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 |
|---|---|---|---|---|
| X-ray hand 2 views (both sides) CPT 73120 | $580.00 | $725.00 | not published | 0 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $626.40 | $783.00 | not published | 0 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $596.80 | $746.00 | not published | 0 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $549.60 | $687.00 | not published | 0 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $666.40 | $833.00 | not published | 0 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $555.20 | $694.00 | not published | 0 |
| X-ray humerus >= 2 views left CPT 73060 | $741.60 | $927.00 | not published | 0 |
| X-ray joint survey 1 view CPT 77077 | $574.40 | $718.00 | not published | 0 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $717.60 | $897.00 | not published | 0 |
| X-ray knee 3 views (both sides) CPT 73562 | $781.60 | $977.00 | not published | 0 |
| X-ray knee ap standing bilateral CPT 73565 | $353.60 | $442.00 | not published | 0 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $819.20 | $1,024.00 | not published | 0 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $471.20 | $589.00 | not published | 0 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $542.40 | $678.00 | not published | 0 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $612.80 | $766.00 | not published | 0 |
| X-ray mandible complete > 4 views CPT 70110 | $503.20 | $629.00 | not published | 0 |
| X-ray mandible ltd <4 views CPT 70100 | $285.60 | $357.00 | not published | 0 |
| X-ray nasal bones complete > 3 views CPT 70160 | $378.40 | $473.00 | not published | 0 |
| X-ray neck soft tissue CPT 70360 | $340.00 | $425.00 | not published | 0 |
| X-ray nose to rectum for foreign body child CPT 76010 | $322.40 | $403.00 | not published | 0 |
| X-ray of mammary ducts CPT 77054 | $2,124.00 | $2,655.00 | not published | 0 |
| X-ray pelvis 1-2 views CPT 72170 | $343.20 | $429.00 | not published | 0 |
| X-ray pelvis complete > 3 views CPT 72190 | $776.80 | $971.00 | not published | 0 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $847.20 | $1,059.00 | not published | 0 |
| X-ray ribs 2 views left CPT 71100 | $501.60 | $627.00 | not published | 0 |
| X-ray ribs 3 views bilateral CPT 71110 | $654.40 | $818.00 | not published | 0 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $690.40 | $863.00 | not published | 0 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $856.00 | $1,070.00 | not published | 0 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $396.00 | $495.00 | not published | 0 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $456.80 | $571.00 | not published | 0 |
| X-ray scapula complete (both sides) CPT 73010 | $844.00 | $1,055.00 | not published | 0 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $608.00 | $760.00 | not published | 0 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $520.00 | $650.00 | not published | 0 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $847.20 | $1,059.00 | not published | 0 |
| X-ray skull < 4 views CPT 70250 | $333.60 | $417.00 | not published | 0 |
| X-ray skull > 4 views complete CPT 70260 | $596.00 | $745.00 | not published | 0 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $1,528.80 | $1,911.00 | not published | 0 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $627.20 | $784.00 | not published | 0 |
| X-ray small intestine follow-through study CPT 74248 | $613.60 | $767.00 | not published | 0 |
| X-ray spine single view CPT 72020 | $366.40 | $458.00 | not published | 0 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $355.20 | $444.00 | not published | 0 |
| X-ray sternum > 2 views CPT 71120 | $388.00 | $485.00 | not published | 0 |
| X-ray surgical specimen CPT 76098 | $563.20 | $704.00 | not published | 0 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $634.40 | $793.00 | not published | 0 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $781.60 | $977.00 | not published | 0 |
| X-ray thoracic spine 2 views CPT 72070 | $459.20 | $574.00 | not published | 0 |
| X-ray thoracic spine 3 views CPT 72072 | $527.20 | $659.00 | not published | 0 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $224.00 | $280.00 | not published | 0 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $295.20 | $369.00 | not published | 0 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $341.60 | $427.00 | not published | 0 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $774.40 | $968.00 | not published | 0 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $406.40 | $508.00 | not published | 0 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $999.20 | $1,249.00 | not published | 0 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $1,024.80 | $1,281.00 | not published | 0 |
| X-ray wrist 2 views (both sides) CPT 73100 | $556.80 | $696.00 | not published | 0 |
| Xylose absorption test blood &/or urine CPT 84620 | $276.00 | $345.00 | not published | 0 |
| Zika virus dna/rna amp probe CPT 87662 | $800.00 | $1,000.00 | not published | 0 |
| Zika virus igm antibody CPT 86794 | $536.80 | $671.00 | 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.