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 |
|---|---|---|---|---|
| Inj, lidocaine w epinephrine HCPCS J2004 | $0.26 | $0.36 | $0.07 – $0.07 | 1 |
| Inj multihance HCPCS A9577 | $15.66 | $21.75 | $2.97 – $2.97 | 1 |
| Inj proc ankle arthr CPT 27648 | $910.08 | $1,264.00 | $298.08 – $708.00 | 3 |
| Inj proc elbow arthro CPT 24220 | $667.44 | $927.00 | $298.08 – $708.00 | 3 |
| Inj retro urethrocysto CPT 51610 | $1,293.12 | $1,796.00 | $298.08 – $708.00 | 3 |
| Insertion catheter bladder non indwelling CPT 51701 | $166.32 | $231.00 | $78.42 – $356.44 | 12 |
| Insertion catheter bladder temporary simple CPT 51702 | $270.00 | $375.00 | $78.42 – $356.44 | 12 |
| Insertion nontunneled centrally inserted central venous catheter >= 5 years old CPT 36556 | $3,399.12 | $4,721.00 | $998.55 – $8,459.04 | 12 |
| Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years CPT 36569 | $1,534.32 | $2,131.00 | $998.55 – $4,217.23 | 12 |
| Insertion picc without port or pump with imaging guidance=>5y CPT 36573 | $3,607.20 | $5,010.00 | $674.76 – $4,217.23 | 12 |
| Ins tun cv cath wo subq prt/pm CPT 36558 | $6,410.88 | $8,904.00 | $1,928.40 – $8,459.04 | 12 |
| Insulin total CPT 83525 | $126.00 | $175.00 | $9.74 – $28.58 | 12 |
| Intens cardiac rehab no exer HCPCS G0423 | $246.24 | $342.00 | $138.14 – $345.35 | 12 |
| Intens cardiac rehab w/exerc HCPCS G0422 | $262.08 | $364.00 | $138.14 – $345.35 | 12 |
| Intrinsic factor antibody CPT 86340 | $87.84 | $122.00 | $8.50 – $37.70 | 12 |
| Intubation endotracheal emergency procedure CPT 31500 | $668.88 | $929.00 | $253.81 – $670.08 | 12 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $1.37 | $1.90 | $0.25 – $0.25 | 1 |
| Iron CPT 83540 | $108.72 | $151.00 | $3.99 – $16.18 | 12 |
| Iron binding capacity CPT 83550 | $122.40 | $170.00 | $3.99 – $21.85 | 12 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $145.44 | $202.00 | $25.29 – $158.04 | 12 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $150.48 | $209.00 | $30.86 – $209.00 | 12 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $150.48 | $209.00 | $209.00 – $209.00 | 2 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $126.00 | $175.00 | $20.07 – $175.00 | 12 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $303.12 | $421.00 | $91.17 – $569.84 | 12 |
| Jak2 targeted sequence analysis CPT 81279 | $501.84 | $697.00 | $121.56 – $463.00 | 12 |
| John cunningham antibody CPT 86711 | $2,745.36 | $3,813.00 | $8.50 – $42.23 | 12 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $12.96 | $18.00 | $0.33 – $0.83 | 11 |
| Kidney imag w/bld flow multi CPT 78709 | $1,694.16 | $2,353.00 | $334.42 – $1,454.64 | 12 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $1,694.16 | $2,353.00 | $334.42 – $1,454.64 | 12 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $1,056.24 | $1,467.00 | $44.81 – $280.08 | 12 |
| Knee arthroscopy/surgery CPT 29880 | not published | not published | not published | 0 |
| Knee MRI (with and without contrast) CPT 73723 | $3,722.40 | $5,170.00 | $370.49 – $2,862.00 | 13 |
| Knee MRI (with contrast) CPT 73722 | $2,949.12 | $4,096.00 | $370.49 – $2,862.00 | 13 |
| Knee MRI (without contrast) CPT 73721 | $2,943.36 | $4,088.00 | $219.59 – $2,862.00 | 13 |
| Knee X-ray CPT 73564 | $541.44 | $752.00 | $51.11 – $280.08 | 12 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $3.24 | $4.50 | $0.58 – $0.58 | 1 |
| Lactate dehydrogenase (ldh) CPT 83615 | $89.28 | $124.00 | $3.99 – $15.10 | 12 |
| Lactated ringers intravenous solution HCPCS J7120 | $32.40 | $45.00 | $3.93 – $3.93 | 1 |
| Lactic acid CPT 83605 | $136.80 | $190.00 | $8.82 – $28.93 | 12 |
| Lactoferrin fecal qualitative CPT 83630 | $54.72 | $76.00 | $8.82 – $49.25 | 12 |
| Lactoferrin fecal quant CPT 83631 | $133.20 | $185.00 | $8.82 – $49.08 | 12 |
| Lap ing hernia repair init CPT 49650 | not published | not published | not published | 0 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | $2,895.12 | $4,021.00 | $549.43 – $4,768.43 | 12 |
| Lead capillary CPT 83655 | $105.84 | $147.00 | $9.08 – $30.28 | 12 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,406.88 | $1,954.00 | $153.26 – $639.23 | 12 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $0.28 | $0.39 | $0.07 – $0.07 | 1 |
| Levetiracetam therapeutic drug level CPT 80177 | $146.16 | $203.00 | $8.95 – $33.13 | 12 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $65.52 | $91.00 | $3.56 – $3.56 | 1 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $0.65 | $0.90 | $0.06 – $0.06 | 1 |
| Lidocaine therapeutic drug level CPT 80176 | $79.20 | $110.00 | $8.95 – $36.73 | 12 |
| Lipase CPT 83690 | $139.68 | $194.00 | $3.99 – $17.23 | 12 |
| Lipoprotein direct measurement hdl CPT 83718 | $65.52 | $91.00 | $3.99 – $20.48 | 12 |
| Lipoprotein direct measurement ldl CPT 83721 | $65.52 | $91.00 | $3.99 – $26.25 | 12 |
| Lithium therapeutic drug level CPT 80178 | $56.88 | $79.00 | $6.61 – $16.53 | 12 |
| Liver Function Test CPT 80076 | $231.84 | $322.00 | $6.67 – $20.43 | 12 |
| Liver/spleen imag static only CPT 78215 | $1,659.60 | $2,305.00 | $428.40 – $1,071.01 | 12 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $134.64 | $187.00 | $2.33 – $2.33 | 1 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,742.48 | $3,809.00 | $187.96 – $2,290.00 | 13 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,626.56 | $3,648.00 | $276.64 – $2,290.00 | 13 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $2,355.84 | $3,272.00 | $97.12 – $2,290.00 | 13 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $4,202.64 | $5,837.00 | $370.49 – $2,862.00 | 13 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,974.32 | $4,131.00 | $370.49 – $2,862.00 | 13 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $3,201.12 | $4,446.00 | $102.28 – $2,862.00 | 13 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $496.80 | $690.00 | $44.81 – $280.08 | 12 |
| Lung Function Test (Spirometry) CPT 94010 | $210.96 | $293.00 | $52.41 – $578.47 | 12 |
| Lung perfusion imaging CPT 78580 | $1,075.68 | $1,494.00 | $428.40 – $1,071.01 | 12 |
| Lymphatics/lymph node imaging CPT 78195 | $2,404.80 | $3,340.00 | $581.86 – $1,454.64 | 12 |
| Magnesium CPT 83735 | $114.48 | $159.00 | $3.99 – $16.75 | 12 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $16.38 | $22.75 | $0.68 – $0.68 | 1 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $130.32 | $181.00 | $52.41 – $356.44 | 12 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $238.32 | $331.00 | $52.41 – $356.44 | 12 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $142.56 | $198.00 | $8.82 – $36.15 | 12 |
| Mayo aathr protein s free CPT 85306 | $149.76 | $208.00 | $3.27 – $38.30 | 12 |
| Mayo activated protein c resistance assay CPT 85307 | $102.96 | $143.00 | $4.38 – $38.30 | 12 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $216.00 | $300.00 | $8.95 – $96.43 | 12 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $76.32 | $106.00 | $8.82 – $36.95 | 12 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $328.32 | $456.00 | $10.33 – $10.82 | 2 |
| Mayo alpha 1 antitrypsin CPT 82103 | $118.08 | $164.00 | $8.82 – $33.60 | 12 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $72.00 | $100.00 | $8.95 – $37.70 | 12 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $300.24 | $417.00 | $34.38 – $304.08 | 12 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $247.68 | $344.00 | $34.38 – $229.15 | 12 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $1,461.60 | $2,030.00 | $1,160.00 – $2,900.00 | 12 |
| Mayo androstenedione CPT 82157 | $99.36 | $138.00 | $9.74 – $73.20 | 12 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $87.84 | $122.00 | $8.82 – $36.50 | 12 |
| Mayo antithrombin iii antigen CPT 85301 | $231.12 | $321.00 | $3.27 – $27.03 | 12 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $138.96 | $193.00 | $8.50 – $37.63 | 12 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $114.48 | $159.00 | $31.63 – $87.73 | 12 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $88.56 | $123.00 | $8.50 – $25.45 | 12 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $545.76 | $758.00 | $121.56 – $362.10 | 12 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $74.16 | $103.00 | $8.50 – $32.25 | 12 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $97.20 | $135.00 | $8.50 – $32.98 | 12 |
| Mayo brcmg brucella antibody igm CPT 86622 | $84.96 | $118.00 | $8.50 – $22.33 | 12 |
| Mayo c1 esterase inhibitor CPT 83883 | $123.12 | $171.00 | $8.50 – $34.00 | 12 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $196.56 | $273.00 | $8.82 – $42.18 | 12 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $262.08 | $364.00 | $34.38 – $305.55 | 12 |
| Mayo ceruloplasmin CPT 82390 | $89.28 | $124.00 | $3.99 – $26.85 | 12 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $138.96 | $193.00 | $8.82 – $35.30 | 12 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $167.04 | $232.00 | $8.50 – $32.20 | 12 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $92.16 | $128.00 | $8.50 – $29.55 | 12 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $145.44 | $202.00 | $8.50 – $31.70 | 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.