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 |
|---|---|---|---|---|
| Pulmonary vent imaging CPT 78579 | not published | not published | $428.40 – $436.97 | 3 |
| Pulse ox continuous overnight monitoring CPT 94762 | $710.40 | $1,184.00 | $137.89 – $140.65 | 3 |
| Pulse ox multiple CPT 94761 | $169.20 | $282.00 | not published | 0 |
| Pulse ox single CPT 94760 | $66.00 | $110.00 | not published | 0 |
| Punc of shunt for asp or inj CPT 61070 | $1,069.20 | $1,782.00 | $756.44 – $3,176.00 | 5 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $128.40 | $214.00 | $142.58 – $1,586.00 | 5 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $818.40 | $1,364.00 | $435.63 – $1,586.00 | 5 |
| Puncture/clear windpipe 31612 CPT 31612 | not published | not published | $3,552.91 – $5,672.00 | 5 |
| Puncture spinal lumbar diagnostic CPT 62270 | $1,832.40 | $3,054.00 | $756.44 – $3,176.00 | 5 |
| Puraply 1 sq cm HCPCS Q4195 | $301.80 | $503.00 | not published | 0 |
| Puraply xt 1 sq cm HCPCS Q4197 | $301.80 | $503.00 | not published | 0 |
| Pvb thoracic 2nd+ inj site CPT 64462 | not published | not published | $693.00 – $1,586.00 | 2 |
| Pvb thoracic cont infusion CPT 64463 | not published | not published | $756.44 – $3,176.00 | 5 |
| Pvb thoracic single inj site CPT 64461 | not published | not published | $756.44 – $3,176.00 | 5 |
| Pwr pck base combo vad, rep HCPCS Q0489 | $20,627.40 | $34,379.00 | not published | 0 |
| Pyelotomy complicated CPT 50135 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Pyelotomy w/drg pyelostomy CPT 50125 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Pyelotomy w/exploration CPT 50120 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Pyelotomy w/removal calculus CPT 50130 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Pyloroplasty 43800 CPT 43800 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Pyruvate CPT 84210 | $145.20 | $242.00 | $14.48 – $14.77 | 3 |
| Pyruvate kinase CPT 84220 | $145.20 | $242.00 | $9.44 – $9.63 | 3 |
| Quan puplmtry phy/qhp uni/bi CPT 95919 | not published | not published | $142.58 – $145.43 | 3 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $1,701.00 | $2,835.00 | $581.86 – $593.49 | 3 |
| Quant diff pulm perf w/imaging CPT 78597 | $1,488.60 | $2,481.00 | $428.40 – $436.97 | 3 |
| Quest t3 uptake CPT 84479 | $117.60 | $196.00 | $6.47 – $6.60 | 3 |
| Quinupristin/dalfopristin HCPCS J2770 | not published | not published | $815.05 – $815.05 | 1 |
| Rabies ig heat-treated human im/subq 90376 CPT 90376 | not published | not published | $352.44 – $412.65 | 4 |
| Rabies ig ht&sol human im/sc CPT 90377 | not published | not published | $242.18 – $386.25 | 4 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | not published | not published | $275.18 – $469.72 | 4 |
| Rabies vaccine id CPT 90676 | not published | not published | $236.86 – $420.98 | 4 |
| Radial keratotomy CPT 65771 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Radiation handling CPT 77790 | $423.60 | $706.00 | not published | 0 |
| Radiation physics consult CPT 77336 | $828.00 | $1,380.00 | $144.03 – $146.92 | 3 |
| Radiation therapy dose plan CPT 77300 | $622.80 | $1,038.00 | $144.03 – $146.92 | 3 |
| Radiation treatment aid(s) CPT 77332 | $464.40 | $774.00 | $144.03 – $146.92 | 3 |
| Radiation treatment aid(s) CPT 77333 | $734.40 | $1,224.00 | $144.03 – $146.92 | 3 |
| Radiation treatment aid(s) CPT 77334 | $1,655.40 | $2,759.00 | $401.25 – $409.27 | 3 |
| Radiation treatment delivery CPT 77402 | $648.00 | $1,080.00 | not published | 0 |
| Radiation treatment delivery CPT 77412 | $3,058.20 | $5,097.00 | $592.11 – $603.96 | 3 |
| Radical abdominal hysterectomy 58210 CPT 58210 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Radical rescj tumor clavicle CPT 23200 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Radical rescj tumor prox hum CPT 23220 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Radical rescj tumor scapula CPT 23210 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Radical resection of elbow CPT 24149 | not published | not published | $6,223.00 – $7,931.41 | 5 |
| Radical resection sternum 21630 CPT 21630 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Radic resect abd tumor<5cm 22904 CPT 22904 | not published | not published | $3,112.75 – $5,339.00 | 5 |
| Radic resect shoulder tumor 5cm/> 23078 CPT 23078 | not published | not published | $3,112.75 – $5,672.00 | 5 |
| Radiesse injection HCPCS Q2026 | not published | not published | $276.14 – $356.17 | 4 |
| Radiology port images(s) CPT 77417 | $331.80 | $553.00 | not published | 0 |
| Radiotherapy dose plan imrt CPT 77301 | $5,911.80 | $9,853.00 | $1,483.26 – $1,512.93 | 3 |
| Radium ra223 dichl ther/uci HCPCS A9606 | not published | not published | $171.09 – $259.81 | 4 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $1,798.80 | $2,998.00 | $581.86 – $593.49 | 3 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | not published | not published | $581.86 – $593.49 | 3 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | $3,138.00 | $5,230.00 | $1,387.37 – $1,415.12 | 3 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $2,091.00 | $3,485.00 | $581.86 – $593.49 | 3 |
| Radphm lcl tumor plr sgl day CPT 78800 | $1,798.80 | $2,998.00 | $428.40 – $436.97 | 3 |
| Rad rescj tum dstl/shft hum CPT 24150 | not published | not published | $7,775.89 – $12,241.00 | 5 |
| Rad rescj tum shoulder<5 cm CPT 23077 | not published | not published | $3,112.75 – $5,339.00 | 5 |
| Rad rescj tum tiss a/e 5 cm+ CPT 24079 | not published | not published | $3,112.75 – $5,672.00 | 5 |
| Rad rescj tum tiss a/e <5cm CPT 24077 | not published | not published | $3,112.75 – $5,339.00 | 5 |
| Rad resec soft tis tum/ft/toe/<3cm 28046 CPT 28046 | not published | not published | $3,112.75 – $5,339.00 | 5 |
| Rad resect abd tumor 5 cm/> CPT 22905 | not published | not published | $3,112.75 – $5,672.00 | 5 |
| Rad resect hand tumor < 3 cm CPT 26117 | not published | not published | $3,112.75 – $5,339.00 | 5 |
| Rad resect hand tumor 3 cm/> CPT 26118 | not published | not published | $3,112.75 – $5,672.00 | 5 |
| Rad resection tum radial h/n CPT 24152 | not published | not published | $7,775.89 – $12,241.00 | 5 |
| Rad resect tumor/neck/ant thor/<5cm21557 CPT 21557 | not published | not published | $3,112.75 – $5,339.00 | 5 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | not published | not published | $75.47 – $113.64 | 4 |
| Range of motion measurements CPT 95852 | not published | not published | $5.27 – $5.38 | 3 |
| Ranibizumab injection HCPCS J2778 | not published | not published | $67.85 – $390.36 | 4 |
| Rapid Strep Test CPT 87880 | $115.20 | $192.00 | $16.53 – $16.86 | 3 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | not published | not published | $382.19 – $589.64 | 4 |
| Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 | not published | not published | $223.68 – $366.10 | 4 |
| Rbc count only automated CPT 85041 | $61.20 | $102.00 | $3.02 – $3.08 | 3 |
| Rbc deglycerolized each unit HCPCS P9039 | $1,192.80 | $1,988.00 | not published | 0 |
| Rbc depletion of harvest CPT 38212 | not published | not published | $472.77 – $1,586.00 | 5 |
| Rbc irradiated each unit HCPCS P9038 | $832.20 | $1,387.00 | not published | 0 |
| Rbc mechanical fragility CPT 85547 | not published | not published | $8.60 – $8.77 | 3 |
| Rbc osmotic fragility CPT 85555 | not published | not published | $7.47 – $7.62 | 3 |
| Rcnst bfrnt sp orb rm&lw fhd CPT 21175 | not published | not published | $6,343.80 – $12,241.00 | 5 |
| Rcnstj forehead w/autograft CPT 21180 | not published | not published | $6,343.80 – $12,241.00 | 5 |
| Rcnstj forehead with grafts CPT 21179 | not published | not published | $6,343.80 – $12,241.00 | 5 |
| Rcnstj mdfc lefort i 1 w/grf CPT 21145 | not published | not published | $6,343.80 – $12,241.00 | 5 |
| Rcnstj mdfc lefort i 2 w/grf CPT 21146 | not published | not published | $6,343.80 – $12,241.00 | 5 |
| Rcnstj mdfc lefort iii w/i CPT 21155 | not published | not published | $6,343.80 – $12,241.00 | 5 |
| Rcnstj mdfc lefort iii without i CPT 21154 | not published | not published | $6,343.80 – $12,241.00 | 5 |
| Rcnstj mdfc lefrtii w/b1 grf CPT 21151 | not published | not published | $6,343.80 – $12,241.00 | 5 |
| Rcnst mdfc lfrtiii advm w/i CPT 21160 | not published | not published | $6,343.80 – $12,241.00 | 5 |
| Rcnst mdfc lfrtiii advm wo i CPT 21159 | not published | not published | $6,343.80 – $12,241.00 | 5 |
| Rdctj forehead cntrg only CPT 21137 | not published | not published | $3,552.91 – $5,672.00 | 5 |
| Rdctj forehead cntrg&prostc CPT 21138 | not published | not published | $6,343.80 – $12,241.00 | 5 |
| Rdctj forehead cntrg&setback CPT 21139 | not published | not published | $6,343.80 – $12,241.00 | 5 |
| Realignment of knee CPT 27457 | not published | not published | $7,775.89 – $12,241.00 | 5 |
| Realignment of knee CPT 27455 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Realignment of tendons CPT 26437 | not published | not published | $3,506.34 – $5,339.00 | 5 |
| Realignment of thigh bone CPT 27454 | not published | not published | $7,775.89 – $17,033.00 | 5 |
| Rebuild eardrum structures CPT 69632 | not published | not published | $6,343.80 – $12,241.00 | 5 |
| Rebuild eardrum structures CPT 69633 | not published | not published | $6,343.80 – $12,241.00 | 5 |
| Rebuild eardrum structures CPT 69636 | not published | not published | $6,343.80 – $12,241.00 | 5 |
| Rebuild outer ear canal CPT 69310 | not published | not published | $6,343.80 – $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.