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 |
|---|---|---|---|---|
| Hc metata joint dislocation anes CPT 28635 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks CPT 17311 | not published | not published | $792.00 – $831.60 | 3 |
| Hc mohs trunk/arm/leg 1st stage 5 blocks CPT 17313 | not published | not published | $792.00 – $831.60 | 3 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | not published | not published | $581.86 – $610.95 | 3 |
| Hc nm fusion spect CT unlisted CPT 78999 | not published | not published | $428.40 – $449.82 | 3 |
| Hc nm kidney imaging with flow CPT 78701 | $1,401.95 | $2,549.00 | $428.40 – $449.82 | 3 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | not published | not published | $581.86 – $610.95 | 3 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | not published | not published | $1,387.37 – $1,456.74 | 3 |
| Head CT scan (with and without contrast) CPT 70470 | $2,230.80 | $4,056.00 | $187.96 – $197.36 | 3 |
| Head CT scan (with contrast) CPT 70460 | $2,059.20 | $3,744.00 | $187.96 – $197.36 | 3 |
| Head CT scan (without contrast) CPT 70450 | $1,887.60 | $3,432.00 | $112.03 – $117.63 | 3 |
| Hearing loss dup/del analys CPT 81431 | not published | not published | $679.57 – $713.55 | 3 |
| Hearing loss sequence analys CPT 81430 | not published | not published | $1,625.00 – $1,706.25 | 3 |
| Heart first pass multiple CPT 78483 | not published | not published | $581.86 – $610.95 | 3 |
| Heart image spect CPT 78494 | not published | not published | $428.40 – $449.82 | 3 |
| Heart infarct image CPT 78466 | $674.30 | $1,226.00 | $428.40 – $449.82 | 3 |
| Heart infarct image (ef) CPT 78468 | not published | not published | $581.86 – $610.95 | 3 |
| Heavy metal qual any number CPT 83015 | not published | not published | $20.94 – $21.99 | 3 |
| Heinz bodies direct CPT 85441 | not published | not published | $4.20 – $4.41 | 3 |
| Heinz bodies induced CPT 85445 | not published | not published | $6.82 – $7.16 | 3 |
| Helicobacter pylori antibody igm CPT 86677 | $438.90 | $798.00 | $16.85 – $17.69 | 3 |
| Hemagglutination inhibition CPT 86280 | not published | not published | $8.19 – $8.60 | 3 |
| Hematocrit CPT 85014 | $32.45 | $59.00 | $2.37 – $2.49 | 3 |
| Hemiepiphyseal arrest CPT 24470 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Hemodialysis one evaluation CPT 90935 | $566.50 | $1,030.00 | $735.47 – $772.24 | 3 |
| Hemoglobin CPT 85018 | $27.50 | $50.00 | $2.37 – $2.49 | 3 |
| Hemoglobin copper sulfate CPT 83026 | not published | not published | $4.01 – $4.21 | 3 |
| Hemoglobin fetal qualitative CPT 83033 | $223.85 | $407.00 | $8.00 – $8.40 | 3 |
| Hemoglobin f (fetal) chemical CPT 83030 | not published | not published | $10.74 – $11.28 | 3 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $146.30 | $266.00 | $8.20 – $8.61 | 3 |
| Hemoglobin-oxygen affinity CPT 82820 | $618.20 | $1,124.00 | $13.34 – $14.01 | 3 |
| Hemoglobin plasma CPT 83051 | $135.30 | $246.00 | $7.31 – $7.68 | 3 |
| Hemoglobin thermolabile CPT 83065 | not published | not published | $9.00 – $9.45 | 3 |
| Hemoglobin urine CPT 83069 | not published | not published | $3.95 – $4.15 | 3 |
| Hemolysin acid CPT 85475 | $75.35 | $137.00 | $8.87 – $9.31 | 3 |
| Hemolysins/agglutinins auto CPT 86940 | $70.95 | $129.00 | $8.77 – $9.21 | 3 |
| Hemolysins and agglutinins incubated CPT 86941 | $70.95 | $129.00 | $12.11 – $12.72 | 3 |
| Hemophilus influenza antibdy CPT 86684 | not published | not published | $15.84 – $16.63 | 3 |
| Hemorrhoidectomy intern transanal deater 2+ 46948 CPT 46948 | not published | not published | $2,974.45 – $3,123.17 | 3 |
| Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 | not published | not published | $996.56 – $1,046.39 | 3 |
| Hemorrhoidopexy stapling 46947 CPT 46947 | not published | not published | $2,974.45 – $3,123.17 | 3 |
| Heparin assay CPT 85520 | $139.15 | $253.00 | $13.09 – $13.74 | 3 |
| Heparin neutralization CPT 85525 | $35.75 | $65.00 | $11.84 – $12.43 | 3 |
| Heparin-protamine tolerance CPT 85530 | not published | not published | $13.09 – $13.74 | 3 |
| Hepatitis a antibody igm CPT 86709 | $243.10 | $442.00 | $11.26 – $11.82 | 3 |
| Hepatitis b core antibody igm CPT 86705 | $22.55 | $41.00 | $11.77 – $12.36 | 3 |
| Hepatitis b core antibody total CPT 86704 | $169.40 | $308.00 | $12.05 – $12.65 | 3 |
| Hepatitis b surface ag quan CPT 87467 | not published | not published | $25.32 – $26.59 | 3 |
| Hepatitis b surface antibody CPT 86706 | $185.90 | $338.00 | $10.74 – $11.28 | 3 |
| Hepatitis c antibody CPT 86803 | $282.70 | $514.00 | $14.27 – $14.98 | 3 |
| Hepatitis c rna dir probe CPT 87520 | not published | not published | $31.22 – $32.78 | 3 |
| Hepatitis d quantification CPT 87523 | not published | not published | $42.84 – $44.98 | 3 |
| Hepatitis g dna amp probe CPT 87526 | not published | not published | $39.26 – $41.22 | 3 |
| Hepatitis g dna dir probe CPT 87525 | not published | not published | $29.80 – $31.29 | 3 |
| Hepatitis g dna quant CPT 87527 | not published | not published | $41.76 – $43.85 | 3 |
| Hepatobiliary system imaging CPT 78226 | $2,806.65 | $5,103.00 | $428.40 – $449.82 | 3 |
| Hereditary colon ca dsordrs CPT 81435 | $1,466.30 | $2,666.00 | $1,303.95 – $1,369.15 | 3 |
| Hered neuroend tum-rlt do 5+ CPT 81437 | $1,105.50 | $2,010.00 | $1,303.95 – $1,369.15 | 3 |
| Hered rta do gen seq 15 CPT 81434 | not published | not published | $597.91 – $627.81 | 3 |
| Hernia Repair (Inguinal) CPT 49505 | not published | not published | $3,836.82 – $4,028.66 | 3 |
| Herpes simplex 1 ag if CPT 87274 | $70.40 | $128.00 | $11.98 – $12.58 | 3 |
| Herpes simplex 2 ag if CPT 87273 | $70.40 | $128.00 | $11.98 – $12.58 | 3 |
| Herpes simplex type 1 antibody igg CPT 86695 | $208.45 | $379.00 | $13.19 – $13.85 | 3 |
| Herpes simplex type 2 antibody igg CPT 86696 | $208.45 | $379.00 | $19.35 – $20.32 | 3 |
| Herpes simplex virus isolation CPT 87255 | $40.70 | $74.00 | $33.86 – $35.55 | 3 |
| Heterophile antibodies screening CPT 86308 | $100.10 | $182.00 | $5.18 – $5.44 | 3 |
| Heterophile antibodies titer CPT 86309 | $124.30 | $226.00 | $6.47 – $6.79 | 3 |
| Heterophile antibody absrbj CPT 86310 | not published | not published | $7.37 – $7.74 | 3 |
| Hexa gene CPT 81255 | not published | not published | $51.45 – $54.02 | 3 |
| Hgb methemoglobin qual CPT 83045 | not published | not published | $6.49 – $6.81 | 3 |
| Hhv-6 dna dir probe CPT 87531 | not published | not published | $58.00 – $60.90 | 3 |
| Hhv-6 dna quant CPT 87533 | $127.05 | $231.00 | $41.76 – $43.85 | 3 |
| Hi enrgy eswt plantar fascia CPT 28890 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Hip arthr0 w/debridement CPT 29862 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Hip arthr0 w/synovectomy CPT 29863 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Hip arthro acetabuloplasty CPT 29915 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Hip arthroscopy dx CPT 29860 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Hip arthro w/fb removal CPT 29861 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Hip arthro w/femoroplasty CPT 29914 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Hip arthro w/labral repair CPT 29916 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Hip X-ray CPT 73502 | $376.20 | $684.00 | $93.26 – $97.92 | 3 |
| Histamine CPT 83088 | $355.30 | $646.00 | $29.53 – $31.01 | 3 |
| Histochemical stains add-on CPT 88314 | $158.95 | $289.00 | not published | 0 |
| Histoplasmosis skin test CPT 86510 | not published | not published | $40.03 – $42.03 | 3 |
| Hiv-1 ag ia CPT 87390 | $84.15 | $153.00 | $24.06 – $25.26 | 3 |
| Hiv-1 dna dir probe CPT 87534 | not published | not published | $21.92 – $23.02 | 3 |
| Hiv-2 ag ia CPT 87391 | not published | not published | $21.90 – $23.00 | 3 |
| HIV 2 pcr qual - sendout CPT 87537 | not published | not published | $21.92 – $23.02 | 3 |
| Hiv-2 quant&revrse trnscripj CPT 87539 | not published | not published | $58.62 – $61.55 | 3 |
| Hla class i high defin qual CPT 86832 | not published | not published | $323.75 – $339.94 | 3 |
| Hla class ii high defin qual CPT 86833 | not published | not published | $325.80 – $342.09 | 3 |
| Hla class i&ii antibody qual CPT 86828 | $863.50 | $1,570.00 | $64.19 – $67.40 | 3 |
| Hla class i/ii antibody qual CPT 86829 | not published | not published | $64.19 – $67.40 | 3 |
| Hla class ii phenotype qual CPT 86831 | not published | not published | $81.88 – $85.97 | 3 |
| Hla class ii semiquant panel CPT 86835 | not published | not published | $322.96 – $339.11 | 3 |
| Hla class i phenotype qual CPT 86830 | not published | not published | $95.52 – $100.30 | 3 |
| Hla class i semiquant panel CPT 86834 | not published | not published | $357.56 – $375.44 | 3 |
| Hla i & ii type verify lr CPT 81371 | not published | not published | $404.52 – $424.75 | 3 |
| Hla i & ii typing hr CPT 81378 | not published | not published | $345.57 – $362.85 | 3 |
| Hla i & ii typing lr CPT 81370 | not published | not published | $402.12 – $422.23 | 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.