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 |
|---|---|---|---|---|
| Inj anifrolumab-fnia 1mg HCPCS J0491 | not published | not published | $18.31 – $27.49 | 4 |
| Inj, aponvie, 1 mg HCPCS C9145 | not published | not published | $3.09 – $3.09 | 1 |
| Inj., aristada initio, 1 mg HCPCS J1943 | not published | not published | $3.25 – $5.05 | 4 |
| Inj. asceniv HCPCS J1554 | not published | not published | $500.93 – $810.83 | 4 |
| Inj, aspara, rylaze, 0.1 mg HCPCS J9021 | not published | not published | $56.29 – $81.72 | 4 |
| Inj aval alfa-nqpt 4mg HCPCS J0219 | not published | not published | $81.20 – $123.82 | 4 |
| Inj belantamab mafodot blmf HCPCS J9037 | not published | not published | $77.19 – $77.19 | 1 |
| Inj., benralizumab, 1 mg HCPCS J0517 | not published | not published | $163.36 – $282.03 | 4 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | not published | not published | $39.83 – $65.75 | 4 |
| Inj bimatoprost itc imp1mcg HCPCS J7351 | not published | not published | $214.02 – $340.58 | 4 |
| Inj, bortezomib, dr. reddy's HCPCS J9046 | not published | not published | $3.46 – $80.11 | 4 |
| Inj, bortezomib freseniuskab HCPCS J9048 | not published | not published | $6.97 – $80.11 | 4 |
| Inj, bortezomib, hospira HCPCS J9049 | not published | not published | $6.42 – $6.42 | 1 |
| Inj., brexanolone, 1 mg HCPCS J1632 | not published | not published | $119.44 – $119.44 | 1 |
| Inj, brolucizumab-dbll, 1 mg HCPCS J0179 | not published | not published | $353.07 – $527.92 | 4 |
| Inj, bupivacaine (posimir) HCPCS C9144 | not published | not published | $0.83 – $0.83 | 1 |
| Inj. byooviz, 0.1 mg HCPCS Q5124 | not published | not published | $70.90 – $364.37 | 4 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | not published | not published | $2.42 – $3.56 | 4 |
| Inj ceftolozane tazobactam HCPCS J0695 | not published | not published | $8.84 – $12.44 | 4 |
| Inj. cetirizine hcl 0.5mg HCPCS J1201 | not published | not published | $16.92 – $24.87 | 4 |
| Inj, cimerli, 0.1 mg HCPCS Q5128 | not published | not published | $83.48 – $461.18 | 4 |
| Inj, clevidipine butyrate HCPCS C9248 | not published | not published | $5.05 – $5.05 | 1 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | not published | not published | $693.00 – $1,586.00 | 2 |
| Inj., copanlisib, 1 mg HCPCS J9057 | not published | not published | $141.37 – $141.37 | 1 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | not published | not published | $1,682.11 – $1,682.11 | 1 |
| Inj cutaquig 100 mg HCPCS J1551 | not published | not published | $13.93 – $23.74 | 4 |
| Inj cuvitru, 100 mg HCPCS J1555 | not published | not published | $17.58 – $26.86 | 4 |
| Inj cyclophosphamd auromedic HCPCS J9071 | not published | not published | $0.52 – $6.39 | 4 |
| Inj disk cerv-thor ea lev CPT 62291 | not published | not published | $693.00 – $1,586.00 | 2 |
| Inj dupuytren cord w/enzyme CPT 20527 | not published | not published | $328.94 – $1,586.00 | 5 |
| Inj, durolane 1 mg HCPCS J7318 | not published | not published | $6.73 – $10.00 | 4 |
| Inj dx for sinogram CPT 20501 | $227.40 | $379.00 | $693.00 – $1,586.00 | 2 |
| Inject for sacroiliac joint HCPCS G0259 | not published | not published | $693.00 – $1,586.00 | 2 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | $2,743.80 | $4,573.00 | $756.44 – $3,176.00 | 5 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | not published | not published | $693.00 – $1,586.00 | 2 |
| Injection, belinostat, 10mg HCPCS J9032 | not published | not published | $53.11 – $78.57 | 4 |
| Injection, burosumab-twza 1m HCPCS J0584 | not published | not published | $498.72 – $703.02 | 4 |
| Injection, cangrelor HCPCS C9460 | not published | not published | $20.02 – $29.91 | 4 |
| Injection, caplacizumab-yhdp HCPCS C9047 | not published | not published | $801.26 – $1,229.17 | 4 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | $364.80 | $608.00 | $328.94 – $1,586.00 | 5 |
| Injection, casimersen, 10 mg HCPCS J1426 | not published | not published | $166.20 – $274.23 | 4 |
| Injection, daratumumab 10 mg HCPCS J9145 | not published | not published | $70.77 – $101.94 | 4 |
| Injection during cath supravalvular aortography CPT 93567 | not published | not published | $693.00 – $1,586.00 | 2 |
| Injection, edaravone, 1 mg HCPCS J1301 | not published | not published | $15.18 – $35.31 | 4 |
| Injection epidural blood patch or clot CPT 62273 | $2,303.40 | $3,839.00 | $756.44 – $3,176.00 | 5 |
| Injection eye drug CPT 67028 | not published | not published | $353.96 – $1,586.00 | 5 |
| Injection for arthrography wrist (both sides) CPT 25246 | not published | not published | $693.00 – $1,586.00 | 2 |
| Injection for bladder x-ray CPT 51600 | $1,060.80 | $1,768.00 | $693.00 – $1,586.00 | 2 |
| Injection for hip x-ray CPT 27095 | not published | not published | $693.00 – $1,586.00 | 2 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $1,060.80 | $1,768.00 | $693.00 – $1,586.00 | 2 |
| Injection for spleen x-ray CPT 38200 | not published | not published | $693.00 – $1,586.00 | 2 |
| Injection for tear sac x-ray CPT 68850 | not published | not published | $693.00 – $1,586.00 | 2 |
| Injection for ureter x-ray CPT 50684 | not published | not published | $693.00 – $1,586.00 | 2 |
| Injection for ureter x-ray CPT 50690 | not published | not published | $693.00 – $1,586.00 | 2 |
| Injection, fulvestrant HCPCS J9395 | not published | not published | $15.63 – $15.63 | 1 |
| Injection glatiramer acetate HCPCS J1595 | not published | not published | $249.86 – $249.86 | 1 |
| Injection, inclisiran, 1 mg HCPCS J1306 | not published | not published | $12.61 – $19.90 | 4 |
| Injection into brain canal CPT 61026 | not published | not published | $756.44 – $3,176.00 | 5 |
| Injection into brain canal CPT 61055 | not published | not published | $328.94 – $1,586.00 | 5 |
| Injection into hemorrhoid(s) CPT 46500 | not published | not published | $996.56 – $3,176.00 | 5 |
| Injection into spinal artery CPT 62294 | not published | not published | $947.82 – $3,176.00 | 5 |
| Injection into vocal cord CPT 31513 | not published | not published | $419.13 – $1,586.00 | 5 |
| Injection intraop add-on CPT 48400 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Injection, isavuconazonium HCPCS J1833 | not published | not published | $1.01 – $1.50 | 4 |
| Injection jaw joint x-ray CPT 21116 | not published | not published | $693.00 – $1,586.00 | 2 |
| Injection jugular CPT 36299 | not published | not published | $693.00 – $1,586.00 | 2 |
| Injection, necitumumab, 1 mg HCPCS J9295 | not published | not published | $5.73 – $9.47 | 4 |
| Injection of HIV prep drug HCPCS G0012 | not published | not published | $77.16 – $78.70 | 3 |
| Injection of sinus tract CPT 20500 | not published | not published | $1,662.71 – $5,339.00 | 5 |
| Injection,onabotulinumtoxina HCPCS J0585 | not published | not published | $6.51 – $10.54 | 4 |
| Injection, peramivir HCPCS J2547 | not published | not published | $1.68 – $2.77 | 4 |
| Injection px peyronie ds CPT 54200 | not published | not published | $267.74 – $1,586.00 | 5 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $1,476.60 | $2,461.00 | $428.40 – $1,586.00 | 5 |
| Injection, renflexis HCPCS Q5104 | not published | not published | $26.80 – $58.66 | 4 |
| Injection, ruconest HCPCS J0596 | not published | not published | $36.67 – $54.48 | 4 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | not published | not published | $756.44 – $3,176.00 | 5 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $1,868.40 | $3,114.00 | $756.44 – $3,176.00 | 5 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $2,157.60 | $3,596.00 | $756.44 – $3,176.00 | 5 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $2,197.20 | $3,662.00 | $947.82 – $3,176.00 | 5 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $1,894.20 | $3,157.00 | $693.00 – $1,586.00 | 2 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $2,527.80 | $4,213.00 | $947.82 – $3,176.00 | 5 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $1,647.60 | $2,746.00 | $693.00 – $1,586.00 | 2 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $2,197.20 | $3,662.00 | $947.82 – $3,176.00 | 5 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $3,108.60 | $5,181.00 | $756.44 – $3,176.00 | 5 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $4,044.00 | $6,740.00 | $756.44 – $3,176.00 | 5 |
| Injection, siltuximab HCPCS J2860 | not published | not published | $174.08 – $229.71 | 4 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $1,688.40 | $2,814.00 | $328.94 – $1,586.00 | 5 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $1,501.20 | $2,502.00 | $328.94 – $1,586.00 | 5 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $1,688.40 | $2,814.00 | $328.94 – $1,586.00 | 5 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $217.20 | $362.00 | $50.18 – $51.18 | 3 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $210.00 | $350.00 | not published | 0 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $244.20 | $407.00 | $227.94 – $232.50 | 3 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $150.00 | $250.00 | $77.16 – $78.70 | 3 |
| Injection treatment of eye CPT 66020 | not published | not published | $2,473.11 – $5,339.00 | 5 |
| Injection treatment of eye CPT 66030 | not published | not published | $2,473.11 – $5,339.00 | 5 |
| Injection treatment of nerve CPT 64605 | not published | not published | $2,092.58 – $5,672.00 | 5 |
| Injection treatment of nerve CPT 64610 | not published | not published | $2,092.58 – $5,672.00 | 5 |
| Injection treatment of nerve CPT 64681 | not published | not published | $947.82 – $3,176.00 | 5 |
| Injection treatment of nose CPT 30200 | not published | not published | $577.95 – $1,586.00 | 5 |
| Inject sacroiliac joint CPT 27096 | $2,662.80 | $4,438.00 | $693.00 – $1,586.00 | 2 |
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.