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 |
|---|---|---|---|---|
| Ureter endoscopy & biopsy CPT 50974 | not published | not published | $4,157.00 – $5,860.72 | 5 |
| Ureter endoscopy & catheter CPT 50972 | not published | not published | $1,963.00 – $3,852.98 | 5 |
| Ureter endoscopy & treatment CPT 50957 | not published | not published | $5,543.00 – $5,860.72 | 5 |
| Ureter endoscopy & treatment CPT 50961 | not published | not published | $5,543.00 – $5,860.72 | 5 |
| Ureter endoscopy & treatment CPT 50976 | not published | not published | $4,157.00 – $5,860.72 | 5 |
| Ureter endoscopy & treatment CPT 50980 | not published | not published | $5,543.00 – $5,860.72 | 5 |
| Ureteroneocystostomy 50780 CPT 50780 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Ureteroureterostomy 50760 CPT 50760 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $1,233.00 | $2,055.00 | $255.69 – $260.80 | 3 |
| Urethrlys transvag with scope CPT 53500 | not published | not published | $3,777.44 – $6,675.00 | 5 |
| Urethrocystography void s&i CPT 74455 | $1,233.00 | $2,055.00 | $255.69 – $260.80 | 3 |
| Uric acid blood CPT 84550 | $82.20 | $137.00 | $4.52 – $4.61 | 3 |
| Uric acid urine CPT 84560 | $82.20 | $137.00 | $5.08 – $5.18 | 3 |
| Urinalysis glass test CPT 81020 | not published | not published | $4.70 – $4.79 | 3 |
| Urinalysis microscopic only CPT 81015 | $91.80 | $153.00 | $3.05 – $3.11 | 3 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | $91.80 | $153.00 | $2.17 – $2.21 | 3 |
| Urinalysis (with microscopy) CPT 81001 | $88.80 | $148.00 | $3.17 – $3.23 | 3 |
| Urinalysis (without microscopy) CPT 81003 | $75.00 | $125.00 | $2.25 – $2.30 | 3 |
| Urinary reflex study CPT 51792 | not published | not published | $63.22 – $1,586.00 | 5 |
| Urine Culture Test CPT 87086 | $68.40 | $114.00 | $8.07 – $8.23 | 3 |
| Urine flow measurement 51736 CPT 51736 | not published | not published | $142.58 – $1,586.00 | 5 |
| Urine pregnancy test CPT 81025 | $140.40 | $234.00 | $8.61 – $8.78 | 3 |
| Urine screen for bacteria CPT 81007 | not published | not published | $29.98 – $30.58 | 3 |
| Urine shunt to intestine CPT 50815 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Urography, antegrade CPT 74425 | $1,233.00 | $2,055.00 | $373.86 – $381.34 | 3 |
| Urography inf drip &/or bolus CPT 74410 | not published | not published | $187.96 – $191.72 | 3 |
| Use 1st target lesion CPT 76982 | not published | not published | $112.03 – $114.27 | 3 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | not published | not published | $11.62 – $20.77 | 4 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | not published | not published | $243.62 – $243.62 | 1 |
| U/s trtmt, not leiomyomata HCPCS C9734 | not published | not published | $5,543.00 – $14,033.33 | 5 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $121.85 – $121.85 | 1 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | not published | not published | $116.13 – $116.13 | 1 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | not published | not published | $264.46 – $264.46 | 1 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | not published | not published | $49.34 – $49.34 | 1 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | not published | not published | $115.40 – $115.40 | 1 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | not published | not published | $21.25 – $21.25 | 1 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | not published | not published | $33.79 – $33.79 | 1 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | not published | not published | $118.27 – $118.27 | 1 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | not published | not published | $35.51 – $35.51 | 1 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | not published | not published | $16.90 – $16.90 | 1 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | not published | not published | $44.35 – $44.35 | 1 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | not published | not published | $115.40 – $115.40 | 1 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | not published | not published | $21.81 – $21.81 | 1 |
| Vaccine mmrv live subcutaneous CPT 90710 | not published | not published | $264.00 – $264.00 | 1 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | not published | not published | $220.23 – $220.23 | 1 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | not published | not published | $425.68 – $425.68 | 1 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | not published | not published | $406.23 – $406.23 | 1 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | not published | not published | $476.29 – $476.29 | 1 |
| Vaccine rabies im CPT 90675 | not published | not published | $315.22 – $544.48 | 4 |
| Vaccinia vrs vac 0.3 ml perq CPT 90622 | not published | not published | $0.01 – $0.02 | 4 |
| Vad battery clip set hmii 14-v li-ion HCPCS Q0497 | $3,481.20 | $5,802.00 | not published | 0 |
| Vag hys/<250g/rmv tube/rpr entero 58263 CPT 58263 | not published | not published | $5,360.72 – $6,675.00 | 5 |
| Vag hyst incl t/o complex CPT 58291 | not published | not published | $5,360.72 – $12,241.00 | 5 |
| Vag hyst including t/o CPT 58262 | not published | not published | $5,360.72 – $6,675.00 | 5 |
| Vag hyst t/o & repair compl CPT 58292 | not published | not published | $7,946.52 – $12,241.00 | 5 |
| Vag hyst w/enterocele compl 58294 CPT 58294 | not published | not published | $5,360.72 – $12,241.00 | 5 |
| Vag hyst w/enterocele repair CPT 58270 | not published | not published | $5,360.72 – $6,675.00 | 5 |
| Vaginal bx CPT 58999 | not published | not published | $216.65 – $1,586.00 | 5 |
| Vaginal delivery after cesarean delivery 59612 CPT 59612 | not published | not published | $3,468.96 – $5,672.00 | 5 |
| Vaginal hysterectomy CPT 58260 | not published | not published | $5,360.72 – $6,675.00 | 5 |
| Vaginectomy partial w/nodes CPT 57109 | not published | not published | $3,468.96 – $5,672.00 | 5 |
| Vag inser rectal control sys HCPCS A4563 | not published | not published | $1,680.58 – $1,714.19 | 3 |
| Vagnc compl rmvl paravag tis CPT 57111 | not published | not published | $6,223.00 – $6,675.00 | 2 |
| Vagnc compl rmvl vag wall CPT 57110 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Vagotomy pfrmd w/prtl dstl gstrct 43635 CPT 43635 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Vagotomy & pylorus repair CPT 43641 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Vagotomy & pylorus repair 43640 CPT 43640 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Valproic acid total therapeutic drug level CPT 80164 | $172.20 | $287.00 | $13.54 – $13.81 | 3 |
| Valrubicin injection HCPCS J9357 | not published | not published | $1,270.52 – $2,296.47 | 4 |
| Valvuloplasty aortic CPT 92986 | not published | not published | $6,099.19 – $17,033.00 | 5 |
| Valvuloplasty aortic valve CPT 33390 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Valvuloplasty aortic valve CPT 33391 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Valvuloplasty mitral CPT 92987 | not published | not published | $7,993.00 – $17,033.00 | 5 |
| Valvuloplasty pulmonary CPT 92990 | not published | not published | $7,993.00 – $17,033.00 | 5 |
| Valvuloplasty/tv without ring insert 33463 CPT 33463 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Valvuloplasty/tv w/ring insertion 33464 CPT 33464 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Vancomycin peak therapeutic drug level CPT 80202 | $233.40 | $389.00 | $13.54 – $13.81 | 3 |
| Vanomycin dna amp probe CPT 87500 | not published | not published | $35.09 – $35.79 | 3 |
| Vantas implant HCPCS J9225 | not published | not published | $8,524.38 – $8,524.38 | 1 |
| Varicella zoster antibody igg CPT 86787 | $184.80 | $308.00 | $12.88 – $13.14 | 3 |
| Varicella-zoster immue globin im CPT 90396 | not published | not published | $2,363.25 – $3,724.58 | 4 |
| Vasc graft into carpal bone CPT 25430 | not published | not published | $3,506.34 – $12,241.00 | 5 |
| Vasectomy CPT 55250 | not published | not published | $2,240.09 – $5,672.00 | 5 |
| Vedolizumab 300 mg intravenous solution HCPCS J3380 | not published | not published | $20.98 – $37.42 | 4 |
| Veeg ea 12-26hr cont mntr CPT 95716 | not published | not published | $920.24 – $938.65 | 3 |
| Veeg unmon 2-12 hrs CPT 95711 | not published | not published | $231.39 – $236.02 | 3 |
| Vein bypass grft fem-popliteal 35583 CPT 35583 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Vein byp fem-tibial peroneal 35585 CPT 35585 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Vein byp pop-tibl peroneal CPT 35587 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Vein gft fem a/p tib/pero/dis art 35566 CPT 35566 | not published | not published | $5,543.00 – $5,672.00 | 2 |
| Vein x-ray adrenal gland CPT 75840 | not published | not published | $3,383.62 – $3,451.29 | 3 |
| Vein x-ray eye socket CPT 75880 | not published | not published | $672.23 – $685.67 | 3 |
| Vein x-ray kidney CPT 75831 | not published | not published | $3,383.62 – $3,451.29 | 3 |
| Vein x-ray liver CPT 75891 | not published | not published | $3,383.62 – $3,451.29 | 3 |
| Vein x-ray liver w/hemodynam CPT 75885 | $1,959.60 | $3,266.00 | $3,383.62 – $3,451.29 | 3 |
| Vein x-ray liver w/hemodynam CPT 75889 | $2,712.00 | $4,520.00 | $3,383.62 – $3,451.29 | 3 |
| Vein x-ray liver without hemodyn CPT 75887 | $1,959.60 | $3,266.00 | $3,383.62 – $3,451.29 | 3 |
| Vein x-ray skull CPT 75870 | not published | not published | $3,383.62 – $3,451.29 | 3 |
| Vein x-ray skull epidural CPT 75872 | not published | not published | $672.23 – $685.67 | 3 |
| Vein x-ray spleen/liver CPT 75810 | not published | not published | $3,383.62 – $3,451.29 | 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.