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 |
|---|---|---|---|---|
| Ligation of neck artery CPT 37606 | not published | not published | $3,383.62 – $7,432.00 | 4 |
| Ligation of salivary duct CPT 42665 | not published | not published | $3,552.91 – $6,314.00 | 4 |
| Ligation of shunt CPT 49428 | not published | not published | $5,947.00 – $5,947.00 | 1 |
| Ligation upper jaw artery CPT 30920 | not published | not published | $3,383.62 – $7,432.00 | 4 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | not published | not published | $3,383.62 – $7,432.00 | 4 |
| Lig/band angioaccess av fistula CPT 37607 | not published | not published | $3,383.62 – $7,432.00 | 4 |
| Lig&div&compl strpg saph vn CPT 37735 | not published | not published | $3,383.62 – $7,432.00 | 4 |
| Limb exercise test CPT 95875 | not published | not published | $137.89 – $140.65 | 3 |
| Limb nerve surgery add-on CPT 64783 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Limited ankle motion ea jnt HCPCS L2200 | $780.80 | $976.00 | not published | 0 |
| Limited visual field xm CPT 92081 | not published | not published | $63.22 – $64.48 | 3 |
| Lipase CPT 83690 | $312.00 | $390.00 | $6.89 – $7.03 | 3 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $3,552.91 – $6,314.00 | 4 |
| Lipoprotein blood high res frac & quant CPT 83701 | not published | not published | $33.86 – $34.54 | 3 |
| Lipoprotein blood quant CPT 83704 | $332.00 | $415.00 | $34.19 – $34.87 | 3 |
| Lipoprotein direct measurement hdl CPT 83718 | $278.40 | $348.00 | $8.19 – $8.35 | 3 |
| Lipoprotein direct measurement ldl CPT 83721 | $122.40 | $153.00 | $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 – $1,766.00 | 4 |
| Listeria monocytogenes CPT 86723 | not published | not published | $13.19 – $13.45 | 3 |
| Lithium therapeutic drug level CPT 80178 | $190.40 | $238.00 | $6.61 – $6.74 | 3 |
| Litt icr 1 traj 1 smpl les CPT 61736 | not published | not published | $6,314.00 – $6,314.00 | 1 |
| Litt icr mlt trj mlt/cplx ls CPT 61737 | not published | not published | $6,314.00 – $6,314.00 | 1 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | $6,314.00 – $6,314.00 | 1 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $816.00 | $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 | $358.40 | $448.00 | $8.17 – $8.33 | 3 |
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | $6,314.00 – $6,314.00 | 1 |
| 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 | $1,532.80 | $1,916.00 | $428.40 – $436.97 | 3 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $428.40 – $436.97 | 3 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $2,547.76 – $6,314.00 | 4 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $3,506.34 – $7,432.00 | 4 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $8.00 | $10.00 | not published | 0 |
| Lo sag rig pnl stays pre cst HCPCS L0626 | $113.60 | $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 – $8,908.00 | 4 |
| Low cost skin substitute app HCPCS C5271 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Low cost skin substitute app HCPCS C5273 | not published | not published | $5,947.00 – $5,947.00 | 1 |
| Low cost skin substitute app HCPCS C5275 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Low cost skin substitute app HCPCS C5277 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Low cost skin substitute app HCPCS C5272 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Low cost skin substitute app HCPCS C5274 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Low cost skin substitute app HCPCS C5276 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Low cost skin substitute app HCPCS C5278 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $3,544.80 | $4,431.00 | $187.96 – $191.72 | 3 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $3,021.60 | $3,777.00 | $373.86 – $381.34 | 3 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $2,638.40 | $3,298.00 | $112.03 – $114.27 | 3 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $5,204.00 | $6,505.00 | $373.86 – $381.34 | 3 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $4,444.00 | $5,555.00 | $373.86 – $381.34 | 3 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $3,682.40 | $4,603.00 | $255.69 – $260.80 | 3 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $554.40 | $693.00 | $112.03 – $114.27 | 3 |
| Lower jaw bone graft CPT 21215 | not published | not published | $6,343.80 – $9,024.00 | 4 |
| Low frequency non-thermal Ultrasound CPT 97610 | $371.20 | $464.00 | $215.00 – $219.30 | 3 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $8,908.00 – $11,618.95 | 4 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $8,908.00 – $11,618.95 | 4 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $8,908.00 – $11,618.95 | 4 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $8,908.00 – $11,618.95 | 4 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $21.99 – $22.43 | 3 |
| Lumbar diskogram s&i CPT 72295 | $4,468.00 | $5,585.00 | $2,092.58 – $2,134.43 | 3 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $8,908.00 – $19,165.36 | 4 |
| Lumizyme injection HCPCS J0221 | not published | not published | $207.51 – $211.66 | 3 |
| Lung function test (mbc/mvv) CPT 94200 | not published | not published | $63.22 – $64.48 | 3 |
| Lung Function Test (Spirometry) CPT 94010 | $344.80 | $431.00 | $231.39 – $236.02 | 3 |
| Lung perfusion imaging CPT 78580 | $1,556.80 | $1,946.00 | $428.40 – $436.97 | 3 |
| Lung transplant double CPT 32853 | not published | not published | $6,314.00 – $6,314.00 | 1 |
| Lung transplant single CPT 32851 | not published | not published | $6,314.00 – $6,314.00 | 1 |
| Lung transplant with bypass CPT 32852 | not published | not published | $6,314.00 – $6,314.00 | 1 |
| Lung transplant with bypass CPT 32854 | not published | not published | $6,314.00 – $6,314.00 | 1 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $6,314.00 – $6,314.00 | 1 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | not published | not published | $212.10 – $216.34 | 3 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $30.99 – $1,766.00 | 4 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $20.05 – $20.45 | 3 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $8,758.76 – $8,933.93 | 4 |
| Lymphatics/lymph node imaging CPT 78195 | $2,411.20 | $3,014.00 | $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 intranasal synechia 30560 CPT 30560 | not published | not published | $577.95 – $1,766.00 | 4 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $3,468.96 – $6,314.00 | 4 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $2,240.09 – $6,314.00 | 4 |
| Macroscopic exam arthropod CPT 87168 | $114.40 | $143.00 | $4.27 – $4.36 | 3 |
| Macroscopic exam parasite CPT 87169 | $198.40 | $248.00 | $4.31 – $4.40 | 3 |
| Magnesium CPT 83735 | $336.00 | $420.00 | $6.70 – $6.83 | 3 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $255.69 – $260.80 | 3 |
| Makena, 10 mg HCPCS J1726 | not published | not published | $22.01 – $22.01 | 1 |
| Malaria antibody CPT 86750 | not published | not published | $13.19 – $13.45 | 3 |
| Male sling procedure CPT 53440 | not published | not published | $11,563.00 – $14,421.12 | 4 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $6,314.00 – $6,314.00 | 1 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $1,723.15 – $1,766.00 | 4 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $1,723.15 – $5,947.00 | 4 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $136.00 | $170.00 | $142.58 – $145.43 | 3 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $136.00 | $170.00 | $142.58 – $145.43 | 3 |
| Manipulation of hip joint CPT 27275 | not published | not published | $1,723.15 – $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.