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 |
|---|---|---|---|---|
| Optx palatal/max fracture CPT 21422 | not published | not published | $6,343.80 – $12,241.00 | 5 |
| Optx palatal/max fx comp CPT 21423 | not published | not published | $6,343.80 – $12,241.00 | 5 |
| Optx partclr fx&/dslc elbw w CPT 24587 | not published | not published | $7,993.00 – $17,033.00 | 5 |
| Optx post ankle fx CPT 27769 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Optx prox humrl fx w/int fix CPT 23615 | not published | not published | $7,993.00 – $17,033.00 | 5 |
| Optx prx hmrl fx fix rpr rpl CPT 23616 | not published | not published | $7,993.00 – $19,165.36 | 5 |
| Optx radial shaft fracture CPT 25515 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Optx rad/uln dislc aqt/chrnc CPT 25676 | not published | not published | $5,543.00 – $7,931.41 | 5 |
| Optx rdcrpl/ntrcrpl dislc 1+ CPT 25670 | not published | not published | $5,543.00 – $7,931.41 | 5 |
| Optx rdl shft fx&cltx rad/ul CPT 25525 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Optx rdl shft fx&dstl rad/ul CPT 25526 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Optx rdl&uln shft fx rds&uln CPT 25575 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Optx rdl&uln shft fx rds/uln CPT 25574 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Optx scapular fx w/int fixj CPT 23585 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Optx sho dislc fx CPT 23670 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Optx sho dislc neck fx fixj CPT 23680 | not published | not published | $7,993.00 – $17,033.00 | 5 |
| Optx strclv dslc aq/chrn grf CPT 23532 | not published | not published | $5,543.00 – $7,931.41 | 5 |
| Optx strnclav dislc aqt/chrn CPT 23530 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Optx thigh fx CPT 27269 | not published | not published | $4,157.00 – $7,931.41 | 5 |
| Optx tmprmand dislocation CPT 21490 | not published | not published | $3,552.91 – $12,241.00 | 5 |
| Optx trns-scphprlnr fx dislc CPT 25685 | not published | not published | $5,543.00 – $7,931.41 | 5 |
| Optx ulnar shft fx int fixj CPT 25545 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Optx ulnar styloid fracture CPT 25652 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Oral hiv-1/hiv-2 screen HCPCS G0435 | not published | not published | $11.98 – $12.22 | 3 |
| Oral netupitant, palonosetro HCPCS J8655 | not published | not published | $397.79 – $761.08 | 4 |
| Orbitocranial approach/skull CPT 61584 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Orbitocranial approach/skull CPT 61585 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Orbitocranial approach/skull CPT 61592 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Orchiectomy partial CPT 54522 | not published | not published | $3,777.44 – $5,672.00 | 5 |
| Orchiopexy (fowler-stephens) CPT 54650 | not published | not published | $3,836.82 – $6,675.00 | 5 |
| Orchiopexy ingun/scrot appr CPT 54640 | not published | not published | $3,836.82 – $6,675.00 | 5 |
| Organic acids total quant ea spec CPT 83918 | not published | not published | $23.60 – $24.07 | 3 |
| Oritavancin 1,200 mg intravenous solution HCPCS J2406 | not published | not published | $43.72 – $68.85 | 4 |
| Oritavancin 400 mg intravenous solution HCPCS J2407 | not published | not published | $28.57 – $44.37 | 4 |
| Oropharyngeal biopsy 42800 CPT 42800 | not published | not published | $1,662.71 – $3,176.00 | 5 |
| Ortho hnd metcrpl fx prefb w/fit&adj HCPCS L3917 | $585.60 | $976.00 | not published | 0 |
| Orthopantogram CPT 70355 | $2,548.20 | $4,247.00 | $93.26 – $95.12 | 3 |
| Orthop traing supvj phys/qhp CPT 92066 | not published | not published | $63.22 – $64.48 | 3 |
| Orthovisc inj per dose HCPCS J7324 | not published | not published | $109.09 – $193.68 | 4 |
| Ortho whf rigd without jnt cstm w/fit&adj HCPCS L3808 | $85.20 | $142.00 | not published | 0 |
| Oscillation chest wall mechanical per session CPT 94669 | $115.20 | $192.00 | $234.66 – $239.35 | 3 |
| Osmolality blood CPT 83930 | $130.80 | $218.00 | $6.61 – $6.74 | 3 |
| Osmolality urine CPT 83935 | $111.00 | $185.00 | $6.82 – $6.96 | 3 |
| Ostectomy complete 1st metatarsal head 28111 CPT 28111 | not published | not published | $3,506.34 – $5,672.00 | 5 |
| Ostectomy scapula partial CPT 23190 | not published | not published | $3,506.34 – $6,675.00 | 5 |
| Osteoart algrft w/surf & b1 CPT 20932 | not published | not published | $693.00 – $1,586.00 | 2 |
| Osteochondral knee allograft CPT 27415 | not published | not published | $7,993.00 – $17,033.00 | 5 |
| Osteochondral knee autograft CPT 27416 | not published | not published | $7,775.89 – $12,241.00 | 5 |
| Osteochondral talus autogrft CPT 28446 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Osteoplasty humerus CPT 24420 | not published | not published | $7,775.89 – $12,241.00 | 5 |
| Osteot dsc ant 1 vrt sgm crv CPT 22220 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Osteot dsc ant 1vrt sgm ea CPT 22226 | not published | not published | $693.00 – $1,586.00 | 2 |
| Osteot dsc ant 1vrt sgm lmbr CPT 22224 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Osteot dsc ant 1vrt sgm thrc CPT 22222 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Osteot humerus w/wo int fixj CPT 24400 | not published | not published | $7,775.89 – $12,241.00 | 5 |
| Osteot mlt relignmt imed rod CPT 27712 | not published | not published | $7,993.00 – $17,033.00 | 5 |
| Osteotomy/graft tarsal/calcaneus/talus 28305 CPT 28305 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Ot evaluation high complexity patient/family CPT 97167 | $278.40 | $464.00 | $102.47 – $104.52 | 3 |
| Ot evaluation low complexity patient/family CPT 97165 | $231.60 | $386.00 | $101.57 – $103.60 | 3 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $247.20 | $412.00 | $96.48 – $98.41 | 3 |
| Other bone graft microvasc CPT 20962 | not published | not published | $7,775.89 – $12,241.00 | 5 |
| Other immunoelectrophoresis CPT 86325 | not published | not published | $23.13 – $23.59 | 3 |
| Oth resp proc, group HCPCS G0239 | $55.20 | $92.00 | $40.03 – $40.83 | 3 |
| Oth resp proc, indiv HCPCS G0238 | $93.00 | $155.00 | $30.99 – $31.61 | 3 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $108.00 | $180.00 | $50.81 – $51.83 | 3 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $105.00 | $175.00 | $47.25 – $48.20 | 3 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $105.00 | $175.00 | $28.43 – $29.00 | 3 |
| Otoplasty 69300 CPT 69300 | not published | not published | $3,552.91 – $5,672.00 | 5 |
| Ot re-evaluation patient/family CPT 97168 | $160.80 | $268.00 | $69.31 – $70.70 | 3 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $105.00 | $175.00 | $33.81 – $34.49 | 3 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $108.00 | $180.00 | $18.55 – $18.92 | 3 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $108.00 | $180.00 | $19.66 – $20.05 | 3 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $105.00 | $175.00 | $29.67 – $30.26 | 3 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $108.00 | $180.00 | $31.82 – $32.46 | 3 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $105.00 | $175.00 | $31.10 – $31.72 | 3 |
| Outflow tarct agmntj heart chamber 33478 CPT 33478 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Ovarian cystectomy 58925 CPT 58925 | not published | not published | $5,360.72 – $6,675.00 | 5 |
| Ovulation tests CPT 84830 | $217.20 | $362.00 | $12.70 – $12.95 | 3 |
| P-32 sod phosphate ther per mci HCPCS A9563 | not published | not published | $60.95 – $283.80 | 4 |
| Pabpn1 gene detc abnor allel CPT 81312 | not published | not published | $137.00 – $139.74 | 3 |
| Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 | not published | not published | $6.02 – $19.90 | 4 |
| Palb2 gene full gene seq CPT 81307 | not published | not published | $676.50 – $690.03 | 3 |
| Palb2 gene known famil vrnt CPT 81308 | not published | not published | $301.35 – $307.38 | 3 |
| Palifermin injection HCPCS J2425 | not published | not published | $36.72 – $43.74 | 4 |
| Paliperidone 117 mg/0.75 ml inj HCPCS J2426 | not published | not published | $15.08 – $23.46 | 4 |
| Palivizumab 50 mg/0.5 ml inj CPT 90378 | not published | not published | $436.75 – $560.47 | 4 |
| Pancreas removal/transplant CPT 48160 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Pancreatectomy CPT 48146 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Pancreatectomy CPT 48152 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Pancreatectomy CPT 48154 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Pancreatectomy 48153 CPT 48153 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Pancreatectomy dist subtot w/wo splenecto 48140 CPT 48140 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Pancreatorrhaphy CPT 48545 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 | not published | not published | $174.39 – $247.02 | 4 |
| Parathormone (pth) intact CPT 83970 | $310.80 | $518.00 | $41.28 – $42.11 | 3 |
| Parathyrdec/expl parathyr medstnl sternal/tthrc 60505 CPT 60505 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Parathyrd planar w/spect&ct CPT 78072 | not published | not published | $581.86 – $593.49 | 3 |
| Parathyroid autotransplantation 60512 CPT 60512 | not published | not published | $693.00 – $1,586.00 | 2 |
| Parathyroid planar imaging CPT 78070 | $1,396.20 | $2,327.00 | $428.40 – $436.97 | 3 |
| Parathyroid planar img w/tomo spect CPT 78071 | not published | not published | $428.40 – $436.97 | 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.