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 |
|---|---|---|---|---|
| Destruction anal lesion(s) CPT 46910 | not published | not published | $2,211.05 – $5,339.00 | 5 |
| Destruction anal lesion(s) CPT 46924 | not published | not published | $2,974.45 – $5,672.00 | 5 |
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | not published | not published | $435.63 – $1,586.00 | 5 |
| Destruction benign lesions < 14 lesions CPT 17110 | not published | not published | $215.00 – $1,586.00 | 5 |
| Destruction by injection tx of nerve 64630 CPT 64630 | not published | not published | $947.82 – $3,176.00 | 5 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | $3,816.00 | $6,360.00 | $693.00 – $1,586.00 | 2 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | $6,431.40 | $10,719.00 | $2,092.58 – $5,672.00 | 5 |
| Destruction ciliary body CPT 66700 | not published | not published | $2,473.11 – $5,339.00 | 5 |
| Destruction ciliary body CPT 66720 | not published | not published | $2,547.76 – $5,672.00 | 5 |
| Destruction ciliary body CPT 66740 | not published | not published | $2,547.76 – $5,672.00 | 5 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | not published | not published | $215.00 – $1,586.00 | 5 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | not published | not published | $2,974.45 – $5,672.00 | 5 |
| Destruction les conjunctiva CPT 68135 | not published | not published | $2,547.76 – $5,672.00 | 5 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | $435.63 – $1,586.00 | 5 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | $435.63 – $1,586.00 | 5 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | not published | not published | $435.63 – $1,586.00 | 5 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | not published | not published | $435.63 – $1,586.00 | 5 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | not published | not published | $435.63 – $1,586.00 | 5 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | $2,211.05 – $5,339.00 | 5 |
| Destruction premal lesions 15/> 17004 CPT 17004 | not published | not published | $435.63 – $1,586.00 | 5 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $2,974.45 – $5,672.00 | 5 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $3,468.96 – $5,672.00 | 5 |
| Destruction vag lesions simple 57061 CPT 57061 | not published | not published | $3,468.96 – $5,672.00 | 5 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $2,211.05 – $5,339.00 | 5 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $30.03 – $30.63 | 3 |
| Detect agnt mult dna direc CPT 87800 | not published | not published | $43.67 – $44.54 | 3 |
| Developmental screen/score/document 96110 CPT 96110 | $164.40 | $274.00 | not published | 0 |
| Devel tst phys/qhp 1st hr CPT 96112 | $331.80 | $553.00 | $137.89 – $140.65 | 3 |
| Devise bowel pouch CPT 44316 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | $186.00 | $310.00 | not published | 0 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $426.60 | $711.00 | $93.26 – $95.12 | 3 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $203.79 – $337.72 | 4 |
| Dexamethasone panel CPT 80420 | not published | not published | $161.88 – $165.12 | 3 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | not published | not published | $49.74 – $187.94 | 4 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $295.80 | $493.00 | $22.23 – $22.67 | 3 |
| Diabetes (HbA1c) Test CPT 83036 | $69.60 | $116.00 | $9.71 – $9.90 | 3 |
| Diab manage trn ind/group HCPCS G0109 | $106.80 | $178.00 | $15.78 – $16.10 | 3 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $1,907.37 – $5,339.00 | 5 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $6,478.50 – $12,241.00 | 5 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $478.72 – $1,586.00 | 5 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $1,282.34 – $5,339.00 | 5 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $117.00 | $195.00 | $142.58 – $1,586.00 | 5 |
| Diagnostic laryngoscopy 31505 CPT 31505 | not published | not published | $213.90 – $1,586.00 | 5 |
| Diagnostic laryngoscopy 31575 CPT 31575 | not published | not published | $213.90 – $1,586.00 | 5 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $625.80 | $1,043.00 | $111.97 – $114.21 | 3 |
| Diagnostic Mammogram (one breast) CPT 77065 | $513.60 | $856.00 | $88.75 – $90.52 | 3 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $93.26 – $95.12 | 3 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | not published | not published | $693.00 – $1,586.00 | 2 |
| Dialysis one evaluation CPT 90945 | $1,207.20 | $2,012.00 | $447.15 – $456.09 | 3 |
| Diathermy eg microwave CPT 97024 | not published | not published | $7.82 – $7.98 | 3 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $4.80 | $8.00 | not published | 0 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.35 – $0.35 | 1 |
| Diffusing capacity CPT 94729 | $253.80 | $423.00 | not published | 0 |
| Digit nerve surgery add-on CPT 64778 | not published | not published | $693.00 – $1,586.00 | 2 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | not published | not published | $5,166.99 – $7,579.39 | 4 |
| Digoxin total therapeutic drug level CPT 80162 | $163.20 | $272.00 | $13.28 – $13.55 | 3 |
| Dilate biliary duct/ampulla CPT 47542 | not published | not published | $693.00 – $1,586.00 | 2 |
| Dilate esophagus CPT 43453 | not published | not published | $2,056.34 – $5,339.00 | 5 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $971.94 – $5,339.00 | 5 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Dilate ic vasospasm init CPT 61640 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Dilate tear duct opening CPT 68801 | not published | not published | $478.72 – $1,586.00 | 5 |
| Dilate urethra stricture CPT 53600 | not published | not published | $267.74 – $1,586.00 | 5 |
| Dilate urethra stricture CPT 53601 | not published | not published | $142.58 – $1,586.00 | 5 |
| Dilate urethra stricture CPT 53605 | not published | not published | $3,777.44 – $5,339.00 | 5 |
| Dilate urethra stricture CPT 53621 | not published | not published | $267.74 – $1,586.00 | 5 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $137.89 – $1,586.00 | 5 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $1,282.34 – $5,339.00 | 5 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $3,468.96 – $5,672.00 | 5 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $1,282.34 – $5,339.00 | 5 |
| Dilation of salivary duct CPT 42660 | not published | not published | $577.95 – $1,586.00 | 5 |
| Dilation of urethra CPT 53661 | not published | not published | $142.58 – $1,586.00 | 5 |
| Dilation of urethra CPT 53665 | not published | not published | $2,240.09 – $5,672.00 | 5 |
| Dilation of vagina CPT 57400 | not published | not published | $3,468.96 – $5,672.00 | 5 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $1,662.71 – $5,339.00 | 5 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $747.24 – $3,176.00 | 5 |
| Dilat xst trc ndurlgc px CPT 50436 | $3,900.60 | $6,501.00 | $3,777.44 – $5,672.00 | 5 |
| Dilat xst trc new access rcs CPT 50437 | $3,900.60 | $6,501.00 | $3,777.44 – $6,675.00 | 5 |
| Dimecaprol injection HCPCS J0470 | not published | not published | $98.69 – $98.69 | 1 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | not published | not published | $748.98 – $1,126.16 | 4 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $40.03 – $40.83 | 3 |
| Disability dlco CPT 94727 | $293.40 | $489.00 | $231.39 – $236.02 | 3 |
| Disaccharidases CPT 82657 | $1,344.00 | $2,240.00 | $22.17 – $22.61 | 3 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $2,211.05 – $5,339.00 | 5 |
| Disarticulation shoulder CPT 23920 | not published | not published | $7,993.00 – $17,033.00 | 5 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Discography cerv/thor spine CPT 72285 | not published | not published | $2,092.58 – $2,134.43 | 3 |
| Dise eval slp do brth flx dx CPT 42975 | not published | not published | $693.00 – $1,945.52 | 5 |
| Dissect brain w/scope CPT 62161 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Dissolve clot heart vessel CPT 92975 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $5,963.01 – $17,033.00 | 5 |
| Div aberrant vsl w/reanast CPT 33803 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $6,343.80 – $12,241.00 | 5 |
| Division of fallopian tube 58605 CPT 58605 | not published | not published | $4,157.00 – $5,339.00 | 2 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | $11,743.80 | $19,573.00 | $5,543.00 – $5,672.00 | 2 |
| Dmd dup/delet analysis CPT 81161 | not published | not published | $279.00 – $284.58 | 3 |
| Dmpk gene charac alleles CPT 81239 | not published | not published | $274.83 – $280.33 | 3 |
| Dmpk gene detc abnor allele CPT 81234 | not published | not published | $137.00 – $139.74 | 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.