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 |
|---|---|---|---|---|
| Anodyne therapy charges pt CPT 97026 | not published | not published | $6.49 – $6.81 | 3 |
| Anogenital exam child w imag CPT 99170 | not published | not published | $216.65 – $227.48 | 3 |
| Anorectal myomectomy CPT 45108 | not published | not published | $2,974.45 – $3,123.17 | 3 |
| Anoscopy CPT 46611 | not published | not published | $996.56 – $1,046.39 | 3 |
| Anoscopy ablation lesion 46615 CPT 46615 | not published | not published | $2,974.45 – $3,123.17 | 3 |
| Anoscopy and biopsy CPT 46606 | not published | not published | $1,282.34 – $1,346.46 | 3 |
| Anoscopy and dilation 46604 CPT 46604 | not published | not published | $1,282.34 – $1,346.46 | 3 |
| Anoscopy control bleeding 46614 CPT 46614 | not published | not published | $1,282.34 – $1,346.46 | 3 |
| Anoscopy remove fb 46608 CPT 46608 | not published | not published | $996.56 – $1,046.39 | 3 |
| Anoscopy remove lesion 46610 CPT 46610 | not published | not published | $2,974.45 – $3,123.17 | 3 |
| Anoscopy remove lesions w/cautery/snare 46612 CPT 46612 | not published | not published | $2,974.45 – $3,123.17 | 3 |
| Ans parasymp & symp w/tilt CPT 95924 | not published | not published | $231.39 – $242.96 | 3 |
| Ant colporrhaphy/rpr cyctocele 57240 CPT 57240 | not published | not published | $5,360.72 – $5,628.75 | 3 |
| Antibody CPT 86744 | not published | not published | $15.99 – $16.79 | 3 |
| Antibody bacterium, not elsewhere specified CPT 86609 | $124.30 | $226.00 | $12.88 – $13.52 | 3 |
| Antibody elution rbc reference CPT 86860 | $243.65 | $443.00 | $182.57 – $191.70 | 3 |
| Antibody htlv/hiv confirm test CPT 86689 | $395.45 | $719.00 | $19.35 – $20.32 | 3 |
| Antibody htlv-i CPT 86687 | not published | not published | $9.09 – $9.54 | 3 |
| Antibody htlv-ii CPT 86688 | not published | not published | $14.00 – $14.70 | 3 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $541.75 | $985.00 | $18.37 – $19.29 | 3 |
| Antibody id rbc panel CPT 86870 | $292.05 | $531.00 | $384.12 – $403.32 | 3 |
| Antibody influenza virus CPT 86710 | $253.55 | $461.00 | $13.55 – $14.23 | 3 |
| Antibody lymphocytic choriomeningitis CPT 86727 | not published | not published | $12.87 – $13.51 | 3 |
| Antibody screen rbc CPT 86850 | $158.95 | $289.00 | $55.84 – $58.64 | 3 |
| Antibody tetanus CPT 86774 | not published | not published | $14.80 – $15.54 | 3 |
| Antidepressant not specified CPT 80338 | $209.00 | $380.00 | not published | 0 |
| Antigen therapy services CPT 95145 | not published | not published | $50.18 – $52.69 | 3 |
| Antigen therapy services CPT 95146 | not published | not published | $50.18 – $52.69 | 3 |
| Antigen therapy services CPT 95147 | not published | not published | $77.16 – $81.01 | 3 |
| Antigen therapy services CPT 95148 | not published | not published | $77.16 – $81.01 | 3 |
| Antigen therapy services CPT 95149 | not published | not published | $77.16 – $81.01 | 3 |
| Antigen therapy services CPT 95165 | not published | not published | $50.18 – $52.69 | 3 |
| Antigen therapy services CPT 95170 | not published | not published | $50.18 – $52.69 | 3 |
| Anti mog serum - sendout CPT 86362 | $207.35 | $377.00 | $12.05 – $12.65 | 3 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $27.50 | $50.00 | $12.05 – $12.65 | 3 |
| Antineutrophil cytoplasmic antibody titer each antibody CPT 86037 | not published | not published | $12.05 – $12.65 | 3 |
| Antinuclear antibodies CPT 86038 | $214.50 | $390.00 | $12.09 – $12.69 | 3 |
| Antinuclear antibodies titer CPT 86039 | $378.95 | $689.00 | $11.16 – $11.72 | 3 |
| Antiphosphatidylserine antibody CPT 86148 | $79.20 | $144.00 | $16.07 – $16.87 | 3 |
| Antistreptolysin o screen CPT 86063 | not published | not published | $5.77 – $6.06 | 3 |
| Antistreptolysin o titer CPT 86060 | $124.30 | $226.00 | $7.30 – $7.66 | 3 |
| Antithrombin iii activity CPT 85300 | $454.30 | $826.00 | $11.85 – $12.44 | 3 |
| Ant/post colporrhap/enterocele rpr 57265 CPT 57265 | not published | not published | $5,360.72 – $5,628.75 | 3 |
| Ant sgm img ir flrscn angrph CPT 92287 | not published | not published | $142.58 – $149.71 | 3 |
| Ant sgm img i&r speclr mic CPT 92286 | not published | not published | $142.58 – $149.71 | 3 |
| Aortic dysfunction/dilation CPT 81410 | not published | not published | $504.00 – $529.20 | 3 |
| Aortic dysfunction/dilation CPT 81411 | not published | not published | $1,350.19 – $1,417.70 | 3 |
| Apc gene dup/delet variants CPT 81203 | not published | not published | $200.00 – $210.00 | 3 |
| Apc gene full sequence CPT 81201 | $1,778.15 | $3,233.00 | $780.00 – $819.00 | 3 |
| Apc gene known fam variants CPT 81202 | not published | not published | $280.00 – $294.00 | 3 |
| Aphakia prosth service temp CPT 92358 | not published | not published | $63.22 – $66.38 | 3 |
| Apheresis platelets CPT 36513 | not published | not published | $472.77 – $496.41 | 3 |
| Apl(pml-rara) quant - sendout CPT 81315 | $502.15 | $913.00 | $207.31 – $217.68 | 3 |
| Appendectomy CPT 44950 | not published | not published | $6,937.47 – $7,284.34 | 3 |
| Appendix Removal (Laparoscopic) CPT 44970 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm CPT 15277 | not published | not published | $2,211.05 – $2,321.60 | 3 |
| App high cost ss f/n/g/h/f <100sq cm addl <25sq cm CPT 15276 | $160.05 | $291.00 | not published | 0 |
| App high cost ss t/a/l >100sq cm 1st 100sq cm CPT 15273 | not published | not published | $2,211.05 – $2,321.60 | 3 |
| App high cost ss t/a/l <100sq cm addl <25sq cm CPT 15272 | $160.05 | $291.00 | not published | 0 |
| Appl bdy cst sho to hip 1thi CPT 29044 | not published | not published | $174.14 – $182.85 | 3 |
| Application clubfoot cast CPT 29450 | not published | not published | $174.14 – $182.85 | 3 |
| Application finger splntstatic 29130 CPT 29130 | $136.40 | $248.00 | $142.58 – $149.71 | 3 |
| Application halo femoral CPT 20663 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Application halo pelvic CPT 20662 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Application long leg splint 29505 CPT 29505 | $402.60 | $732.00 | $174.14 – $182.85 | 3 |
| Application lower leg splint 29515 CPT 29515 | $541.75 | $985.00 | $174.14 – $182.85 | 3 |
| Application multi layer compression below knee (both sides) CPT 29581 | $450.45 | $819.00 | $174.14 – $182.85 | 3 |
| Application of forearm cast 29075 CPT 29075 | $304.70 | $554.00 | not published | 0 |
| Application of long leg cast 29345 CPT 29345 | $264.55 | $481.00 | not published | 0 |
| Application of paste boot 29580 CPT 29580 | $473.55 | $861.00 | $174.14 – $182.85 | 3 |
| Application short leg cast 29405 CPT 29405 | $344.30 | $626.00 | not published | 0 |
| Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm CPT 15275 | $3,404.50 | $6,190.00 | $792.00 – $831.60 | 3 |
| Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm CPT 15271 | $2,549.80 | $4,636.00 | $792.00 – $831.60 | 3 |
| Appl mltpln uni ext fixj sys CPT 20692 | not published | not published | $13,758.17 – $14,446.08 | 3 |
| Appl modality 1/> areas paraffin bath 97018 CPT 97018 | $71.50 | $130.00 | $6.06 – $6.36 | 3 |
| Appl modality 1/> areas vasopneumatic devices 97016 CPT 97016 | not published | not published | $11.72 – $12.31 | 3 |
| Appl modality 1+lllt po pain CPT 97037 | $72.05 | $131.00 | $40.03 – $42.03 | 3 |
| Appl multlay comprs arm/hand CPT 29584 | $155.10 | $282.00 | $174.14 – $182.85 | 3 |
| Appl unipln uni ext fixj sys CPT 20690 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Apply finger cast 29086 CPT 29086 | not published | not published | $174.14 – $182.85 | 3 |
| Apply forearm splintdynamic 29126 CPT 29126 | $174.35 | $317.00 | $142.58 – $149.71 | 3 |
| Apply halo w/removal cranial CPT 20661 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Apply hand/wrist cast 29085 CPT 29085 | not published | not published | $174.14 – $182.85 | 3 |
| Apply of finger splint 29131 CPT 29131 | $147.95 | $269.00 | $63.22 – $66.38 | 3 |
| Apply rem fixation device CPT 20660 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Apply rigid leg cast 29445 CPT 29445 | $506.00 | $920.00 | not published | 0 |
| App mltpln uni xtrnl fix xch CPT 20697 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| App skn cll ssp f/n/g/hf 1st CPT 15017 | not published | not published | $2,211.05 – $2,321.60 | 3 |
| App skn cl ssp agrft t/a/l 1 CPT 15015 | not published | not published | $2,211.05 – $2,321.60 | 3 |
| #aptt mix-1:1 incubated CPT 87532 | not published | not published | $35.09 – $36.84 | 3 |
| Aqaprn-4 antb flo cytmtry ea CPT 86053 | $800.80 | $1,456.00 | $37.73 – $39.62 | 3 |
| Aquaporin-4 antibody cba each CPT 86052 | $592.90 | $1,078.00 | $12.05 – $12.65 | 3 |
| Aquaporin-4 antibody elisa CPT 86051 | $253.55 | $461.00 | $11.53 – $12.11 | 3 |
| Aqua therapy w/exercise/ea 15 min 97113 CPT 97113 | not published | not published | $37.72 – $39.61 | 3 |
| Aquatic exercise - group charge CPT 97150 | $89.10 | $162.00 | $17.73 – $18.62 | 3 |
| Arterial blood draw/perc 36620 CPT 36620 | $607.75 | $1,105.00 | not published | 0 |
| Artery to vein shunt CPT 36835 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Artery-vein nonautograft CPT 36830 | not published | not published | $5,963.01 – $6,261.16 | 3 |
| Artery xray each vessel 7577426 CPT 75774 | $2,228.60 | $4,052.00 | not published | 0 |
| Artery xray of abdomen 75726-26 CPT 75726 | $9,543.60 | $17,352.00 | $5,963.01 – $6,261.16 | 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.