $45.99 | 4 |
| Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 | not published | not published | $262.99 – $268.25 | 3 |
| Amp metatarsal w/toe single 28810 CPT 28810 | not published | not published | $3,506.34 – $5,672.00 | 5 |
| Amp thigh through femur re-amp 27596 CPT 27596 | not published | not published | $3,506.34 – $17,033.00 | 5 |
| Amputate hand at wrist CPT 25922 | not published | not published | $1,723.15 – $5,672.00 | 5 |
| Amputate hand at wrist CPT 25920 | not published | not published | $3,506.34 – $17,033.00 | 5 |
| Amputate leg at thigh CPT 27591 | not published | not published | $3,506.34 – $21,651.00 | 5 |
| Amputate leg at thigh CPT 27592 | not published | not published | $3,506.34 – $21,651.00 | 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.