HSHS Holy Family Hospital
200 HEALTH CARE DR, GREENVILLE, IL · Hshs · · NPI 1205850690
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 |
|---|---|---|---|---|
| Susceptibility enzyme detection per enzyme CPT 87185 | $18.00 | $25.00 | $4.75 – $11.88 | 12 |
| Susceptibility mic per plate CPT 87186 | $175.68 | $244.00 | $7.78 – $21.63 | 12 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $48.96 | $68.00 | $4.40 – $11.00 | 12 |
| T3 (triiodothyronine) free CPT 84481 | $279.36 | $388.00 | $9.74 – $42.35 | 12 |
| T3 (triiodothyronine) total CPT 84480 | $156.24 | $217.00 | $9.74 – $35.45 | 12 |
| T4 (thyroxine) free CPT 84439 | $167.04 | $232.00 | $9.02 – $22.55 | 12 |
| T4 (thyroxine) total CPT 84436 | $108.72 | $151.00 | $6.87 – $17.18 | 12 |
| Tacrolimus therapeutic drug level CPT 80197 | $344.16 | $478.00 | $8.95 – $34.33 | 12 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $271.44 | $377.00 | $30.13 – $154.95 | 12 |
| Tc-99m non-heu per study dose HCPCS Q9969 | $18.72 | $26.00 | $16.50 – $16.50 | 1 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $145.44 | $202.00 | $30.13 – $117.45 | 12 |
| T cells total count CPT 86359 | $117.36 | $163.00 | $30.13 – $94.33 | 12 |
| Telehealth original site facility fee HCPCS Q3014 | $42.48 | $59.00 | $12.81 – $79.63 | 12 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $573.51 | $796.54 | $186.97 – $796.54 | 12 |
| Test stress cardiovascular tracing only CPT 93017 | $874.80 | $1,215.00 | $75.42 – $289.23 | 12 |
| Tgsap so neo 5-50 rna alys CPT 81449 | $2,255.04 | $3,132.00 | $597.91 – $1,801.28 | 12 |
| Theophylline therapeutic drug level CPT 80198 | $115.92 | $161.00 | $8.95 – $35.35 | 12 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $39.60 | $55.00 | $30.24 – $88.95 | 12 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $34.56 | $48.00 | $26.15 – $76.90 | 12 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $17.28 | $24.00 | $2.99 – $2.99 | 1 |
| Thrombin time CPT 85670 | $41.04 | $57.00 | $3.27 – $14.43 | 12 |
| Thyroglobulin antibody CPT 86800 | $25.92 | $36.00 | $8.50 – $39.78 | 12 |
| Thyroid imaging CPT 78013 | $792.00 | $1,100.00 | $334.42 – $1,071.01 | 12 |
| Thyroid (TSH) Test CPT 84443 | $187.92 | $261.00 | $9.74 – $37.50 | 12 |
| Thyroid Ultrasound CPT 76536 | $981.36 | $1,363.00 | $44.81 – $140.04 | 12 |
| Thyroxine binding globulin (tbg) CPT 84442 | $115.20 | $160.00 | $9.74 – $36.95 | 12 |
| Tissue exam koh skin/hair/nails CPT 87220 | $62.64 | $87.00 | $4.27 – $10.68 | 12 |
| Tissue transglutaminase iga CPT 86364 | $109.44 | $152.00 | $8.50 – $28.83 | 12 |
| Tobramycin peak therapeutic drug level CPT 80200 | $115.20 | $160.00 | $8.95 – $40.33 | 12 |
| Tomosynthesis breast diagnostic left HCPCS G0279 | $108.00 | $150.00 | $10.51 – $45.53 | 12 |
| Tomosynthesis breast screen bilateral CPT 77063 | $102.24 | $142.00 | $19.36 – $53.78 | 12 |
| Total tau CPT 84394 | $511.20 | $710.00 | $128.92 – $322.30 | 11 |
| Toxoplasma antibody igg CPT 86777 | $103.68 | $144.00 | $8.50 – $35.98 | 12 |
| Toxoplasma antibody igm CPT 86778 | $103.68 | $144.00 | $8.50 – $36.03 | 12 |
| Training self management diabetes individual outpatient department per 30 minutes HCPCS G0108 | $55.44 | $77.00 | $55.18 – $137.95 | 12 |
| Transferrin CPT 84466 | $126.72 | $176.00 | $8.82 – $31.90 | 12 |
| Transfusion blood/blood component(s) CPT 36430 | $488.16 | $678.00 | $367.49 – $1,181.93 | 12 |
| Treat fracture of radius CPT 25520 | $1,728.72 | $2,401.00 | $418.59 – $4,307.88 | 12 |
| Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour CPT 94644 | $264.24 | $367.00 | $52.41 – $356.44 | 12 |
| Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour CPT 94645 | $236.88 | $329.00 | $52.41 – $286.00 | 3 |
| Treatment inhalation pressurized/nonpressurized acute airway obstruction CPT 94640 | $192.96 | $268.00 | $52.41 – $586.65 | 12 |
| Treponema pallidum antibody CPT 86780 | $151.20 | $210.00 | $8.50 – $33.10 | 12 |
| Triamcinolone acetonide 40 mg/ml suspension for injection HCPCS J3301 | $7.38 | $10.25 | $1.22 – $1.22 | 1 |
| Triglycerides CPT 84478 | $101.52 | $141.00 | $3.99 – $14.35 | 12 |
| Trluml dil aq o/f can without st CPT 66174 | not published | not published | not published | 0 |
| Trnscath tx thromblytc vein ini day CPT 37212 | $3,399.12 | $4,721.00 | $3,352.93 – $8,459.04 | 12 |
| Troponin quantitative CPT 84484 | $203.76 | $283.00 | $8.82 – $31.18 | 12 |
| Tte w or without contr, cont ecg HCPCS C8930 | $1,519.92 | $2,111.00 | $394.09 – $2,100.16 | 12 |
| Tte w or without fol w/con,stres HCPCS C8928 | $1,519.92 | $2,111.00 | $197.04 – $1,050.08 | 12 |
| Ultrasound abdomen aorta screening study aaa CPT 76706 | $826.56 | $1,148.00 | $44.81 – $280.08 | 12 |
| Ultrasound breast complete CPT 76641 | $807.84 | $1,122.00 | $99.47 – $280.08 | 12 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $245.52 | $341.00 | $93.26 – $233.14 | 12 |
| Ultrasound chest CPT 76604 | $280.08 | $389.00 | $44.81 – $280.08 | 12 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $280.08 | $389.00 | $99.47 – $280.08 | 12 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $826.56 | $1,148.00 | $91.63 – $280.08 | 12 |
| Ultrasound guidance for vascular access CPT 76937 | $1,260.00 | $1,750.00 | $102.28 – $742.00 | 3 |
| Ultrasound guided needle placement supervision & interpretation CPT 76942 | $905.76 | $1,258.00 | $102.28 – $742.00 | 3 |
| Ultrasound guide intraoperative CPT 76998 | $972.72 | $1,351.00 | $102.28 – $742.00 | 3 |
| Ultrasound hips infant dynamic CPT 76885 | $208.08 | $289.00 | $93.26 – $233.14 | 12 |
| Ultrasound infant hips ltd without stress CPT 76886 | $208.08 | $289.00 | $93.26 – $233.14 | 12 |
| Ultrasound joint complete left CPT 76881 | $601.20 | $835.00 | $99.47 – $280.08 | 12 |
| Ultrasound joint/nonvascular extremity limited left CPT 76882 | $826.56 | $1,148.00 | $44.81 – $280.08 | 12 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $363.60 | $505.00 | $91.63 – $505.00 | 3 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $826.56 | $1,148.00 | $91.63 – $742.00 | 3 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $591.84 | $822.00 | $91.63 – $639.23 | 12 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $822.96 | $1,143.00 | $91.63 – $280.08 | 12 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | $697.68 | $969.00 | $91.63 – $280.08 | 12 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | $794.88 | $1,104.00 | $91.63 – $280.08 | 12 |
| Ultrasound retroperitoneal limited CPT 76775 | $318.96 | $443.00 | $44.81 – $280.08 | 12 |
| Ultrasound scrotum and contents CPT 76870 | $907.20 | $1,260.00 | $44.81 – $280.08 | 12 |
| Ultrasound spinal canal and contents CPT 76800 | $465.84 | $647.00 | $99.47 – $280.08 | 12 |
| Ultrasound transvaginal non obstetric CPT 76830 | $826.56 | $1,148.00 | $44.81 – $140.04 | 12 |
| Unlisted hystsc px uterus CPT 58579 | not published | not published | not published | 0 |
| Unlisted transfusion med px CPT 86999 | $47.52 | $66.00 | $3.27 – $77.49 | 12 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $3,722.40 | $5,170.00 | $149.54 – $2,862.00 | 13 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $3,244.32 | $4,506.00 | $370.49 – $2,862.00 | 13 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $3,178.08 | $4,414.00 | $102.28 – $2,862.00 | 13 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | not published | not published | not published | 0 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | not published | not published | not published | 0 |
| Urea nitrogen CPT 84520 | $67.68 | $94.00 | $3.95 – $9.88 | 12 |
| Urea nitrogen 24 hour urine CPT 84540 | $92.88 | $129.00 | $3.99 – $13.90 | 12 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $1,406.88 | $1,954.00 | $107.70 – $639.23 | 12 |
| Uric acid blood CPT 84550 | $87.84 | $122.00 | $3.99 – $11.30 | 12 |
| Uric acid urine CPT 84560 | $56.88 | $79.00 | $3.99 – $12.70 | 12 |
| Urinalysis microscopic only CPT 81015 | $21.60 | $30.00 | $2.22 – $7.63 | 12 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | $25.20 | $35.00 | $2.17 – $5.43 | 12 |
| Urinalysis (with microscopy) CPT 81001 | $94.32 | $131.00 | $2.22 – $7.93 | 12 |
| Urinalysis (without microscopy) CPT 81003 | $72.72 | $101.00 | $2.22 – $5.63 | 12 |
| Urine Culture Test CPT 87086 | $156.24 | $217.00 | $7.78 – $20.18 | 12 |
| Urine pregnancy test CPT 81025 | $132.48 | $184.00 | $2.22 – $21.53 | 12 |
| Urography, antegrade CPT 74425 | $1,406.88 | $1,954.00 | $107.70 – $934.65 | 12 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $72.00 | $100.00 | $19.34 – $77.50 | 12 |
| Vaccine rabies im CPT 90675 | $1,502.28 | $2,086.50 | $102.41 – $799.37 | 12 |
| Vaccine tdap >=7 years im CPT 90715 | $167.40 | $232.50 | $19.34 – $65.49 | 3 |
| Valproic acid total therapeutic drug level CPT 80164 | $154.08 | $214.00 | $8.95 – $33.85 | 12 |
| Vancomycin 1,000 mg intravenous injection HCPCS J3373 | $0.62 | $0.86 | $0.05 – $0.05 | 1 |
| Vancomycin peak therapeutic drug level CPT 80202 | $169.20 | $235.00 | $8.95 – $33.85 | 12 |
| Varicella zoster antibody igg CPT 86787 | $266.40 | $370.00 | $8.50 – $32.20 | 12 |
| Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture) CPT 36410 | $68.40 | $95.00 | $68.36 – $71.62 | 2 |
| Very long chain fatty acids CPT 82726 | $209.52 | $291.00 | $8.82 – $49.38 | 12 |
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.