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 |
|---|---|---|---|---|
| Myelography via inj w/s&i lumbosacral CPT 62304 | $2,006.40 | $3,648.00 | $840.06 – $882.07 | 3 |
| Myelography via inj w/s&i thoracic CPT 62303 | $3,292.85 | $5,987.00 | $840.06 – $882.07 | 3 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $378.40 | $688.00 | $11.53 – $12.11 | 3 |
| Myocrd img pet 1std rst/strs CPT 78491 | not published | not published | $1,532.36 – $1,608.98 | 3 |
| Myocrd img pet 1 std w/ct CPT 78429 | not published | not published | $1,532.36 – $1,608.98 | 3 |
| Myocrd img pet mlt rst&strs CPT 78492 | not published | not published | $1,532.36 – $1,608.98 | 3 |
| Myocrd img pet rst/strs w/ct CPT 78430 | not published | not published | $1,532.36 – $1,608.98 | 3 |
| Myomectomy vag method CPT 58145 | not published | not published | $3,468.96 – $3,642.41 | 3 |
| Myringoplasty CPT 69620 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Nasal endoscopy dx uni/bi separate proc CPT 31231 | $435.05 | $791.00 | not published | 0 |
| Nasal endoscopy with removal of nasal foreign body CPT 30999 | $420.20 | $764.00 | not published | 0 |
| Nasal function studies CPT 92512 | not published | not published | $231.39 – $242.96 | 3 |
| Nasal/sinus endoscopy surg CPT 31287 | not published | not published | $7,562.90 – $7,941.05 | 3 |
| Nasal/sinus endoscopy surg w/bx 31237 CPT 31237 | $2,032.80 | $3,696.00 | $1,907.37 – $2,002.74 | 3 |
| Nasal/sinus endo spendt remove tiss 31288 CPT 31288 | not published | not published | $7,562.90 – $7,941.05 | 3 |
| Nasal/sinus endo surg w/concha bullosa resct 31240 CPT 31240 | not published | not published | $1,907.37 – $2,002.74 | 3 |
| Nasal/sinus endo w/ethmoidectomy part 31254 CPT 31254 | not published | not published | $7,562.90 – $7,941.05 | 3 |
| Nasal/sinus endo w/ethmoidectomy tot 31255 CPT 31255 | not published | not published | $7,562.90 – $7,941.05 | 3 |
| Nasal/sinus endo w/front sinus expl 31276 CPT 31276 | not published | not published | $7,562.90 – $7,941.05 | 3 |
| Nasal/sinus sphenoid endoscopy dx 31235 CPT 31235 | not published | not published | $1,907.37 – $2,002.74 | 3 |
| Nasal sinus therapy CPT 30210 | not published | not published | $1,662.71 – $1,745.84 | 3 |
| Nasopharyngoscopy w/endoscope CPT 92511 | $305.80 | $556.00 | not published | 0 |
| Natriuretic peptide CPT 83880 | $111.10 | $202.00 | $39.26 – $41.22 | 3 |
| Natural killer cells total count CPT 86357 | $214.50 | $390.00 | $37.73 – $39.62 | 3 |
| Navigational bronchoscopy 31627 CPT 31627 | $1,568.60 | $2,852.00 | not published | 0 |
| N block inj common digit CPT 64632 | not published | not published | $328.94 – $345.38 | 3 |
| Nctrnl pen tmscn&/rgdity tst CPT 54250 | not published | not published | $267.74 – $281.13 | 3 |
| Ndl emg musc 1 xtr/non-limb CPT 95870 | not published | not published | $142.58 – $149.71 | 3 |
| Ndl insj without njx 1 or 2 musc CPT 20560 | $24.75 | $45.00 | $30.99 – $32.54 | 3 |
| Ndl insj without njx 3+ musc CPT 20561 | $33.55 | $61.00 | $30.99 – $32.54 | 3 |
| Ndl oculoelectromyography 1+ CPT 92265 | not published | not published | $63.22 – $66.38 | 3 |
| Ndsc dcmprn 1 ntrspc lumbar CPT 62380 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Neck (Cervical Spine) CT scan (with and without contrast) CPT 72127 | $2,586.65 | $4,703.00 | $187.96 – $197.36 | 3 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | $2,434.30 | $4,426.00 | $373.86 – $392.55 | 3 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $2,282.50 | $4,150.00 | $112.03 – $117.63 | 3 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $4,480.85 | $8,147.00 | $373.86 – $392.55 | 3 |
| Neck (Cervical Spine) MRI (with contrast) CPT 72142 | $3,664.65 | $6,663.00 | $373.86 – $392.55 | 3 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $3,529.90 | $6,418.00 | $255.69 – $268.47 | 3 |
| Neck MRA (blood vessel MRI, with and without contrast) CPT 70549 | $3,405.05 | $6,191.00 | $373.86 – $392.55 | 3 |
| Neck MRA (blood vessel MRI, with contrast) CPT 70548 | $3,164.15 | $5,753.00 | $373.86 – $392.55 | 3 |
| Neck MRA (blood vessel MRI, without contrast) CPT 70547 | $2,637.80 | $4,796.00 | $255.69 – $268.47 | 3 |
| Neck spine disk surgery CPT 63020 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Neck spine disk surgery 63075 CPT 63075 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Needle emg guid w/chemodenervation add-on CPT 95874 | $61.60 | $112.00 | not published | 0 |
| Neisseria meningitidis CPT 86741 | not published | not published | $13.19 – $13.85 | 3 |
| Nerobehav stas exam by psy/md f2f 1st hr CPT 96116 | not published | not published | $231.39 – $242.96 | 3 |
| Nerve conduction 7-8 studies CPT 95910 | $690.80 | $1,256.00 | $399.88 – $419.88 | 3 |
| Nerve conduction studies 11-12 CPT 95912 | $1,113.20 | $2,024.00 | $399.88 – $419.88 | 3 |
| Nerve conduction studies 1-2 CPT 95907 | $218.35 | $397.00 | $231.39 – $242.96 | 3 |
| Nerve conduction studies 13+ CPT 95913 | $663.30 | $1,206.00 | $399.88 – $419.88 | 3 |
| Nerve conduction studies 3-4 CPT 95908 | $371.80 | $676.00 | $231.39 – $242.96 | 3 |
| Nerve conduction studies 5-6 CPT 95909 | $557.15 | $1,013.00 | $231.39 – $242.96 | 3 |
| Nerve conduction studies 9-10 CPT 95911 | $1,728.10 | $3,142.00 | $399.88 – $419.88 | 3 |
| Nerve palsy fascial graft CPT 15840 | not published | not published | $3,797.52 – $3,987.40 | 3 |
| Nerve palsy microsurg graft CPT 15842 | not published | not published | $2,211.05 – $2,321.60 | 3 |
| Nerve palsy muscle graft CPT 15841 | not published | not published | $3,797.52 – $3,987.40 | 3 |
| Neuroeltrd stim post tibial CPT 64566 | not published | not published | $328.94 – $345.38 | 3 |
| Neuromuscular junction testing ea nerve any 1 method CPT 95937 | not published | not published | $137.89 – $144.78 | 3 |
| Neurovascular pedicle flap CPT 15750 | not published | not published | $3,797.52 – $3,987.40 | 3 |
| Neutrlzg antb sarscov2 scr CPT 86408 | not published | not published | $42.13 – $44.24 | 3 |
| Neutrlzg antb sarscov2 titer CPT 86409 | not published | not published | $79.61 – $83.59 | 3 |
| New Patient Office Visit (level 2) CPT 99202 | $131.45 | $239.00 | not published | 0 |
| New Patient Office Visit (level 3) CPT 99203 | $148.50 | $270.00 | not published | 0 |
| New Patient Office Visit (level 4) CPT 99204 | $205.15 | $373.00 | not published | 0 |
| New Patient Office Visit (level 5) CPT 99205 | $226.60 | $412.00 | not published | 0 |
| Nfct ds bv&vaginitis dna alg CPT 81514 | not published | not published | $262.99 – $276.14 | 3 |
| N. gonorrhoeae assay w/optic CPT 87850 | not published | not published | $24.56 – $25.79 | 3 |
| N.gonorrhoeae dna quant CPT 87592 | not published | not published | $42.84 – $44.98 | 3 |
| N-invas est c ffr sw aly cta CPT 75580 | not published | not published | $920.24 – $966.25 | 3 |
| Nipple/areola reconst 19350 CPT 19350 | not published | not published | $4,195.85 – $4,405.64 | 3 |
| Nipple exploration CPT 19110 | not published | not published | $4,195.85 – $4,405.64 | 3 |
| Nitroblue tetrazolium dye CPT 86384 | not published | not published | $13.61 – $14.29 | 3 |
| Njx aa&/strd nrv nrvtg si jt CPT 64451 | not published | not published | $756.44 – $794.26 | 3 |
| Njx aa&/strd vagus nrv CPT 64408 | not published | not published | $328.94 – $345.38 | 3 |
| Njx px nfrosgrm &/urtrgrm CPT 50430 | $1,655.50 | $3,010.00 | $747.24 – $784.60 | 3 |
| Njx px peyronie ds exps plaq CPT 54205 | not published | not published | $5,745.80 – $6,033.09 | 3 |
| Nm imaging bone/joint 3 phase study CPT 78315 | $2,072.40 | $3,768.00 | $428.40 – $449.82 | 3 |
| Nm imaging bone/joint whole body CPT 78306 | $1,902.45 | $3,459.00 | $428.40 – $449.82 | 3 |
| Nm imaging cardiac blood pooling planar single study at rest or stress CPT 78472 | $3,878.05 | $7,051.00 | $428.40 – $449.82 | 3 |
| Nm imaging gastric emptying study CPT 78264 | $2,825.35 | $5,137.00 | $428.40 – $449.82 | 3 |
| Nm imaging gastrointestinal acute blood loss CPT 78278 | $1,571.35 | $2,857.00 | $428.40 – $449.82 | 3 |
| Nm imaging hepatobiliary system w/pharmacologic intervention CPT 78227 | $2,861.65 | $5,203.00 | $581.86 – $610.95 | 3 |
| Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention CPT 78708 | $1,921.15 | $3,493.00 | $581.86 – $610.95 | 3 |
| Nm imaging pulmonary ventilation/perfusion CPT 78582 | $1,286.45 | $2,339.00 | $581.86 – $610.95 | 3 |
| Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s) CPT 78014 | $2,033.90 | $3,698.00 | $428.40 – $449.82 | 3 |
| Nm radiopharmaceutical therapy oral administration CPT 79005 | $1,043.35 | $1,897.00 | not published | 0 |
| Non-card vasc flow imaging CPT 78445 | $1,064.80 | $1,936.00 | $428.40 – $449.82 | 3 |
| Non-cov proc, clinical trial HCPCS G0294 | not published | not published | $40.03 – $42.03 | 3 |
| Non-cov surg proc,clin trial HCPCS G0293 | not published | not published | $40.03 – $42.03 | 3 |
| Non-imaging heart function CPT 78414 | not published | not published | $581.86 – $610.95 | 3 |
| Non-ophthalmic fva HCPCS C9733 | not published | not published | $373.86 – $392.55 | 3 |
| Noonan spectrum disorders CPT 81442 | not published | not published | $2,143.60 – $2,250.78 | 3 |
| No pt prsnt train add 15 HCPCS G0542 | $55.00 | $100.00 | not published | 0 |
| No pt prsnt train initial 30 HCPCS G0541 | $71.50 | $130.00 | $30.99 – $32.54 | 3 |
| Npm1 gene CPT 81310 | $558.80 | $1,016.00 | $246.52 – $258.85 | 3 |
| Nps surg dilat eust tube bi CPT 69706 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Nps surg dilat eust tube uni CPT 69705 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Npsy tst eval phsy/qhp 1st hr CPT 96132 | not published | not published | $399.88 – $419.88 | 3 |
| Nras gene variants exon 2&3 CPT 81311 | $666.05 | $1,211.00 | $295.79 – $310.58 | 3 |
| Nr lnr acclrtr tx max 5 sessions CPT 77373 | $13,475.00 | $24,500.00 | not published | 0 |
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.