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 |
|---|---|---|---|---|
| Injection intraop add-on CPT 48400 | not published | not published | $6,314.00 – $6,314.00 | 1 |
| Injection jaw joint x-ray CPT 21116 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Injection jugular CPT 36299 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Injection, khapzory, 0.5 mg HCPCS J0642 | not published | not published | $2.26 – $2.26 | 1 |
| Injection, necitumumab, 1 mg HCPCS J9295 | not published | not published | $5.73 – $5.85 | 3 |
| Injection of HIV prep drug HCPCS G0012 | not published | not published | $77.16 – $78.70 | 3 |
| Injection of sinus tract CPT 20500 | not published | not published | $1,662.71 – $5,947.00 | 4 |
| Injection,onabotulinumtoxina HCPCS J0585 | not published | not published | $6.51 – $6.64 | 3 |
| Injection px peyronie ds CPT 54200 | not published | not published | $267.74 – $1,766.00 | 4 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $1,860.80 | $2,326.00 | $428.40 – $1,766.00 | 4 |
| Injection, renflexis HCPCS Q5104 | not published | not published | $26.80 – $27.34 | 3 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | not published | not published | $756.44 – $3,541.00 | 4 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $2,137.60 | $2,672.00 | $756.44 – $3,541.00 | 4 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $4,568.00 | $5,710.00 | $756.44 – $3,541.00 | 4 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $4,568.00 | $5,710.00 | $947.82 – $3,541.00 | 4 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $4,106.40 | $5,133.00 | $1,766.00 – $1,766.00 | 1 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $4,568.00 | $5,710.00 | $947.82 – $3,541.00 | 4 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $4,106.40 | $5,133.00 | $1,766.00 – $1,766.00 | 1 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $4,568.00 | $5,710.00 | $947.82 – $3,541.00 | 4 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $4,503.20 | $5,629.00 | $756.44 – $3,541.00 | 4 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $2,573.60 | $3,217.00 | $756.44 – $3,541.00 | 4 |
| Injection, siltuximab HCPCS J2860 | not published | not published | $158.97 – $177.56 | 3 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $1,093.60 | $1,367.00 | $328.94 – $1,766.00 | 4 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $1,093.60 | $1,367.00 | $328.94 – $1,766.00 | 4 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $1,093.60 | $1,367.00 | $328.94 – $1,766.00 | 4 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $324.80 | $406.00 | $50.18 – $51.18 | 3 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $312.80 | $391.00 | not published | 0 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $364.00 | $455.00 | $227.94 – $232.50 | 3 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $223.20 | $279.00 | $77.16 – $78.70 | 3 |
| Injection treatment of eye CPT 66020 | not published | not published | $2,473.11 – $5,947.00 | 4 |
| Injection treatment of eye CPT 66030 | not published | not published | $2,473.11 – $5,947.00 | 4 |
| Injection treatment of nerve CPT 64605 | not published | not published | $2,092.58 – $6,314.00 | 4 |
| Injection treatment of nerve CPT 64610 | not published | not published | $2,092.58 – $6,314.00 | 4 |
| Injection treatment of nerve CPT 64681 | $7,538.40 | $9,423.00 | $947.82 – $3,541.00 | 4 |
| Injection treatment of nose CPT 30200 | not published | not published | $577.95 – $1,766.00 | 4 |
| Inject sacroiliac joint CPT 27096 | $3,216.00 | $4,020.00 | $1,766.00 – $1,766.00 | 1 |
| Inject/treat eye socket CPT 67500 | not published | not published | $340.14 – $1,766.00 | 4 |
| Inject/treat eye socket CPT 67505 | not published | not published | $340.14 – $1,766.00 | 4 |
| Inject/treat eye socket CPT 67515 | not published | not published | $340.14 – $1,766.00 | 4 |
| Inj., emapalumab-lzsg, 1 mg HCPCS J9210 | not published | not published | $378.22 – $391.82 | 3 |
| Inj., emicizumab-kxwh 0.5 mg HCPCS J7170 | not published | not published | $55.64 – $56.75 | 3 |
| Inj epidural sgl cerv-thor without img CPT 62320 | $3,051.20 | $3,814.00 | $756.44 – $3,541.00 | 4 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $2,050.40 | $2,563.00 | $947.82 – $3,541.00 | 4 |
| Inj, factor x, (human), 1iu HCPCS J7175 | not published | not published | $9.95 – $10.15 | 3 |
| Inj, faricimab-svoa, 0.1mg HCPCS J2777 | not published | not published | $32.87 – $33.52 | 3 |
| Inj., fibryga, 1 mg HCPCS J7177 | not published | not published | $1.23 – $1.26 | 3 |
| Inj for ext venography CPT 36005 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Inj for mammo ductogram CPT 19030 | $938.40 | $1,173.00 | $1,766.00 – $1,766.00 | 1 |
| Inj. herceptin hylecta, 10mg HCPCS J9356 | not published | not published | $59.91 – $61.11 | 3 |
| Inj herzuma 10 mg HCPCS Q5113 | not published | not published | $56.02 – $57.14 | 3 |
| Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Inj hrt cath w/s&i sel hrt ang CPT 93563 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Inj hrt cath w/s&i sel hrt art CPT 93564 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Inj hrt cath w/s&i sel left vent CPT 93565 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Inj hrt cath w/s&i sel right vent CPT 93566 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Inj human fibrinogen con nos HCPCS J7178 | not published | not published | $1.52 – $1.55 | 3 |
| Inj hydroxyprogst capoat nos HCPCS J1729 | not published | not published | $15.27 – $15.27 | 1 |
| Inj., ibalizumab-uiyk, 10 mg HCPCS J1746 | not published | not published | $77.68 – $79.23 | 3 |
| Inj, imm glob bivigam, 500mg HCPCS J1556 | not published | not published | $77.10 – $81.03 | 3 |
| Inj. inebilizumab-cdon, 1 mg HCPCS J1823 | not published | not published | $495.54 – $505.46 | 3 |
| Inj/inf neurolyt sbst spinal canal lesion 62282 CPT 62282 | not published | not published | $947.82 – $3,541.00 | 4 |
| Inj. infugem, 100 mg HCPCS J9198 | not published | not published | $42.56 – $42.56 | 1 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | not published | not published | $215.00 – $1,766.00 | 4 |
| Inj intralesional > 7 lsns CPT 11901 | not published | not published | $215.00 – $1,766.00 | 4 |
| Inj ivig privigen 500 mg HCPCS J1459 | not published | not published | $49.53 – $50.52 | 3 |
| Inj. jivi 1 iu HCPCS J7208 | not published | not published | $2.66 – $2.71 | 3 |
| Inj, kovaltry, 1 i.u HCPCS J7211 | not published | not published | $1.56 – $1.60 | 3 |
| Inj, lanreotide, (cipla) 1mg HCPCS J1932 | not published | not published | $32.19 – $32.83 | 3 |
| Inj levoleucovorin nos 0.5mg HCPCS J0641 | not published | not published | $0.38 – $0.38 | 1 |
| Inj. lumasiran, 0.5 mg HCPCS J0224 | not published | not published | $327.72 – $334.27 | 3 |
| Inj., lumoxiti, 0.01 mg HCPCS J9313 | not published | not published | $23.39 – $23.86 | 3 |
| Inj luxturna 1 billion vec g HCPCS J3398 | not published | not published | $3,070.09 – $3,131.49 | 3 |
| Inj melpha hydroch nos 50 mg HCPCS J9245 | not published | not published | $120.67 – $123.08 | 3 |
| Inj mogamulizumab-kpkc, 1 mg HCPCS J9204 | not published | not published | $240.22 – $258.54 | 3 |
| Inj multihance HCPCS A9577 | $10.40 | $13.00 | not published | 0 |
| Inj multihance multipack HCPCS A9578 | $10.40 | $13.00 | not published | 0 |
| Inj nephrosto/ureterogram w/img exstng access CPT 50431 | not published | not published | $747.24 – $3,541.00 | 4 |
| Inj non-compmd foam sclrsnt mlt trncl veins same leg CPT 36466 | $1,651.20 | $2,064.00 | $2,211.05 – $5,947.00 | 4 |
| Inj non-compmd foam sclrsnt sgl trncl vein CPT 36465 | $1,651.20 | $2,064.00 | $2,211.05 – $5,947.00 | 4 |
| Inj ogivri 10 mg HCPCS Q5114 | not published | not published | $35.78 – $36.50 | 3 |
| Inj onase abepar-xioi treat HCPCS J3399 | not published | not published | $2,524,941.44 – $2,638,829.00 | 3 |
| Inj ontruzant 10 mg HCPCS Q5112 | not published | not published | $29.81 – $30.40 | 3 |
| Inj, pasireotide long acting HCPCS J2502 | not published | not published | $595.31 – $608.23 | 3 |
| Inj., patisiran, 0.1 mg HCPCS J0222 | not published | not published | $100.90 – $102.91 | 3 |
| Inj pegfilgrastim-bmez 0.5mg HCPCS Q5120 | not published | not published | $119.64 – $122.03 | 3 |
| Inj peritoneal venous shunt CPT 49427 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Inj proc ankle arthr CPT 27648 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Inj proc elbow arthro CPT 24220 | $1,367.20 | $1,709.00 | $1,766.00 – $1,766.00 | 1 |
| Inj proc for lymphang CPT 38790 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Inj proc lumbr disk ea lvl CPT 62290 | $8,780.00 | $10,975.00 | $1,766.00 – $1,766.00 | 1 |
| Inj proc myelogram lumbar CPT 62284 | $2,524.80 | $3,156.00 | $1,766.00 – $1,766.00 | 1 |
| Inj proc sialogram CPT 42550 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Inj prohance multipack HCPCS A9576 | $10.40 | $13.00 | not published | 0 |
| Inj, releuko 1 mcg HCPCS Q5125 | not published | not published | $0.32 – $0.33 | 3 |
| Inj retacrit esrd on dialysi HCPCS Q5105 | not published | not published | $1.23 – $1.23 | 1 |
| Inj retro urethrocysto CPT 51610 | $1,522.40 | $1,903.00 | $1,766.00 – $1,766.00 | 1 |
| Inj, rimabotulinumtoxinb HCPCS J0587 | not published | not published | $13.28 – $13.55 | 3 |
| Inj romidepsin non-lyo 0.1mg HCPCS J9318 | not published | not published | $28.52 – $29.09 | 3 |
| Inj scleros sol mult veins CPT 36471 | not published | not published | $435.63 – $1,766.00 | 4 |
| Inj scleros sol sgl vein CPT 36470 | not published | not published | $435.63 – $1,766.00 | 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.