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 |
|---|---|---|---|---|
| Largsc w/ther injection CPT 31573 | not published | not published | $1,907.37 – $2,002.74 | 3 |
| Laryngeal function studies CPT 92520 | not published | not published | $142.58 – $149.71 | 3 |
| Laryngoplasty cricoid split CPT 31587 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Laryngoplasty fx rdctj fixj CPT 31584 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Laryngoplasty laryngeal sten CPT 31551 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Laryngoplasty laryngeal sten CPT 31552 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Laryngoplasty laryngeal sten CPT 31553 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Laryngoplasty laryngeal sten CPT 31554 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Laryngoplasty laryngeal web CPT 31580 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Laryngoplasty medialization CPT 31591 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Laryngoscope w/vc inj CPT 31570 | not published | not published | $3,995.36 – $4,195.13 | 3 |
| Laryngoscopic sensory vid CPT 92614 | not published | not published | $57.05 – $59.90 | 3 |
| Laryngoscop w/arytenoidectom CPT 31560 | not published | not published | $7,562.90 – $7,941.05 | 3 |
| Laryngoscop w/vc inj + scope CPT 31571 | not published | not published | $3,995.36 – $4,195.13 | 3 |
| Laryngoscopy and dilation CPT 31528 | not published | not published | $3,995.36 – $4,195.13 | 3 |
| Laryngoscopy and dilation CPT 31529 | not published | not published | $3,995.36 – $4,195.13 | 3 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | $2,157.10 | $3,922.00 | $1,907.37 – $2,002.74 | 3 |
| Laryngoscopy for treatment CPT 31527 | not published | not published | $3,995.36 – $4,195.13 | 3 |
| Laryngoscopy telescopic CPT 31579 | $762.30 | $1,386.00 | not published | 0 |
| Laryngoscopy w/biopsy CPT 31535 | not published | not published | $3,995.36 – $4,195.13 | 3 |
| Laryngoscopy w/bx & op scope CPT 31536 | not published | not published | $3,995.36 – $4,195.13 | 3 |
| Laryngoscopy w/exc of tumor CPT 31540 | not published | not published | $3,995.36 – $4,195.13 | 3 |
| Laryngoscopy w/fb & op scope CPT 31531 | not published | not published | $3,995.36 – $4,195.13 | 3 |
| Laryngoscopy w/fb removal CPT 31530 | $4,387.90 | $7,978.00 | $1,907.37 – $2,002.74 | 3 |
| Laryngoscopy with biopsy CPT 31576 | not published | not published | $1,907.37 – $2,002.74 | 3 |
| Laryngoscopy with biopsy 31510 CPT 31510 | not published | not published | $3,995.36 – $4,195.13 | 3 |
| Laryngoscopy w/w/o tracheoscopy aspiration CPT 31515 | $434.50 | $790.00 | not published | 0 |
| Larynscop remve cart + scop CPT 31561 | not published | not published | $7,562.90 – $7,941.05 | 3 |
| Larynscop w/tumr exc + scope CPT 31541 | not published | not published | $3,995.36 – $4,195.13 | 3 |
| Laser surgery of cervix 57513 CPT 57513 | not published | not published | $3,468.96 – $3,642.41 | 3 |
| Laser surgery of prostate CPT 52648 | not published | not published | $5,745.80 – $6,033.09 | 3 |
| Laser surg penis lesion(s) CPT 54057 | not published | not published | $2,211.05 – $2,321.60 | 3 |
| Lateral canthopexy CPT 21282 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Lat retinacular release open CPT 27425 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Lavh >250 gms 58553 CPT 58553 | not published | not published | $11,391.13 – $11,960.68 | 3 |
| Lb with mastopexy 15839 CPT 15839 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $5,748.59 | $10,451.99 | not published | 0 |
| Lead capillary CPT 83655 | $131.45 | $239.00 | $12.11 – $12.72 | 3 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $1,913.57 | $3,479.22 | not published | 0 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $11,269.88 | $20,490.69 | not published | 0 |
| Lefort i-1 piece without graft CPT 21141 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Lefort i-2 piece without graft CPT 21142 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Lefort i-3/> piece with graft CPT 21147 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Lefort i-3/> piece without graft CPT 21143 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Lefort ii anterior intrusion CPT 21150 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Legion pneumo dna dir prob CPT 87540 | not published | not published | $20.05 – $21.05 | 3 |
| Legion pneumo dna quant CPT 87542 | not published | not published | $41.76 – $43.85 | 3 |
| Leg vein fusion 34530 CPT 34530 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,442.10 | $2,622.00 | $255.69 – $268.47 | 3 |
| Leishmania antibody CPT 86717 | not published | not published | $12.25 – $12.86 | 3 |
| Lengthening of hand tendon CPT 26478 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Lengthening of palate CPT 42227 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Lengthening of palate+pharyngeal flap 42226 CPT 42226 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Lengthening of thigh bone CPT 27466 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Lengthening of thigh tendon CPT 27393 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Lengthening of thigh tendons CPT 27394 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Lengthening of thigh tendons CPT 27395 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Lengthening or shortening - tibia and fibula 27715 CPT 27715 | not published | not published | $13,758.17 – $14,446.08 | 3 |
| Lengthen metacarpal/finger CPT 26568 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Lengthen radius or ulna CPT 25391 | not published | not published | $13,758.17 – $14,446.08 | 3 |
| Lengthen radius & ulna CPT 25393 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $1,164.69 | $2,117.61 | not published | 0 |
| Leukacyte transfusion CPT 86950 | not published | not published | $182.57 – $191.70 | 3 |
| Leukocyte phagocytosis CPT 86344 | not published | not published | $10.39 – $10.91 | 3 |
| Levetiracetam therapeutic drug level CPT 80177 | $29.70 | $54.00 | $13.25 – $13.91 | 3 |
| L hrt cath chd nm/abn nt cnj CPT 93595 | not published | not published | $3,474.11 – $3,647.82 | 3 |
| Liberta rc ipg HCPCS C1820 | $16,328.57 | $29,688.31 | not published | 0 |
| Lidocaine therapeutic drug level CPT 80176 | $180.95 | $329.00 | $14.69 – $15.42 | 3 |
| Ligate leg veins open CPT 37761 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Ligate leg veins radical 37760 CPT 37760 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Ligate/strip long leg vein CPT 37722 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Ligate/strip short leg vein CPT 37718 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | not published | not published | $3,468.96 – $3,642.41 | 3 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Ligation/divis of long saph vein 37700 CPT 37700 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Ligation external carotid artery 37600 CPT 37600 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Ligation internal/common carotid artery 37605 CPT 37605 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Ligation internal jugular vein 37565 CPT 37565 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Ligation major artery neck CPT 37615 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Ligation nasal sinus artery CPT 30915 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Ligation of abdomen artery 37617 CPT 37617 | not published | not published | $5,963.01 – $6,261.16 | 3 |
| Ligation of femoral vein CPT 37650 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Ligation of inf vena cava CPT 37619 | not published | not published | $5,963.01 – $6,261.16 | 3 |
| Ligation of neck artery CPT 37606 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Ligation of salivary duct CPT 42665 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Ligation upper jaw artery CPT 30920 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Lig/band angioaccess av fistula CPT 37607 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Lig&div&compl strpg saph vn CPT 37735 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Limb exercise test CPT 95875 | not published | not published | $137.89 – $144.78 | 3 |
| Limited visual field xm CPT 92081 | not published | not published | $63.22 – $66.38 | 3 |
| Lipase CPT 83690 | $151.25 | $275.00 | $6.89 – $7.23 | 3 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Lipoprotein blood high res frac & quant CPT 83701 | $163.90 | $298.00 | $33.86 – $35.55 | 3 |
| Lipoprotein blood quant CPT 83704 | $103.40 | $188.00 | $34.19 – $35.90 | 3 |
| Lipoprotein direct measurement hdl CPT 83718 | $109.45 | $199.00 | $8.19 – $8.60 | 3 |
| Lipoprotein direct measurement ldl CPT 83721 | $127.60 | $232.00 | $10.50 – $11.02 | 3 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $34.19 – $35.90 | 3 |
| Lip surgery procedure CPT 40799 | $371.80 | $676.00 | not published | 0 |
| Listeria monocytogenes CPT 86723 | not published | not published | $13.19 – $13.85 | 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.