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 |
|---|---|---|---|---|
| Thorax spine fusion CPT 22610 | not published | not published | $18,789.56 – $19,729.04 | 3 |
| Thorcscpy w/biop pleura CPT 32609 | not published | not published | $6,478.50 – $6,802.42 | 3 |
| Thrcspy w/diag bp lng inf uni CPT 32607 | not published | not published | $11,391.13 – $11,960.68 | 3 |
| Thrcspy w/diag bp lng nod uni CPT 32608 | not published | not published | $11,391.13 – $11,960.68 | 3 |
| Throat x-ray & fluoroscopy CPT 70370 | not published | not published | $93.26 – $97.92 | 3 |
| Thrombectmy crnry perq mechanical CPT 92973 | $5,848.70 | $10,634.00 | not published | 0 |
| Thrombectomy/inf pq dialysis circuit CPT 36904 | $12,690.70 | $23,074.00 | $6,099.19 – $6,404.14 | 3 |
| Thrombectomy/inf pq dialysis circuit w/pta CPT 36905 | $25,296.15 | $45,993.00 | $12,370.97 – $12,989.52 | 3 |
| Thrombectomy/inf pq dialysis circuit w/stent plcmnt CPT 36906 | $24,769.80 | $45,036.00 | $19,644.52 – $20,626.75 | 3 |
| Thrombin time CPT 85670 | $118.25 | $215.00 | $5.77 – $6.06 | 3 |
| Thrombin time titer CPT 85675 | not published | not published | $6.85 – $7.19 | 3 |
| Thromboendarterectomy including patch graft if preformed; CPT 35321 | not published | not published | $5,963.01 – $6,261.16 | 3 |
| Thrombomodulin CPT 85337 | not published | not published | $17.27 – $18.13 | 3 |
| Thromboplastin inhibition CPT 85705 | $89.10 | $162.00 | $9.63 – $10.11 | 3 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $69.85 | $127.00 | $6.47 – $6.79 | 3 |
| Thromboxane urine CPT 84431 | not published | not published | $35.11 – $36.87 | 3 |
| Thumb fusion with graft CPT 26820 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Thumb fusion with graft CPT 26842 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Thumb tendon transfer CPT 26510 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Thymectomy prtl/tot transcervical appr 60520 CPT 60520 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Thyroglobulin antibody CPT 86800 | $237.60 | $432.00 | $15.91 – $16.71 | 3 |
| Thyroid imaging CPT 78013 | $926.20 | $1,684.00 | $428.40 – $449.82 | 3 |
| Thyroid met imaging CPT 78015 | not published | not published | $428.40 – $449.82 | 3 |
| Thyroid met imaging/studies CPT 78016 | not published | not published | $428.40 – $449.82 | 3 |
| Thyroid mets imag whole body CPT 78018 | $1,482.80 | $2,696.00 | $581.86 – $610.95 | 3 |
| Thyroid (TSH) Test CPT 84443 | $147.40 | $268.00 | $16.80 – $17.64 | 3 |
| Thyroid Ultrasound CPT 76536 | $1,102.20 | $2,004.00 | $112.03 – $117.63 | 3 |
| Thyroid uptake measurement CPT 78012 | $732.60 | $1,332.00 | $428.40 – $449.82 | 3 |
| Thyrotropin releasing hormone CPT 80438 | not published | not published | $50.41 – $52.93 | 3 |
| Thyroxine binding globulin (tbg) CPT 84442 | $215.60 | $392.00 | $14.78 – $15.52 | 3 |
| Tibial arthroscopy/surgery CPT 29855 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Tibial arthroscopy/surgery CPT 29856 | not published | not published | $13,758.17 – $14,446.08 | 3 |
| Tib/per revasc stent & ather 37231 CPT 37231 | $24,231.35 | $44,057.00 | not published | 0 |
| Tib/per revasc stnt & ather CPT 37235 | $15,762.45 | $28,659.00 | not published | 0 |
| Tib/per revasc w/ather add-on 37233 CPT 37233 | $12,192.40 | $22,168.00 | not published | 0 |
| Tilt table study CPT 93660 | $880.00 | $1,600.00 | $399.88 – $419.88 | 3 |
| Tissue culture placenta CPT 88235 | $2,742.85 | $4,987.00 | $150.30 – $157.82 | 3 |
| Tissue culture skin/biopsy CPT 88233 | $847.00 | $1,540.00 | $140.73 – $147.77 | 3 |
| Tissue culture tumor CPT 88239 | not published | not published | $147.52 – $154.90 | 3 |
| Tissue exam koh skin/hair/nails CPT 87220 | $31.35 | $57.00 | $4.27 – $4.48 | 3 |
| Tissue transglutaminase iga CPT 86364 | $27.50 | $50.00 | $11.53 – $12.11 | 3 |
| Tixagev and cilgav inj HCPCS M0220 | $179.30 | $326.00 | not published | 0 |
| Tl-201 thallium diag per mci HCPCS A9505 | $87.45 | $159.00 | not published | 0 |
| Tlh uterus 250 g or less CPT 58570 | not published | not published | $11,391.13 – $11,960.68 | 3 |
| Tlh uterus over 250 g CPT 58572 | not published | not published | $11,391.13 – $11,960.68 | 3 |
| Tlh w/t/o 250 g or less CPT 58571 | not published | not published | $11,391.13 – $11,960.68 | 3 |
| Tlh w/t/o uterus over 250 g CPT 58573 | not published | not published | $11,391.13 – $11,960.68 | 3 |
| Tnot opn elbw to sho ea tdn CPT 24310 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Tobramycin peak therapeutic drug level CPT 80200 | $225.50 | $410.00 | $16.13 – $16.94 | 3 |
| Toe joint transfer CPT 26556 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Tomosynthesis breast diagnostic left HCPCS G0279 | not published | not published | $13.04 – $13.69 | 3 |
| Tomosynthesis breast screen bilateral CPT 77063 | $74.80 | $136.00 | $21.51 – $22.59 | 3 |
| Tone decay hearing test CPT 92563 | not published | not published | $40.03 – $42.03 | 3 |
| Tongue base vol reduction CPT 41530 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Tongue biopsy; posterior one-third 41105 CPT 41105 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Tongue suspension CPT 41512 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Tongue to lip surgery CPT 41510 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Tonsillectomy (age 12+) CPT 42826 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Tonsillectomy (child under 12) CPT 42825 | not published | not published | $6,343.80 – $6,660.99 | 3 |
| Total hip arthroplasty CPT 27132 | not published | not published | $13,758.17 – $14,446.08 | 3 |
| Total Hip Replacement CPT 27130 | not published | not published | $13,758.17 – $14,446.08 | 3 |
| Total Knee Replacement CPT 27447 | not published | not published | $13,758.17 – $14,446.08 | 3 |
| Total tau CPT 84394 | not published | not published | $128.92 – $135.37 | 3 |
| Tot disc arthrp 1ntrspc crv CPT 22856 | not published | not published | $18,789.56 – $19,729.04 | 3 |
| Tot disc arthrp 1ntrspc lmbr CPT 22857 | not published | not published | $18,789.56 – $19,729.04 | 3 |
| Tot estradiol response panel CPT 80415 | not published | not published | $55.89 – $58.68 | 3 |
| Toxoplasma antibody igg CPT 86777 | $185.90 | $338.00 | $14.39 – $15.11 | 3 |
| Toxoplasma antibody igm CPT 86778 | $270.60 | $492.00 | $14.41 – $15.13 | 3 |
| Tp53 gene full gene sequence CPT 81351 | $579.70 | $1,054.00 | $641.85 – $673.94 | 3 |
| Tp53 gene known famil vrnt CPT 81353 | not published | not published | $308.00 – $323.40 | 3 |
| Tp53 gene trgt sequence alys CPT 81352 | $1,689.60 | $3,072.00 | $329.51 – $345.99 | 3 |
| Tpmt gene com vrnts CPT 81335 | $637.45 | $1,159.00 | $174.81 – $183.55 | 3 |
| Tprnl balo cntnc dev adjmt CPT 53454 | not published | not published | $267.74 – $281.13 | 3 |
| Tprnl balo cntnc dev rmvl ea CPT 53453 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Tprnl plmt biodegrdabl matrl CPT 55874 | not published | not published | $5,745.80 – $6,033.09 | 3 |
| Trachelectomy (cervicectomy) 57530 CPT 57530 | not published | not published | $5,360.72 – $5,628.75 | 3 |
| Tracheobrnchsc thru est trachs incisn CPT 31615 | $642.40 | $1,168.00 | not published | 0 |
| Tracheostoma revision; simple, without flap rotation CPT 31613 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Training self management diabetes individual outpatient department per 30 minutes HCPCS G0108 | $107.25 | $195.00 | $57.84 – $60.73 | 3 |
| Transabdom amnioinfus w/us CPT 59070 | not published | not published | $326.55 – $342.88 | 3 |
| Transcath biopsy CPT 37200 | not published | not published | $5,963.01 – $6,261.16 | 3 |
| Transcath closure of asd CPT 93580 | not published | not published | $19,644.52 – $20,626.75 | 3 |
| Transcath closure of vsd CPT 93581 | not published | not published | $19,644.52 – $20,626.75 | 3 |
| Transcath occlusion cns CPT 61624 | not published | not published | $19,644.52 – $20,626.75 | 3 |
| Transcath occlusion non-cns CPT 61626 | not published | not published | $12,370.97 – $12,989.52 | 3 |
| Transcath rmvl perm ldss pmkr rv CPT 33275 | $3,063.50 | $5,570.00 | $3,383.62 – $3,552.80 | 3 |
| Transcrv abltj utrn fibrd rf CPT 58580 | not published | not published | $7,946.52 – $8,343.84 | 3 |
| Transcutaneous carboxyhb CPT 88740 | not published | not published | $9.37 – $9.84 | 3 |
| Transcutaneous hgb 88738 CPT 88738 | not published | not published | $5.02 – $5.27 | 3 |
| Transcutaneous methb CPT 88741 | not published | not published | $9.37 – $9.84 | 3 |
| Transfer of abdominal muscle CPT 27100 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Transfer of embryo CPT 58976 | not published | not published | $326.55 – $342.88 | 3 |
| Transfer of iliopsoas muscle CPT 27110 | not published | not published | $7,775.89 – $8,164.69 | 3 |
| Transfer of iliopsoas muscle CPT 27111 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Transfer of spinal muscle CPT 27105 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Transferrin CPT 84466 | $59.95 | $109.00 | $12.76 – $13.40 | 3 |
| Transfer skin pedicle flap CPT 15650 | not published | not published | $2,211.05 – $2,321.60 | 3 |
| Transfer tendon to pelvis CPT 27098 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Transfusion blood/blood component(s) CPT 36430 | $751.85 | $1,367.00 | $472.77 – $496.41 | 3 |
| Transorl lwr esophgl myotomy CPT 43497 | not published | not published | $6,505.69 – $6,830.97 | 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.