SSM Health Good Samaritan Hospital - Mt. Vernon
1 Good Samaritan Way, Mount Vernon, IL · SSM Health · · NPI 1609897339
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 |
|---|---|---|---|---|
| Culture mycobacteria definitive id each isolate CPT 87118 | $146.85 | $267.00 | $14.61 – $15.34 | 3 |
| Culture mycoplasma any source CPT 87109 | $42.35 | $77.00 | $15.39 – $16.16 | 3 |
| Culture of specimen by kit CPT 87084 | not published | not published | $27.07 – $28.42 | 3 |
| Culture quantitative aerobic other source CPT 87071 | $85.25 | $155.00 | $9.89 – $10.38 | 3 |
| Culture screening strep group a CPT 87081 | $95.15 | $173.00 | $6.63 – $6.96 | 3 |
| Culture type pulse field gel CPT 87152 | not published | not published | $7.74 – $8.13 | 3 |
| Culture typing added method CPT 87158 | not published | not published | $7.74 – $8.13 | 3 |
| Culture typing glc/hplc CPT 87143 | not published | not published | $12.52 – $13.15 | 3 |
| Culture typing immunologic CPT 87147 | $44.00 | $80.00 | $5.18 – $5.44 | 3 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | $485.65 | $883.00 | $218.06 – $228.96 | 3 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $58.85 | $107.00 | $35.09 – $36.84 | 3 |
| Culture urine each isolate CPT 87088 | $58.30 | $106.00 | $8.09 – $8.49 | 3 |
| Culture virus isolation CPT 87250 | not published | not published | $19.56 – $20.54 | 3 |
| Cutter lead HCPCS C1773 | $1,468.52 | $2,670.03 | not published | 0 |
| Cv line/pic reposition CPT 36597 | $1,230.35 | $2,237.00 | $1,686.89 – $1,771.24 | 3 |
| Cyanocobalamin unsat binding capacity CPT 82608 | $199.10 | $362.00 | $14.32 – $15.04 | 3 |
| Cyclic citrullinated peptide antibody CPT 86200 | $95.70 | $174.00 | $12.95 – $13.60 | 3 |
| Cyclosporine 2 hour CPT 80158 | $268.40 | $488.00 | $18.05 – $18.95 | 3 |
| Cyp2c19 gene com variants CPT 81225 | $231.00 | $420.00 | $291.36 – $305.93 | 3 |
| Cyp2c9 gene com variants CPT 81227 | $479.05 | $871.00 | $174.81 – $183.55 | 3 |
| Cyp2d6 gene com variants CPT 81226 | $1,015.30 | $1,846.00 | $450.91 – $473.46 | 3 |
| Cyp3a4 gene common variants CPT 81230 | $138.60 | $252.00 | $174.81 – $183.55 | 3 |
| Cyp3a5 gene common variants CPT 81231 | $138.60 | $252.00 | $174.81 – $183.55 | 3 |
| Cystatin c CPT 82610 | $88.00 | $160.00 | $18.52 – $19.45 | 3 |
| Cystic fibrosis cftr CPT 81223 | $2,844.05 | $5,171.00 | $499.00 – $523.95 | 3 |
| Cystine urine quantitative CPT 82131 | $116.05 | $211.00 | $22.98 – $24.13 | 3 |
| Cysto cgen post urtl valves CPT 52400 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $629.20 | $1,144.00 | $373.86 – $392.55 | 3 |
| Cystometrogram w/up 51727 CPT 51727 | not published | not published | $747.24 – $784.60 | 3 |
| Cysto rx balo cath urtl strx CPT 52284 | not published | not published | $5,745.80 – $6,033.09 | 3 |
| Cystoscopy and biopsy CPT 52007 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cystoscopy and radiotracer CPT 52250 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cystoscopy and treatment CPT 52214 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cystoscopy and treatment CPT 52224 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cystoscopy and treatment CPT 52234 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cystoscopy and treatment CPT 52235 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cystoscopy and treatment CPT 52240 | not published | not published | $5,745.80 – $6,033.09 | 3 |
| Cystoscopy and treatment CPT 52260 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Cystoscopy and treatment CPT 52265 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Cystoscopy and treatment CPT 52276 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Cystoscopy and treatment CPT 52277 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cystoscopy and treatment CPT 52283 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Cystoscopy and treatment CPT 52285 | not published | not published | $747.24 – $784.60 | 3 |
| Cystoscopy and treatment CPT 52290 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Cystoscopy and treatment CPT 52300 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cystoscopy and treatment CPT 52301 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cystoscopy and treatment CPT 52305 | not published | not published | $5,745.80 – $6,033.09 | 3 |
| Cystoscopy and treatment CPT 52310 | $2,783.00 | $5,060.00 | $2,240.09 – $2,352.10 | 3 |
| Cystoscopy and treatment CPT 52315 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Cystoscopy and treatment CPT 52320 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cystoscopy and treatment CPT 52330 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cystoscopy (Bladder Scope) CPT 52000 | $1,252.90 | $2,278.00 | $747.24 – $784.60 | 3 |
| Cystoscopy chemodenervation CPT 52287 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Cystoscopy & duct catheter CPT 52010 | not published | not published | $747.24 – $784.60 | 3 |
| Cystoscopy implant stent CPT 52282 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cystoscopy inject material CPT 52327 | not published | not published | $5,745.80 – $6,033.09 | 3 |
| Cystoscopy prostatic imp 1-3 HCPCS C9739 | not published | not published | $5,745.80 – $6,033.09 | 3 |
| Cystoscopy removal of clots CPT 52001 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cystoscopy & revise urethra CPT 52270 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Cystoscopy & revise urethra CPT 52275 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Cystoscopy stone removal CPT 52325 | not published | not published | $5,745.80 – $6,033.09 | 3 |
| Cystoscopy & ureter catheter CPT 52005 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Cystostomy cystotomy w/drainage 51040 CPT 51040 | $3,465.00 | $6,300.00 | $2,240.09 – $2,352.10 | 3 |
| Cystotomy/cystostomy fulg+/insj radact matrl 51020 CPT 51020 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cystotomy excise/incise/repair 51535 CPT 51535 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cystouretero & or pyeloscope CPT 52351 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cysto/uretero stricture tx CPT 52344 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cystouretero w/biopsy CPT 52354 | not published | not published | $5,745.80 – $6,033.09 | 3 |
| Cystouretero w/excise tumor CPT 52355 | not published | not published | $5,745.80 – $6,033.09 | 3 |
| Cysto/uretero w/lithotripsy CPT 52356 | not published | not published | $5,745.80 – $6,033.09 | 3 |
| Cystouretero w/lithotripsy CPT 52353 | not published | not published | $5,745.80 – $6,033.09 | 3 |
| Cystouretero w/renal strict CPT 52346 | not published | not published | $5,745.80 – $6,033.09 | 3 |
| Cystouretero w/stone remove CPT 52352 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cysto/uretero w/up stricture CPT 52345 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cystourethro cut ejacul duct CPT 52402 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | $3,065.15 | $5,573.00 | $2,240.09 – $2,352.10 | 3 |
| Cystourethroscopy w/biopsy(s) 52204 CPT 52204 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Cysto w/renal stricture tx CPT 52343 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cysto w/up stricture tx CPT 52342 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cysto w/ureter stricture tx CPT 52341 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Cytog alys chrml abnr lw-ps CPT 81349 | not published | not published | $1,197.94 – $1,257.84 | 3 |
| Cytogenetics 25-99 CPT 88274 | $575.30 | $1,046.00 | $42.38 – $44.50 | 3 |
| Cytogenetics 3-5 CPT 88272 | not published | not published | $40.70 – $42.74 | 3 |
| Cytogenomic neo microra alys CPT 81277 | not published | not published | $1,160.00 – $1,218.00 | 3 |
| Cytogenom microarray copy nmbr var CPT 81228 | not published | not published | $900.00 – $945.00 | 3 |
| Cytog genom-wid alys hem mal CPT 81195 | not published | not published | $1,863.22 – $1,956.38 | 3 |
| Cytomegalovirus ag ia CPT 87332 | not published | not published | $11.98 – $12.58 | 3 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $253.55 | $461.00 | $14.39 – $15.11 | 3 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $220.55 | $401.00 | $16.85 – $17.69 | 3 |
| Cytomegalovirus dfa CPT 87271 | not published | not published | $13.42 – $14.09 | 3 |
| Cytomeg dna dir probe CPT 87495 | not published | not published | $30.03 – $31.53 | 3 |
| Cytopath c/v auto in fluid CPT 88174 | not published | not published | $25.37 – $26.64 | 3 |
| Cytopath c/v automated CPT 88147 | not published | not published | $50.56 – $53.09 | 3 |
| Cytopath c/v auto redo CPT 88152 | not published | not published | $27.64 – $29.02 | 3 |
| Cytopath c/v auto rescreen CPT 88148 | not published | not published | $18.54 – $19.47 | 3 |
| Cytopath c/v index add-on CPT 88155 | not published | not published | $14.65 – $15.38 | 3 |
| Cytopath c/v manual CPT 88150 | not published | not published | $18.54 – $19.47 | 3 |
| Cytopath c/v redo CPT 88153 | not published | not published | $24.03 – $25.23 | 3 |
| Cytopath c/v thin layer redo CPT 88143 | not published | not published | $23.04 – $24.19 | 3 |
| Cytopath fl nongyn filter CPT 88106 | not published | not published | $30.99 – $32.54 | 3 |
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.