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 |
|---|---|---|---|---|
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | $4,425.12 | $6,146.00 | $1,932.08 – $6,146.00 | 4 |
| Cystourethroscopy w/biopsy(s) 52204 CPT 52204 | not published | not published | not published | 0 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $130.32 | $181.00 | $11.58 – $181.00 | 4 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $141.12 | $196.00 | $11.58 – $181.00 | 4 |
| Cyto/molecular report CPT 88291 | $199.44 | $277.00 | $103.63 – $277.00 | 4 |
| Cytopath fl nongyn filter CPT 88106 | $87.84 | $122.00 | $33.06 – $122.00 | 4 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $162.00 | $225.00 | $33.06 – $225.00 | 4 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $158.40 | $220.00 | $20.26 – $22.64 | 4 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $141.84 | $197.00 | $20.26 – $22.64 | 4 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $93.60 | $130.00 | $33.06 – $130.00 | 4 |
| Cytp urine 3-5 probes cmptr CPT 88121 | $444.96 | $618.00 | $183.39 – $618.00 | 4 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $61.49 | $85.40 | $25.72 – $4,860.08 | 6 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $0.21 | $0.29 | $0.05 – $0.29 | 3 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | $101.89 | $141.51 | $90.85 – $4,860.08 | 6 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $13,374.72 | $18,576.00 | $4.98 – $1,486.10 | 6 |
| Dch glucoscan CPT 82948 | $38.16 | $53.00 | $5.44 – $53.00 | 4 |
| Deamidated gliadin antibody iga CPT 86258 | $91.44 | $127.00 | $11.58 – $125.00 | 4 |
| Debridement (>20 cm) charge pt CPT 97598 | $327.60 | $455.00 | $300.00 – $1,386.21 | 5 |
| Debridement bone <= 20 sq cm CPT 11044 | $3,043.44 | $4,227.00 | $1,260.19 – $4,227.00 | 4 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $734.40 | $1,020.00 | $1,020.00 – $1,386.21 | 4 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $1,607.04 | $2,232.00 | $1,260.19 – $2,232.00 | 4 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $973.44 | $1,352.00 | $473.71 – $1,352.00 | 4 |
| Debride nail1-5 11720 CPT 11720 | $151.92 | $211.00 | $82.43 – $211.00 | 4 |
| Debride nail6 or more 11721 CPT 11721 | $246.24 | $342.00 | $82.43 – $342.00 | 4 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $678.24 | $942.00 | $942.00 – $1,386.21 | 4 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $1,440.00 | $2,000.00 | $473.71 – $2,000.00 | 4 |
| Decalcification CPT 88311 | $66.96 | $93.00 | $40.01 – $93.00 | 4 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $638.64 | $887.00 | $365.53 – $887.00 | 4 |
| Decompression of tibia nerve CPT 28035 | not published | not published | not published | 0 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | $20.69 | $28.73 | $7.34 – $399.93 | 6 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $108.03 | $150.04 | $48.61 – $1,260.55 | 6 |
| Dentoalveolar/drain abs/cyst/hema 41800 CPT 41800 | $278.64 | $387.00 | $210.21 – $387.00 | 4 |
| Dermagraft HCPCS Q4106 | $79.92 | $111.00 | $84.05 – $111.00 | 3 |
| Desoxycorticosterone CPT 82633 | $215.28 | $299.00 | $35.20 – $299.00 | 4 |
| Destruction benign lesions < 14 lesions CPT 17110 | not published | not published | not published | 0 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $198.00 | $275.00 | $97.84 – $275.00 | 4 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $0.27 | $0.38 | $0.02 – $0.15 | 3 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $3.24 | $4.50 | $0.18 – $1.50 | 3 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $32.40 | $45.00 | $2.89 – $45.00 | 3 |
| Dextrose 5 % IV bolus HCPCS J7070 | $32.40 | $45.00 | $4.85 – $45.00 | 3 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $133.20 | $185.00 | $13.28 – $185.00 | 4 |
| Diabetes (HbA1c) Test CPT 83036 | $159.84 | $222.00 | $5.44 – $222.00 | 4 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | not published | 0 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $419.04 | $582.00 | $210.21 – $582.00 | 4 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $537.84 | $747.00 | $59.26 – $111.50 | 4 |
| Diagnostic Mammogram (one breast) CPT 77065 | $498.96 | $693.00 | $59.26 – $87.67 | 4 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $58.18 | $80.80 | $11.04 – $59.08 | 3 |
| Dicyclomine injection HCPCS J0500 | $134.78 | $187.20 | $18.69 – $118.10 | 3 |
| Diffusing capacity CPT 94729 | $349.92 | $486.00 | $71.47 – $486.00 | 4 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $19.01 | $26.40 | $15.79 – $26.40 | 3 |
| Digoxin total therapeutic drug level CPT 80162 | $178.56 | $248.00 | $12.21 – $248.00 | 4 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | not published | 0 |
| Dilation salivary duct 42650 CPT 42650 | $3,729.60 | $5,180.00 | $2,255.37 – $5,180.00 | 4 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $0.26 | $0.36 | $0.05 – $0.17 | 3 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $12.96 | $18.00 | $1.17 – $18.00 | 3 |
| Disaccharidases CPT 82657 | $321.84 | $447.00 | $12.03 – $447.00 | 4 |
| Dna antibody native/double stranded CPT 86225 | $293.04 | $407.00 | $11.58 – $407.00 | 4 |
| Dna gardnerella CPT 87510 | $42.48 | $59.00 | $10.60 – $59.00 | 4 |
| Dna trichomonas CPT 87660 | $42.48 | $59.00 | $10.60 – $59.00 | 4 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $26.94 | $37.42 | $1.07 – $48.91 | 6 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $6.55 | $9.10 | $1.32 – $9.10 | 3 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $1,216.08 | $1,689.00 | $102.83 – $620.00 | 4 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $555.12 | $771.00 | $67.81 – $677.00 | 4 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $36.19 | $50.27 | $4.59 – $32.35 | 3 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $0.87 | $1.21 | $0.17 – $1.21 | 3 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $1,519.92 | $2,111.00 | $1,484.66 – $2,111.00 | 4 |
| Drainage external ear simple 69000 CPT 69000 | $1,519.92 | $2,111.00 | $210.21 – $2,111.00 | 4 |
| Drainage of arm bursa 23931 CPT 23931 | $3,499.92 | $4,861.00 | $2,220.53 – $4,861.00 | 4 |
| Drainage of urethra abscess 53060 CPT 53060 | $4,425.12 | $6,146.00 | $3,555.04 – $6,146.00 | 4 |
| Drain blood from under nail 11740 CPT 11740 | $278.64 | $387.00 | $82.43 – $387.00 | 4 |
| Drain finger abscess;simple 26010 CPT 26010 | $908.64 | $1,262.00 | $204.86 – $1,262.00 | 4 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $522.72 | $726.00 | $226.16 – $726.00 | 4 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $474.48 | $659.00 | $226.16 – $659.00 | 4 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $863.28 | $1,199.00 | $473.71 – $1,199.00 | 4 |
| Drng of eyelid abscess 67700 CPT 67700 | $645.84 | $897.00 | $358.49 – $897.00 | 4 |
| Drng of finger abscess comp 26011 CPT 26011 | $3,499.92 | $4,861.00 | $1,331.13 – $4,861.00 | 4 |
| Drng of hydrocele 55000 CPT 55000 | not published | not published | not published | 0 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $36.76 | $51.05 | $11.85 – $51.05 | 3 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $23.04 | $32.00 | $32.00 – $209.78 | 3 |
| Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm HCPCS A2007 | $338.40 | $470.00 | $123.00 – $209.78 | 3 |
| Drug assay posaconazole CPT 80187 | $168.48 | $234.00 | $12.21 – $234.00 | 4 |
| Drug assay vedolizumab CPT 80280 | $317.52 | $441.00 | $12.21 – $441.00 | 4 |
| Drug assay voriconazole CPT 80285 | $256.32 | $356.00 | $12.21 – $356.00 | 4 |
| Drug/substance nos 4-6 CPT 80376 | $54.00 | $75.00 | $14.08 – $75.00 | 4 |
| Drug test def 1-7 classes HCPCS G0480 | $144.00 | $200.00 | $70.22 – $200.00 | 4 |
| Drug test def 22+ classes HCPCS G0483 | $270.72 | $376.00 | $163.43 – $376.00 | 4 |
| Drug test prsmv instrmnt CPT 80306 | $276.48 | $384.00 | $14.08 – $384.00 | 4 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $274.32 | $381.00 | $70.22 – $95.00 | 4 |
| Drvvt confirm - quest CPT 85597 | $95.76 | $133.00 | $4.46 – $133.00 | 4 |
| Ductogram sgl duct CPT 77053 | $835.92 | $1,161.00 | $36.72 – $161.54 | 4 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $1,664.64 | $2,312.00 | $135.63 – $2,312.00 | 4 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $1,004.40 | $1,395.00 | $135.63 – $1,395.00 | 4 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | $149.86 | $208.14 | $142.35 – $2,444.06 | 6 |
| Ear irrigation 69209 CPT 69209 | $128.16 | $178.00 | $178.00 – $178.00 | 1 |
| Ecg 12 lead tracing only CPT 93005 | $257.76 | $358.00 | $31.90 – $358.00 | 4 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | $128.16 | $178.00 | $31.90 – $178.00 | 4 |
| Ecg external < 48 hours recording CPT 93225 | $677.52 | $941.00 | $76.63 – $941.00 | 4 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $884.88 | $1,229.00 | $76.63 – $1,229.00 | 4 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $2,491.20 | $3,460.00 | $537.33 – $3,460.00 | 4 |
| Echocardiography doppler color flow mapping CPT 93325 | $657.36 | $913.00 | $67.81 – $913.00 | 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.