HSHS St. Francis Hospital
1215 FRANCISCAN DRIVE, LITCHFIELD, IL · Hshs · · NPI 1326057076
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 |
|---|---|---|---|---|
| Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides) CPT 36561 | not published | not published | not published | 0 |
| In situ hybridization per specimen initial single probe stain CPT 88365 | $650.16 | $903.00 | $163.25 – $903.00 | 4 |
| Instillation anticarcinogenic agent bladder CPT 51720 | $1,253.52 | $1,741.00 | $500.71 – $1,741.00 | 4 |
| Insulin total CPT 83525 | $115.92 | $161.00 | $13.28 – $74.00 | 4 |
| Intens cardiac rehab no exer HCPCS G0423 | $274.32 | $381.00 | $193.64 – $381.00 | 4 |
| Intens cardiac rehab w/exerc HCPCS G0422 | $274.32 | $381.00 | $193.64 – $381.00 | 4 |
| Intrinsic factor antibody CPT 86340 | $43.92 | $61.00 | $11.58 – $61.00 | 4 |
| Intubation endotracheal emergency procedure CPT 31500 | $690.48 | $959.00 | $872.12 – $959.33 | 4 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $1.37 | $1.90 | $0.25 – $1.71 | 3 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | $24.77 | $34.40 | $2.95 – $34.40 | 3 |
| Iron CPT 83540 | $120.96 | $168.00 | $5.44 – $168.00 | 4 |
| Iron binding capacity CPT 83550 | $244.08 | $339.00 | $5.44 – $339.00 | 4 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $2.18 | $3.03 | $0.40 – $2.82 | 3 |
| Irradiation of blood product each unit reference CPT 86945 | $95.04 | $132.00 | $105.15 – $132.00 | 4 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $206.64 | $287.00 | $57.48 – $287.00 | 4 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $223.92 | $311.00 | $311.00 – $402.08 | 4 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $223.92 | $311.00 | $311.00 – $402.08 | 4 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $223.92 | $311.00 | $311.00 – $629.88 | 4 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $405.36 | $563.00 | $365.53 – $563.00 | 4 |
| Jak2 targeted sequence analysis CPT 81279 | $566.64 | $787.00 | $165.74 – $787.00 | 4 |
| John cunningham antibody CPT 86711 | $1,989.36 | $2,763.00 | $11.58 – $2,763.00 | 4 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $48.96 | $68.00 | $5.44 – $68.00 | 4 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $12.96 | $18.00 | $0.54 – $4.50 | 3 |
| Kidney imaging morphology CPT 78700 | $962.64 | $1,337.00 | $455.98 – $1,337.00 | 4 |
| Kidney imag w/bld flow multi CPT 78709 | $1,848.96 | $2,568.00 | $455.98 – $2,568.00 | 4 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $1,329.12 | $1,846.00 | $455.98 – $1,846.00 | 4 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $1,145.52 | $1,591.00 | $208.96 – $1,591.00 | 4 |
| Kit gene analys d816 variant CPT 81273 | $635.04 | $882.00 | $46.87 – $882.00 | 4 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | $187.20 | $260.00 | $209.78 – $260.00 | 3 |
| Knee Arthroscopy (Meniscus Repair) CPT 29881 | $7,008.48 | $9,734.00 | $2,654.23 – $9,734.00 | 4 |
| Knee arthroscopy/surgery CPT 29873 | $7,008.48 | $9,734.00 | $2,654.23 – $9,734.00 | 4 |
| Knee arthroscopy/surgery CPT 29876 | not published | not published | not published | 0 |
| Knee arthroscopy/surgery CPT 29879 | not published | not published | not published | 0 |
| Knee arthroscopy/surgery CPT 29880 | $7,008.48 | $9,734.00 | $2,654.23 – $9,734.00 | 4 |
| Knee arthroscopy/surgery CPT 29888 | $15,430.32 | $21,431.00 | $6,694.03 – $21,431.00 | 4 |
| Knee MRI (with and without contrast) CPT 73723 | $3,672.00 | $5,100.00 | $505.16 – $5,100.00 | 5 |
| Knee MRI (with contrast) CPT 73722 | $3,111.84 | $4,322.00 | $505.16 – $4,322.00 | 5 |
| Knee MRI (without contrast) CPT 73721 | $3,006.00 | $4,175.00 | $299.41 – $4,175.00 | 5 |
| Knee X-ray CPT 73564 | $601.20 | $835.00 | $69.68 – $835.00 | 4 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $12.96 | $18.00 | $0.58 – $4.50 | 3 |
| Lactate dehydrogenase (ldh) CPT 83615 | $120.96 | $168.00 | $5.44 – $168.00 | 4 |
| Lactated ringers intravenous solution HCPCS J7120 | $32.40 | $45.00 | $3.93 – $45.00 | 3 |
| Lactation class HCPCS S9443 | $254.16 | $353.00 | $89.20 – $196.00 | 4 |
| Lactic acid CPT 83605 | $179.28 | $249.00 | $12.03 – $249.00 | 4 |
| Lactoferrin fecal qualitative CPT 83630 | $123.84 | $172.00 | $12.03 – $172.00 | 4 |
| Lactoferrin fecal quant CPT 83631 | $205.20 | $285.00 | $12.03 – $285.00 | 4 |
| Laparo cholecystectomy/graph CPT 47563 | not published | not published | not published | 0 |
| Laparoscopy aspiration CPT 49322 | not published | not published | not published | 0 |
| Laparoscopy excise lesions CPT 58662 | not published | not published | not published | 0 |
| Lap ing hernia repair init CPT 49650 | not published | not published | not published | 0 |
| Largsc w/rmvl foreign bdy(s) CPT 31577 | $838.80 | $1,165.00 | $749.15 – $1,165.00 | 4 |
| Lead capillary CPT 83655 | $22.32 | $31.00 | $12.39 – $31.00 | 4 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,432.80 | $1,990.00 | $208.96 – $1,990.00 | 4 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $44.85 | $62.29 | $6.34 – $32.11 | 3 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $1,561.05 | $2,168.12 | $281.79 – $2,168.11 | 6 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $6,224.65 | $8,645.35 | $1,200.04 – $8,645.35 | 6 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $0.27 | $0.37 | $0.07 – $0.37 | 3 |
| Levetiracetam therapeutic drug level CPT 80177 | $73.44 | $102.00 | $12.21 – $102.00 | 4 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $32.76 | $45.50 | $3.56 – $30.33 | 3 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $36.49 | $50.68 | $9.87 – $50.68 | 3 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $2.59 | $3.60 | $0.06 – $0.08 | 3 |
| Lidocaine therapeutic drug level CPT 80176 | $189.36 | $263.00 | $12.21 – $263.00 | 4 |
| Ligation/major artery/extremity 37618 CPT 37618 | $1,071.36 | $1,488.00 | $1,488.00 – $2,858.98 | 4 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $21.89 | $30.40 | $4.52 – $30.40 | 3 |
| Lipase CPT 83690 | $141.84 | $197.00 | $5.44 – $174.00 | 4 |
| Lipoprotein direct measurement hdl CPT 83718 | $94.32 | $131.00 | $5.44 – $131.00 | 4 |
| Lipoprotein direct measurement ldl CPT 83721 | $94.32 | $131.00 | $5.44 – $131.00 | 4 |
| Lithium therapeutic drug level CPT 80178 | $167.76 | $233.00 | $12.21 – $233.00 | 4 |
| Liver Function Test CPT 80076 | $191.52 | $266.00 | $9.09 – $266.00 | 4 |
| Liver/spleen imag static only CPT 78215 | $1,232.64 | $1,712.00 | $1,092.13 – $1,712.00 | 4 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $133.92 | $186.00 | $2.33 – $18.00 | 3 |
| Low cost skin substitute app HCPCS C5271 | $1,321.92 | $1,836.00 | $1,836.00 – $2,650.29 | 4 |
| Low cost skin substitute app HCPCS C5273 | $3,951.36 | $5,488.00 | $2,409.36 – $5,488.00 | 4 |
| Low cost skin substitute app HCPCS C5275 | $1,321.92 | $1,836.00 | $1,836.00 – $2,650.29 | 4 |
| Low cost skin substitute app HCPCS C5277 | $1,321.92 | $1,836.00 | $1,836.00 – $2,650.29 | 4 |
| Low cost skin substitute app HCPCS C5272 | $252.72 | $351.00 | $351.00 – $2,650.29 | 4 |
| Low cost skin substitute app HCPCS C5274 | $689.76 | $958.00 | $958.00 – $2,650.29 | 4 |
| Low cost skin substitute app HCPCS C5276 | $252.72 | $351.00 | $351.00 – $2,650.29 | 4 |
| Low cost skin substitute app HCPCS C5278 | $689.76 | $958.00 | $958.00 – $2,650.29 | 4 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,204.64 | $3,062.00 | $377.20 – $3,062.00 | 5 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,023.20 | $2,810.00 | $377.20 – $2,810.00 | 5 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,918.80 | $2,665.00 | $132.42 – $2,665.00 | 5 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $3,983.04 | $5,532.00 | $505.16 – $5,532.00 | 5 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $3,332.16 | $4,628.00 | $505.16 – $4,628.00 | 5 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $3,158.64 | $4,387.00 | $149.70 – $4,387.00 | 5 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $449.28 | $624.00 | $69.68 – $624.00 | 4 |
| Lung Function Test (Spirometry) CPT 94010 | $302.40 | $420.00 | $71.47 – $420.00 | 4 |
| Lung perfusion imaging CPT 78580 | $1,851.12 | $2,571.00 | $1,092.13 – $2,571.00 | 4 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $358.20 | $497.50 | $347.79 – $4,860.08 | 6 |
| Lymphatics/lymph node imaging CPT 78195 | $1,935.36 | $2,688.00 | $1,092.13 – $2,688.00 | 4 |
| Lymphocyte transformation mitogen CPT 86353 | $484.56 | $673.00 | $41.08 – $673.00 | 4 |
| Macroscopic exam arthropod CPT 87168 | $64.80 | $90.00 | $10.60 – $90.00 | 4 |
| Magnesium CPT 83735 | $109.44 | $152.00 | $5.44 – $152.00 | 4 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $32.76 | $45.50 | $0.68 – $2.25 | 3 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $278.64 | $387.00 | $71.47 – $387.00 | 4 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $278.64 | $387.00 | $71.47 – $387.00 | 4 |
| Marker biop eviva buckle ss HCPCS A4648 | $181.44 | $252.00 | $252.00 – $252.00 | 1 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $139.68 | $194.00 | $12.03 – $194.00 | 4 |
| Mayo aathr protein s free CPT 85306 | $58.32 | $81.00 | $4.46 – $81.00 | 4 |
| Mayo activated protein c resistance assay CPT 85307 | $38.88 | $54.00 | $5.97 – $54.00 | 4 |
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.