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 |
|---|---|---|---|---|
| Pelvic MRI (with contrast) CPT 72196 | not published | not published | $373.86 – $381.34 | 3 |
| Pelvic MRI (without contrast) CPT 72195 | $4,119.60 | $6,866.00 | $255.69 – $260.80 | 3 |
| Pelvic ring fracture uni/bil HCPCS G0413 | not published | not published | $6,223.00 – $7,931.41 | 5 |
| Pelvic ring fx treat int fix HCPCS G0414 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Pelvic Ultrasound (complete) CPT 76856 | $742.80 | $1,238.00 | $112.03 – $114.27 | 3 |
| Pelvic Ultrasound (limited) CPT 76857 | $543.60 | $906.00 | $112.03 – $114.27 | 3 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | not published | not published | $61.25 – $90.44 | 4 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | not published | not published | $4.04 – $13.08 | 4 |
| Peng benzathine/procaine inj HCPCS J0558 | not published | not published | $19.52 – $25.86 | 4 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | not published | not published | $31.46 – $33.28 | 4 |
| Penicillin g procaine inj HCPCS J2510 | not published | not published | $71.58 – $71.58 | 1 |
| Penile injection CPT 54235 | not published | not published | $267.74 – $1,586.00 | 5 |
| Penile vascular study CPT 93980 | not published | not published | $112.03 – $114.27 | 3 |
| Penile vascular study CPT 93981 | $939.60 | $1,566.00 | $112.03 – $114.27 | 3 |
| Penile venous occlusion CPT 37790 | not published | not published | $3,777.44 – $6,675.00 | 5 |
| Penis plastic surgery CPT 54360 | not published | not published | $3,777.44 – $12,241.00 | 5 |
| Penis study CPT 54240 | not published | not published | $231.39 – $1,586.00 | 5 |
| Pentobarbital sodium inj HCPCS J2515 | not published | not published | $36.84 – $50.04 | 4 |
| Pentostatin 10 mg intravenous solution HCPCS J9268 | not published | not published | $2,626.33 – $3,939.75 | 4 |
| Perc cryo ablate renal tum CPT 50593 | not published | not published | $7,993.00 – $17,033.00 | 5 |
| Perc d-e cor revasc chro add HCPCS C9608 | not published | not published | $693.00 – $1,586.00 | 2 |
| Perc d-e cor revasc chro sin HCPCS C9607 | not published | not published | $10,384.00 – $21,651.00 | 5 |
| Perc d-e cor revasc t cabg b HCPCS C9605 | not published | not published | $693.00 – $1,586.00 | 2 |
| Perc d-e cor revasc t cabg s HCPCS C9604 | not published | not published | $10,384.00 – $21,651.00 | 5 |
| Perc d-e cor stent ather br HCPCS C9603 | not published | not published | $693.00 – $1,586.00 | 2 |
| Perc d-e cor stent ather s HCPCS C9602 | not published | not published | $10,384.00 – $21,651.00 | 5 |
| Perc drug-el cor stent bran HCPCS C9601 | not published | not published | $693.00 – $1,586.00 | 2 |
| Perc drug-el cor stent sing HCPCS C9600 | not published | not published | $10,384.00 – $21,651.00 | 5 |
| Perc rf ablate renal tumor CPT 50592 | not published | not published | $6,478.50 – $17,033.00 | 5 |
| Percut ablate liver rf CPT 47382 | not published | not published | $6,478.50 – $17,033.00 | 5 |
| Pericardial drain w/cath pq w/ct guid CPT 33019 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Pericardiectomy/sub or com/w bypas 33031 CPT 33031 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Pericardiocentesis wwo imaging CPT 33016 | $2,079.60 | $3,466.00 | $1,686.89 – $3,176.00 | 5 |
| Pericardiotomy/clot/for bod remove 33020 CPT 33020 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Peri-implt capslc brst compl CPT 19371 | not published | not published | $4,195.85 – $6,675.00 | 5 |
| Perineoplasty rpr per nonob CPT 56810 | not published | not published | $3,468.96 – $5,672.00 | 5 |
| Peripheral vascular rehab CPT 93668 | $135.60 | $226.00 | $63.22 – $64.48 | 3 |
| Peritoneal cath sub q resv per CPT 49419 | not published | not published | $5,963.01 – $17,033.00 | 5 |
| Peritoneogram rs&i CPT 74190 | not published | not published | $585.55 – $597.26 | 3 |
| Perit-vens shunt pat tst CPT 78291 | not published | not published | $428.40 – $436.97 | 3 |
| Perq art m-thrombect &/nfs CPT 61645 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Perq clsr tcat l atr apndge CPT 33340 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Perq dev breast 1st mr guide CPT 19287 | not published | not published | $758.85 – $3,176.00 | 5 |
| Perq dev breast 1st strtctc CPT 19283 | not published | not published | $758.85 – $3,176.00 | 5 |
| Perq nl/pl lithotrp cplx>2cm CPT 50081 | not published | not published | $8,099.00 – $12,241.00 | 5 |
| Perq nl/pl lithotrp smpl<2cm CPT 50080 | not published | not published | $8,099.00 – $12,241.00 | 5 |
| Perq p-art revsc 1 abnor bi CPT 33903 | not published | not published | $10,384.00 – $21,651.00 | 5 |
| Perq p-art revsc 1 abnor uni CPT 33902 | not published | not published | $10,384.00 – $21,651.00 | 5 |
| Perq p-art revsc 1 nm nt bi CPT 33901 | not published | not published | $10,384.00 – $21,651.00 | 5 |
| Perq p-art revsc 1 nm nt uni CPT 33900 | not published | not published | $10,384.00 – $21,651.00 | 5 |
| Perq p-art revsc each addl CPT 33904 | not published | not published | $693.00 – $1,586.00 | 2 |
| Perq plmt bile duct stent CPT 47538 | not published | not published | $6,478.50 – $17,033.00 | 5 |
| Perq plmt bile duct stent CPT 47539 | not published | not published | $6,478.50 – $17,033.00 | 5 |
| Perq plmt bile duct stent CPT 47540 | not published | not published | $6,478.50 – $17,033.00 | 5 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | $925.80 | $1,543.00 | $267.74 – $1,586.00 | 5 |
| Perq skel fix rad/uln dislc CPT 25671 | not published | not published | $3,506.34 – $5,672.00 | 5 |
| Perq skel fix ulnar styld fx CPT 25651 | not published | not published | $3,506.34 – $5,672.00 | 5 |
| Perq transcath closure each CPT 93592 | not published | not published | $693.00 – $1,586.00 | 2 |
| Perq transcath closure pda CPT 93582 | not published | not published | $10,182.00 – $21,697.00 | 5 |
| Perq transcath cls aortic CPT 93591 | not published | not published | $11,661.00 – $23,867.00 | 5 |
| Perq transcath cls mitral CPT 93590 | not published | not published | $11,661.00 – $23,867.00 | 5 |
| Perq transcath septal reduxn CPT 93583 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Perq trluml angp nt/recr coa CPT 33897 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Perq tx big toe fracture w/manip 28496 CPT 28496 | not published | not published | $3,506.34 – $5,672.00 | 5 |
| Perq tx malar fracture CPT 21355 | not published | not published | $3,552.91 – $12,241.00 | 5 |
| Perq tx mndblr fx xtrnl fixj CPT 21452 | not published | not published | $4,157.00 – $6,470.68 | 5 |
| Perq tx nasoethmoid fx CPT 21340 | not published | not published | $3,552.91 – $12,241.00 | 5 |
| Pertussis ag if CPT 87265 | not published | not published | $11.98 – $12.22 | 3 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | not published | not published | $17.02 – $25.36 | 4 |
| Pertuzu, trastuzu, 10 mg HCPCS J9316 | not published | not published | $60.22 – $112.55 | 4 |
| Pet CT skull-mid thgh initial CPT 78815 | $8,884.20 | $14,807.00 | $1,532.36 – $1,563.01 | 3 |
| Pet CT whole body initial CPT 78816 | $9,827.40 | $16,379.00 | $1,532.36 – $1,563.01 | 3 |
| Pet fdg brain metoblic eval sb CPT 78608 | $7,297.20 | $12,162.00 | $1,532.36 – $1,563.01 | 3 |
| Pet image full body CPT 78813 | not published | not published | $1,532.36 – $1,563.01 | 3 |
| Pet image ltd area CPT 78811 | not published | not published | $1,387.37 – $1,415.12 | 3 |
| Pet image skull-thigh CPT 78812 | not published | not published | $1,532.36 – $1,563.01 | 3 |
| Pet image w/ct lmtd CPT 78814 | $12,204.60 | $20,341.00 | $1,532.36 – $1,563.01 | 3 |
| Pet not otherwise specified HCPCS G0235 | not published | not published | $428.40 – $436.97 | 3 |
| Ph1 assmt&mgmt nqhp 11-20 CPT 98967 | $95.40 | $159.00 | $21.04 – $21.46 | 3 |
| Ph1 assmt&mgmt nqhp 21-30 CPT 98968 | $141.60 | $236.00 | $29.14 – $29.72 | 3 |
| Ph1 assmt&mgmt nqhp 5-10 CPT 98966 | $49.20 | $82.00 | $10.56 – $10.77 | 3 |
| Phalangectomy ea toe 28150 CPT 28150 | not published | not published | $3,506.34 – $5,672.00 | 5 |
| Ph body fluid CPT 83986 | $79.80 | $133.00 | $3.58 – $3.65 | 3 |
| Phencyclidine (pcp) CPT 83992 | $352.20 | $587.00 | not published | 0 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | not published | not published | $64.98 – $64.98 | 1 |
| Phenobarbital therapeutic drug level CPT 80184 | $174.00 | $290.00 | $15.30 – $15.61 | 3 |
| Phentolaine mesylate inj HCPCS J2760 | not published | not published | $257.45 – $756.00 | 4 |
| Phenytoin total therapeutic drug level CPT 80185 | $214.80 | $358.00 | $13.25 – $13.52 | 3 |
| Phlebotomy therapeutic CPT 99195 | $385.80 | $643.00 | $142.58 – $145.43 | 3 |
| Phleb veins 1 extrm 10-20 stab CPT 37765 | not published | not published | $3,383.62 – $6,675.00 | 5 |
| Phleb veins 1 extrm >20 stab CPT 37766 | not published | not published | $3,383.62 – $6,675.00 | 5 |
| Phosphorus CPT 84100 | $81.00 | $135.00 | $4.74 – $4.83 | 3 |
| Phosphorus 24 hour urine CPT 84105 | $180.00 | $300.00 | $5.78 – $5.90 | 3 |
| Photchmtx tar&uvb/ptrltm&uvb CPT 96910 | not published | not published | $63.22 – $64.48 | 3 |
| Photochemotherapy puva CPT 96912 | not published | not published | $63.22 – $64.48 | 3 |
| Photochemotherapy uv-a or b CPT 96913 | not published | not published | $435.63 – $444.34 | 3 |
| Photodynamic tx addl 15 min CPT 96571 | not published | not published | $693.00 – $1,586.00 | 2 |
| Photodynmc tx 30 min add-on CPT 96570 | not published | not published | $693.00 – $1,586.00 | 2 |
| Photo patch test CPT 95052 | not published | not published | $63.22 – $64.48 | 3 |
| Photopheresis CPT 36522 | not published | not published | $4,667.44 – $12,241.00 | 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.