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 |
|---|---|---|---|---|
| Removal foreign body foot cmplx CPT 28193 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Removal foreign body foot subcutaneous right CPT 28190 | $431.75 | $785.00 | $758.85 – $796.79 | 3 |
| Removal foreign body gum 41805 CPT 41805 | not published | not published | $1,662.71 – $1,745.84 | 3 |
| Removal foreign body jawbone CPT 41806 | not published | not published | $1,662.71 – $1,745.84 | 3 |
| Removal implant from finger/hand 26320 CPT 26320 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Removal implant superficial separate procedure CPT 20670 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Removal mamma implant mat 19330 CPT 19330 | not published | not published | $4,195.85 – $4,405.64 | 3 |
| Removal neck/armpit lesion CPT 38550 | not published | not published | $4,195.85 – $4,405.64 | 3 |
| Removal neck/armpit lesion 38555 CPT 38555 | not published | not published | $7,115.73 – $7,471.51 | 3 |
| Removal of adenoids CPT 42830 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Removal of adenoids CPT 42831 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Removal of adenoids CPT 42836 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Removal of adenoids <12yrs 42835 CPT 42835 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Removal of anal fissure CPT 46200 | not published | not published | $2,974.45 – $3,123.17 | 3 |
| Removal of anal tags CPT 46230 | not published | not published | $2,974.45 – $3,123.17 | 3 |
| Removal of ankle bone CPT 28130 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Removal of ankle/heel lesion CPT 28100 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Removal of ankle implant CPT 27704 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Removal of arm artery clot 34111 CPT 34111 | not published | not published | $5,963.01 – $6,261.16 | 3 |
| Removal of artery clot 34101 CPT 34101 | not published | not published | $5,963.01 – $6,261.16 | 3 |
| Removal of bladder lesion CPT 51520 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Removal of bladder stone CPT 51050 | not published | not published | $5,745.80 – $6,033.09 | 3 |
| Removal of bone for graft CPT 20900 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Removal of bone for graft CPT 20902 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Removal of bone lesion CPT 23140 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Removal of bone lesion CPT 23145 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Removal of bone lesion CPT 23146 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Removal of breast lesion CPT 19120 | not published | not published | $4,195.85 – $4,405.64 | 3 |
| Removal of brow wrinkles CPT 15826 | not published | not published | $3,797.52 – $3,987.40 | 3 |
| Removal of calcium deposits CPT 23000 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Removal of epididymis CPT 54860 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Removal of epididymis CPT 54861 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Removal of ethmoid sinus CPT 31200 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Removal of ethmoid sinus CPT 31201 | not published | not published | $1,662.71 – $1,745.84 | 3 |
| Removal of external ear CPT 69120 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Removal of face wrinkles CPT 15828 | not published | not published | $3,797.52 – $3,987.40 | 3 |
| Removal of fascia for graft CPT 20920 | not published | not published | $2,211.05 – $2,321.60 | 3 |
| Removal of fascia for graft CPT 20922 | not published | not published | $2,211.05 – $2,321.60 | 3 |
| Removal of finger lesion CPT 26210 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Removal of finger tendon CPT 26180 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Removal of foot fascia CPT 28062 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Removal of foot joint lining CPT 28070 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Removal of foot joint lining CPT 28072 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Removal of foot lesion CPT 28080 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Removal of foot lesion CPT 28090 | $2,994.20 | $5,444.00 | $1,723.15 – $1,809.31 | 3 |
| Removal of foot lesion CPT 28104 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Removal of forearm lesion CPT 25120 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Removal of forehead wrinkles CPT 15824 | not published | not published | $2,211.05 – $2,321.60 | 3 |
| Removal of foreign body CPT 27372 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Removal of frontal sinus CPT 31080 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Removal of frontal sinus CPT 31081 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Removal of frontal sinus CPT 31084 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Removal of frontal sinus CPT 31086 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Removal of frontal sinus CPT 31087 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Removal of frontal sinus 31085 CPT 31085 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Removal of gum tissue CPT 41830 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Removal of head of humerus CPT 23195 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Removal of heel bone CPT 28118 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Removal of heel spur CPT 28119 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Removal of hip foreign body 27087 CPT 27087 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Removal of hip joint lining CPT 27054 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Removal of hip prosthesis CPT 27090 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Removal of hip prosthesis CPT 27091 | not published | not published | $13,758.17 – $14,446.08 | 3 |
| Removal of humerus lesion CPT 23150 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Removal of humerus lesion CPT 23155 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Removal of humerus lesion CPT 23156 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Removal of hydrocele CPT 55040 | not published | not published | $3,836.82 – $4,028.66 | 3 |
| Removal of hydrocele CPT 55500 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Removal of hydroceles CPT 55041 | not published | not published | $3,836.82 – $4,028.66 | 3 |
| Removal of implant deep CPT 20680 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Removal of intranasal lesion CPT 30117 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Removal of intranasal lesion CPT 30118 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Removal of ischial bursa CPT 27060 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Removal of jaw bone lesion CPT 21044 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Removal of jaw joint CPT 21050 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Removal of kneecap CPT 27350 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Removal of kneecap bursa CPT 27340 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Removal of knee cartilage CPT 27332 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Removal of knee cartilage CPT 27333 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Removal of knee cyst CPT 27345 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Removal of knee prosthesis CPT 27488 | not published | not published | $13,758.17 – $14,446.08 | 3 |
| Removal of larynx lesion CPT 31300 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Removal of larynx lesion 31512 CPT 31512 | not published | not published | $3,995.36 – $4,195.13 | 3 |
| Removal of lymph nodes neck CPT 38700 | not published | not published | $7,115.73 – $7,471.51 | 3 |
| Removal of metatarsal CPT 28140 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Removal of metatarsal heads CPT 28114 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Removal of neck wrinkles CPT 15825 | not published | not published | $3,797.52 – $3,987.40 | 3 |
| Removal of nose CPT 30160 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Removal of nose lesion CPT 30124 | not published | not published | $1,662.71 – $1,745.84 | 3 |
| Removal of nose lesion CPT 30125 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Removal of nose polyp(s) 30115 CPT 30115 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Removal of omentum 49255 CPT 49255 | not published | not published | $6,937.47 – $7,284.34 | 3 |
| Removal of palm tendon each CPT 26170 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Removal of rib CPT 21615 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Removal of salivary stone CPT 42340 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Removal of salivary stone 42335 CPT 42335 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Removal of scrotum CPT 55150 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Removal of scrotum lesion CPT 55120 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Removal of sesamoid bone CPT 28315 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Removal of shunt CPT 49429 | not published | not published | $3,383.62 – $3,552.80 | 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.