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 |
|---|---|---|---|---|
| Insertion picc without port or pump with imaging guidance=>5y CPT 36573 | $1,832.00 | $2,290.00 | not published | 0 |
| Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber CPT 33249 | $29,456.00 | $36,820.00 | not published | 0 |
| Insertion/replacement temporary single chamber electrode/pacemaker catheter CPT 33210 | $14,073.60 | $17,592.00 | not published | 0 |
| Insertion single tranvenous electrode/ppm/implantable defibrillator CPT 33216 | $7,312.80 | $9,141.00 | not published | 0 |
| Insert pm/icd lead dual CPT 33217 | $7,312.80 | $9,141.00 | not published | 0 |
| Ins icd gen exist sgl lead CPT 33240 | $20,569.60 | $25,712.00 | not published | 0 |
| Insitu hybridization (fish) CPT 88366 | $809.60 | $1,012.00 | not published | 0 |
| Insitu hybridization manual CPT 88368 | $770.40 | $963.00 | not published | 0 |
| In situ hybridization per specimen each additional single probe stain CPT 88364 | $672.00 | $840.00 | not published | 0 |
| In situ hybridization per specimen initial single probe stain CPT 88365 | $600.80 | $751.00 | not published | 0 |
| Instillation anticarcinogenic agent bladder CPT 51720 | $571.20 | $714.00 | not published | 0 |
| Insulin total CPT 83525 | $167.20 | $209.00 | not published | 0 |
| Interdental fixation CPT 21110 | $2,156.00 | $2,695.00 | not published | 0 |
| Intrinsic factor antibody CPT 86340 | $204.00 | $255.00 | not published | 0 |
| Intro long gi tube w/mult fluo CPT 74340 | $592.80 | $741.00 | not published | 0 |
| Intubation endotracheal emergency procedure CPT 31500 | $2,747.20 | $3,434.00 | not published | 0 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $5.60 | $7.00 | not published | 0 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $5.60 | $7.00 | not published | 0 |
| Iron CPT 83540 | $134.40 | $168.00 | not published | 0 |
| Iron binding capacity CPT 83550 | $162.40 | $203.00 | not published | 0 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $224.80 | $281.00 | not published | 0 |
| Ivc venogram s&i CPT 75825 | $2,644.00 | $3,305.00 | not published | 0 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $305.60 | $382.00 | not published | 0 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $283.20 | $354.00 | not published | 0 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $279.20 | $349.00 | not published | 0 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $667.20 | $834.00 | not published | 0 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $1,712.80 | $2,141.00 | not published | 0 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $140.80 | $176.00 | not published | 0 |
| Kidney imaging morphology CPT 78700 | $1,771.20 | $2,214.00 | not published | 0 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $3,512.00 | $4,390.00 | not published | 0 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $1,312.00 | $1,640.00 | 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 | $2,249.60 | $2,812.00 | not published | 0 |
| Knee MRI (with and without contrast) CPT 73723 | $7,845.60 | $9,807.00 | not published | 0 |
| Knee MRI (with contrast) CPT 73722 | $6,336.80 | $7,921.00 | not published | 0 |
| Knee MRI (without contrast) CPT 73721 | $5,815.20 | $7,269.00 | not published | 0 |
| Knee orth pos locking joint HCPCS L1831 | $780.80 | $976.00 | not published | 0 |
| Knee X-ray CPT 73564 | $934.40 | $1,168.00 | not published | 0 |
| Kras gene addl variants CPT 81276 | $1,083.20 | $1,354.00 | not published | 0 |
| Kras gene variants exon 2 CPT 81275 | $1,445.60 | $1,807.00 | not published | 0 |
| Lactate dehydrogenase (ldh) CPT 83615 | $140.80 | $176.00 | not published | 0 |
| Lactic acid CPT 83605 | $399.20 | $499.00 | not published | 0 |
| Lactoferrin fecal qualitative CPT 83630 | $178.40 | $223.00 | not published | 0 |
| Lead capillary CPT 83655 | $240.00 | $300.00 | not published | 0 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,452.00 | $1,815.00 | not published | 0 |
| Levetiracetam therapeutic drug level CPT 80177 | $247.20 | $309.00 | 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 | $316.80 | $396.00 | not published | 0 |
| Lipoprotein blood high res frac & quant CPT 83701 | $119.20 | $149.00 | not published | 0 |
| Lipoprotein blood quant CPT 83704 | $228.00 | $285.00 | not published | 0 |
| Lipoprotein direct measurement hdl CPT 83718 | $131.20 | $164.00 | not published | 0 |
| Lipoprotein direct measurement ldl CPT 83721 | $94.40 | $118.00 | not published | 0 |
| Lithium therapeutic drug level CPT 80178 | $253.60 | $317.00 | 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 | $217.60 | $272.00 | not published | 0 |
| Liver/spleen imag static only CPT 78215 | $2,201.60 | $2,752.00 | not published | 0 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $5.60 | $7.00 | 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 | $3,472.00 | $4,340.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $3,303.20 | $4,129.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $3,336.00 | $4,170.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $5,146.40 | $6,433.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $4,436.00 | $5,545.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $4,057.60 | $5,072.00 | not published | 0 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $471.20 | $589.00 | not published | 0 |
| Low frequency non-thermal Ultrasound CPT 97610 | $371.20 | $464.00 | not published | 0 |
| Lung function test (mbc/mvv) CPT 94200 | $129.60 | $162.00 | not published | 0 |
| Lung Function Test (Spirometry) CPT 94010 | $541.60 | $677.00 | not published | 0 |
| Lung perfusion imaging CPT 78580 | $2,148.00 | $2,685.00 | not published | 0 |
| Lymphatics/lymph node imaging CPT 78195 | $2,142.40 | $2,678.00 | not published | 0 |
| Macroscopic exam parasite CPT 87169 | $153.60 | $192.00 | not published | 0 |
| Magnesium CPT 83735 | $168.00 | $210.00 | not published | 0 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $136.00 | $170.00 | not published | 0 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $136.00 | $170.00 | not published | 0 |
| Marker biop eviva buckle ss HCPCS A4648 | $4,476.80 | $5,596.00 | not published | 0 |
| Mastoids complete CPT 70130 | $1,455.20 | $1,819.00 | not published | 0 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $215.20 | $269.00 | not published | 0 |
| Mayo aathr protein s free CPT 85306 | $305.60 | $382.00 | not published | 0 |
| Mayo activated protein c resistance assay CPT 85307 | $338.40 | $423.00 | not published | 0 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $964.80 | $1,206.00 | not published | 0 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $273.60 | $342.00 | not published | 0 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $404.00 | $505.00 | not published | 0 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $233.60 | $292.00 | not published | 0 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $185.60 | $232.00 | not published | 0 |
| Mayo alpha 1 antitrypsin CPT 82103 | $219.20 | $274.00 | not published | 0 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $226.40 | $283.00 | not published | 0 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | $64.80 | $81.00 | not published | 0 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | $246.40 | $308.00 | not published | 0 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $1,393.60 | $1,742.00 | not published | 0 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $1,072.00 | $1,340.00 | not published | 0 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $2,549.60 | $3,187.00 | not published | 0 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $6,428.00 | $8,035.00 | not published | 0 |
| Mayo androstenedione CPT 82157 | $306.40 | $383.00 | not published | 0 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $276.00 | $345.00 | not published | 0 |
| Mayo antithrombin iii antigen CPT 85301 | $156.80 | $196.00 | not published | 0 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $129.60 | $162.00 | not published | 0 |
| Mayo avwpr vw factor activity CPT 85397 | $689.60 | $862.00 | not published | 0 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $48.80 | $61.00 | 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.