Ascension Alexian Brothers Behavioral Health Hospital
1650 Moon Lake Blvd, Hoffman Estates, IL · Ascension · · NPI 1013017839
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 |
|---|---|---|---|---|
| Ultrasound guided needle placement supervision & interpretation CPT 76942 | not published | not published | $69.52 – $673.38 | 6 |
| Ultrasound guide intraoperative CPT 76998 | not published | not published | $215.05 – $219.30 | 5 |
| Ultrasound guide tissue ablation CPT 76940 | not published | not published | $617.32 – $629.52 | 5 |
| Ultrasound hips infant dynamic CPT 76885 | not published | not published | $211.96 – $474.72 | 6 |
| Ultrasound infant hips ltd without stress CPT 76886 | not published | not published | $176.83 – $350.88 | 6 |
| Ultrasound joint complete left CPT 76881 | not published | not published | $27.75 – $436.02 | 6 |
| Ultrasound joint/nonvascular extremity limited left CPT 76882 | not published | not published | $23.66 – $436.02 | 6 |
| Ultrasound nrv&acc strux 1xtr compre CPT 76883 | not published | not published | $36.76 – $36.76 | 1 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | not published | not published | $103.12 – $371.52 | 6 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | not published | not published | $52.42 – $268.32 | 6 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | not published | not published | $215.05 – $815.28 | 6 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | not published | not published | $171.92 – $387.00 | 6 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | not published | not published | $125.24 – $319.92 | 6 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | not published | not published | $141.62 – $379.26 | 6 |
| Ultrasound prostate/transrectal CPT 76872 | not published | not published | $258.76 – $497.94 | 6 |
| Ultrasound retroperitoneal limited CPT 76775 | not published | not published | $78.53 – $407.64 | 6 |
| Ultrasound scrotum and contents CPT 76870 | not published | not published | $175.20 – $420.54 | 6 |
| Ultrasound spinal canal and contents CPT 76800 | not published | not published | $238.26 – $428.28 | 6 |
| Ultrasound transabd ea addl gest CPT 76812 | not published | not published | $266.85 – $737.88 | 6 |
| Ultrasound transvaginal non obstetric CPT 76830 | not published | not published | $215.33 – $441.18 | 6 |
| Ultrasound trgt dyn mbubb 1st les CPT 76978 | not published | not published | $442.96 – $442.96 | 1 |
| Ultrasound trgt dyn mbubb ea addl CPT 76979 | not published | not published | $313.63 – $313.63 | 1 |
| Ultraviolet therapy CPT 97028 | not published | not published | $8.47 – $20.76 | 2 |
| Unlisted CT procedure CPT 76497 | not published | not published | $368.00 – $368.00 | 1 |
| Unlisted cv px dx nuc med CPT 78499 | not published | not published | $538.32 – $538.32 | 1 |
| Unlisted cytogenetic study CPT 88299 | not published | not published | $6.07 – $75.99 | 2 |
| Unlisted cytopathology px CPT 88199 | not published | not published | $6.07 – $75.99 | 2 |
| Unlisted endocrine px dx nuc CPT 78099 | not published | not published | $538.32 – $538.32 | 1 |
| Unlisted fluoroscopic px CPT 76496 | not published | not published | $98.40 – $98.40 | 1 |
| Unlisted gi px dx nuc med CPT 78299 | not published | not published | $538.32 – $538.32 | 1 |
| Unlisted gu px dx nuc med CPT 78799 | not published | not published | $538.32 – $538.32 | 1 |
| Unlisted hematology&coagj px CPT 85999 | not published | not published | $6.07 – $20.21 | 2 |
| Unlisted maaa CPT 81599 | not published | not published | $371.36 – $371.36 | 1 |
| Unlisted misc path test CPT 89240 | not published | not published | $6.07 – $75.99 | 2 |
| Unlisted mr procedure CPT 76498 | not published | not published | $540.00 – $540.00 | 1 |
| Unlisted muscskel px dx nuc CPT 78399 | not published | not published | $538.32 – $538.32 | 1 |
| Unlisted nrvs sys px dx nuc CPT 78699 | not published | not published | $538.32 – $538.32 | 1 |
| Unlisted procedure microbiology CPT 87999 | not published | not published | $6.07 – $20.21 | 2 |
| Unlisted procedure urinary 58750 CPT 58750 | not published | not published | $2,749.50 – $2,749.50 | 1 |
| Unlisted px med radj physics CPT 77399 | not published | not published | $173.81 – $173.81 | 1 |
| Unlisted px ther rad tx plng CPT 77299 | not published | not published | $173.81 – $173.81 | 1 |
| Unlisted reprod med lab proc CPT 89398 | not published | not published | $12.50 – $12.50 | 1 |
| Unlisted resp px dx nuc med CPT 78599 | not published | not published | $538.32 – $538.32 | 1 |
| Unlisted surgical path px CPT 88399 | not published | not published | $6.07 – $75.99 | 2 |
| Unlisted transfusion med px CPT 86999 | not published | not published | $16.07 – $20.21 | 2 |
| Unlisted ultrasound procedure CPT 76999 | not published | not published | $149.00 – $149.00 | 1 |
| Unlisted urinalysis px CPT 81099 | not published | not published | $6.07 – $20.21 | 2 |
| Unlstd hematop ret/endo lymp CPT 78199 | not published | not published | $538.32 – $538.32 | 1 |
| Upgrade pm system CPT 33214 | not published | not published | $11,749.00 – $11,749.00 | 1 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | not published | not published | $559.07 – $2,925.72 | 6 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | not published | not published | $493.74 – $2,100.12 | 6 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | not published | not published | $315.99 – $1,909.20 | 6 |
| Urea nitrogen CPT 84520 | not published | not published | $1.08 – $12.90 | 9 |
| Urea nitrogen 24 hour urine CPT 84540 | not published | not published | $3.89 – $15.48 | 9 |
| Urea nitrogen clearance CPT 84545 | not published | not published | $5.15 – $16.85 | 9 |
| Urea nitrogen semi-quant CPT 84525 | not published | not published | $3.59 – $12.00 | 9 |
| Ureteral reflux study CPT 78740 | not published | not published | $439.50 – $704.34 | 6 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | not published | not published | $263.12 – $268.32 | 5 |
| Urethrocystography void s&i CPT 74455 | not published | not published | $221.06 – $319.92 | 6 |
| Uric acid blood CPT 84550 | not published | not published | $1.08 – $12.90 | 9 |
| Uric acid urine CPT 84560 | not published | not published | $3.69 – $15.48 | 9 |
| Urinalysis glass test CPT 81020 | not published | not published | $3.29 – $11.00 | 9 |
| Urinalysis microscopic only CPT 81015 | not published | not published | $2.29 – $10.32 | 9 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | not published | not published | $1.63 – $7.74 | 9 |
| Urinalysis (with microscopy) CPT 81001 | not published | not published | $2.38 – $10.32 | 9 |
| Urinalysis (without microscopy) CPT 81003 | not published | not published | $1.69 – $7.74 | 9 |
| Urinary bldr retent nuc study CPT 78730 | not published | not published | $150.63 – $270.90 | 6 |
| Urine Culture Test CPT 87086 | not published | not published | $6.05 – $28.38 | 9 |
| Urine pregnancy test CPT 81025 | not published | not published | $6.03 – $20.64 | 9 |
| Urine screen for bacteria CPT 81007 | not published | not published | $4.31 – $70.15 | 9 |
| Urography, antegrade CPT 74425 | not published | not published | $242.88 – $280.05 | 6 |
| Urography inf drip &/or bolus CPT 74410 | not published | not published | $293.88 – $405.06 | 6 |
| Use 1st target lesion CPT 76982 | not published | not published | $161.27 – $161.27 | 1 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | not published | not published | $178.02 – $178.02 | 1 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | not published | not published | $178.02 – $178.02 | 1 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | not published | not published | $159.94 – $159.94 | 1 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | not published | not published | $107.09 – $107.09 | 1 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | not published | not published | $79.97 – $79.97 | 1 |
| Vaccine dtap < 7 years im CPT 90700 | not published | not published | $93.61 – $95.46 | 5 |
| Vaccine dtap-hep b-ipv im CPT 90723 | not published | not published | $301.07 – $307.02 | 5 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | not published | not published | $194.81 – $198.66 | 5 |
| Vaccine dtap-ipv/hib im CPT 90698 | not published | not published | $296.01 – $301.86 | 5 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | not published | not published | $93.61 – $95.46 | 5 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | not published | not published | $93.61 – $95.46 | 5 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | not published | not published | $258.06 – $263.16 | 5 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | not published | not published | $354.20 – $361.20 | 5 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | not published | not published | $129.03 – $131.58 | 5 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | not published | not published | $116.38 – $118.68 | 5 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $56.58 – $95.46 | 6 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | not published | not published | $53.22 – $250.26 | 6 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | not published | not published | $195.54 – $2,420.00 | 2 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | not published | not published | $21.04 – $95.46 | 6 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | not published | not published | $397.21 – $405.06 | 5 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | not published | not published | $39.48 – $89.55 | 2 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | not published | not published | $35.27 – $1,564.00 | 2 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | not published | not published | $73.37 – $74.82 | 5 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | not published | not published | $15.58 – $51.60 | 6 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | not published | not published | $14.80 – $25.47 | 2 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | not published | not published | $94.38 – $2,420.00 | 2 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | not published | not published | $17.06 – $1,564.00 | 2 |
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.