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 |
|---|---|---|---|---|
| MRA chest wo IV cont HCPCS C8910 | not published | not published | $255.69 – $260.80 | 3 |
| MRA chest wwo IV cont HCPCS C8911 | not published | not published | $373.86 – $381.34 | 3 |
| MRA ext low(run-off)pst cntrst CPT 73725 | $6,179.40 | $10,299.00 | not published | 0 |
| MRA pelvis CPT 72198 | $4,119.60 | $6,866.00 | not published | 0 |
| MRA pelvis w IV cont HCPCS C8918 | not published | not published | $373.86 – $381.34 | 3 |
| MRA pelvis wo IV cont HCPCS C8919 | not published | not published | $255.69 – $260.80 | 3 |
| MRA upper extremity post contrast-bil CPT 73225 | $6,179.40 | $10,299.00 | not published | 0 |
| MRA w/cont, abd HCPCS C8900 | not published | not published | $373.86 – $381.34 | 3 |
| MRA w/cont, lwr ext HCPCS C8912 | not published | not published | $373.86 – $381.34 | 3 |
| Mra, w/dye, spinal canal HCPCS C8931 | not published | not published | $373.86 – $381.34 | 3 |
| Mra, w/dye, upper extremity HCPCS C8934 | not published | not published | $373.86 – $381.34 | 3 |
| MRA without cont, abd HCPCS C8901 | not published | not published | $255.69 – $260.80 | 3 |
| MRA without cont, lwr ext HCPCS C8913 | not published | not published | $255.69 – $260.80 | 3 |
| Mra, without dye, spinal canal HCPCS C8932 | not published | not published | $255.69 – $260.80 | 3 |
| Mra, without dye, upper extr HCPCS C8935 | not published | not published | $255.69 – $260.80 | 3 |
| MRA without fol w/cont, abd HCPCS C8902 | not published | not published | $373.86 – $381.34 | 3 |
| MRA without fol w/cont, lwr ext HCPCS C8914 | not published | not published | $373.86 – $381.34 | 3 |
| MRA without fol w/cont, pelvis HCPCS C8920 | not published | not published | $373.86 – $381.34 | 3 |
| Mra, w/o&w/dye, spinal canal HCPCS C8933 | not published | not published | $373.86 – $381.34 | 3 |
| Mra, w/o&w/dye, upper extr HCPCS C8936 | not published | not published | $373.86 – $381.34 | 3 |
| Mr elastography CPT 76391 | not published | not published | $255.69 – $260.80 | 3 |
| Mrgfus strtctc ablt trgt icr CPT 61715 | not published | not published | $11,940.72 – $12,179.53 | 3 |
| MRI brain w/dye CPT 70558 | not published | not published | $187.96 – $191.72 | 3 |
| MRI brain without dye CPT 70557 | not published | not published | $585.55 – $597.26 | 3 |
| MRI brain without & w/dye CPT 70559 | not published | not published | $187.96 – $191.72 | 3 |
| MRI breast c- unilateral CPT 77046 | not published | not published | $255.69 – $260.80 | 3 |
| MRI breast c-+ w/cad uni CPT 77048 | $4,410.00 | $7,350.00 | not published | 0 |
| MRI breast without cont bi CPT 77047 | $6,179.40 | $10,299.00 | $255.69 – $260.80 | 3 |
| MRI breast w IV cont bi CPT 77049 | $6,179.40 | $10,299.00 | not published | 0 |
| MRI cardiac morph & func wo IV cont CPT 75557 | not published | not published | $255.69 – $260.80 | 3 |
| MRI cardiac morph & func wwo IV cont CPT 75561 | not published | not published | $373.86 – $381.34 | 3 |
| MRI cardiac morph & func wwo IV cont w/stress img CPT 75563 | not published | not published | $840.06 – $856.87 | 3 |
| MRI chest without contrast CPT 71550 | $4,141.20 | $6,902.00 | $255.69 – $260.80 | 3 |
| MRI chest without & w/contrast CPT 71552 | $4,446.60 | $7,411.00 | $373.86 – $381.34 | 3 |
| MRI chest w IV cont CPT 71551 | not published | not published | $840.06 – $856.87 | 3 |
| MRI fetal sngl/1st gestation CPT 74712 | not published | not published | $255.69 – $260.80 | 3 |
| MRI loex nonjt w IV cont CPT 73719 | not published | not published | $373.86 – $381.34 | 3 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $6,179.40 | $10,299.00 | $255.69 – $260.80 | 3 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $6,179.40 | $10,299.00 | $373.86 – $381.34 | 3 |
| MRI orbit/face/neck without contrast CPT 70540 | $4,119.60 | $6,866.00 | $255.69 – $260.80 | 3 |
| MRI orbit/face/neck without & w/contrast CPT 70543 | $4,119.60 | $6,866.00 | $373.86 – $381.34 | 3 |
| MRI orbit fac&nck w IV cont CPT 70542 | not published | not published | $373.86 – $381.34 | 3 |
| MRI tmj CPT 70336 | not published | not published | $255.69 – $260.80 | 3 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $4,119.60 | $6,866.00 | $255.69 – $260.80 | 3 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $4,119.60 | $6,866.00 | $373.86 – $381.34 | 3 |
| MRI upper extremity w/dye CPT 73219 | not published | not published | $373.86 – $381.34 | 3 |
| MRI w/cont, breast, bi HCPCS C8906 | not published | not published | $373.86 – $381.34 | 3 |
| MRI w/cont, breast, uni HCPCS C8903 | not published | not published | $187.96 – $191.72 | 3 |
| MRI without fol w/cont, breast HCPCS C8908 | not published | not published | $373.86 – $381.34 | 3 |
| MRI without fol w/cont, brst, un HCPCS C8905 | not published | not published | $373.86 – $381.34 | 3 |
| Mr safety determination physician/other qhp CPT 76016 | $134.40 | $224.00 | $93.26 – $95.12 | 3 |
| Mr safety implant elec prepj CPT 76018 | $140.40 | $234.00 | not published | 0 |
| Mr safety implant&/fb assmt clin staff ea add 30 CPT 76015 | $75.60 | $126.00 | not published | 0 |
| Mr safety implt pos&/immoblj CPT 76019 | $90.60 | $151.00 | $63.22 – $64.48 | 3 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | $37.80 | $63.00 | $30.99 – $31.61 | 3 |
| Mr sfty med physics xm cstmz CPT 76017 | $369.60 | $616.00 | $255.69 – $260.80 | 3 |
| Mr spectroscopy CPT 76390 | not published | not published | $93.26 – $95.12 | 3 |
| Msh2 gene dup/delete variant CPT 81297 | not published | not published | $213.30 – $217.57 | 3 |
| Msh2 gene full seq CPT 81295 | $1,095.60 | $1,826.00 | $381.70 – $389.33 | 3 |
| Msh2 gene known variants CPT 81296 | not published | not published | $337.73 – $344.48 | 3 |
| Msh6 gene dup/delete variant CPT 81300 | not published | not published | $238.00 – $242.76 | 3 |
| Msh6 gene full seq CPT 81298 | $1,842.00 | $3,070.00 | $641.85 – $654.69 | 3 |
| Msh6 gene known variants CPT 81299 | not published | not published | $308.00 – $314.16 | 3 |
| Mt bone graft microvasc CPT 20957 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Mthfr gene analy common variants CPT 81291 | $964.80 | $1,608.00 | $65.34 – $66.65 | 3 |
| M.tuberculo dna dir probe CPT 87555 | not published | not published | $26.88 – $27.42 | 3 |
| M.tuberculo dna quant CPT 87557 | not published | not published | $42.84 – $43.70 | 3 |
| Mucin synovial fluid CPT 83872 | $175.20 | $292.00 | $5.86 – $5.98 | 3 |
| Mucopolysaccharides CPT 83864 | $793.80 | $1,323.00 | $28.50 – $29.07 | 3 |
| Mucormycosis antibody CPT 86732 | not published | not published | $15.00 – $15.30 | 3 |
| Multifocal erg w/i&r CPT 92274 | not published | not published | $137.89 – $140.65 | 3 |
| Multiple sleep latency test CPT 95805 | $2,931.00 | $4,885.00 | $920.24 – $938.65 | 3 |
| Mumps antibody igg CPT 86735 | $118.80 | $198.00 | $13.05 – $13.31 | 3 |
| Muscle-skin graft arm CPT 15736 | not published | not published | $2,211.05 – $5,339.00 | 5 |
| Muscle-skin graft leg CPT 15738 | not published | not published | $3,797.52 – $6,675.00 | 5 |
| Muscle-skin graft trunk CPT 15734 | not published | not published | $3,797.52 – $6,675.00 | 5 |
| Muscle test cran nerv unilat CPT 95867 | not published | not published | $231.39 – $236.02 | 3 |
| Muscle test hemidiaphragm CPT 95866 | not published | not published | $137.89 – $140.65 | 3 |
| Muscle test larynx CPT 95865 | not published | not published | $142.58 – $145.43 | 3 |
| Muscle test one fiber CPT 95872 | not published | not published | $231.39 – $236.02 | 3 |
| Muscle transfers CPT 23397 | not published | not published | $7,775.89 – $12,241.00 | 5 |
| Muscle transfer shoulder/arm CPT 23395 | not published | not published | $7,775.89 – $12,241.00 | 5 |
| Musc myoq/fscq flp h&n pedcl CPT 15733 | not published | not published | $3,797.52 – $6,675.00 | 5 |
| Musc/tdn transfer upr a/e 1 CPT 24301 | not published | not published | $6,223.00 – $7,931.41 | 5 |
| Mycobacteria dna amp probe CPT 87551 | not published | not published | $48.24 – $49.20 | 3 |
| Mycobacteria dna dir probe CPT 87550 | not published | not published | $20.05 – $20.45 | 3 |
| Mycobacteria dna quant CPT 87552 | not published | not published | $42.84 – $43.70 | 3 |
| Mycoplasma antibody igm CPT 86738 | $130.20 | $217.00 | $13.24 – $13.50 | 3 |
| Myd88 gene p.leu265pro vrnt CPT 81305 | $939.00 | $1,565.00 | $175.40 – $178.91 | 3 |
| Myelogphy 2/> spine regions CPT 72270 | not published | not published | $840.06 – $856.87 | 3 |
| Myelography l-s spine CPT 72265 | $1,102.80 | $1,838.00 | $840.06 – $856.87 | 3 |
| Myelography neck spine CPT 72240 | not published | not published | $840.06 – $856.87 | 3 |
| Myelography thoracic spine CPT 72255 | not published | not published | $840.06 – $856.87 | 3 |
| Myelography via inj w/s&i 2+ regions CPT 62305 | $2,425.20 | $4,042.00 | $840.06 – $3,176.00 | 5 |
| Myelography via inj w/s&i cervical CPT 62302 | not published | not published | $840.06 – $3,176.00 | 5 |
| Myelography via inj w/s&i lumbosacral CPT 62304 | $2,734.80 | $4,558.00 | $840.06 – $3,176.00 | 5 |
| Myelography via inj w/s&i thoracic CPT 62303 | not published | not published | $840.06 – $3,176.00 | 5 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $2,854.80 | $4,758.00 | $11.53 – $11.76 | 3 |
| Myocardial resection 33542 CPT 33542 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Myocrd img pet 1std rst/strs CPT 78491 | not published | not published | $1,532.36 – $1,563.01 | 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.