HSHS St. Anthony's Memorial Hospital
101 Coles Centre Dr., Mattoon, IL · Hshs · · NPI 1306800602
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 |
|---|---|---|---|---|
| Ghs irrigate corpora cavernosa for priapism CPT 54220 | $512.64 | $712.00 | $78.42 – $712.00 | 14 |
| Ghs IV infusion bamlanivimab/etesevimab HCPCS M0245 | $707.76 | $983.00 | $268.08 – $983.00 | 3 |
| Ghs IV infusion casirivimab/imdevimab HCPCS M0243 | $811.44 | $1,127.00 | $268.08 – $1,127.00 | 3 |
| Ghs IV infusion sotrovimab HCPCS M0247 | $1,025.28 | $1,424.00 | $268.08 – $1,424.00 | 3 |
| Ghs IV thrombolytics - cerebral CPT 37195 | $718.56 | $998.00 | $268.08 – $998.00 | 14 |
| Ghs lac repair mouth.ant tong 2.5cm/less CPT 41250 | $466.56 | $648.00 | $154.17 – $1,111.10 | 14 |
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | $563.76 | $783.00 | $347.42 – $1,011.10 | 14 |
| Ghs layer closure 2.5 cm or less - 12041 CPT 12041 | $599.76 | $833.00 | $347.42 – $1,011.10 | 14 |
| Ghs layer closure 2.5cm or less - 12051 CPT 12051 | $563.76 | $783.00 | $347.42 – $1,011.10 | 14 |
| Ghs layer closure 2.6 - 5.0 cm - 12052 CPT 12052 | $648.00 | $900.00 | $347.42 – $1,011.10 | 14 |
| Ghs layer closure 2.6 - 7.5 cm - 12042 CPT 12042 | $778.32 | $1,081.00 | $347.42 – $1,081.00 | 14 |
| Ghs layer closure 5.1 - 7.5 cm - 12053 CPT 12053 | $563.76 | $783.00 | $347.42 – $1,011.10 | 14 |
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | $837.36 | $1,163.00 | $347.42 – $1,163.00 | 14 |
| Ghs layer closure 7.6 - 12.5 cm - 12044 CPT 12044 | $873.36 | $1,213.00 | $347.42 – $1,838.24 | 14 |
| Ghs layer closure 7.6 - 12.5 cm - 12054 CPT 12054 | $563.76 | $783.00 | $347.42 – $1,011.10 | 14 |
| Ghs mbp CPT 83873 | $169.20 | $235.00 | $8.82 – $235.00 | 14 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $771.12 | $1,071.00 | $20.72 – $1,071.00 | 3 |
| Ghs moderate sedation < 5 yr, 30 min, other CPT 99155 | $795.60 | $1,105.00 | $20.72 – $1,105.00 | 3 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $435.60 | $605.00 | $20.72 – $605.00 | 3 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $195.12 | $271.00 | $20.72 – $200.00 | 3 |
| Ghs musc test done w/n test comp CPT 95886 | $1,308.24 | $1,817.00 | $120.64 – $1,817.00 | 3 |
| Ghs musc tst done w/nerv tst lim CPT 95885 | $265.68 | $369.00 | $120.64 – $369.00 | 3 |
| Ghs musc tst done w/n tst non ext CPT 95887 | $184.32 | $256.00 | $120.64 – $256.00 | 3 |
| Ghs nailbed repair/nail removal CPT 11760 | $1,024.56 | $1,423.00 | $60.45 – $1,838.24 | 14 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | $3,312.72 | $4,601.00 | $1,015.11 – $4,601.00 | 14 |
| Ghs nerve blk intercostal, single level CPT 64420 | $1,451.52 | $2,016.00 | $363.04 – $2,016.00 | 14 |
| Ghs nerve block axillary nerve CPT 64417 | $1,629.36 | $2,263.00 | $363.04 – $2,263.00 | 14 |
| Ghs nerve block brachial plexus CPT 64415 | $2,634.48 | $3,659.00 | $1,015.11 – $3,659.00 | 14 |
| Ghs nerve block interscaline CPT 64510 | $3,312.72 | $4,601.00 | $1,015.11 – $4,601.00 | 14 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $3,312.72 | $4,601.00 | $695.24 – $4,601.00 | 14 |
| Ghs nerve block sciatic nerve CPT 64445 | $1,873.44 | $2,602.00 | $363.04 – $2,602.00 | 14 |
| Ghs nerve block suprascapular CPT 64418 | $2,634.48 | $3,659.00 | $363.04 – $3,659.00 | 14 |
| Ghs ng placement w fluoro guidance CPT 43752 | $466.56 | $648.00 | $354.02 – $1,111.10 | 14 |
| Ghs o2 saturation CPT 82810 | $398.16 | $553.00 | $3.99 – $553.00 | 14 |
| Ghs opcc repair cvp without subq port CPT 36575 | $1,200.24 | $1,667.00 | $670.79 – $1,667.00 | 14 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | $57.60 | $80.00 | $24.78 – $80.00 | 14 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $109.44 | $152.00 | $32.81 – $152.00 | 15 |
| Ghs pacing - transcutaneous CPT 92953 | $1,204.56 | $1,673.00 | $563.94 – $1,673.00 | 14 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $1,069.20 | $1,485.00 | $695.24 – $1,485.00 | 3 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $1,176.48 | $1,634.00 | $695.24 – $1,421.00 | 3 |
| Ghs peritonsillar abscess i andd CPT 42700 | $496.08 | $689.00 | $154.17 – $689.00 | 14 |
| Ghs phenylketonurid CPT 84030 | $258.48 | $359.00 | $3.99 – $359.00 | 14 |
| Ghs plngl fx pm cl CPT 26725 | $447.84 | $622.00 | $283.10 – $622.00 | 14 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $74.88 | $104.00 | $3.99 – $104.00 | 14 |
| Ghs protoporphyrins fract CPT 84202 | $21.60 | $30.00 | $8.82 – $32.29 | 14 |
| Ghs pr without cont pulse ox CPT 94625 | $125.28 | $174.00 | $31.11 – $174.00 | 14 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | $822.96 | $1,143.00 | $27.58 – $1,143.00 | 4 |
| Ghs quinidine CPT 80194 | $100.80 | $140.00 | $8.95 – $140.00 | 14 |
| Ghs removal intranasal foreign body CPT 30300 | $387.36 | $538.00 | $152.70 – $538.00 | 14 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $38.16 | $53.00 | $7.78 – $53.00 | 14 |
| Ghs semen analysis fert CPT 89320 | $594.00 | $825.00 | $3.66 – $825.00 | 14 |
| Ghs sensitivity (per antimicro) CPT 87184 | $82.08 | $114.00 | $7.48 – $114.00 | 14 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $467.28 | $649.00 | $165.87 – $1,011.10 | 14 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $467.28 | $649.00 | $165.87 – $1,011.10 | 14 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $472.32 | $656.00 | $165.87 – $1,011.10 | 14 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $252.00 | $350.00 | $165.87 – $499.02 | 14 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $342.00 | $475.00 | $165.87 – $499.02 | 14 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $375.12 | $521.00 | $165.87 – $521.00 | 14 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $534.96 | $743.00 | $165.87 – $743.00 | 14 |
| Ghs sleep study unattended CPT 95800 | $909.36 | $1,263.00 | $138.16 – $1,263.00 | 14 |
| Ghs somatosensory testing lower extremit CPT 95926 | $460.08 | $639.00 | $120.64 – $639.00 | 14 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $2,107.44 | $2,927.00 | $120.64 – $2,927.00 | 14 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $182.88 | $254.00 | $45.64 – $254.00 | 14 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $123.12 | $171.00 | $32.81 – $220.95 | 14 |
| Ghs strapping shoulder - 29240 CPT 29240 | $150.48 | $209.00 | $68.88 – $330.92 | 14 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $1,046.88 | $1,454.00 | $347.42 – $1,838.24 | 14 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $442.08 | $614.00 | $283.10 – $614.00 | 14 |
| Ghs urine, porphyrins quant CPT 84120 | $113.76 | $158.00 | $8.82 – $158.00 | 14 |
| Ghs vaginal delivery only CPT 59409 | $3,720.24 | $5,167.00 | $1,960.03 – $8,051.47 | 14 |
| Gi inhouse confirmation CPT 87045 | $173.52 | $241.00 | $7.78 – $241.00 | 14 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $2,963.52 | $4,116.00 | $105.42 – $4,116.00 | 15 |
| Glucagon plasma - sendout CPT 82943 | $85.68 | $119.00 | $9.74 – $119.00 | 14 |
| Glucose 1 hr post dose CPT 82950 | $101.52 | $141.00 | $3.99 – $141.00 | 14 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | $96.48 | $134.00 | $3.99 – $134.00 | 14 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $20.16 | $28.00 | $3.28 – $28.00 | 14 |
| Glucose blood quantitative CPT 82947 | $74.88 | $104.00 | $3.93 – $104.00 | 14 |
| Glucose body fluid CPT 82945 | $127.44 | $177.00 | $3.93 – $177.00 | 14 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $204.48 | $284.00 | $8.82 – $284.00 | 14 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $50.40 | $70.00 | $3.92 – $70.00 | 14 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $63.40 | $88.05 | $0.63 – $9.00 | 3 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $179.28 | $249.00 | $9.74 – $249.00 | 14 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $182.16 | $253.00 | $9.74 – $238.00 | 14 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $4,104.00 | $5,700.00 | $142.83 – $309.52 | 14 |
| Graft axiofill 1000mg HCPCS J3590 | $802.10 | $1,114.03 | $1,114.03 – $1,114.03 | 1 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $194.40 | $270.00 | $142.83 – $309.52 | 14 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $3,672.00 | $5,100.00 | $142.83 – $3,900.00 | 14 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $8,856.00 | $12,300.00 | $750.00 – $750.00 | 1 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $2,808.00 | $3,900.00 | $2,100.00 – $2,100.00 | 1 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $131.04 | $182.00 | $142.83 – $309.52 | 14 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $308.88 | $429.00 | $142.83 – $429.00 | 14 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $1,944.00 | $2,700.00 | $142.83 – $667.00 | 14 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $11,880.00 | $16,500.00 | $225.00 – $225.00 | 1 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | not published | 0 |
| Grfg autol fat lipo ea addl CPT 15772 | not published | not published | not published | 0 |
| G-tube reposition CPT 43761 | $578.88 | $804.00 | $286.75 – $804.00 | 14 |
| Gu dilat ureter/urethra s&i CPT 74485 | $3,150.00 | $4,375.00 | $183.97 – $5,199.26 | 14 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $1,944.00 | $2,700.00 | $10.00 – $10.00 | 1 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $324.00 | $450.00 | $150.00 – $150.00 | 1 |
| Gw stiffened micro access kit HCPCS C1894 | $864.00 | $1,200.00 | $10.00 – $10.00 | 1 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $12.96 | $18.00 | $1.20 – $18.00 | 3 |
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.