OSF Saint Elizabeth Medical Center
1100 East Norris Drive, Ottawa, IL · Osfhealthcare · · NPI 1588713440
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 |
|---|---|---|---|---|
| Lipase CPT 83690 | $229.80 | $383.00 | $6.89 – $7.03 | 3 |
| Lipoprotein blood high res frac & quant CPT 83701 | not published | not published | $33.86 – $34.54 | 3 |
| Lipoprotein blood quant CPT 83704 | $208.80 | $348.00 | $34.19 – $34.87 | 3 |
| Lipoprotein direct measurement hdl CPT 83718 | $149.40 | $249.00 | $8.19 – $8.35 | 3 |
| Lipoprotein direct measurement ldl CPT 83721 | $85.80 | $143.00 | $10.50 – $10.71 | 3 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $34.19 – $34.87 | 3 |
| Lip surgery procedure CPT 40799 | not published | not published | $253.81 – $258.89 | 3 |
| Lisocabtagene mara car pos t HCPCS Q2054 | not published | not published | $562,260.84 – $573,506.05 | 3 |
| Listeria monocytogenes CPT 86723 | not published | not published | $13.19 – $13.45 | 3 |
| Lithium therapeutic drug level CPT 80178 | $133.20 | $222.00 | $6.61 – $6.74 | 3 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $612.00 | $1,020.00 | $176.19 – $179.71 | 3 |
| Liver elastography 91200 CPT 91200 | not published | not published | $137.89 – $140.65 | 3 |
| Liver Function Test CPT 80076 | $201.60 | $336.00 | $8.17 – $8.33 | 3 |
| Liver imaging CPT 78201 | not published | not published | $581.86 – $593.49 | 3 |
| Liver imag w/vasclr flow CPT 78202 | not published | not published | $581.86 – $593.49 | 3 |
| Liver/spleen imag static only CPT 78215 | $1,156.20 | $1,927.00 | $428.40 – $436.97 | 3 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $428.40 – $436.97 | 3 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $3,506.34 – $3,576.46 | 3 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $13.20 | $22.00 | not published | 0 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | not published | not published | $221.49 – $225.92 | 3 |
| Lo sag rig pnl stays pre cst HCPCS L0626 | $85.20 | $142.00 | not published | 0 |
| Loudness balance test CPT 92562 | not published | not published | $231.39 – $236.02 | 3 |
| Low back disk surgery CPT 63030 | not published | not published | $7,775.89 – $7,931.41 | 3 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $3,219.00 | $5,365.00 | $187.96 – $191.72 | 3 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,994.60 | $4,991.00 | $373.86 – $381.34 | 3 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $2,403.60 | $4,006.00 | $112.03 – $114.27 | 3 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $4,239.00 | $7,065.00 | $373.86 – $381.34 | 3 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $3,491.40 | $5,819.00 | $373.86 – $381.34 | 3 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,997.60 | $4,996.00 | $255.69 – $260.80 | 3 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $415.80 | $693.00 | $112.03 – $114.27 | 3 |
| Low frequency non-thermal Ultrasound CPT 97610 | $278.40 | $464.00 | $215.00 – $219.30 | 3 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $11,391.13 – $11,618.95 | 3 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $11,391.13 – $11,618.95 | 3 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $11,391.13 – $11,618.95 | 3 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $11,391.13 – $11,618.95 | 3 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $21.99 – $22.43 | 3 |
| Lumbar diskogram s&i CPT 72295 | $5,983.80 | $9,973.00 | $2,092.58 – $2,134.43 | 3 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $18,789.56 – $19,165.36 | 3 |
| Lumizyme injection HCPCS J0221 | not published | not published | $207.51 – $211.66 | 3 |
| Lung function test (mbc/mvv) CPT 94200 | $57.60 | $96.00 | $63.22 – $64.48 | 3 |
| Lung Function Test (Spirometry) CPT 94010 | $216.00 | $360.00 | $231.39 – $236.02 | 3 |
| Lung perfusion imaging CPT 78580 | $1,349.40 | $2,249.00 | $428.40 – $436.97 | 3 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | not published | not published | $212.10 – $216.34 | 3 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | not published | not published | $42.75 – $43.60 | 3 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | not published | not published | $319.94 – $326.34 | 3 |
| Lutetium lu 177 vipivotide HCPCS A9607 | not published | not published | $259.60 – $264.79 | 3 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $30.99 – $31.61 | 3 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $20.05 – $20.45 | 3 |
| Lymphatics/lymph node imaging CPT 78195 | $1,411.80 | $2,353.00 | $581.86 – $593.49 | 3 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $36.56 – $37.29 | 3 |
| Lymphocyte transformation mitogen CPT 86353 | not published | not published | $49.03 – $50.01 | 3 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $189.51 – $193.30 | 3 |
| Lymphocytotoxicity assay CPT 86806 | not published | not published | $47.59 – $48.54 | 3 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $672.23 – $685.67 | 3 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $1,686.89 – $1,720.63 | 3 |
| Lymph vessel x-ray trunk CPT 75805 | not published | not published | $3,383.62 – $3,451.29 | 3 |
| Lymph vessel x-ray trunk CPT 75807 | not published | not published | $3,383.62 – $3,451.29 | 3 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $3,468.96 – $3,538.34 | 3 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $2,240.09 – $2,284.90 | 3 |
| Macroscopic exam arthropod CPT 87168 | $75.60 | $126.00 | $4.27 – $4.36 | 3 |
| Macroscopic exam parasite CPT 87169 | $127.20 | $212.00 | $4.31 – $4.40 | 3 |
| Magnesium CPT 83735 | $196.80 | $328.00 | $6.70 – $6.83 | 3 |
| Magnetic image bone marrow CPT 77084 | $2,445.00 | $4,075.00 | $255.69 – $260.80 | 3 |
| Malaria antibody CPT 86750 | not published | not published | $13.19 – $13.45 | 3 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $1,723.15 – $1,757.62 | 3 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $1,723.15 – $1,757.62 | 3 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $102.00 | $170.00 | $142.58 – $145.43 | 3 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $102.00 | $170.00 | $142.58 – $145.43 | 3 |
| Manipulation of hip joint CPT 27275 | not published | not published | $1,723.15 – $1,757.62 | 3 |
| Manipulation of spine CPT 22505 | not published | not published | $1,723.15 – $1,757.62 | 3 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $264.33 – $269.62 | 3 |
| Manual diff wbc count b-coat CPT 85009 | not published | not published | $5.07 – $5.17 | 3 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | not published | not published | $53.27 – $54.34 | 3 |
| Marker biop eviva buckle ss HCPCS A4648 | $3,357.60 | $5,596.00 | not published | 0 |
| Marker lymphatic sentimag magtrace 10 vial HCPCS A9697 | not published | not published | $1,254.00 – $1,279.08 | 3 |
| Mastectomy partial CPT 19301 | not published | not published | $4,195.85 – $4,279.77 | 3 |
| Mast mod rad CPT 19307 | not published | not published | $7,115.73 – $7,258.04 | 3 |
| Mastoids complete CPT 70130 | $723.60 | $1,206.00 | $112.03 – $114.27 | 3 |
| Mastopexy CPT 19316 | not published | not published | $7,115.73 – $7,258.04 | 3 |
| Mast simple complete CPT 19303 | not published | not published | $7,115.73 – $7,258.04 | 3 |
| M.avium-intra dna amp prob CPT 87561 | not published | not published | $35.09 – $35.79 | 3 |
| M.avium-intra dna dir prob CPT 87560 | not published | not published | $27.29 – $27.84 | 3 |
| M.avium-intra dna quant CPT 87562 | not published | not published | $42.84 – $43.70 | 3 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $141.00 | $235.00 | $14.46 – $14.75 | 3 |
| Mayo aathr protein s free CPT 85306 | $391.20 | $652.00 | $15.32 – $15.63 | 3 |
| Mayo activated protein c resistance assay CPT 85307 | $139.20 | $232.00 | $15.32 – $15.63 | 3 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $657.00 | $1,095.00 | $38.57 – $39.34 | 3 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $190.20 | $317.00 | not published | 0 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $274.80 | $458.00 | not published | 0 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $88.20 | $147.00 | $14.78 – $15.08 | 3 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $126.60 | $211.00 | not published | 0 |
| Mayo alpha 1 antitrypsin CPT 82103 | $135.00 | $225.00 | $13.44 – $13.71 | 3 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $81.60 | $136.00 | $15.08 – $15.38 | 3 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | $45.00 | $75.00 | not published | 0 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | $167.40 | $279.00 | not published | 0 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $1,435.20 | $2,392.00 | $121.63 – $124.06 | 3 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $1,289.40 | $2,149.00 | $91.66 – $93.49 | 3 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $1,732.80 | $2,888.00 | $137.00 – $139.74 | 3 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $4,807.80 | $8,013.00 | $1,160.00 – $1,183.20 | 3 |
| Mayo androstenedione CPT 82157 | $198.60 | $331.00 | $29.28 – $29.87 | 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.