OSF Saint Paul Medical Center
1401 E 12Th Street, Mendota, IL · Osfhealthcare · · NPI 1609803113
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 |
|---|---|---|---|---|
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $2,092.00 | $2,615.00 | not published | 0 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $1,107.20 | $1,384.00 | not published | 0 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $1,107.20 | $1,384.00 | not published | 0 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $504.00 | $630.00 | not published | 0 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $558.40 | $698.00 | not published | 0 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $773.60 | $967.00 | not published | 0 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $232.80 | $291.00 | not published | 0 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $224.00 | $280.00 | not published | 0 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $262.40 | $328.00 | not published | 0 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $160.00 | $200.00 | not published | 0 |
| Injection treatment of nerve CPT 64681 | $1,393.60 | $1,742.00 | not published | 0 |
| Inject sacroiliac joint CPT 27096 | $2,571.20 | $3,214.00 | not published | 0 |
| Inj epidural sgl cerv-thor without img CPT 62320 | $1,107.20 | $1,384.00 | not published | 0 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $1,107.20 | $1,384.00 | not published | 0 |
| Inj for mammo ductogram CPT 19030 | $801.60 | $1,002.00 | not published | 0 |
| Inj multihance HCPCS A9577 | $18.40 | $23.00 | not published | 0 |
| Inj non-compmd foam sclrsnt mlt trncl veins same leg CPT 36466 | $1,648.80 | $2,061.00 | not published | 0 |
| Inj non-compmd foam sclrsnt sgl trncl vein CPT 36465 | $1,648.80 | $2,061.00 | not published | 0 |
| Inj proc ankle arthr CPT 27648 | $582.40 | $728.00 | not published | 0 |
| Inj proc elbow arthro CPT 24220 | $729.60 | $912.00 | not published | 0 |
| Inj proc lumbr disk ea lvl CPT 62290 | $2,565.60 | $3,207.00 | not published | 0 |
| Inj proc sialogram CPT 42550 | $380.00 | $475.00 | not published | 0 |
| Inj prohance multipack HCPCS A9576 | $9.60 | $12.00 | not published | 0 |
| Inj retro urethrocysto CPT 51610 | $380.00 | $475.00 | not published | 0 |
| Inj(s) sclerosant spider veins limb/trunk CPT 36468 | $1,506.40 | $1,883.00 | not published | 0 |
| Inj w/fluor eval cv device CPT 36598 | $869.60 | $1,087.00 | not published | 0 |
| Insertion catheter bladder non indwelling CPT 51701 | $108.00 | $135.00 | not published | 0 |
| Insertion catheter bladder temporary simple CPT 51702 | $108.00 | $135.00 | not published | 0 |
| Insertion nontunneled centrally inserted central venous catheter >= 5 years old CPT 36556 | $2,696.00 | $3,370.00 | not published | 0 |
| Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular CPT 33208 | $9,350.40 | $11,688.00 | not published | 0 |
| Insertion of new/replacement ppm w/transvenous electrode(s) ventricular CPT 33207 | $9,350.40 | $11,688.00 | not published | 0 |
| Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years CPT 36569 | $2,532.00 | $3,165.00 | not published | 0 |
| Insertion picc without port or pump with imaging guidance=>5y CPT 36573 | $2,285.60 | $2,857.00 | not published | 0 |
| Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber CPT 33249 | $29,036.80 | $36,296.00 | not published | 0 |
| Insertion/replacement temporary single chamber electrode/pacemaker catheter CPT 33210 | $7,388.80 | $9,236.00 | not published | 0 |
| Insertion single tranvenous electrode/ppm/implantable defibrillator CPT 33216 | $7,388.80 | $9,236.00 | not published | 0 |
| Insert pm/icd lead dual CPT 33217 | $7,388.80 | $9,236.00 | not published | 0 |
| Ins icd gen exist sgl lead CPT 33240 | $20,785.60 | $25,982.00 | not published | 0 |
| In situ hybridization per specimen initial single probe stain CPT 88365 | $676.00 | $845.00 | not published | 0 |
| Ins picc wo subq prt/pmp w image guidnc <5yr CPT 36572 | $2,622.40 | $3,278.00 | not published | 0 |
| Instillation anticarcinogenic agent bladder CPT 51720 | $577.60 | $722.00 | not published | 0 |
| Ins tun cv cath wo subq prt/pm CPT 36558 | $990.40 | $1,238.00 | not published | 0 |
| Insulin total CPT 83525 | $163.20 | $204.00 | not published | 0 |
| Intrinsic factor antibody CPT 86340 | $276.00 | $345.00 | not published | 0 |
| Intro catheter aorta CPT 36200 | $389.60 | $487.00 | not published | 0 |
| Intubation endotracheal emergency procedure CPT 31500 | $679.20 | $849.00 | not published | 0 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $4.80 | $6.00 | not published | 0 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $7.20 | $9.00 | not published | 0 |
| Ip/obs cnsltj new/est low 45 CPT 99253 | $607.20 | $759.00 | not published | 0 |
| Ip/obs cnsltj new/est mod 60 CPT 99254 | $749.60 | $937.00 | not published | 0 |
| Ip/obs consltj new/est hi 80 CPT 99255 | $900.00 | $1,125.00 | not published | 0 |
| Ip/obs consltj new/est sf 35 CPT 99252 | $457.60 | $572.00 | not published | 0 |
| Iron CPT 83540 | $140.00 | $175.00 | not published | 0 |
| Iron binding capacity CPT 83550 | $156.80 | $196.00 | not published | 0 |
| Irradiation of blood product each unit reference CPT 86945 | $114.40 | $143.00 | not published | 0 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $194.40 | $243.00 | not published | 0 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $240.80 | $301.00 | not published | 0 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $224.00 | $280.00 | not published | 0 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $222.40 | $278.00 | not published | 0 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $528.80 | $661.00 | not published | 0 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $1,185.60 | $1,482.00 | not published | 0 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $91.20 | $114.00 | not published | 0 |
| Kidney imag w/bld flow multi CPT 78709 | $1,728.00 | $2,160.00 | not published | 0 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $1,521.60 | $1,902.00 | not published | 0 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $1,175.20 | $1,469.00 | not published | 0 |
| Kit cast tcc 3in w/2reg boots total contact cast HCPCS Q4038 | $780.80 | $976.00 | not published | 0 |
| Kit gene analys d816 variant CPT 81273 | $1,738.40 | $2,173.00 | not published | 0 |
| Knee MRI (with and without contrast) CPT 73723 | $5,664.80 | $7,081.00 | not published | 0 |
| Knee MRI (with contrast) CPT 73722 | $4,945.60 | $6,182.00 | not published | 0 |
| Knee MRI (without contrast) CPT 73721 | $4,629.60 | $5,787.00 | not published | 0 |
| Knee orth pos locking joint HCPCS L1831 | $780.80 | $976.00 | not published | 0 |
| Knee X-ray CPT 73564 | $878.40 | $1,098.00 | not published | 0 |
| Kras gene addl variants CPT 81276 | $962.40 | $1,203.00 | not published | 0 |
| Kras gene variants exon 2 CPT 81275 | $962.40 | $1,203.00 | not published | 0 |
| Lactate dehydrogenase (ldh) CPT 83615 | $128.00 | $160.00 | not published | 0 |
| Lactic acid CPT 83605 | $408.00 | $510.00 | not published | 0 |
| Lactoferrin fecal qualitative CPT 83630 | $156.00 | $195.00 | not published | 0 |
| Largsc w/rmvl foreign bdy(s) CPT 31577 | $1,424.80 | $1,781.00 | not published | 0 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | $1,448.80 | $1,811.00 | not published | 0 |
| Lead capillary CPT 83655 | $245.60 | $307.00 | not published | 0 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $917.60 | $1,147.00 | not published | 0 |
| Levetiracetam therapeutic drug level CPT 80177 | $278.40 | $348.00 | not published | 0 |
| Lidocaine therapeutic drug level CPT 80176 | $136.00 | $170.00 | not published | 0 |
| Lift heel adj small gl60404sm HCPCS L3332 | $113.60 | $142.00 | not published | 0 |
| Limited ankle motion ea jnt HCPCS L2200 | $780.80 | $976.00 | not published | 0 |
| Lipase CPT 83690 | $308.80 | $386.00 | not published | 0 |
| Lipoprotein blood high res frac & quant CPT 83701 | $56.00 | $70.00 | not published | 0 |
| Lipoprotein blood quant CPT 83704 | $189.60 | $237.00 | not published | 0 |
| Lipoprotein direct measurement hdl CPT 83718 | $155.20 | $194.00 | not published | 0 |
| Lipoprotein direct measurement ldl CPT 83721 | $117.60 | $147.00 | not published | 0 |
| Lithium therapeutic drug level CPT 80178 | $111.20 | $139.00 | not published | 0 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $816.00 | $1,020.00 | not published | 0 |
| Liver Function Test CPT 80076 | $228.00 | $285.00 | not published | 0 |
| Liver imag w/vasclr flow CPT 78202 | $1,504.00 | $1,880.00 | not published | 0 |
| Liver/spleen imag static only CPT 78215 | $1,503.20 | $1,879.00 | not published | 0 |
| Lo sag rig pnl stays pre cst HCPCS L0626 | $113.60 | $142.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,411.20 | $3,014.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,363.20 | $2,954.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $2,306.40 | $2,883.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $4,840.00 | $6,050.00 | not published | 0 |
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.