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 |
|---|---|---|---|---|
| Bx breast pq tomo guide CPT 19499 | $3,784.00 | $6,880.00 | $4,195.85 – $4,405.64 | 3 |
| Bx/curett of cervix w/scope 57454 CPT 57454 | not published | not published | $326.55 – $342.88 | 3 |
| Bx/exc lymph node/open/deep cervic 38510 CPT 38510 | not published | not published | $4,195.85 – $4,405.64 | 3 |
| Bx/exc lymph node/open/superfic 38500 CPT 38500 | not published | not published | $4,195.85 – $4,405.64 | 3 |
| Bx leg/ankle soft tissue deep 27614 CPT 27614 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Bx muscle CPT 20200 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Bx nasopharynx/unknown pri lesion 42806 CPT 42806 | not published | not published | $3,552.91 – $3,730.55 | 3 |
| Bx of breast open 19101 CPT 19101 | not published | not published | $4,195.85 – $4,405.64 | 3 |
| Bx of cervix w/scope leep 57460 CPT 57460 | not published | not published | $3,468.96 – $3,642.41 | 3 |
| Bx pancreas pq ndl CPT 48102 | $1,874.95 | $3,409.00 | $1,769.88 – $1,858.38 | 3 |
| Bx perianal mass CPT 46999 | not published | not published | $996.56 – $1,046.39 | 3 |
| Bx pleura pq ndl CPT 32400 | $2,049.30 | $3,726.00 | $1,769.88 – $1,858.38 | 3 |
| Bx prostate trnsrctl u/s guid CPT 55707 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Bx prst8 ndl sat sampling CPT 55706 | not published | not published | $3,777.44 – $3,966.31 | 3 |
| Bx shoulder tissues deep 23066 CPT 23066 | not published | not published | $3,112.75 – $3,268.38 | 3 |
| Bx shoulder tissues supf 23065 CPT 23065 | $1,666.50 | $3,030.00 | $1,769.88 – $1,858.38 | 3 |
| Bx skin incisnl ea sep/add l les CPT 11107 | $183.70 | $334.00 | not published | 0 |
| Bx skin punch ea sep/ addl les CPT 11105 | $183.70 | $334.00 | not published | 0 |
| Bx skin tangential ea sep/ addl les CPT 11103 | $174.35 | $317.00 | not published | 0 |
| Bx/soft tis/forearm/wrist/superfic 25065 CPT 25065 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Bx soft tiss pelvis+hip area supf 27040 CPT 27040 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Bx soft tiss pelvis/hip deep 27041 CPT 27041 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Bx soft tissue back/flank deep 21925 CPT 21925 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Bx soft tissue back/flank supf 21920 CPT 21920 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Bx spinal cord pq ndl CPT 62269 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Bx thigh/knee soft tiss supf 27323 CPT 27323 | not published | not published | $1,769.88 – $1,858.38 | 3 |
| Bx thyroid/percutan core needle 60100 CPT 60100 | $856.90 | $1,558.00 | $758.85 – $796.79 | 3 |
| Bx vag mucos smpl (sep proc) CPT 57100 | not published | not published | $987.01 – $1,036.37 | 3 |
| Bx vulva or perineum/1 lesion 56605 CPT 56605 | $425.15 | $773.00 | $987.01 – $1,036.37 | 3 |
| Bx vulva or perineum/ea add lesion 56606 CPT 56606 | $163.35 | $297.00 | not published | 0 |
| Bypass temp external fem-fem CPT 37799 | $1,069.20 | $1,944.00 | $672.23 – $705.84 | 3 |
| C1 esterase inhibitor func - sendout CPT 86161 | $288.20 | $524.00 | $12.00 – $12.60 | 3 |
| Cable cath 22-pin diag HCPCS C1730 | $874.92 | $1,590.76 | not published | 0 |
| Cacna1a gene full gene seq CPT 81185 | not published | not published | $846.27 – $888.58 | 3 |
| Cad breast MRI w/r&i HCPCS C8937 | $193.60 | $352.00 | not published | 0 |
| Cadd pump refill CPT 96521 | not published | not published | $227.94 – $239.33 | 3 |
| Calcium 24 hour urine CPT 82340 | $79.75 | $145.00 | $6.03 – $6.33 | 3 |
| Calcium ionized CPT 82330 | $123.20 | $224.00 | $13.68 – $14.36 | 3 |
| Calcium total CPT 82310 | $100.10 | $182.00 | $5.16 – $5.42 | 3 |
| Calculi urinary-sendout CPT 82360 | not published | not published | $12.87 – $13.51 | 3 |
| Calculus analysis qual CPT 82355 | not published | not published | $11.58 – $12.16 | 3 |
| Caloric vstblr test w/rec CPT 92538 | $432.85 | $787.00 | $231.39 – $242.96 | 3 |
| Calprotectin fecal CPT 83993 | $151.25 | $275.00 | $19.63 – $20.61 | 3 |
| Campylobacter antibody CPT 86625 | $198.00 | $360.00 | $13.12 – $13.78 | 3 |
| Candida dna CPT 87480 | not published | not published | $20.05 – $21.05 | 3 |
| Candida skin test CPT 86485 | not published | not published | $30.99 – $32.54 | 3 |
| Cannula declotting 36861 CPT 36861 | not published | not published | $5,963.01 – $6,261.16 | 3 |
| Cannula ercp contour 5-4-3 tip HCPCS C1889 | $1,543.86 | $2,807.02 | not published | 0 |
| Cap nerve 2x15mm HCPCS C1763 | $831.91 | $1,512.57 | not published | 0 |
| Capsular contracture release CPT 23020 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Capsulotomy; interphalangeal joint, each joint (separate proc) CPT 28272 | not published | not published | $1,723.15 – $1,809.31 | 3 |
| Capsulotomy mpj ea joint (sep proc) CPT 28270 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Cap trach decann 15mm HCPCS C1750 | $1,077.47 | $1,959.04 | not published | 0 |
| Carbamazepine free CPT 80157 | $84.70 | $154.00 | $13.25 – $13.91 | 3 |
| Carbamazepine free -sendout CPT 80161 | $22.00 | $40.00 | $18.64 – $19.57 | 3 |
| Carbamazepine total therapeutic drug level CPT 80156 | $225.50 | $410.00 | $14.57 – $15.30 | 3 |
| Carbohydrate deficient transf - sendout CPT 82373 | not published | not published | $18.06 – $18.96 | 3 |
| Carbohydrate urine - sendout CPT 84377 | not published | not published | $5.50 – $5.78 | 3 |
| Carbon dioxide CPT 82374 | $83.05 | $151.00 | $4.88 – $5.12 | 3 |
| Carboxyhemoglobin quantitative CPT 82375 | $237.60 | $432.00 | $12.32 – $12.94 | 3 |
| Carcinoembryonic ag (cea) CPT 82378 | $372.90 | $678.00 | $18.96 – $19.91 | 3 |
| Cardiac MRI seg dys strain HCPCS C9762 | not published | not published | $585.55 – $614.83 | 3 |
| Cardiac MRI seg dys stress HCPCS C9763 | not published | not published | $585.55 – $614.83 | 3 |
| Cardiac MRI w/stress img CPT 75559 | not published | not published | $585.55 – $614.83 | 3 |
| Cardiac perf planar mult/ef/wm CPT 78454 | $2,589.95 | $4,709.00 | $1,387.37 – $1,456.74 | 3 |
| Cardiac perf planar sgl/ef/wm CPT 78453 | $1,963.50 | $3,570.00 | $1,387.37 – $1,456.74 | 3 |
| Cardiac perf spect sgl/ef/wm rst/strs CPT 78451 | $2,752.20 | $5,004.00 | $1,387.37 – $1,456.74 | 3 |
| Cardiac rehabilitation op phase 2 w/continous ecg monitoring CPT 93798 | $240.90 | $438.00 | $138.14 – $145.05 | 3 |
| Cardiac rehabilitation op phase 2 without continous ecg monitoring CPT 93797 | not published | not published | $138.14 – $145.05 | 3 |
| Cardiac shunt imaging CPT 78428 | not published | not published | $428.40 – $449.82 | 3 |
| Cardiokymography HCPCS Q0035 | not published | not published | $40.03 – $42.03 | 3 |
| Cardiolipin antibody iga CPT 86147 | $192.50 | $350.00 | $25.45 – $26.72 | 3 |
| Cardioversion elective electrical conversion arrhythmia external CPT 92960 | $1,300.75 | $2,365.00 | $708.28 – $743.69 | 3 |
| Cardioversion/elective/internal 92961 CPT 92961 | $1,970.65 | $3,583.00 | $708.28 – $743.69 | 3 |
| Caregiver training strategies&tq 1st 30 minutes CPT 97550 | $63.25 | $115.00 | not published | 0 |
| Caregiver training strategies&tq ea addl 15 min CPT 97551 | $55.00 | $100.00 | not published | 0 |
| Car ion chnnlpath inc 10 gns CPT 81413 | not published | not published | $584.90 – $614.14 | 3 |
| Car ion chnnlpath inc 2 gns CPT 81414 | not published | not published | $584.90 – $614.14 | 3 |
| Carotene CPT 82380 | $111.65 | $203.00 | $9.22 – $9.68 | 3 |
| Carotid Artery Ultrasound (Duplex) CPT 93880 | $1,229.25 | $2,235.00 | $255.69 – $268.47 | 3 |
| Car seat/bed test 60 minutes CPT 94780 | $71.50 | $130.00 | $40.03 – $42.03 | 3 |
| Car seat/bed test additional 30 minutes CPT 94781 | $35.75 | $65.00 | not published | 0 |
| Car-t admn autologous CPT 38228 | not published | not published | $353.96 – $371.66 | 3 |
| Ca screen;flexi sigmoidscope HCPCS G0104 | not published | not published | $996.56 – $1,046.39 | 3 |
| Catecholamines,fractionated, urine CPT 82382 | not published | not published | $27.30 – $28.66 | 3 |
| Cath 2lum 14.5frx43cm maxid kt mahurkar HCPCS C1752 | $744.39 | $1,353.43 | not published | 0 |
| Cath acuity innr ic130 6f 63cm HCPCS C1887 | $3,476.05 | $6,320.09 | not published | 0 |
| Cath adherent clot 10mm 6f 10 HCPCS C1757 | $13,074.30 | $23,771.45 | not published | 0 |
| Cath baloon occl urnry 34f 7x2x65 HCPCS C2628 | $1,609.74 | $2,926.80 | not published | 0 |
| Cath combo lt&rt heart w/inj/s CPT 93453 | $5,684.80 | $10,336.00 | $3,474.11 – $3,647.82 | 3 |
| Cath cv dl inj 7fx16cm HCPCS C1751 | $2,712.53 | $4,931.88 | not published | 0 |
| Cath del ampltz 12f 45d 80cm HCPCS C1893 | $185.67 | $337.59 | not published | 0 |
| Catheter declot mechanical CPT 36596 | $1,144.00 | $2,080.00 | $1,686.89 – $1,771.24 | 3 |
| Catheterization collection of specimen single patient all places of service HCPCS P9612 | $7.15 | $13.00 | $9.34 – $9.81 | 3 |
| Catheter stripping venous CPT 36595 | $3,095.95 | $5,629.00 | $3,383.62 – $3,552.80 | 3 |
| Cath groshong MRI 8fr plstc port HCPCS C1788 | $572.21 | $1,040.39 | not published | 0 |
| Cath hawkone s directional HCPCS C1714 | $6,624.08 | $12,043.78 | not published | 0 |
| Cath imag ivus pv 8.5fx90 .035 HCPCS C1753 | $1,885.44 | $3,428.07 | not published | 0 |
| Cathj rmvl dev ischmc rmdlg CPT 53866 | not published | not published | $267.74 – $281.13 | 3 |
| Cathj umbilical vein dx/ther nb CPT 36510 | $79.20 | $144.00 | 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.