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 |
|---|---|---|---|---|
| Inject/treat eye socket CPT 67500 | not published | not published | $340.14 – $1,586.00 | 5 |
| Inject/treat eye socket CPT 67505 | not published | not published | $340.14 – $1,586.00 | 5 |
| Inject/treat eye socket CPT 67515 | not published | not published | $340.14 – $1,586.00 | 5 |
| Inj eflapegrastim-xnst 0.1mg HCPCS J1449 | not published | not published | $38.96 – $52.42 | 4 |
| Inj., emapalumab-lzsg, 1 mg HCPCS J9210 | not published | not published | $384.14 – $649.64 | 4 |
| Inj., emicizumab-kxwh 0.5 mg HCPCS J7170 | not published | not published | $55.64 – $84.17 | 4 |
| Inj epidural sgl cerv-thor without img CPT 62320 | not published | not published | $756.44 – $3,176.00 | 5 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | not published | not published | $947.82 – $3,176.00 | 5 |
| Inj, evinacumab-dgnb, 5mg HCPCS J1305 | not published | not published | $197.63 – $290.04 | 4 |
| Inj., evomela, 1 mg HCPCS J9246 | not published | not published | $19.43 – $27.13 | 4 |
| Inj, factor x, (human), 1iu HCPCS J7175 | not published | not published | $9.95 – $15.00 | 4 |
| Inj, faricimab-svoa, 0.1mg HCPCS J2777 | not published | not published | $32.87 – $61.20 | 4 |
| Inj. fe derisomaltose 10 mg HCPCS J1437 | not published | not published | $21.93 – $34.01 | 4 |
| Inj fensolvi 0.25 mg HCPCS J1951 | not published | not published | $140.71 – $229.04 | 4 |
| Inj., fibryga, 1 mg HCPCS J7177 | not published | not published | $1.24 – $1.82 | 4 |
| Inj for ext venography CPT 36005 | not published | not published | $693.00 – $1,586.00 | 2 |
| Inj for mammo ductogram CPT 19030 | $622.80 | $1,038.00 | $693.00 – $1,586.00 | 2 |
| Inj fosnetupitant, palonoset HCPCS J1454 | not published | not published | $524.18 – $613.80 | 4 |
| Inj., fremanezumab-vfrm 1 mg HCPCS J3031 | not published | not published | $3.30 – $3.30 | 1 |
| Inj, fulvestrant (fresenius) HCPCS J9394 | not published | not published | $2.72 – $27.65 | 4 |
| Inj, fulvestrant (teva) HCPCS J9393 | not published | not published | $34.98 – $42.50 | 4 |
| Inj givosiran 0.5 mg HCPCS J0223 | not published | not published | $120.98 – $185.61 | 4 |
| Inj golodirsen 10 mg HCPCS J1429 | not published | not published | $274.18 – $274.18 | 1 |
| Inj, granisetron, xr, 0.1 mg HCPCS J1627 | not published | not published | $3.88 – $9.70 | 4 |
| Inj., guselkumab, 1 mg HCPCS J1628 | not published | not published | $67.81 – $125.05 | 4 |
| Inj, hemgenix, per tx dose HCPCS J1411 | not published | not published | $3,691,450.00 – $6,930,000.00 | 4 |
| Inj. herceptin hylecta, 10mg HCPCS J9356 | not published | not published | $59.91 – $108.21 | 4 |
| Inj herzuma 10 mg HCPCS Q5113 | not published | not published | $49.29 – $57.14 | 4 |
| Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 | not published | not published | $693.00 – $1,586.00 | 2 |
| Inj hrt cath w/s&i sel hrt ang CPT 93563 | not published | not published | $693.00 – $1,586.00 | 2 |
| Inj hrt cath w/s&i sel hrt art CPT 93564 | not published | not published | $693.00 – $1,586.00 | 2 |
| Inj hrt cath w/s&i sel left vent CPT 93565 | not published | not published | $693.00 – $1,586.00 | 2 |
| Inj hrt cath w/s&i sel right vent CPT 93566 | not published | not published | $693.00 – $1,586.00 | 2 |
| Inj human fibrinogen con nos HCPCS J7178 | not published | not published | $1.52 – $2.28 | 4 |
| Inj hydroxyprogst capoat nos HCPCS J1729 | not published | not published | $14.60 – $14.60 | 1 |
| Inj., ibalizumab-uiyk, 10 mg HCPCS J1746 | not published | not published | $77.68 – $122.58 | 4 |
| Inj imip 4 cilas 4 releb 2mg HCPCS J0742 | not published | not published | $4.11 – $4.11 | 1 |
| Inj, imm glob bivigam, 500mg HCPCS J1556 | not published | not published | $79.44 – $120.38 | 4 |
| Inj. inebilizumab-cdon, 1 mg HCPCS J1823 | not published | not published | $495.54 – $779.30 | 4 |
| Inj/inf neurolyt sbst spinal canal lesion 62282 CPT 62282 | not published | not published | $947.82 – $3,176.00 | 5 |
| Inj. infugem, 100 mg HCPCS J9198 | not published | not published | $66.46 – $66.46 | 1 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | not published | not published | $215.00 – $1,586.00 | 5 |
| Inj intralesional > 7 lsns CPT 11901 | not published | not published | $215.00 – $1,586.00 | 5 |
| Inj, invega hafyera/trinza HCPCS J2427 | not published | not published | $12.95 – $19.98 | 4 |
| Inj ivig privigen 500 mg HCPCS J1459 | not published | not published | $49.53 – $79.18 | 4 |
| Inj, ixinity, 1 i.u HCPCS J7213 | not published | not published | $1.97 – $2.89 | 4 |
| Inj. jivi 1 iu HCPCS J7208 | not published | not published | $2.66 – $3.88 | 4 |
| Inj, kovaltry, 1 i.u HCPCS J7211 | not published | not published | $1.56 – $2.38 | 4 |
| Inj, lanreotide, (cipla) 1mg HCPCS J1932 | not published | not published | $32.19 – $84.78 | 4 |
| Inj, lenacapavir, 1 mg HCPCS J1961 | not published | not published | $22.30 – $35.76 | 4 |
| Inj levoleucovorin nos 0.5mg HCPCS J0641 | not published | not published | $0.07 – $0.07 | 1 |
| Inj. lumasiran, 0.5 mg HCPCS J0224 | not published | not published | $327.72 – $526.35 | 4 |
| Inj., lumoxiti, 0.01 mg HCPCS J9313 | not published | not published | $23.39 – $38.59 | 4 |
| Inj luxturna 1 billion vec g HCPCS J3398 | not published | not published | $3,070.09 – $4,829.37 | 4 |
| Inj melpha hydroch nos 50 mg HCPCS J9245 | not published | not published | $120.67 – $254.41 | 4 |
| Inj, melphalan flufenami 1mg HCPCS J9247 | not published | not published | $830.78 – $830.78 | 1 |
| Inj., meropenem, vaborbactam HCPCS J2186 | not published | not published | $2.17 – $3.33 | 4 |
| Inj mogamulizumab-kpkc, 1 mg HCPCS J9204 | not published | not published | $253.47 – $374.07 | 4 |
| Inj multihance HCPCS A9577 | $13.80 | $23.00 | not published | 0 |
| Inj. naxitamab-gqgk, 1 mg HCPCS J9348 | not published | not published | $686.09 – $956.42 | 4 |
| Inj nephrosto/ureterogram w/img exstng access CPT 50431 | $894.00 | $1,490.00 | $747.24 – $3,176.00 | 5 |
| Inj non-compmd foam sclrsnt mlt trncl veins same leg CPT 36466 | $1,483.80 | $2,473.00 | $2,211.05 – $5,339.00 | 5 |
| Inj non-compmd foam sclrsnt sgl trncl vein CPT 36465 | $1,483.80 | $2,473.00 | $2,211.05 – $5,339.00 | 5 |
| Inj, ocriplasmin, 0.125 mg HCPCS J7316 | not published | not published | $153.48 – $153.48 | 1 |
| Inj ogivri 10 mg HCPCS Q5114 | not published | not published | $35.78 – $66.68 | 4 |
| Inj, oliceridine 0.1 mg HCPCS C9101 | not published | not published | $1.82 – $1.82 | 1 |
| Inj olipudase alfa-rpcp 1mg HCPCS J0218 | not published | not published | $395.60 – $622.89 | 4 |
| Inj, omacetaxine mep, 0.01mg HCPCS J9262 | not published | not published | $6.62 – $6.62 | 1 |
| Inj., omadacycline, 1 mg HCPCS J0121 | not published | not published | $4.13 – $6.07 | 4 |
| Inj onase abepar-xioi treat HCPCS J3399 | not published | not published | $2,587,087.26 – $4,463,735.93 | 4 |
| Inj ontruzant 10 mg HCPCS Q5112 | not published | not published | $29.81 – $77.43 | 4 |
| Inj, panzyga, 500 mg HCPCS J1576 | not published | not published | $73.83 – $108.47 | 4 |
| Inj, pasireotide long acting HCPCS J2502 | not published | not published | $596.30 – $696.22 | 4 |
| Inj., patisiran, 0.1 mg HCPCS J0222 | not published | not published | $100.90 – $165.78 | 4 |
| Inj, pedmark, 100 mg HCPCS J0208 | not published | not published | $95.45 – $158.86 | 4 |
| Inj pegfilgrastim-bmez 0.5mg HCPCS Q5120 | not published | not published | $49.58 – $122.03 | 4 |
| Inj. pemetrexed, 10 mg HCPCS J9304 | not published | not published | $7.99 – $106.39 | 4 |
| Inj pemetrexed (accord) 10mg HCPCS J9296 | not published | not published | $9.66 – $15.94 | 4 |
| Inj pemetrexed ditromethamin HCPCS J9323 | not published | not published | $12.39 – $12.39 | 1 |
| Inj pemetrexed, hospira 10mg HCPCS J9294 | not published | not published | $5.20 – $16.50 | 4 |
| Inj pemetrexed (sandoz) 10mg HCPCS J9297 | not published | not published | $2.85 – $2.85 | 1 |
| Inj pemetrexed (teva) 10mg HCPCS J9314 | not published | not published | $10.99 – $20.30 | 4 |
| Inj peritoneal venous shunt CPT 49427 | not published | not published | $693.00 – $1,586.00 | 2 |
| Inj., perseris, 0.5 mg HCPCS J2798 | not published | not published | $12.17 – $19.26 | 4 |
| Inj plasminogen tvmh 1mg HCPCS J2998 | not published | not published | $38.39 – $49.67 | 4 |
| Inj., plazomicin, 5 mg HCPCS J0291 | not published | not published | $3.51 – $5.54 | 4 |
| Inj proc ankle arthr CPT 27648 | not published | not published | $693.00 – $1,586.00 | 2 |
| Inj proc elbow arthro CPT 24220 | not published | not published | $693.00 – $1,586.00 | 2 |
| Inj proc for lymphang CPT 38790 | not published | not published | $693.00 – $1,586.00 | 2 |
| Inj proc lumbr disk ea lvl CPT 62290 | not published | not published | $693.00 – $1,586.00 | 2 |
| Inj proc myelogram lumbar CPT 62284 | $897.60 | $1,496.00 | $693.00 – $1,586.00 | 2 |
| Inj proc sialogram CPT 42550 | not published | not published | $693.00 – $1,586.00 | 2 |
| Inj prohance multipack HCPCS A9576 | $13.80 | $23.00 | not published | 0 |
| Inj recombin esperoct per iu HCPCS J7204 | not published | not published | $2.22 – $3.48 | 4 |
| Inj, releuko 1 mcg HCPCS Q5125 | not published | not published | $0.32 – $0.97 | 4 |
| Inj retro urethrocysto CPT 51610 | not published | not published | $693.00 – $1,586.00 | 2 |
| Inj, rimabotulinumtoxinb HCPCS J0587 | not published | not published | $13.28 – $20.99 | 4 |
| Inj romidepsin non-lyo 0.1mg HCPCS J9318 | not published | not published | $28.52 – $55.95 | 4 |
| Inj scleros sol mult veins CPT 36471 | not published | not published | $435.63 – $1,586.00 | 5 |
| Inj scleros sol sgl vein CPT 36470 | not published | not published | $435.63 – $1,586.00 | 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.