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 |
|---|---|---|---|---|
| Cath left heart/lv gram CPT 93452 | $5,848.70 | $10,634.00 | $3,474.11 – $3,647.82 | 3 |
| Cath lt/rt pulm art CPT 36014 | $790.90 | $1,438.00 | not published | 0 |
| Cath malecot 28fr 4-wing ltx HCPCS C1729 | $626.79 | $1,139.62 | not published | 0 |
| Cath place 1st order venous 36011 CPT 36011 | $739.20 | $1,344.00 | not published | 0 |
| Cath plc art ang/grft lt/rt hr CPT 93461 | $17,981.70 | $32,694.00 | $3,474.11 – $3,647.82 | 3 |
| Cath plc art/angio/rt hrt cath CPT 93456 | $5,012.70 | $9,114.00 | $3,474.11 – $3,647.82 | 3 |
| Cath plc art/grft/angio right hrt CPT 93457 | $8,908.90 | $16,198.00 | $3,474.11 – $3,647.82 | 3 |
| Cath right heart w/o2 sat & card CPT 93451 | $5,432.35 | $9,877.00 | $3,474.11 – $3,647.82 | 3 |
| Cath/saline/contrast/sis/hysteosal 58340 CPT 58340 | $721.60 | $1,312.00 | not published | 0 |
| Cath stripping venous s&i CPT 75901 | $484.00 | $880.00 | not published | 0 |
| Cath temp pace flo bipol 5fr electrd HCPCS C1779 | $3,214.98 | $5,845.42 | not published | 0 |
| Cath uret open tp 6fx70cm HCPCS C1758 | $109.57 | $199.22 | not published | 0 |
| Cauterization chemical granulation tissue CPT 17250 | $228.25 | $415.00 | $215.00 – $225.75 | 3 |
| Cauterization of cervix 57510 CPT 57510 | not published | not published | $3,468.96 – $3,642.41 | 3 |
| #cbg+cort-cbg CPT 84449 | $79.75 | $145.00 | $18.00 – $18.90 | 3 |
| Ccnd1/igh translocation alys CPT 81168 | not published | not published | $207.31 – $217.68 | 3 |
| Cdna analysis for variants CPT 81403 | $830.50 | $1,510.00 | $185.20 – $194.46 | 3 |
| Cdp-sot 6 cond w/i&r CPT 92548 | not published | not published | $142.58 – $149.71 | 3 |
| Cdp-sot 6 cond w/i&r mct&adt CPT 92549 | not published | not published | $142.58 – $149.71 | 3 |
| Cebpa gene full sequence CPT 81218 | not published | not published | $241.90 – $254.00 | 3 |
| #celiac hla-dq2 CPT 81377 | not published | not published | $94.74 – $99.48 | 3 |
| #celiac hla-dq8 CPT 81383 | $491.15 | $893.00 | $109.13 – $114.59 | 3 |
| Cell count body fluid CPT 89050 | $161.70 | $294.00 | $4.72 – $4.96 | 3 |
| Cell count w differential body fluid CPT 89051 | $184.80 | $336.00 | $5.60 – $5.88 | 3 |
| Cell cryopreserve/storage CPT 88240 | not published | not published | $13.07 – $13.72 | 3 |
| Cell enumeration & id CPT 86152 | not published | not published | $250.78 – $263.32 | 3 |
| Cell function assay w/stim CPT 86352 | $672.10 | $1,222.00 | $135.86 – $142.65 | 3 |
| Cell marker study CPT 88182 | $570.35 | $1,037.00 | $55.84 – $58.64 | 3 |
| Centralization wrist on ulna CPT 25335 | not published | not published | $3,506.34 – $3,681.65 | 3 |
| Cerclage of uterine cervix nonob 57700 CPT 57700 | not published | not published | $3,468.96 – $3,642.41 | 3 |
| Cerebrospinal fld flw imag CPT 78645 | not published | not published | $581.86 – $610.95 | 3 |
| Cervical lymphadenectomy 38720 CPT 38720 | not published | not published | $7,115.73 – $7,471.51 | 3 |
| Cesarean section delivery only 59514 CPT 59514 | $4,507.25 | $8,195.00 | not published | 0 |
| #cf-97variants CPT 81220 | $558.80 | $1,016.00 | $556.60 – $584.43 | 3 |
| Cftr gene dup/delet variants CPT 81222 | $1,246.85 | $2,267.00 | $435.07 – $456.82 | 3 |
| Cftr gene intron poly t CPT 81224 | not published | not published | $168.75 – $177.19 | 3 |
| Cftr gene known fam variants CPT 81221 | not published | not published | $97.22 – $102.08 | 3 |
| Change cystostomy tube; complex 51710 CPT 51710 | $922.90 | $1,678.00 | $747.24 – $784.60 | 3 |
| Change cystostomy tube simple CPT 51705 | $480.15 | $873.00 | $267.74 – $281.13 | 3 |
| Change gastric port open CPT 43888 | not published | not published | $3,797.52 – $3,987.40 | 3 |
| Change g-tube to g-j perc CPT 49446 | $1,727.00 | $3,140.00 | $2,056.34 – $2,159.15 | 3 |
| Change nephroureteral cath CPT 50387 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Change of ureter tube/stent CPT 50688 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Change of windpipe airway 31502 CPT 31502 | $265.65 | $483.00 | not published | 0 |
| Change stent via transureth CPT 50385 | not published | not published | $2,240.09 – $2,352.10 | 3 |
| Change ureter stent percut CPT 50382 | $3,141.05 | $5,711.00 | $2,240.09 – $2,352.10 | 3 |
| Chct for mal hyperthermia CPT 89049 | not published | not published | $182.57 – $191.70 | 3 |
| Chemical exfoliation acne 17360 CPT 17360 | not published | not published | $215.00 – $225.75 | 3 |
| Chemical peel face epiderm 15788 CPT 15788 | not published | not published | $435.63 – $457.41 | 3 |
| Chemical peel nonfacial 15793 CPT 15793 | not published | not published | $435.63 – $457.41 | 3 |
| Chemical peel nonfacial; epidermal CPT 15792 | not published | not published | $792.00 – $831.60 | 3 |
| Chemo adm cns w/lmbr punct CPT 96450 | $685.85 | $1,247.00 | $353.96 – $371.66 | 3 |
| Chemodener muscle larynx emg CPT 64617 | not published | not published | $756.44 – $794.26 | 3 |
| Chemodenerv 1 extrem 5/> ea 64645 CPT 64645 | $128.15 | $233.00 | not published | 0 |
| Chemodenerv 1 extrem 5/> mus 64644 CPT 64644 | $1,018.60 | $1,852.00 | $756.44 – $794.26 | 3 |
| Chemodenerv 1 extremity 1-4 64642 CPT 64642 | $1,018.60 | $1,852.00 | $756.44 – $794.26 | 3 |
| Chemodenervation anal musc CPT 46505 | $2,640.55 | $4,801.00 | $1,282.34 – $1,346.46 | 3 |
| Chemodenervation/face muscl/unilat 64612 CPT 64612 | not published | not published | $328.94 – $345.38 | 3 |
| Chemodenerv eccrine glands CPT 64653 | not published | not published | $328.94 – $345.38 | 3 |
| Chemodenerv eccrine glands 64650 CPT 64650 | not published | not published | $328.94 – $345.38 | 3 |
| Chemodenerv musc migraine 64615 CPT 64615 | $264.55 | $481.00 | $328.94 – $345.38 | 3 |
| Chemodenerv musc neck dyston 64616 CPT 64616 | $418.55 | $761.00 | $328.94 – $345.38 | 3 |
| Chemodenerv saliv glands bilat 64611 CPT 64611 | not published | not published | $328.94 – $345.38 | 3 |
| Chemodenerv trunk musc 1-5 64646 CPT 64646 | not published | not published | $756.44 – $794.26 | 3 |
| Chemodenerv trunk musc 6/] 64647 CPT 64647 | not published | not published | $756.44 – $794.26 | 3 |
| Chemo extend IV infus w/pump HCPCS G0498 | $799.15 | $1,453.00 | $353.96 – $371.66 | 3 |
| Chemo ia infuse each addl hr CPT 96423 | not published | not published | $50.18 – $52.69 | 3 |
| Chemo ia infusion up to 1 hr CPT 96422 | not published | not published | $353.96 – $371.66 | 3 |
| Chemo ia push tecnique CPT 96420 | not published | not published | $353.96 – $371.66 | 3 |
| Chemo intralesional over 7 CPT 96406 | not published | not published | $227.94 – $239.33 | 3 |
| Chemo intralesional up to 7 96405 CPT 96405 | not published | not published | $77.16 – $81.01 | 3 |
| Chemotaxis assay CPT 86155 | not published | not published | $15.99 – $16.79 | 3 |
| Chemotherapy injection 96542 CPT 96542 | not published | not published | $353.96 – $371.66 | 3 |
| Chemotx admn pertl cav impl CPT 96446 | not published | not published | $353.96 – $371.66 | 3 |
| Chest 2 vws w oblique CPT 71048 | $651.20 | $1,184.00 | $112.03 – $117.63 | 3 |
| Chest apical lordotic proj CPT 71047 | $520.30 | $946.00 | $93.26 – $97.92 | 3 |
| Chest CT scan (with and without contrast) CPT 71270 | $2,359.50 | $4,290.00 | $187.96 – $197.36 | 3 |
| Chest CT scan (with contrast) CPT 71260 | $2,178.55 | $3,961.00 | $187.96 – $197.36 | 3 |
| Chest CT scan (without contrast) CPT 71250 | $1,996.50 | $3,630.00 | $112.03 – $117.63 | 3 |
| Chest X-ray CPT 71046 | $391.05 | $711.00 | $93.26 – $97.92 | 3 |
| Chest X-ray (single view) CPT 71045 | $260.70 | $474.00 | $93.26 – $97.92 | 3 |
| Chg pr pul rehab for copd patients CPT 94626 | $84.15 | $153.00 | $63.22 – $66.38 | 3 |
| Chg radiologic exam esophagus double contrast CPT 74221 | $1,790.25 | $3,255.00 | $187.96 – $197.36 | 3 |
| Chimerism anal no cell selec CPT 81267 | not published | not published | $207.46 – $217.83 | 3 |
| Chimerism anal w/cell select CPT 81268 | not published | not published | $260.79 – $273.83 | 3 |
| Chlamydia culture CPT 87110 | $196.90 | $358.00 | $19.60 – $20.58 | 3 |
| Chlamydia trachomatis ag if CPT 87270 | not published | not published | $11.98 – $12.58 | 3 |
| Chlamydia type CPT 87140 | $57.20 | $104.00 | $5.57 – $5.85 | 3 |
| Chloride CPT 82435 | $63.80 | $116.00 | $4.60 – $4.83 | 3 |
| Chloride 24 hour urine CPT 82436 | $67.10 | $122.00 | $5.75 – $6.04 | 3 |
| Chmotx admn plrl cav thrcnts CPT 96440 | not published | not published | $353.96 – $371.66 | 3 |
| Cholangiogram percutaneous compl CPT 47532 | $5,471.40 | $9,948.00 | $3,836.82 – $4,028.66 | 3 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $598.95 | $1,089.00 | not published | 0 |
| Cholecystostomy complete w/supervision & interpretation CPT 47490 | $4,730.55 | $8,601.00 | $3,836.82 – $4,028.66 | 3 |
| Cholesterol CPT 82465 | $117.70 | $214.00 | $4.35 – $4.57 | 3 |
| Cholesterol body fluid CPT 84999 | $243.65 | $443.00 | not published | 0 |
| Cholesterol (Lipid) Test CPT 80061 | $143.55 | $261.00 | $13.39 – $14.06 | 3 |
| Cholinesterase CPT 82480 | $99.55 | $181.00 | $7.87 – $8.26 | 3 |
| Cholinesterase challenge CPT 95857 | not published | not published | $231.39 – $242.96 | 3 |
| Chorion biopsy CPT 59015 | not published | not published | $987.01 – $1,036.37 | 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.