OSF Saint James John W Albrecht Medical Center
2500 West Reynolds Street, Pontiac, IL · Osfhealthcare · · NPI 1407808090
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 |
|---|---|---|---|---|
| Dest mal lesion feenlm 1.1 - 2.0 cm 17282 CPT 17282 | not published | not published | $215.00 – $1,766.00 | 4 |
| Dest mal lesion snhfg <0.5cm 17270 CPT 17270 | not published | not published | $215.00 – $1,766.00 | 4 |
| Dest mal lesion snhfg 0.6-1cm 17271 CPT 17271 | not published | not published | $215.00 – $1,766.00 | 4 |
| Dest mal lesion snhfg 1.1-2cm 17272 CPT 17272 | not published | not published | $215.00 – $1,766.00 | 4 |
| Dest mal lesion tal <0.5 17260 CPT 17260 | not published | not published | $215.00 – $1,766.00 | 4 |
| Dest mal lesion tal 0.6-1.0cm 17261 CPT 17261 | not published | not published | $215.00 – $1,766.00 | 4 |
| Dest mal lesion tal 1.1-2.0cm 17262 CPT 17262 | not published | not published | $215.00 – $1,766.00 | 4 |
| Dest mal lesion tal 2.1-3.0cm 17263 CPT 17263 | not published | not published | $215.00 – $1,766.00 | 4 |
| Destroy cervthor facet jnt 64633 CPT 64633 | $6,712.80 | $8,391.00 | $2,092.58 – $6,314.00 | 4 |
| Destroy cth facet jnt addl 64634 CPT 64634 | $4,188.80 | $5,236.00 | $1,766.00 – $1,766.00 | 1 |
| Destroy internal hemorrhoids destroy 46930 CPT 46930 | not published | not published | $1,282.34 – $3,541.00 | 4 |
| Destroy premlg lesns;1st lesn 17000 CPT 17000 | not published | not published | $215.00 – $1,766.00 | 4 |
| Destroy vulva lesion extensive 56515 CPT 56515 | not published | not published | $2,211.05 – $5,947.00 | 4 |
| Destroy vulva lesion simple 56501 CPT 56501 | not published | not published | $2,211.05 – $5,947.00 | 4 |
| Destruct ben lesion 15/> 17111 CPT 17111 | not published | not published | $215.00 – $1,766.00 | 4 |
| Destruct cut vasl lesions 10-50cm 17107 CPT 17107 | not published | not published | $792.00 – $1,766.00 | 4 |
| Destruct cut vasl lesions <10cm 17106 CPT 17106 | not published | not published | $435.63 – $1,766.00 | 4 |
| Destruct cut vasl lesions >50cm 17108 CPT 17108 | not published | not published | $2,211.05 – $5,947.00 | 4 |
| Destruction 2-14 lesions 17003 CPT 17003 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Destruction anal lesion(s) CPT 46910 | not published | not published | $2,211.05 – $5,947.00 | 4 |
| Destruction anal lesion(s) CPT 46924 | not published | not published | $2,974.45 – $6,314.00 | 4 |
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | not published | not published | $435.63 – $1,766.00 | 4 |
| Destruction benign lesions < 14 lesions CPT 17110 | not published | not published | $215.00 – $1,766.00 | 4 |
| Destruction by injection tx of nerve 64630 CPT 64630 | not published | not published | $947.82 – $3,541.00 | 4 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | $4,188.80 | $5,236.00 | $1,766.00 – $1,766.00 | 1 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | $6,712.80 | $8,391.00 | $2,092.58 – $6,314.00 | 4 |
| Destruction ciliary body CPT 66700 | not published | not published | $2,473.11 – $5,947.00 | 4 |
| Destruction ciliary body CPT 66720 | not published | not published | $2,547.76 – $6,314.00 | 4 |
| Destruction ciliary body CPT 66740 | not published | not published | $2,547.76 – $6,314.00 | 4 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | not published | not published | $215.00 – $1,766.00 | 4 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | not published | not published | $2,974.45 – $6,314.00 | 4 |
| Destruction les conjunctiva CPT 68135 | not published | not published | $2,547.76 – $6,314.00 | 4 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | $435.63 – $1,766.00 | 4 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | $435.63 – $1,766.00 | 4 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | not published | not published | $435.63 – $1,766.00 | 4 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | not published | not published | $435.63 – $1,766.00 | 4 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | not published | not published | $435.63 – $1,766.00 | 4 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | $2,211.05 – $5,947.00 | 4 |
| Destruction premal lesions 15/> 17004 CPT 17004 | not published | not published | $435.63 – $1,766.00 | 4 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $2,974.45 – $6,314.00 | 4 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $3,468.96 – $6,314.00 | 4 |
| Destruction vag lesions simple 57061 CPT 57061 | not published | not published | $3,468.96 – $6,314.00 | 4 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $2,211.05 – $5,947.00 | 4 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $30.03 – $30.63 | 3 |
| Detect agnt mult dna direc CPT 87800 | not published | not published | $43.67 – $44.54 | 3 |
| Developmental screen/score/document 96110 CPT 96110 | $219.20 | $274.00 | not published | 0 |
| Devel tst phys/qhp 1st hr CPT 96112 | $442.40 | $553.00 | $137.89 – $140.65 | 3 |
| Devise bowel pouch CPT 44316 | not published | not published | $6,314.00 – $6,314.00 | 1 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | $248.00 | $310.00 | not published | 0 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $445.60 | $557.00 | $93.26 – $95.12 | 3 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $203.79 – $207.87 | 3 |
| Dexamethasone panel CPT 80420 | not published | not published | $161.88 – $165.12 | 3 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $524.80 | $656.00 | $22.23 – $22.67 | 3 |
| Diabetes (HbA1c) Test CPT 83036 | $92.80 | $116.00 | $9.71 – $9.90 | 3 |
| Diab manage trn ind/group HCPCS G0109 | $110.40 | $138.00 | $15.78 – $16.10 | 3 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $1,907.37 – $5,947.00 | 4 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $6,478.50 – $9,024.00 | 4 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $478.72 – $1,766.00 | 4 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $1,282.34 – $5,947.00 | 4 |
| Diagnostic anoscopy spx 46600 CPT 46600 | not published | not published | $142.58 – $1,766.00 | 4 |
| Diagnostic laryngoscopy 31505 CPT 31505 | not published | not published | $213.90 – $1,766.00 | 4 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $206.40 | $258.00 | $213.90 – $1,766.00 | 4 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $750.40 | $938.00 | $111.97 – $114.21 | 3 |
| Diagnostic Mammogram (one breast) CPT 77065 | $567.20 | $709.00 | $88.75 – $90.52 | 3 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $93.26 – $95.12 | 3 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Dialysis one evaluation CPT 90945 | not published | not published | $447.15 – $456.09 | 3 |
| Diathermy eg microwave CPT 97024 | not published | not published | $7.82 – $7.98 | 3 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $4.80 | $6.00 | not published | 0 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.25 – $0.25 | 1 |
| Diffusing capacity CPT 94729 | $141.60 | $177.00 | not published | 0 |
| Digit nerve surgery add-on CPT 64778 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Digoxin total therapeutic drug level CPT 80162 | $220.00 | $275.00 | $13.28 – $13.55 | 3 |
| Dilate biliary duct/ampulla CPT 47542 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Dilate esophagus CPT 43453 | not published | not published | $2,056.34 – $5,947.00 | 4 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $971.94 – $5,947.00 | 4 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | not published | not published | $6,314.00 – $6,314.00 | 1 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | not published | not published | $6,314.00 – $6,314.00 | 1 |
| Dilate ic vasospasm init CPT 61640 | not published | not published | $6,314.00 – $6,314.00 | 1 |
| Dilate tear duct opening CPT 68801 | not published | not published | $478.72 – $1,766.00 | 4 |
| Dilate urethra stricture CPT 53600 | not published | not published | $267.74 – $1,766.00 | 4 |
| Dilate urethra stricture CPT 53601 | not published | not published | $142.58 – $1,766.00 | 4 |
| Dilate urethra stricture CPT 53605 | not published | not published | $3,777.44 – $5,947.00 | 4 |
| Dilate urethra stricture CPT 53621 | not published | not published | $267.74 – $1,766.00 | 4 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $137.89 – $1,766.00 | 4 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $1,282.34 – $5,947.00 | 4 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $3,468.96 – $6,314.00 | 4 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $1,282.34 – $5,947.00 | 4 |
| Dilation of salivary duct CPT 42660 | not published | not published | $577.95 – $1,766.00 | 4 |
| Dilation of urethra CPT 53661 | not published | not published | $142.58 – $1,766.00 | 4 |
| Dilation of urethra CPT 53665 | not published | not published | $2,240.09 – $6,314.00 | 4 |
| Dilation of vagina CPT 57400 | not published | not published | $3,468.96 – $6,314.00 | 4 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $1,662.71 – $5,947.00 | 4 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $747.24 – $3,541.00 | 4 |
| Dilat xst trc ndurlgc px CPT 50436 | not published | not published | $3,777.44 – $6,314.00 | 4 |
| Dilat xst trc new access rcs CPT 50437 | not published | not published | $3,777.44 – $7,432.00 | 4 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $40.03 – $40.83 | 3 |
| Disability dlco CPT 94727 | $810.40 | $1,013.00 | $231.39 – $236.02 | 3 |
| Disaccharidases CPT 82657 | $1,794.40 | $2,243.00 | $22.17 – $22.61 | 3 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $2,211.05 – $5,947.00 | 4 |
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.