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 |
|---|---|---|---|---|
| Artery x-rays adrenal gland CPT 75731 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Artery x-rays adrenals CPT 75733 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Artery x-rays arm/leg 75710-26 CPT 75710 | $4,513.30 | $8,206.00 | $3,383.62 – $3,552.80 | 3 |
| Artery x-rays arms/legs 75716-26 CPT 75716 | $4,612.30 | $8,386.00 | $3,383.62 – $3,552.80 | 3 |
| Artery x-rays chest CPT 75756 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Artery x-rays lung CPT 75741 | $5,000.05 | $9,091.00 | $3,383.62 – $3,552.80 | 3 |
| Artery x-rays lung CPT 75746 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Artery x-rays lungs CPT 75743 | $10,000.10 | $18,182.00 | $3,383.62 – $3,552.80 | 3 |
| Artery xrays of pelvis 75736 26 CPT 75736 | not published | not published | $5,963.01 – $6,261.16 | 3 |
| Artery x-rays spine CPT 75705 | not published | not published | $5,963.01 – $6,261.16 | 3 |
| Arthrd ant ntrbd min dsc crv CPT 22554 | not published | not published | $13,758.17 – $14,446.08 | 3 |
| Arthrd ant ntrbdy cervical CPT 22551 | not published | not published | $13,758.17 – $14,446.08 | 3 |
| Arthrd dst rad/ul jt sgm rsc CPT 25830 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Arthrd elbow jt autog graft CPT 24802 | not published | not published | $13,758.17 – $14,446.08 | 3 |
| Arthrd glenohumeral jt w/grf CPT 23802 | not published | not published | $13,758.17 – $14,446.08 | 3 |
| Arthrd si jt perq/min nvas CPT 27279 | not published | not published | $18,789.56 – $19,729.04 | 3 |
| Arthrd si jt prq wo tfxj dev CPT 27278 | not published | not published | $18,789.56 – $19,729.04 | 3 |
| Arthrd wrist complete wo grf CPT 25800 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Arthrd wrist lmtd without b1 grf CPT 25820 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Arthrd wrist with autograft CPT 25825 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Arthrd wrist w/sliding graft CPT 25805 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Arthrd wrst iliac/oth agrft CPT 25810 | not published | not published | $13,758.17 – $14,446.08 | 3 |
| Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right CPT 20605 | $501.60 | $912.00 | $328.94 – $345.38 | 3 |
| Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides) CPT 20606 | $728.75 | $1,325.00 | $756.44 – $794.26 | 3 |
| Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides) CPT 20611 | $1,424.50 | $2,590.00 | $328.94 – $345.38 | 3 |
| Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance CPT 20600 | $497.20 | $904.00 | $328.94 – $345.38 | 3 |
| Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides) CPT 20610 | $1,391.50 | $2,530.00 | $328.94 – $345.38 | 3 |
| Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604 CPT 20604 | not published | not published | $328.94 – $345.38 | 3 |
| Arthrodesis big toe joint 28760 CPT 28760 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Arthrodesis elbw joint local CPT 24800 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Arthrodesis glenohumeral jt CPT 23800 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Arthrodesis pantalar CPT 28705 | not published | not published | $18,789.56 – $19,729.04 | 3 |
| Arthrodesis presacral intrbod with instr l5-s1 22586 CPT 22586 | not published | not published | $18,789.56 – $19,729.04 | 3 |
| Arthrodesis/sg level/cerv/below c2 22600 CPT 22600 | not published | not published | $18,789.56 – $19,729.04 | 3 |
| Arthrodesis subtalar CPT 28725 | not published | not published | $13,758.17 – $14,446.08 | 3 |
| Arthrodesis triple CPT 28715 | not published | not published | $13,758.17 – $14,446.08 | 3 |
| Arthroplasty finger joint 26535 CPT 26535 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Arthro shoulder surgical distal claviculectomy incl/distal art surf left (rest method ii cah) CPT 29824 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Arthro/shoul surg; w/spacer HCPCS C9781 | not published | not published | $13,758.17 – $14,446.08 | 3 |
| Arthrotomy carpometacarpal joint 26070 CPT 26070 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Arthrotomy/elbow/exp/drain/rmv fb 24000 CPT 24000 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Arthrotomy glenhumrl jt w/bx CPT 23100 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Arthrotomy glenohumeral jt CPT 23105 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Arthrotomy strnclav joint CPT 23106 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Arthrp ntrcrp/crp/mtcr ntrps CPT 25447 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Arthrp ntrcrpl/crp/mtcrp ssp CPT 25448 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Arthrp prostc dstl scph crpl CPT 25443 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Arthrp w/prostc dstl rds CPT 25441 | not published | not published | $13,758.17 – $14,446.08 | 3 |
| Arthrp w/prostc dstl ulna CPT 25442 | not published | not published | $18,789.56 – $19,729.04 | 3 |
| Arthrp w/prostc dst rds&crps CPT 25446 | not published | not published | $18,789.56 – $19,729.04 | 3 |
| Arthrp w/prostc lunate CPT 25444 | not published | not published | $13,758.17 – $14,446.08 | 3 |
| Arthrp w/prostc trapezium CPT 25445 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Arthrs kne srg drlg ost diss CPT 29885 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Arthrt acrmclv/strnclav jt CPT 23101 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Arthrt ac sc jt exp/rmvl fb CPT 23044 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Arthrt elbow w/synovectomy CPT 24102 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Arthrt elbw capsl exc rls CPT 24006 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Arthrt elbw jt expl bx rmvl CPT 24101 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Arthrt elbw synovial bx only CPT 24100 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Arthrt gh jt expl/drg/rmv fb CPT 23040 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Arthrt glenhumrl jt w/expl CPT 23107 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Arthrt hip expl/rmv loose/fb CPT 27033 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Arthrt rdcrpl/midcarpl jt CPT 25040 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Artificial insemination CPT 58321 | not published | not published | $326.55 – $342.88 | 3 |
| Artific inseminationintrauterine 58322 CPT 58322 | not published | not published | $216.65 – $227.48 | 3 |
| Art pressure waveform analys CPT 93050 | not published | not published | $30.99 – $32.54 | 3 |
| Aspa gene CPT 81200 | not published | not published | $47.25 – $49.61 | 3 |
| Asp core fat pad CPT 17999 | $216.70 | $394.00 | $215.00 – $225.75 | 3 |
| Asp & inj bone cyst CPT 20615 | not published | not published | $758.85 – $796.79 | 3 |
| Asp & inj w/heparin pleurx cath CPT 32999 | not published | not published | $672.23 – $705.84 | 3 |
| Aspirate bladder/sprapubic cath 51102 CPT 51102 | $1,889.80 | $3,436.00 | $2,240.09 – $2,352.10 | 3 |
| Aspirate/inj ganglion cyst 20612 CPT 20612 | $402.05 | $731.00 | $328.94 – $345.38 | 3 |
| Aspirate pleura without imaging 32554 CPT 32554 | $1,286.45 | $2,339.00 | $672.23 – $705.84 | 3 |
| Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion CPT 10005 | $996.60 | $1,812.00 | $758.85 – $796.79 | 3 |
| Aspir/inj thyroid cyst 60300 CPT 60300 | $659.45 | $1,199.00 | $758.85 – $796.79 | 3 |
| Assay acid phosphatase CPT 84060 | not published | not published | $7.64 – $8.02 | 3 |
| Assay alkaline phosphatase CPT 84078 | not published | not published | $8.26 – $8.67 | 3 |
| Assay blood catecholamines CPT 82383 | not published | not published | $29.08 – $30.53 | 3 |
| Assay chondroitin sulfate CPT 82485 | not published | not published | $20.65 – $21.68 | 3 |
| Assay dir meas fr estradiol CPT 82681 | $243.65 | $443.00 | $27.94 – $29.34 | 3 |
| Assay duodenal fluid trypsin CPT 84485 | not published | not published | $7.20 – $7.56 | 3 |
| Assay free hydroxyproline CPT 83500 | not published | not published | $22.65 – $23.78 | 3 |
| Assay malate dehydrogenase CPT 83775 | not published | not published | $7.37 – $7.74 | 3 |
| Assay myeloperoxidase CPT 83876 | $47.30 | $86.00 | $50.86 – $53.40 | 3 |
| Assay neurflmnt light chain CPT 83884 | not published | not published | $116.23 – $122.04 | 3 |
| Assay of adp & amp CPT 82030 | not published | not published | $25.80 – $27.09 | 3 |
| Assay of androsterone CPT 82160 | not published | not published | $25.55 – $26.83 | 3 |
| Assay of blood lipoprotein CPT 83719 | not published | not published | $12.75 – $13.39 | 3 |
| Assay of bradykinin CPT 82286 | not published | not published | $5.16 – $5.42 | 3 |
| Assay of breath ethanol CPT 82075 | $47.30 | $86.00 | $30.00 – $31.50 | 3 |
| Assay of cathepsin-d CPT 82387 | not published | not published | $18.06 – $18.96 | 3 |
| Assay of chloramphenicol CPT 82415 | not published | not published | $12.67 – $13.30 | 3 |
| Assay of corticosterone CPT 82528 | not published | not published | $22.52 – $23.65 | 3 |
| Assay of digoxin free CPT 80163 | not published | not published | $13.28 – $13.94 | 3 |
| Assay of endocrine hormone CPT 84235 | not published | not published | $71.23 – $74.79 | 3 |
| Assay of estrogen CPT 84233 | not published | not published | $87.88 – $92.27 | 3 |
| Assay of etiocholanolone CPT 82696 | not published | not published | $26.24 – $27.55 | 3 |
| Assay of feces for trypsin CPT 84490 | not published | not published | $9.93 – $10.43 | 3 |
| Assay of feces porphyrins CPT 84126 | $187.55 | $341.00 | $39.11 – $41.07 | 3 |
| Assay of feces/urobilinogen CPT 84577 | not published | not published | $16.80 – $17.64 | 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.