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 |
|---|---|---|---|---|
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | not published | not published | $11.29 – $21.93 | 4 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $210.60 | $351.00 | $18.58 – $18.95 | 3 |
| Gonadotropin hormone panel CPT 80426 | not published | not published | $148.41 – $151.38 | 3 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $377.40 | $629.00 | $18.52 – $18.89 | 3 |
| Gonioscopy CPT 92020 | not published | not published | $142.58 – $145.43 | 3 |
| Goniotomy CPT 65820 | not published | not published | $4,429.45 – $5,672.00 | 5 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | not published | not published | $1,012.39 – $1,012.39 | 1 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $129.00 | $215.00 | not published | 0 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $3,506.34 – $6,675.00 | 5 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $89.40 | $149.00 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $168.00 | $280.00 | not published | 0 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $301.80 | $503.00 | not published | 0 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $569.40 | $949.00 | not published | 0 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $70.80 | $118.00 | not published | 0 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $284.40 | $474.00 | not published | 0 |
| Great toe-hand transfer CPT 26551 | not published | not published | $7,775.89 – $12,241.00 | 5 |
| Great toe with reduction 28495 CPT 28495 | $322.20 | $537.00 | $264.33 – $1,586.00 | 5 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $2,211.05 – $5,339.00 | 5 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $3,797.52 – $6,675.00 | 5 |
| Grfg autol fat lipo ea addl CPT 15772 | not published | not published | $693.00 – $1,586.00 | 2 |
| Grfg autol soft tiss dir exc CPT 15769 | not published | not published | $3,797.52 – $6,675.00 | 5 |
| Group mnt 2 or more 30 mins HCPCS G0271 | not published | not published | $12.23 – $12.47 | 3 |
| Group train without patient HCPCS G0543 | not published | not published | $30.99 – $31.61 | 3 |
| Growth hormone antibody CPT 86277 | not published | not published | $15.74 – $16.05 | 3 |
| Growth hormone panel CPT 80428 | not published | not published | $66.70 – $68.03 | 3 |
| Growth hormone panel CPT 80430 | not published | not published | $129.33 – $131.92 | 3 |
| Growth stimulation gene 2 CPT 83006 | not published | not published | $75.60 – $77.11 | 3 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Gstr rstcv oth/thn v-band CPT 43843 | not published | not published | $8,099.00 – $12,241.00 | 2 |
| Gstr rstcv px shrt roux-en-y CPT 43846 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Gstr rstcv px sm int rcnstj CPT 43847 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Gstr rstcv px v-banded gstp CPT 43842 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $2,056.34 – $5,672.00 | 5 |
| G-tube reposition CPT 43761 | $3,010.20 | $5,017.00 | $267.74 – $1,586.00 | 5 |
| Gu dilat ureter/urethra s&i CPT 74485 | not published | not published | $2,240.09 – $2,284.90 | 3 |
| Guided cath fluid drainage 10030 CPT 10030 | $973.20 | $1,622.00 | $758.85 – $3,176.00 | 5 |
| Guid loc target vol rad tx CPT 77387 | $498.00 | $830.00 | not published | 0 |
| Gum graft CPT 41870 | not published | not published | $1,662.71 – $5,339.00 | 5 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $4,195.85 – $5,672.00 | 5 |
| Hair removal by electrolysis 17380 CPT 17380 | not published | not published | $693.00 – $1,586.00 | 5 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $435.63 – $1,586.00 | 5 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $435.63 – $1,586.00 | 5 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $3,506.34 – $6,675.00 | 5 |
| Hand tendon reconstruction CPT 26500 | not published | not published | $4,157.00 – $7,931.41 | 5 |
| Hand tendon reconstruction CPT 26502 | not published | not published | $3,506.34 – $6,675.00 | 5 |
| Hand X-ray CPT 73130 | $604.20 | $1,007.00 | $93.26 – $95.12 | 3 |
| Haptoglobin quantitative CPT 83010 | $303.60 | $506.00 | $12.58 – $12.83 | 3 |
| Harvest allogeneic stem cell CPT 38205 | not published | not published | $693.00 – $1,586.00 | 2 |
| Harvest auto stem cells CPT 38206 | not published | not published | $1,668.97 – $5,339.00 | 5 |
| Harvest cultured skin graft 15040 CPT 15040 | not published | not published | $2,211.05 – $5,339.00 | 5 |
| Harvest eye tissue alograft CPT 68371 | not published | not published | $2,547.76 – $5,672.00 | 5 |
| Harvest femoropopliteal vein 35572 CPT 35572 | not published | not published | $693.00 – $1,586.00 | 2 |
| Harvest stem cell concentrte CPT 38215 | not published | not published | $472.77 – $1,586.00 | 5 |
| Harvest vein for bypass 35500 CPT 35500 | not published | not published | $693.00 – $1,586.00 | 2 |
| Hast w/i&r phys/qhp CPT 94452 | not published | not published | $142.58 – $145.43 | 3 |
| Hast w/oxygen titrate CPT 94453 | not published | not published | $142.58 – $145.43 | 3 |
| Hba1/hba2 full gene sequence CPT 81259 | $1,005.60 | $1,676.00 | $600.00 – $612.00 | 3 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $872.40 | $1,454.00 | $202.40 – $206.45 | 3 |
| Hba1/hba2 gene fam vrnt CPT 81258 | not published | not published | $375.25 – $382.76 | 3 |
| Hbb full gene sequence CPT 81364 | $1,005.60 | $1,676.00 | $324.58 – $331.07 | 3 |
| Hbb gene com variants CPT 81361 | not published | not published | $174.81 – $178.31 | 3 |
| Hbb gene dup/del variants CPT 81363 | $1,417.20 | $2,362.00 | $202.40 – $206.45 | 3 |
| Hbb gene known fam variant CPT 81362 | not published | not published | $375.25 – $382.76 | 3 |
| Hb glycosylated a1c home dev CPT 83037 | not published | not published | $9.71 – $9.90 | 3 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | not published | not published | $187.96 – $191.72 | 3 |
| Hcg free betachain test CPT 84704 | not published | not published | $15.29 – $15.60 | 3 |
| Hcg qualitative CPT 84703 | $165.00 | $275.00 | $7.52 – $7.67 | 3 |
| Hcg quantitative CPT 84702 | $229.80 | $383.00 | $15.05 – $15.35 | 3 |
| Hc metata joint dislocation anes CPT 28635 | not published | not published | $1,723.15 – $5,339.00 | 5 |
| Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks CPT 17311 | not published | not published | $693.00 – $1,586.00 | 5 |
| Hc mohs micrographic h/n/h/f/g each addl stage CPT 17312 | not published | not published | $693.00 – $1,586.00 | 2 |
| Hc mohs trunk/arm/leg 1st stage 5 blocks CPT 17313 | not published | not published | $693.00 – $1,586.00 | 5 |
| Hc mohs trunk/arm/leg ea addl block any stage CPT 17315 | not published | not published | $693.00 – $1,586.00 | 2 |
| Hc mohs trunk/arm/leg ea stage after 1st stage CPT 17314 | not published | not published | $693.00 – $1,586.00 | 2 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | not published | not published | $581.86 – $593.49 | 3 |
| Hc nm fusion spect CT unlisted CPT 78999 | not published | not published | $428.40 – $436.97 | 3 |
| Hc nm kidney imaging with flow CPT 78701 | not published | not published | $428.40 – $436.97 | 3 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | not published | not published | $581.86 – $593.49 | 3 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | not published | not published | $1,387.37 – $1,415.12 | 3 |
| Hc transcatheter placement and sbsq removal cepd perq CPT 33370 | not published | not published | $693.00 – $1,586.00 | 2 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | $2,383.20 | $3,972.00 | not published | 0 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | $2,739.60 | $4,566.00 | not published | 0 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | $3,151.80 | $5,253.00 | not published | 0 |
| Hdr rdncl skn surf brachytx CPT 77767 | not published | not published | $413.32 – $421.59 | 3 |
| Hdr rdncl skn surf brachytx CPT 77768 | not published | not published | $413.32 – $421.59 | 3 |
| Head CT scan (with and without contrast) CPT 70470 | $2,446.80 | $4,078.00 | $187.96 – $191.72 | 3 |
| Head CT scan (with contrast) CPT 70460 | $2,446.80 | $4,078.00 | $187.96 – $191.72 | 3 |
| Head CT scan (without contrast) CPT 70450 | $2,446.80 | $4,078.00 | $112.03 – $114.27 | 3 |
| Hearing loss dup/del analys CPT 81431 | not published | not published | $679.57 – $693.16 | 3 |
| Hearing loss sequence analys CPT 81430 | not published | not published | $1,625.00 – $1,657.50 | 3 |
| Heart first pass multiple CPT 78483 | not published | not published | $581.86 – $593.49 | 3 |
| Heart image spect CPT 78494 | not published | not published | $428.40 – $436.97 | 3 |
| Heart infarct image CPT 78466 | not published | not published | $428.40 – $436.97 | 3 |
| Heart infarct image (ef) CPT 78468 | not published | not published | $581.86 – $593.49 | 3 |
| Heart revascularize (tmr) CPT 33140 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Heart tmr w/other procedure 33141 CPT 33141 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Heavy metal qual any number CPT 83015 | not published | not published | $20.94 – $21.36 | 3 |
| Heinz bodies direct CPT 85441 | not published | not published | $4.20 – $4.28 | 3 |
| Heinz bodies induced CPT 85445 | not published | not published | $6.82 – $6.96 | 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.