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 |
|---|---|---|---|---|
| Repair of lower leg CPT 27725 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Repair of lower leg CPT 27727 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Repair of metatarsals CPT 28322 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Repair of nasal septum CPT 30520 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Repair of penis CPT 54440 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Repair of rectocele 45560 CPT 45560 | not published | not published | $2,974.45 – $3,123.17 | 3 |
| Repair of rectum CPT 45500 | not published | not published | $2,974.45 – $3,123.17 | 3 |
| Repair of rectum CPT 45505 | not published | not published | $2,974.45 – $3,123.17 | 3 |
| Repair of ruptured tendon CPT 24342 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Repair of shoulder CPT 23420 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Repair of sperm duct CPT 55400 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Repair of thigh CPT 27470 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Repair of thigh muscle CPT 27385 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Repair of tibia CPT 27720 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Repair of tibia epiphysis CPT 27730 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Repair of toe dislocation CPT 28675 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Repair of urethra defect CPT 53275 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Repair of urethra defect CPT 53520 | not published | not published | $5,745.80 – $6,033.09 | 3 |
| Repair of urethra injury CPT 53505 | not published | not published | $5,745.80 – $6,033.09 | 3 |
| Repair of urethra injury CPT 53510 | not published | not published | $5,745.80 – $6,033.09 | 3 |
| Repair of urethra injury CPT 53515 | not published | not published | $5,745.80 – $6,033.09 | 3 |
| Repair of urethra injury 53502 CPT 53502 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Repair of urethral lesion CPT 57230 | not published | not published | $3,468.96 – $3,642.41 | 3 |
| Repair of web finger CPT 26560 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Repair of web finger CPT 26561 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Repair of web finger CPT 26562 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Repair of windpipe CPT 31750 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Repair of windpipe CPT 31755 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Repair of windpipe defect CPT 31825 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Repair oronasal fistula 30600 CPT 30600 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Repair palate CPT 42182 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Repair palate CPT 42235 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Repair palate pharynx/uvula CPT 42145 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Repair paravag defect lap CPT 57423 | not published | not published | $11,391.13 – $11,960.68 | 3 |
| Repair paravag defect vag 57285 CPT 57285 | not published | not published | $7,946.52 – $8,343.84 | 3 |
| Repair penis CPT 54380 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Repair penis CPT 54385 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Repair pm/icd lead dual CPT 33220 | $3,628.35 | $6,597.00 | not published | 0 |
| Repair pm/icd lead sgl CPT 33218 | $4,716.80 | $8,576.00 | not published | 0 |
| Repair radius or ulna CPT 25400 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Repair radius & ulna CPT 25415 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Repair rectum & vagina CPT 57250 | not published | not published | $5,360.72 – $5,628.75 | 3 |
| Repair rectum-vagina fistula CPT 57300 | not published | not published | $3,468.96 – $3,642.41 | 3 |
| Repair recur fem hernia reduce 49555 CPT 49555 | not published | not published | $3,836.82 – $4,028.66 | 3 |
| Repair/revise wrist joint CPT 25320 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Repair rotator cuff acute CPT 23410 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Repair rotator cuff chronic CPT 23412 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Repair rpr lac tongue floor mouth > 2.6 cm/cmplx CPT 41252 | $1,262.25 | $2,295.00 | not published | 0 |
| Repair rpr lip full thickness vermilion only CPT 40650 | $908.05 | $1,651.00 | not published | 0 |
| Repair salivary duct CPT 42500 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Repair salivary duct CPT 42505 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Repair shoulder capsule CPT 23450 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Repair shoulder capsule CPT 23455 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Repair shoulder capsule CPT 23460 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Repair shoulder capsule CPT 23462 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Repair shoulder capsule CPT 23465 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Repair shoulder capsule CPT 23466 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Repair stern/nuss without scope CPT 21742 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Repair sternum/nuss w/scope CPT 21743 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Repair stomach opening CPT 43870 | not published | not published | $4,131.60 – $4,338.18 | 3 |
| Repair tendon extensor foot 1/2 each tendon CPT 28208 | $3,219.70 | $5,854.00 | $3,506.34 – $3,681.65 | 3 |
| Repair tendon/muscle forearm/wrist prime sngl ea CPT 25260 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Repair testis injury CPT 54670 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Repair throat wound CPT 42900 | not published | not published | $1,662.71 – $1,745.84 | 3 |
| Repair toe dislocation CPT 28645 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Repair tongue lac <2.5cm past 1/3 tongue 41251 CPT 41251 | $386.10 | $702.00 | not published | 0 |
| Repair umbilical lesion CPT 49600 | not published | not published | $3,836.82 – $4,028.66 | 3 |
| Repair upper arm/elbow tendon/muscle ea CPT 24341 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Repair upper jaw fistula CPT 30580 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Repair urethrovaginal lesion 57310 CPT 57310 | not published | not published | $7,946.52 – $8,343.84 | 3 |
| Repair vagina CPT 57335 | not published | not published | $5,360.72 – $5,628.75 | 3 |
| Repair vagina/perineum CPT 57210 | not published | not published | $3,468.96 – $3,642.41 | 3 |
| Repair valve femoral vein CPT 34501 | not published | not published | $5,963.01 – $6,261.16 | 3 |
| Repair webbed toe(s) CPT 28345 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Repair windpipe opening CPT 31614 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Repeat thyroid surgery CPT 60260 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Replace duod/jej tube perc CPT 49451 | $987.80 | $1,796.00 | $971.94 – $1,020.54 | 3 |
| Replace elbow joint CPT 24363 | not published | not published | $18,789.56 – $19,729.04 | 3 |
| Replace g/c tube perc CPT 49450 | $859.10 | $1,562.00 | $971.94 – $1,020.54 | 3 |
| Replace g-j tube perc CPT 49452 | $1,298.55 | $2,361.00 | $971.94 – $1,020.54 | 3 |
| Replacement of contact lens CPT 92326 | not published | not published | $63.22 – $66.38 | 3 |
| Replace picvad cath CPT 36585 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Replace tissue expander w/perm prost 11970 CPT 11970 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Replace tunneled cv cath CPT 36578 | not published | not published | $3,383.62 – $3,552.80 | 3 |
| Replacment pt electronic sys HCPCS G0555 | not published | not published | $920.24 – $966.25 | 3 |
| Replantation arm complete CPT 20802 | not published | not published | $18,789.56 – $19,729.04 | 3 |
| Replantation digit complete CPT 20822 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Replantation digit complete CPT 20816 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Replantation foot complete CPT 20838 | not published | not published | $18,789.56 – $19,729.04 | 3 |
| Replantation hand complete CPT 20808 | not published | not published | $18,789.56 – $19,729.04 | 3 |
| Replantation thumb complete CPT 20827 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Replantation thumb complete CPT 20824 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Replant forearm complete CPT 20805 | not published | not published | $18,789.56 – $19,729.04 | 3 |
| Reposg phrnc nrv stim trnsvn CPT 33281 | not published | not published | $3,746.49 – $3,933.82 | 3 |
| Reposition pm/icd lead CPT 33215 | $2,796.20 | $5,084.00 | $3,383.62 – $3,552.80 | 3 |
| Reposition vad w/image rt/lt sep session CPT 33993 | $1,405.80 | $2,556.00 | not published | 0 |
| Repos lv lead pm/icd CPT 33226 | $2,819.85 | $5,127.00 | $3,383.62 – $3,552.80 | 3 |
| Repr elbow lat ligmnt w/tiss CPT 24343 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Repr elbw med ligmnt w/tissu CPT 24345 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Repr of anal fistula w/glue CPT 46706 | not published | not published | $2,974.45 – $3,123.17 | 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.