OSF Healthcare Divine Mercy Continuing Care Hospital
500 W Romeo B Garrett Avenue, Peoria, IL · Osfhealthcare · · NPI 1770721508
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 |
|---|---|---|---|---|
| Ot evaluation high complexity patient/family CPT 97167 | $278.40 | $464.00 | not published | 0 |
| Ot evaluation low complexity patient/family CPT 97165 | $231.60 | $386.00 | not published | 0 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $247.20 | $412.00 | not published | 0 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $108.00 | $180.00 | not published | 0 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $105.00 | $175.00 | not published | 0 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $105.00 | $175.00 | not published | 0 |
| Ot re-evaluation patient/family CPT 97168 | $160.80 | $268.00 | not published | 0 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $105.00 | $175.00 | not published | 0 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $108.00 | $180.00 | not published | 0 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $108.00 | $180.00 | not published | 0 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $105.00 | $175.00 | not published | 0 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $108.00 | $180.00 | not published | 0 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $105.00 | $175.00 | not published | 0 |
| Parathormone (pth) intact CPT 83970 | $182.40 | $304.00 | not published | 0 |
| Parathyroid planar imaging CPT 78070 | $819.00 | $1,365.00 | not published | 0 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $1,788.60 | $2,981.00 | not published | 0 |
| Pelvic CT scan (with contrast) CPT 72193 | $1,671.00 | $2,785.00 | not published | 0 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,632.60 | $2,721.00 | not published | 0 |
| Pelvic MRI (with and without contrast) CPT 72197 | $2,665.80 | $4,443.00 | not published | 0 |
| Pelvic MRI (with contrast) CPT 72196 | $2,448.00 | $4,080.00 | not published | 0 |
| Pelvic MRI (without contrast) CPT 72195 | $2,448.00 | $4,080.00 | not published | 0 |
| Pelvic Ultrasound (complete) CPT 76856 | $549.00 | $915.00 | not published | 0 |
| Pelvic Ultrasound (limited) CPT 76857 | $355.20 | $592.00 | not published | 0 |
| Pet CT skull-mid thgh initial CPT 78815 | $3,603.00 | $6,005.00 | not published | 0 |
| Pet CT whole body initial CPT 78816 | $3,588.00 | $5,980.00 | not published | 0 |
| Pet fdg brain metoblic eval sb CPT 78608 | $3,459.00 | $5,765.00 | not published | 0 |
| Pet image w/ct lmtd CPT 78814 | $3,198.00 | $5,330.00 | not published | 0 |
| Ph body fluid CPT 83986 | $37.80 | $63.00 | not published | 0 |
| Phenytoin total therapeutic drug level CPT 80185 | $67.80 | $113.00 | not published | 0 |
| Phlebotomy therapeutic CPT 99195 | $142.20 | $237.00 | not published | 0 |
| Phosphorus CPT 84100 | $42.60 | $71.00 | not published | 0 |
| Phosphorus 24 hour urine CPT 84105 | $15.00 | $25.00 | not published | 0 |
| Phys blood bank serv reactj CPT 86078 | $268.20 | $447.00 | not published | 0 |
| Pin service 60m per month HCPCS G0023 | $141.00 | $235.00 | not published | 0 |
| Plasma cryoprecipitate reduced each unit HCPCS P9044 | $332.40 | $554.00 | not published | 0 |
| Platelet aggregation each agent teg CPT 85576 | $111.00 | $185.00 | not published | 0 |
| Platelet pheresis each unit HCPCS P9034 | $816.00 | $1,360.00 | not published | 0 |
| Platelet pheresis irr ea HCPCS P9036 | $1,127.40 | $1,879.00 | not published | 0 |
| Platelets each unit HCPCS P9019 | $169.20 | $282.00 | not published | 0 |
| Platelets hla matched leukocytes reduced apheresis/pheresis each unit HCPCS P9052 | $1,726.80 | $2,878.00 | not published | 0 |
| Platelets irradiated ea unit HCPCS P9032 | $232.20 | $387.00 | not published | 0 |
| Platelets leukocytes reduced each unit HCPCS P9031 | $442.20 | $737.00 | not published | 0 |
| Platelets leukocytes reduced irradiated each unit HCPCS P9033 | $831.00 | $1,385.00 | not published | 0 |
| Platelets pheresis leukocytes reduced cmv negative irradiated each unit HCPCS P9053 | $896.40 | $1,494.00 | not published | 0 |
| Platelets pheresis leukocytes reduced each unit HCPCS P9035 | $912.60 | $1,521.00 | not published | 0 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $1,055.40 | $1,759.00 | not published | 0 |
| Pm device progr eval dual CPT 93280 | $120.60 | $201.00 | not published | 0 |
| #pnh-flow cytometry interp CPT 88187 | $109.20 | $182.00 | not published | 0 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $216.60 | $361.00 | not published | 0 |
| Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 | $2,617.80 | $4,363.00 | not published | 0 |
| Potassium 24 hour urine CPT 84133 | $29.40 | $49.00 | not published | 0 |
| Potassium serum/plasma/whole blood CPT 84132 | $30.60 | $51.00 | not published | 0 |
| Pq dr cath chg w cont s&i CPT 75984 | $805.20 | $1,342.00 | not published | 0 |
| Pr debridement open wound topical appl/wound asmt per session 20 sq cm/< CPT 97597 | $187.80 | $313.00 | not published | 0 |
| Prealbumin CPT 84134 | $87.60 | $146.00 | not published | 0 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $558.60 | $931.00 | not published | 0 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $456.00 | $760.00 | not published | 0 |
| Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 | $157.20 | $262.00 | not published | 0 |
| Pretreat rbc absorption reference CPT 86978 | $100.20 | $167.00 | not published | 0 |
| Pretreat rbc density gradient separation reference CPT 86972 | $108.00 | $180.00 | not published | 0 |
| Pretreat rbc w chem/drugs reference CPT 86970 | $81.00 | $135.00 | not published | 0 |
| Pretreat rbc w enzyme reference CPT 86971 | $108.00 | $180.00 | not published | 0 |
| Prin care mgmt staff 1st 30 CPT 99426 | $141.00 | $235.00 | not published | 0 |
| Pr incision & drainage abscess simple/single CPT 10060 | $417.60 | $696.00 | not published | 0 |
| Procalcitonin CPT 84145 | $45.00 | $75.00 | not published | 0 |
| Prolactin CPT 84146 | $122.40 | $204.00 | not published | 0 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $39.60 | $66.00 | not published | 0 |
| Protein total 24 hour urine CPT 84156 | $55.80 | $93.00 | not published | 0 |
| Protein total body fluid CPT 84157 | $10.80 | $18.00 | not published | 0 |
| Protein total serum plasma whole blood CPT 84155 | $44.40 | $74.00 | not published | 0 |
| PSA (Prostate) Test CPT 84153 | $28.80 | $48.00 | not published | 0 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $86.40 | $144.00 | not published | 0 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $86.40 | $144.00 | not published | 0 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $80.40 | $134.00 | not published | 0 |
| Pt application of modality traction mechanical CPT 97012 | $80.40 | $134.00 | not published | 0 |
| Pt evaluation high complexity patient/family CPT 97163 | $278.40 | $464.00 | not published | 0 |
| Pt evaluation low complexity patient/family CPT 97161 | $231.60 | $386.00 | not published | 0 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $247.20 | $412.00 | not published | 0 |
| Pt re-evaluation patient/family CPT 97164 | $160.80 | $268.00 | not published | 0 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $118.20 | $197.00 | not published | 0 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $105.00 | $175.00 | not published | 0 |
| Pt wheelchair management each 15 minutes CPT 97542 | $108.00 | $180.00 | not published | 0 |
| Pulmonary vent imaging CPT 78579 | $578.40 | $964.00 | not published | 0 |
| Pulse ox continuous overnight monitoring CPT 94762 | $184.20 | $307.00 | not published | 0 |
| Pulse ox multiple CPT 94761 | $94.80 | $158.00 | not published | 0 |
| Pulse ox single CPT 94760 | $45.60 | $76.00 | not published | 0 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $82.80 | $138.00 | not published | 0 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $1,230.60 | $2,051.00 | not published | 0 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $1,739.40 | $2,899.00 | not published | 0 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $2,485.20 | $4,142.00 | not published | 0 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $1,341.00 | $2,235.00 | not published | 0 |
| Rbc irradiated each unit HCPCS P9038 | $537.00 | $895.00 | not published | 0 |
| Red blood cells each unit HCPCS P9021 | $256.80 | $428.00 | not published | 0 |
| Red blood cells leukocytes reduced cmv negative irradiated each unit HCPCS P9058 | $612.00 | $1,020.00 | not published | 0 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $320.40 | $534.00 | not published | 0 |
| Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 | $435.00 | $725.00 | not published | 0 |
| Red blood cells washed each unit HCPCS P9022 | $672.00 | $1,120.00 | not published | 0 |
| Removal central venous catheter tunneled without port/pump CPT 36589 | $608.40 | $1,014.00 | not published | 0 |
| Renal function panel CPT 80069 | $128.40 | $214.00 | not published | 0 |
| Reticulocyte automated CPT 85045 | $32.40 | $54.00 | 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.