OSF Holy Family Medical Center
1000 W Harlem Avenue, Monmouth, IL · Osfhealthcare · · NPI 1548393184
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $291.20 | $364.00 | not published | 0 |
| 17-hydroxypregnenolone CPT 84143 | $228.00 | $285.00 | not published | 0 |
| 17-ketosteroids CPT 83586 | $268.00 | $335.00 | not published | 0 |
| 3d recon without postprocess indpndt CPT 76376 | $2,965.60 | $3,707.00 | not published | 0 |
| 5' nucleotidase - sendout CPT 83915 | $217.60 | $272.00 | not published | 0 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $3,264.00 | $4,080.00 | not published | 0 |
| Abdominal CT scan (with contrast) CPT 74160 | $2,709.60 | $3,387.00 | not published | 0 |
| Abdominal CT scan (without contrast) CPT 74150 | $2,639.20 | $3,299.00 | not published | 0 |
| Abdominal MRI (with and without contrast) CPT 74183 | $4,437.60 | $5,547.00 | not published | 0 |
| Abdominal MRI (with contrast) CPT 74182 | $3,937.60 | $4,922.00 | not published | 0 |
| Abdominal MRI (without contrast) CPT 74181 | $3,828.00 | $4,785.00 | not published | 0 |
| Abdominal paracentesis w/image guidance CPT 49083 | $1,586.40 | $1,983.00 | not published | 0 |
| Abdominal Ultrasound (complete) CPT 76700 | $1,445.60 | $1,807.00 | not published | 0 |
| Abdominal Ultrasound (limited) CPT 76705 | $1,161.60 | $1,452.00 | not published | 0 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $1,767.20 | $2,209.00 | not published | 0 |
| Abl1 gene CPT 81170 | $1,712.80 | $2,141.00 | not published | 0 |
| Acetaminophen level CPT 80143 | $487.20 | $609.00 | not published | 0 |
| Acetone qualitative CPT 82009 | $143.20 | $179.00 | not published | 0 |
| Acetylcholine receptor modulating antibody CPT 86043 | $210.40 | $263.00 | not published | 0 |
| Acetylcholinesterase assay CPT 82013 | $248.80 | $311.00 | not published | 0 |
| Aco cont gluc mnt phys/qhp eqp 95250aco CPT 95250 | $431.20 | $539.00 | not published | 0 |
| Acute hepatitis panel CPT 80074 | $627.20 | $784.00 | not published | 0 |
| #acylcarnitineprfl CPT 82017 | $400.00 | $500.00 | not published | 0 |
| Adenovirus ag ia CPT 87301 | $350.40 | $438.00 | not published | 0 |
| Adh-sendout CPT 84588 | $372.80 | $466.00 | not published | 0 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $268.00 | $335.00 | not published | 0 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $639.20 | $799.00 | not published | 0 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $365.60 | $457.00 | not published | 0 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $295.20 | $369.00 | not published | 0 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $193.60 | $242.00 | not published | 0 |
| Administration immunization 1 vaccine CPT 90471 | $128.00 | $160.00 | not published | 0 |
| Administration immunization each additional vaccine CPT 90472 | $110.40 | $138.00 | not published | 0 |
| Administration vaccine hepatitis b HCPCS G0010 | $68.00 | $85.00 | not published | 0 |
| Administration vaccine influenza virus HCPCS G0008 | $78.40 | $98.00 | not published | 0 |
| Administration vaccine pneumococcal HCPCS G0009 | $84.80 | $106.00 | not published | 0 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $615.20 | $769.00 | not published | 0 |
| Afo molded ankle gauntlet HCPCS L1904 | $225.60 | $282.00 | not published | 0 |
| Afo rig ant tib tcf/= custom HCPCS L1932 | $4,564.00 | $5,705.00 | not published | 0 |
| Albumin body fluid quantitative each specimen CPT 82042 | $219.20 | $274.00 | not published | 0 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $70.40 | $88.00 | not published | 0 |
| Albumin serum plasma or whole blood CPT 82040 | $172.00 | $215.00 | not published | 0 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $167.20 | $209.00 | not published | 0 |
| Alkaline phosphatase CPT 84075 | $95.20 | $119.00 | not published | 0 |
| Allergen alpha lactalbumin ige CPT 86008 | $567.20 | $709.00 | not published | 0 |
| Allergen egg white ige CPT 86003 | $237.60 | $297.00 | not published | 0 |
| Allergy Skin Testing CPT 95004 | $52.80 | $66.00 | not published | 0 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $922.40 | $1,153.00 | not published | 0 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $592.80 | $741.00 | not published | 0 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | $922.40 | $1,153.00 | not published | 0 |
| Alpha-fetoprotein tumor marker CPT 82105 | $228.00 | $285.00 | not published | 0 |
| Alt/sgpt CPT 84460 | $155.20 | $194.00 | not published | 0 |
| Aluminum - quest CPT 82108 | $247.20 | $309.00 | not published | 0 |
| Amino acid screen, urine CPT 82128 | $738.40 | $923.00 | not published | 0 |
| Aminolevulinic acid delta CPT 82135 | $316.80 | $396.00 | not published | 0 |
| Amitriptyline (elavil) -sendout CPT 80335 | $225.60 | $282.00 | not published | 0 |
| Ammonia CPT 82140 | $173.60 | $217.00 | not published | 0 |
| Amniocentesisdiagnostic 59000 CPT 59000 | $731.20 | $914.00 | not published | 0 |
| Amphetamine confirm urine -sendout CPT 80324 | $475.20 | $594.00 | not published | 0 |
| Amphetamines 5 or more CPT 80326 | $333.60 | $417.00 | not published | 0 |
| Amylase CPT 82150 | $301.60 | $377.00 | not published | 0 |
| Anabolic steroid 1 or 2 CPT 80327 | $240.00 | $300.00 | not published | 0 |
| Ana ds-dna CPT 86226 | $203.20 | $254.00 | not published | 0 |
| Analysis gene f2 20210g>a variant CPT 81240 | $820.80 | $1,026.00 | not published | 0 |
| Analysis gene f5 leiden variant CPT 81241 | $352.00 | $440.00 | not published | 0 |
| Anaplsma phgcytophlm amp prb CPT 87468 | $52.80 | $66.00 | not published | 0 |
| Anca screen with reflex to titer -quest CPT 86021 | $316.80 | $396.00 | not published | 0 |
| An cholangiogram percutaneous compl CPT 47531 | $3,173.60 | $3,967.00 | not published | 0 |
| An fluoro guide for cvp CPT 77001 | $1,859.20 | $2,324.00 | not published | 0 |
| Ankle X-ray CPT 73610 | $836.80 | $1,046.00 | not published | 0 |
| Anora (draw only) CPT 99001 | $16.80 | $21.00 | not published | 0 |
| Antibody bacterium, not elsewhere specified CPT 86609 | $371.20 | $464.00 | not published | 0 |
| Antibody elution rbc reference CPT 86860 | $217.60 | $272.00 | not published | 0 |
| Antibody htlv/hiv confirm test CPT 86689 | $350.40 | $438.00 | not published | 0 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $454.40 | $568.00 | not published | 0 |
| Antibody id rbc panel CPT 86870 | $305.60 | $382.00 | not published | 0 |
| Antibody influenza virus CPT 86710 | $307.20 | $384.00 | not published | 0 |
| Antibody screen rbc CPT 86850 | $233.60 | $292.00 | not published | 0 |
| Antibody tetanus CPT 86774 | $88.00 | $110.00 | not published | 0 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $40.00 | $50.00 | not published | 0 |
| Antinuclear antibodies CPT 86038 | $197.60 | $247.00 | not published | 0 |
| Antinuclear antibodies titer CPT 86039 | $213.60 | $267.00 | not published | 0 |
| Antiphosphatidylserine antibody CPT 86148 | $447.20 | $559.00 | not published | 0 |
| Antistreptolysin o titer CPT 86060 | $176.00 | $220.00 | not published | 0 |
| Antithrombin iii activity CPT 85300 | $160.80 | $201.00 | not published | 0 |
| Aortic dysfunction/dilation CPT 81410 | $10,606.40 | $13,258.00 | not published | 0 |
| App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm CPT 15277 | $3,105.60 | $3,882.00 | not published | 0 |
| App high cost ss f/n/g/h/f >100sq cm addl 100sq cm CPT 15278 | $1,863.20 | $2,329.00 | not published | 0 |
| App high cost ss f/n/g/h/f <100sq cm addl <25sq cm CPT 15276 | $1,863.20 | $2,329.00 | not published | 0 |
| App high cost ss t/a/l >100sq cm 1st 100sq cm CPT 15273 | $6,384.80 | $7,981.00 | not published | 0 |
| App high cost ss t/a/l >100sq cm addl 100sq cm CPT 15274 | $3,830.40 | $4,788.00 | not published | 0 |
| App high cost ss t/a/l <100sq cm addl <25sq cm CPT 15272 | $1,863.20 | $2,329.00 | not published | 0 |
| Application finger splntstatic 29130 CPT 29130 | $625.60 | $782.00 | not published | 0 |
| Application long leg splint 29505 CPT 29505 | $827.20 | $1,034.00 | not published | 0 |
| Application lower leg splint 29515 CPT 29515 | $1,195.20 | $1,494.00 | not published | 0 |
| Application multi layer compression below knee (both sides) CPT 29581 | $386.40 | $483.00 | not published | 0 |
| Application of forearm cast 29075 CPT 29075 | $347.20 | $434.00 | not published | 0 |
| Application of long arm cast 29065 CPT 29065 | $347.20 | $434.00 | not published | 0 |
| Application of long leg cast CPT 29355 | $538.40 | $673.00 | not published | 0 |
| Application of long leg cast 29345 CPT 29345 | $410.40 | $513.00 | not published | 0 |
| Application of paste boot 29580 CPT 29580 | $2,097.60 | $2,622.00 | 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.