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 |
|---|---|---|---|---|
| Injection of sinus tract CPT 20500 | not published | not published | $1,662.71 – $1,745.84 | 3 |
| Injection px peyronie ds CPT 54200 | not published | not published | $267.74 – $281.13 | 3 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $717.20 | $1,304.00 | $428.40 – $449.82 | 3 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | $4,248.20 | $7,724.00 | $756.44 – $794.26 | 3 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $706.75 | $1,285.00 | $756.44 – $794.26 | 3 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $963.05 | $1,751.00 | $756.44 – $794.26 | 3 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $646.80 | $1,176.00 | not published | 0 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $879.45 | $1,599.00 | not published | 0 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | not published | not published | $756.44 – $794.26 | 3 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | not published | not published | $756.44 – $794.26 | 3 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $418.55 | $761.00 | $328.94 – $345.38 | 3 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $463.65 | $843.00 | $328.94 – $345.38 | 3 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $513.70 | $934.00 | $328.94 – $345.38 | 3 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $204.05 | $371.00 | $50.18 – $52.69 | 3 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $180.95 | $329.00 | not published | 0 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $390.50 | $710.00 | $227.94 – $239.33 | 3 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $158.40 | $288.00 | $77.16 – $81.01 | 3 |
| Inj epidural sgl cerv-thor without img CPT 62320 | not published | not published | $756.44 – $794.26 | 3 |
| Inj for ext venography CPT 36005 | $367.95 | $669.00 | not published | 0 |
| Inj for mammo ductogram CPT 19030 | $136.40 | $248.00 | not published | 0 |
| Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 | $1,034.55 | $1,881.00 | not published | 0 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | not published | not published | $215.00 – $225.75 | 3 |
| Inj intralesional > 7 lsns CPT 11901 | not published | not published | $215.00 – $225.75 | 3 |
| Inj nephrosto/ureterogram w/img exstng access CPT 50431 | $1,812.25 | $3,295.00 | $747.24 – $784.60 | 3 |
| Inj non-compmd foam sclrsnt mlt trncl veins same leg CPT 36466 | not published | not published | $2,211.05 – $2,321.60 | 3 |
| Inj non-compmd foam sclrsnt sgl trncl vein CPT 36465 | not published | not published | $2,211.05 – $2,321.60 | 3 |
| Inj proc elbow arthro CPT 24220 | $246.40 | $448.00 | not published | 0 |
| Inj proc myelogram lumbar CPT 62284 | $1,201.20 | $2,184.00 | not published | 0 |
| Inj proc sialogram CPT 42550 | $510.95 | $929.00 | not published | 0 |
| Inj retro urethrocysto CPT 51610 | $669.35 | $1,217.00 | not published | 0 |
| Inj scleros sol mult veins CPT 36471 | not published | not published | $435.63 – $457.41 | 3 |
| Inj scleros sol sgl vein CPT 36470 | not published | not published | $435.63 – $457.41 | 3 |
| Inj(s) sclerosant spider veins limb/trunk CPT 36468 | not published | not published | $435.63 – $457.41 | 3 |
| Inj w/fluor eval cv device CPT 36598 | $1,493.80 | $2,716.00 | $227.94 – $239.33 | 3 |
| Ins cath ren art 1st bi CPT 36252 | $12,274.90 | $22,318.00 | $3,383.62 – $3,552.80 | 3 |
| Ins cath ren art 1st uni CPT 36251 | $5,897.10 | $10,722.00 | $3,383.62 – $3,552.80 | 3 |
| Ins cath ren art 2nd+ bi CPT 36254 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Ins cath ren art 2nd+ uni CPT 36253 | not published | not published | $5,963.01 – $6,261.16 | 3 |
| Ins cerv dilator (sep proc) CPT 59200 | $380.60 | $692.00 | $326.55 – $342.88 | 3 |
| Insemination of oocytes CPT 89268 | not published | not published | $182.57 – $191.70 | 3 |
| Insert and remove bone pin CPT 20650 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Insert cannula hemo oth 36815 CPT 36815 | not published | not published | $5,963.01 – $6,261.16 | 3 |
| Insert cannula vein-to-vein hemodialysis CPT 36800 | not published | not published | $5,963.01 – $6,261.16 | 3 |
| Insert cath pleura with image CPT 32557 | $1,135.75 | $2,065.00 | $1,686.89 – $1,771.24 | 3 |
| Insert cath pleura without image CPT 32556 | $1,529.55 | $2,781.00 | $2,056.34 – $2,159.15 | 3 |
| Insert drug delivery implant CPT 11981 | not published | not published | $142.58 – $149.71 | 3 |
| Insert hepatic shunt (tips) CPT 37182 | not published | not published | $19,644.52 – $20,626.75 | 3 |
| Insert heyman uteri capsule CPT 58346 | not published | not published | $5,360.72 – $5,628.75 | 3 |
| Insertion catheter artery nfs ther chemotx 36640 CPT 36640 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Insertion catheter bladder non indwelling CPT 51701 | $264.55 | $481.00 | $142.58 – $149.71 | 3 |
| Insertion catheter bladder temporary simple CPT 51702 | $513.70 | $934.00 | $142.58 – $149.71 | 3 |
| Insertion catheter pleural indwelling tunneled with cuff CPT 32550 | $3,835.70 | $6,974.00 | $3,836.82 – $4,028.66 | 3 |
| Insertion intra aortic balloon assist device percutaneous CPT 33967 | $10,297.10 | $18,722.00 | not published | 0 |
| Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance CPT 37191 | $6,088.50 | $11,070.00 | $5,963.01 – $6,261.16 | 3 |
| Insertion nontunneled centrally inserted central venous catheter >= 5 years old CPT 36556 | $1,268.30 | $2,306.00 | $3,383.62 – $3,552.80 | 3 |
| Insertion of cannula CPT 36810 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Insertion of heart electrode 33211 CPT 33211 | $8,292.90 | $15,078.00 | $8,868.06 – $9,311.46 | 3 |
| Insertion of infusion pump CPT 36260 | not published | not published | $5,963.01 – $6,261.16 | 3 |
| Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular CPT 33208 | $19,374.30 | $35,226.00 | $11,200.55 – $11,760.58 | 3 |
| Insertion of new/replacement ppm w/transvenous electrode(s) ventricular CPT 33207 | $15,761.35 | $28,657.00 | $11,200.55 – $11,760.58 | 3 |
| Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator CPT 33225 | $22,627.00 | $41,140.00 | not published | 0 |
| Insertion palate prosthesis CPT 42281 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years CPT 36569 | $1,856.25 | $3,375.00 | $1,686.89 – $1,771.24 | 3 |
| Insertion picc without port or pump with imaging guidance=>5y CPT 36573 | $1,271.60 | $2,312.00 | $1,686.89 – $1,771.24 | 3 |
| Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber CPT 33249 | $41,764.80 | $75,936.00 | $33,636.89 – $35,318.74 | 3 |
| Insertion/replacement temporary single chamber electrode/pacemaker catheter CPT 33210 | $9,598.60 | $17,452.00 | $8,868.06 – $9,311.46 | 3 |
| Insertion single tranvenous electrode/ppm/implantable defibrillator CPT 33216 | $11,188.10 | $20,342.00 | $8,868.06 – $9,311.46 | 3 |
| Insertion subcutaneous cardiac rhythm monitor CPT 33285 | $13,988.70 | $25,434.00 | $8,868.06 – $9,311.46 | 3 |
| Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides) CPT 36561 | $3,686.65 | $6,703.00 | $3,383.62 – $3,552.80 | 3 |
| Insertion ureth cath CPT 51045 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Insert nasal septal button CPT 30220 | not published | not published | $1,662.71 – $1,745.84 | 3 |
| Insert palate implants HCPCS C9727 | not published | not published | $1,662.71 – $1,745.84 | 3 |
| Insert pessary/other device CPT 57160 | not published | not published | $216.65 – $227.48 | 3 |
| Insert picvad cath CPT 36570 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Insert pm/icd lead dual CPT 33217 | $11,188.10 | $20,342.00 | $8,868.06 – $9,311.46 | 3 |
| Insert prost urethral stent CPT 53855 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Insert/repl sq defib w/eltrd CPT 33270 | not published | not published | $33,636.89 – $35,318.74 | 3 |
| Insert sq defib electrode CPT 33271 | not published | not published | $8,868.06 – $9,311.46 | 3 |
| Insert swan-ganz cath CPT 93503 | $2,125.20 | $3,864.00 | $1,686.89 – $1,771.24 | 3 |
| Insert tissue expander(s) CPT 11960 | not published | not published | $3,797.52 – $3,987.40 | 3 |
| Insert tunneled cv 2cath 2sits without port/pmp 36565 CPT 36565 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Insert tunneled cv cath CPT 36560 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Insert tunneled cv cath CPT 36563 | not published | not published | $5,963.01 – $6,261.16 | 3 |
| Insert uteri tandem/ovoids CPT 57155 | not published | not published | $5,360.72 – $5,628.75 | 3 |
| Insert vad art access left hrt arterial access CPT 33990 | $4,504.50 | $8,190.00 | not published | 0 |
| Ins icd gen exist mlt leads CPT 33231 | $35,956.25 | $65,375.00 | $33,636.89 – $35,318.74 | 3 |
| Ins icd gen exist sgl lead CPT 33240 | $27,667.75 | $50,305.00 | $23,836.63 – $25,028.46 | 3 |
| Insitu hybridization auto CPT 88367 | $513.15 | $933.00 | $384.12 – $403.32 | 3 |
| Insitu hybridization (fish) CPT 88366 | not published | not published | $182.57 – $191.70 | 3 |
| Insitu hybridization manual CPT 88368 | $519.20 | $944.00 | $384.12 – $403.32 | 3 |
| In situ hybridization per specimen each additional single probe stain CPT 88364 | $404.25 | $735.00 | not published | 0 |
| In situ hybridization per specimen initial single probe stain CPT 88365 | $946.55 | $1,721.00 | $182.57 – $191.70 | 3 |
| Insj stablj dev w/dcmprn CPT 22867 | not published | not published | $18,789.56 – $19,729.04 | 3 |
| Insj stablj dev without dcmprn CPT 22869 | not published | not published | $13,758.17 – $14,446.08 | 3 |
| Ins lv lead exist pm/icd CPT 33224 | $16,266.80 | $29,576.00 | $11,200.55 – $11,760.58 | 3 |
| Ins mark abd/pel for right perq CPT 49411 | $2,333.65 | $4,243.00 | not published | 0 |
| Ins mark thor for right perq CPT 32553 | $2,333.65 | $4,243.00 | not published | 0 |
| Ins picad w subq port 5yr> CPT 36571 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Ins picc wo subq prt/pmp w image guidnc <5yr CPT 36572 | not published | not published | $672.23 – $705.84 | 3 |
| Ins pm gen exist dual lead CPT 33230 | not published | not published | $23,836.63 – $25,028.46 | 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.