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 |
|---|---|---|---|---|
| Exc malig feenl 3.1-4.0 11644 CPT 11644 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc malig feenl >4cm 11646 CPT 11646 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc malig snhfg 0.5cm or less 11620 CPT 11620 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc malig snhfg 0.6-1.0 cm 11621 CPT 11621 | not published | not published | $758.85 – $796.79 | 3 |
| Exc malig snhfg 2.1-3 cm 11623 CPT 11623 | $1,515.25 | $2,755.00 | $1,769.88 – $1,858.38 | 3 |
| Exc malig tal <0.5cm 11600 CPT 11600 | not published | not published | $758.85 – $796.79 | 3 |
| Exc malig tal 0.6-1.0cm 11601 CPT 11601 | not published | not published | $758.85 – $796.79 | 3 |
| Exc mal+marg tal 1.1-2 cm 11602 CPT 11602 | not published | not published | $435.63 – $457.41 | 3 |
| Exc mal+marg tal 2.1-3 cm 11603 CPT 11603 | $1,207.80 | $2,196.00 | $758.85 – $796.79 | 3 |
| Exc mal+marg tal 3.1-4 cm 11604 CPT 11604 | not published | not published | $758.85 – $796.79 | 3 |
| Exc mandible 21025 CPT 21025 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Exc neck tum deep < 5 cm CPT 21556 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc neck tum deep 5 cm/> CPT 21554 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc of facial bones/osteomy/abcess 21026 CPT 21026 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Exc of residual cervix via aginal approach 57550 CPT 57550 | not published | not published | $5,360.72 – $5,628.75 | 3 |
| Exc/pilonidal cyst/sinus/simple 11770 CPT 11770 | $2,627.90 | $4,778.00 | $3,112.75 – $3,268.38 | 3 |
| Exc prtl bn phlnx toe CPT 28124 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Exc rect tum transanal full CPT 45172 | not published | not published | $2,974.45 – $3,123.17 | 3 |
| Exc rect tum transanal part CPT 45171 | not published | not published | $2,974.45 – $3,123.17 | 3 |
| Exc sac pr ulc prim str ostc CPT 15933 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc sac pr ulc skn flp ostc CPT 15935 | not published | not published | $3,797.52 – $3,987.40 | 3 |
| Exc sacral pr ulc prim sutr CPT 15931 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc sacral pr ulc skn flap CPT 15934 | not published | not published | $3,797.52 – $3,987.40 | 3 |
| Exc shoulder tum deep < 5 cm CPT 23076 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc skn hdrdnt ax complex CPT 11451 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc skn hdrdnt ax smpl/ntrm CPT 11450 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc skn hdrdnt ing complex CPT 11463 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc snhfg mal+mrg 1.1-2 11622 CPT 11622 | not published | not published | $758.85 – $796.79 | 3 |
| Exc snhfg mal+mrg 3.1-4 11624 CPT 11624 | $1,816.10 | $3,302.00 | $1,769.88 – $1,858.38 | 3 |
| Exc snhfg mal+mrg >4 cm 11626 CPT 11626 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc sq tum/leg or ankle area <3 cm 27618 CPT 27618 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc sq tum/neck/ant thorax 3cm/> 21552 CPT 21552 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc sq tum/neck or ant thorax <3cm 21555 CPT 21555 | $2,050.95 | $3,729.00 | $1,769.88 – $1,858.38 | 3 |
| Exc sq tumor/foot or toe < 1.5 cm 28039 CPT 28039 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc sq tumor/forearm/wrist/<3cm 25075 CPT 25075 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc sq tumor/leg/ankle 3cm/> 27632 CPT 27632 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc sq tumor/shoulder area 3cm/> 23071 CPT 23071 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc sq tumor/thigh/knee area 3cm/> 27337 CPT 27337 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc sq tum/vasc malform/hand/fngr 26111 CPT 26111 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc subq tum/sft tis/pel/hip 3cm/> 27043 CPT 27043 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc tendon sheath or cap lesion 26160 CPT 26160 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Exc thigh/knee les sc<3cm 27327 CPT 27327 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc thigh/knee tum deep <5cm CPT 27328 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc thigh/knee tum dep 5cm/> CPT 27339 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc thrombosed hemorrhoid 46320 CPT 46320 | $2,100.45 | $3,819.00 | $1,282.34 – $1,346.46 | 3 |
| Exc tmr sft tiss shldr subq <3cm CPT 23075 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc torus mandibularis 21031 CPT 21031 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Exc trchntric pr ulcer w/prim sutr w/ostectomy 15951 CPT 15951 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Exc trchntr pr ulc flp clsr CPT 15952 | not published | not published | $2,211.05 – $2,321.60 | 3 |
| Exc trchntr pr ulc flp ostc CPT 15953 | not published | not published | $3,797.52 – $3,987.40 | 3 |
| Exc trchntr pr ulc prep flap CPT 15956 | not published | not published | $2,211.05 – $2,321.60 | 3 |
| Exc trchntr pr ulc prep ostc CPT 15958 | not published | not published | $3,797.52 – $3,987.40 | 3 |
| Exc trchntr pr ulc prim sutr CPT 15950 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc tr-ext mal+marg tal >4 cm 11606 CPT 11606 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Exc vagina lesion 57135 CPT 57135 | not published | not published | $3,468.96 – $3,642.41 | 3 |
| Exercise tst brncspsm w/ecg CPT 94617 | not published | not published | $142.58 – $149.71 | 3 |
| Exercise tst brncspsm wo ecg CPT 94619 | not published | not published | $63.22 – $66.38 | 3 |
| Exhaled breath condensate CPT 83987 | not published | not published | $3.58 – $3.76 | 3 |
| Exome re-evaluation CPT 81417 | not published | not published | $320.00 – $336.00 | 3 |
| Exome sequence analysis CPT 81415 | not published | not published | $4,780.00 – $5,019.00 | 3 |
| Exome sequence analysis CPT 81416 | not published | not published | $12,000.00 – $12,600.00 | 3 |
| Ex palate/uvula lesion without closure 42104 CPT 42104 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Exploration for testis CPT 54550 | not published | not published | $3,836.82 – $4,028.66 | 3 |
| Exploration for testis CPT 54560 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Exploration maxillary sinus CPT 31030 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Exploration maxillary sinus CPT 31256 | not published | not published | $3,995.36 – $4,195.13 | 3 |
| Exploration of ankle joint CPT 27612 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Exploration of foot joint CPT 28020 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Exploration of foot joint CPT 28022 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Exploration of frontal sinus CPT 31070 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Exploration of frontal sinus CPT 31075 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Exploration of knee joint CPT 27310 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Exploration of middle ear CPT 69440 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Exploration of sinuses CPT 31090 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Exploration of spinal fusion CPT 22830 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Exploration of toe joint CPT 28024 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Exploration retroperitoneal area 49010 CPT 49010 | not published | not published | $6,937.47 – $7,284.34 | 3 |
| Explore deep node(s) neck CPT 38542 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Explore epididymis CPT 54865 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Explore inner ear CPT 69805 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Explore inner ear CPT 69806 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Explore limb vessels 35860 CPT 35860 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Explore neck vessels 35800 CPT 35800 | not published | not published | $5,963.01 – $6,261.16 | 3 |
| Explore parathyroid glands CPT 60500 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Explore penetrating wnd/extremity 20103 CPT 20103 | $1,138.50 | $2,070.00 | $1,769.88 – $1,858.38 | 3 |
| Explore scrotum CPT 55110 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Explore/treat ankle joint CPT 27620 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Explore/treat finger joint CPT 26075 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Explore/treat finger joint CPT 26080 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Explore/treat knee joint CPT 27331 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Explore/treat wrist joint CPT 25101 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Explore wound abdomen 20102 CPT 20102 | not published | not published | $2,211.05 – $2,321.60 | 3 |
| Explore woundchest 20101 CPT 20101 | not published | not published | $2,211.05 – $2,321.60 | 3 |
| Exp w remove/deep fb/forearm/wrist 25248 CPT 25248 | $1,548.80 | $2,816.00 | $1,723.15 – $1,809.31 | 3 |
| Ex sq tumor/face or scalp < 2 cm 21011 CPT 21011 | $1,515.25 | $2,755.00 | $1,769.88 – $1,858.38 | 3 |
| Ex sq tumor/face or scalp 2 cm/> 21012 CPT 21012 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Ext ecg>48hr<7d scan a/r CPT 93243 | not published | not published | $142.58 – $149.71 | 3 |
| Ext ecg>7d<15d scan a/r CPT 93247 | not published | not published | $142.58 – $149.71 | 3 |
| Extended visual field xm CPT 92083 | not published | not published | $142.58 – $149.71 | 3 |
| Extensive ear canal surgery 69150 CPT 69150 | not published | not published | $6,343.80 – $6,660.99 | 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.