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 |
|---|---|---|---|---|
| Psycl/nrpsyc tech 1st CPT 96138 | $335.20 | $419.00 | not published | 0 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $115.20 | $144.00 | not published | 0 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $115.20 | $144.00 | not published | 0 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $107.20 | $134.00 | not published | 0 |
| Pt application of modality traction mechanical CPT 97012 | $107.20 | $134.00 | not published | 0 |
| Pten gene full sequence CPT 81321 | $5,082.40 | $6,353.00 | not published | 0 |
| Pt evaluation high complexity patient/family CPT 97163 | $371.20 | $464.00 | not published | 0 |
| Pt evaluation low complexity patient/family CPT 97161 | $308.80 | $386.00 | not published | 0 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $329.60 | $412.00 | not published | 0 |
| Pt re-evaluation patient/family CPT 97164 | $214.40 | $268.00 | not published | 0 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $157.60 | $197.00 | not published | 0 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $140.00 | $175.00 | not published | 0 |
| Pt wheelchair management each 15 minutes CPT 97542 | $144.00 | $180.00 | not published | 0 |
| Pulse ox continuous overnight monitoring CPT 94762 | $329.60 | $412.00 | not published | 0 |
| Pulse ox multiple CPT 94761 | $206.40 | $258.00 | not published | 0 |
| Pulse ox single CPT 94760 | $44.00 | $55.00 | not published | 0 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $137.60 | $172.00 | not published | 0 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $445.60 | $557.00 | not published | 0 |
| Puncture spinal lumbar diagnostic CPT 62270 | $1,107.20 | $1,384.00 | not published | 0 |
| Puraply 1 sq cm HCPCS Q4195 | $402.40 | $503.00 | not published | 0 |
| Puraply xt 1 sq cm HCPCS Q4197 | $402.40 | $503.00 | not published | 0 |
| Pwr pck base combo vad, rep HCPCS Q0489 | $27,503.20 | $34,379.00 | not published | 0 |
| Pyruvate kinase CPT 84220 | $143.20 | $179.00 | not published | 0 |
| Quant diff pulm perf w/imaging CPT 78597 | $1,120.80 | $1,401.00 | not published | 0 |
| Quest t3 uptake CPT 84479 | $140.00 | $175.00 | not published | 0 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $2,702.40 | $3,378.00 | not published | 0 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $4,440.80 | $5,551.00 | not published | 0 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | $2,410.40 | $3,013.00 | not published | 0 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $1,608.00 | $2,010.00 | not published | 0 |
| Radphm lcl tumor plr sgl day CPT 78800 | $1,535.20 | $1,919.00 | not published | 0 |
| Rapid Strep Test CPT 87880 | $124.00 | $155.00 | not published | 0 |
| Rbc count only automated CPT 85041 | $48.80 | $61.00 | not published | 0 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $638.40 | $798.00 | not published | 0 |
| Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 | $739.20 | $924.00 | not published | 0 |
| Refill maint impl spine pump CPT 95991 | $450.40 | $563.00 | not published | 0 |
| Refill/maint pump/resvr syst CPT 96522 | $580.00 | $725.00 | not published | 0 |
| Rem/biv cast full arm/leg CPT 29705 | $227.20 | $284.00 | not published | 0 |
| Removal central venous device tunneled w/port/pump central/peripheral insertion CPT 36590 | $1,347.20 | $1,684.00 | not published | 0 |
| Removal cerumen impacted (both sides) CPT 69210 | $261.60 | $327.00 | not published | 0 |
| Removal devitalized tissue non-selective debridement without anesthesia per session CPT 97602 | $340.80 | $426.00 | not published | 0 |
| Removal embedded foreign body vestibule mouth smpl CPT 40804 | $787.20 | $984.00 | not published | 0 |
| Removal foreign body foot subcutaneous right CPT 28190 | $832.00 | $1,040.00 | not published | 0 |
| Removal skin tags fibrocutaneous any area <= 15 lesions CPT 11200 | $271.20 | $339.00 | not published | 0 |
| Remove shoulder foreign body subq 23330 CPT 23330 | $1,360.80 | $1,701.00 | not published | 0 |
| Remove spine eltrd perq aray CPT 63661 | $3,922.40 | $4,903.00 | not published | 0 |
| Renal function panel CPT 80069 | $234.40 | $293.00 | not published | 0 |
| Repair complex wound scalp/arms/legs 2.6 - 7.5 cm CPT 13121 | $716.80 | $896.00 | not published | 0 |
| Repair extns tendon finger without grft ea CPT 26418 | $2,287.20 | $2,859.00 | not published | 0 |
| Repair rpr lac tongue floor mouth > 2.6 cm/cmplx CPT 41252 | $2,315.20 | $2,894.00 | not published | 0 |
| Replace g/c tube perc CPT 49450 | $1,251.20 | $1,564.00 | not published | 0 |
| Replace/revise brain shunt CPT 62230 | $9,200.80 | $11,501.00 | not published | 0 |
| Reptilase test CPT 85635 | $142.40 | $178.00 | not published | 0 |
| Resuscitation cardiopulmonary CPT 92950 | $859.20 | $1,074.00 | not published | 0 |
| Reticulocyte automated CPT 85045 | $109.60 | $137.00 | not published | 0 |
| Revise spine eltrd perq aray CPT 63663 | $5,512.80 | $6,891.00 | not published | 0 |
| Rheumatoid factor qualitative CPT 86430 | $110.40 | $138.00 | not published | 0 |
| Rheumatoid factor quantitative CPT 86431 | $72.80 | $91.00 | not published | 0 |
| Rmvl icd gen w/rplc icd gen sgl lead sys CPT 33262 | $20,884.80 | $26,106.00 | not published | 0 |
| Rmvl perm pm pulse gen CPT 33233 | $7,388.80 | $9,236.00 | not published | 0 |
| Rmvl pm gen w/rplc pm gen mlt lead sys CPT 33229 | $16,904.00 | $21,130.00 | not published | 0 |
| Rpl non-tun cvc wo sbq prt/pmp CPT 36580 | $1,008.80 | $1,261.00 | not published | 0 |
| Rp loclzj tum 2+area 1+d img CPT 78801 | $1,650.40 | $2,063.00 | not published | 0 |
| Rp loclzj tum spect w/ct 1 CPT 78830 | $2,141.60 | $2,677.00 | not published | 0 |
| Rp loclzj tum spect w/ct 2 CPT 78832 | $3,214.40 | $4,018.00 | not published | 0 |
| Rsv assay w/optic CPT 87807 | $424.80 | $531.00 | not published | 0 |
| Rtm 1st set-up&pt educaj eqp CPT 98975 | $313.60 | $392.00 | not published | 0 |
| Rtm dev sply mscskl 16-30 d CPT 98977 | $90.40 | $113.00 | not published | 0 |
| Rtm dev sply resp sys 16-30d CPT 98976 | $90.40 | $113.00 | not published | 0 |
| Rubella antibody igg CPT 86762 | $216.80 | $271.00 | not published | 0 |
| Rubeola antibody igg CPT 86765 | $115.20 | $144.00 | not published | 0 |
| Russell viper venom diluted CPT 85613 | $301.60 | $377.00 | not published | 0 |
| Rx metab gen seq alys pnl 6 CPT 81418 | $3,189.60 | $3,987.00 | not published | 0 |
| Sarscov coronavirus ag ia CPT 87426 | $75.20 | $94.00 | not published | 0 |
| Sarscov & inf vir a&b ag ia CPT 87428 | $379.20 | $474.00 | not published | 0 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $1,175.20 | $1,469.00 | not published | 0 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $1,016.80 | $1,271.00 | not published | 0 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $855.20 | $1,069.00 | not published | 0 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $1,033.60 | $1,292.00 | not published | 0 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $1,181.60 | $1,477.00 | not published | 0 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $843.20 | $1,054.00 | not published | 0 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $1,373.60 | $1,717.00 | not published | 0 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $1,129.60 | $1,412.00 | not published | 0 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $1,149.60 | $1,437.00 | not published | 0 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0145 | $171.20 | $214.00 | not published | 0 |
| Screening Mammogram CPT 77067 | $468.80 | $586.00 | not published | 0 |
| Screening prostate cancer PSA HCPCS G0103 | $237.60 | $297.00 | not published | 0 |
| Screen pap by tech w md supv HCPCS P3000 | $120.00 | $150.00 | not published | 0 |
| Sedimentation rate erythrocyte automated CPT 85652 | $76.00 | $95.00 | not published | 0 |
| Semen analysis presence/motility CPT 89321 | $96.00 | $120.00 | not published | 0 |
| Shoe post-op mens m HCPCS L3260 | $1,524.00 | $1,905.00 | not published | 0 |
| Shoulder MRI (with and without contrast) CPT 73223 | $5,399.20 | $6,749.00 | not published | 0 |
| Shoulder MRI (with contrast) CPT 73222 | $4,799.20 | $5,999.00 | not published | 0 |
| Shoulder MRI (without contrast) CPT 73221 | $4,634.40 | $5,793.00 | not published | 0 |
| Shoulder X-ray CPT 73030 | $824.00 | $1,030.00 | not published | 0 |
| Shrinker prosth above knee HCPCS L8460 | $780.80 | $976.00 | not published | 0 |
| Sialography s&i CPT 70390 | $1,217.60 | $1,522.00 | not published | 0 |
| Sickling rbc CPT 85660 | $98.40 | $123.00 | not published | 0 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $230.40 | $288.00 | not published | 0 |
| Sinus CT scan (with and without contrast) CPT 70488 | $2,262.40 | $2,828.00 | not published | 0 |
| Sinus CT scan (with contrast) CPT 70487 | $2,222.40 | $2,778.00 | 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.