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 |
|---|---|---|---|---|
| Remove mastoid structures CPT 69505 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Remove maxilla cyst complex CPT 21048 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Remove middle ear nerve CPT 69676 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Remove muti-comp penis pros CPT 54406 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Remove nasal foreign body CPT 30310 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Remove nasal foreign body CPT 30320 | not published | not published | $1,662.71 – $1,745.84 | 3 |
| Remove part lumbar vertebra CPT 22102 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Remove part lumbar vertebra CPT 22114 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Remove part of neck vertebra CPT 22100 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Remove part of neck vertebra CPT 22110 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Remove part thorax vertebra CPT 22112 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Remove pilonidal cyst compl CPT 11772 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Remove pilonidal cyst exten CPT 11771 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Remove prostate regrowth CPT 52630 | not published | not published | $5,745.80 – $6,033.09 | 3 |
| Remove renal tube w/fluoro CPT 50389 | $947.65 | $1,723.00 | $747.24 – $784.60 | 3 |
| Remove/repair hearing aid CPT 69711 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Remove/revise male sling CPT 53442 | not published | not published | $5,745.80 – $6,033.09 | 3 |
| Remove sacrum pressure sore close 15936 CPT 15936 | not published | not published | $2,211.05 – $2,321.60 | 3 |
| Remove sacrum pressure sore ostc 15937 CPT 15937 | not published | not published | $2,211.05 – $2,321.60 | 3 |
| Remove self-contd penis pros CPT 54415 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Remove shoulder blade lesion CPT 23172 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Remove shoulder fb deep CPT 23333 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Remove shoulder foreign body subq 23330 CPT 23330 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Remove sperm pouch lesion CPT 55680 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Remove spine eltrd plate CPT 63662 | not published | not published | $3,746.49 – $3,933.82 | 3 |
| Remove spine fixation device CPT 22850 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Remove spine fixation device CPT 22852 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Remove spine lamieieiotina >2 crvcl 63015 CPT 63015 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Remove spine lamina 1/2 crvl CPT 63001 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Remove spine lamina 1/2 lmbr CPT 63005 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Remove spine lamina 1/2 scrl CPT 63011 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Remove spine lamina 1/2 thrc CPT 63003 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Remove spine lamina >2 lmbr CPT 63017 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Remove spine lamina >2 thrc CPT 63016 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Remove stent via transureth CPT 50386 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Remove sympathetic nerves CPT 64821 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Remove sympathetic nerves CPT 64822 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Remove thyroid duct lesion CPT 60280 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Remove thyroid duct lesion CPT 60281 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Remove thyroid lesion 60200 CPT 60200 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Remove tonsils and adenoids CPT 42820 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Remove tonsils and adenoids CPT 42821 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Remove/transplant tendon CPT 23440 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Remove ureter calculus CPT 51065 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Remove ureter stent percut CPT 50384 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Remove uro sphincter CPT 53446 | not published | not published | $5,745.80 – $6,033.09 | 3 |
| Remove vaginal foreign body 57415 CPT 57415 | not published | not published | $3,468.96 – $3,642.41 | 3 |
| Remove vagina tissue part CPT 57107 | not published | not published | $3,468.96 – $3,642.41 | 3 |
| Remove vc lesion scope/graft CPT 31546 | not published | not published | $7,562.90 – $7,941.05 | 3 |
| Remove vc lesion w/scope 31545 CPT 31545 | not published | not published | $3,995.36 – $4,195.13 | 3 |
| Remove ventilating tube CPT 69424 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Remove ventricular device 33977 CPT 33977 | $1,660.45 | $3,019.00 | not published | 0 |
| Remove windpipe lesion CPT 31785 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Remove wrist/forearm lesion CPT 25115 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Remove wrist/forearm lesion CPT 25116 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Remove wrist joint cartilage CPT 25107 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Remove wrist joint implant CPT 25449 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Remove wrist joint lining CPT 25105 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Remove wrist joint lining CPT 26130 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Remove wrist tendon lesion CPT 25110 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Remove wrist tendon lesion CPT 25111 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Remvl peritoneal fb frm cavity CPT 49402 | not published | not published | $3,836.82 – $4,028.66 | 3 |
| Renal abscess open drng 50020 CPT 50020 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Renal cyst study s&i CPT 74470 | not published | not published | $585.55 – $614.83 | 3 |
| Renal endoscopy 50572 CPT 50572 | not published | not published | $747.24 – $784.60 | 3 |
| Renal function panel CPT 80069 | $139.15 | $253.00 | $8.68 – $9.11 | 3 |
| Renal venogram bil s&i CPT 75833 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Renin stimulation panel CPT 80416 | not published | not published | $209.32 – $219.79 | 3 |
| Renin stimulation panel CPT 80417 | not published | not published | $43.99 – $46.19 | 3 |
| Reopen fallopian tube CPT 58350 | not published | not published | $5,360.72 – $5,628.75 | 3 |
| Repair achilles tendon CPT 27650 | $3,622.85 | $6,587.00 | $7,775.89 – $8,164.69 | 3 |
| Repair anal fistula CPT 46288 | not published | not published | $2,974.45 – $3,123.17 | 3 |
| Repair anorectal fist w/plug CPT 46707 | not published | not published | $2,974.45 – $3,123.17 | 3 |
| Repair av fistula ext 35190 CPT 35190 | not published | not published | $5,963.01 – $6,261.16 | 3 |
| Repair biceps tendon CPT 23430 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Repair bladder defect CPT 57288 | not published | not published | $5,360.72 – $5,628.75 | 3 |
| Repair bladder neck CPT 51845 | not published | not published | $5,360.72 – $5,628.75 | 3 |
| Repair bladder & vagina CPT 57289 | not published | not published | $7,946.52 – $8,343.84 | 3 |
| Repair bladder-vagina lesion CPT 57320 | not published | not published | $5,360.72 – $5,628.75 | 3 |
| Repair bladder-vagina lesion CPT 57330 | not published | not published | $7,946.52 – $8,343.84 | 3 |
| Repair blood ves direct neck 35201 CPT 35201 | not published | not published | $5,963.01 – $6,261.16 | 3 |
| Repair blood vessel direct hand finger CPT 35207 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Repair blood vessel dir lower extr CPT 35226 | $1,933.25 | $3,515.00 | $758.85 – $796.79 | 3 |
| Repair blood vessel dir upper extr CPT 35206 | $3,732.85 | $6,787.00 | $3,383.62 – $3,552.80 | 3 |
| Repair blood vessel lesion CPT 35180 | not published | not published | $1,686.89 – $1,771.24 | 3 |
| Repair blood vessel lesion CPT 35184 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Repair blood vessel lesion CPT 35188 | not published | not published | $5,963.01 – $6,261.16 | 3 |
| Repair blood vessel lesion CPT 35261 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Repair blood vessel lesion CPT 35266 | not published | not published | $5,963.01 – $6,261.16 | 3 |
| Repair blood vessel w/graft lower extremity 35286 CPT 35256 | not published | not published | $5,963.01 – $6,261.16 | 3 |
| Repair blood vessel w/vein graft lower extremity 35256 CPT 35231 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Repair carpal bone shorten CPT 25394 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Repair cleft hand CPT 26580 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Repair cleft lip/nasal CPT 40700 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Repair cleft lip/nasal CPT 40701 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Repair cleft lip/nasal CPT 40702 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Repair cleft lip/nasal CPT 40720 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Repair cleft lip/nasal CPT 40761 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Repair complex wound scalp/arms/legs 2.6 - 7.5 cm CPT 13121 | $841.50 | $1,530.00 | $435.63 – $457.41 | 3 |
| Repair corporeal tear CPT 54437 | not published | not published | $3,777.44 – $3,966.31 | 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.