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 |
|---|---|---|---|---|
| Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm CPT 14061 | not published | not published | $2,211.05 – $5,947.00 | 4 |
| Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm CPT 14021 | not published | not published | $2,211.05 – $5,947.00 | 4 |
| Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm CPT 14001 | not published | not published | $2,211.05 – $5,947.00 | 4 |
| Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/< CPT 14000 | not published | not published | $2,211.05 – $5,947.00 | 4 |
| Trnsplj pd lvr&bwl cd154+cll CPT 81560 | not published | not published | $640.73 – $653.54 | 3 |
| Trnspl rej kdn mrna qpcr 139 CPT 81558 | not published | not published | $3,240.00 – $3,304.80 | 3 |
| Trnsxj/repos abrrnt rnl vsls CPT 50100 | not published | not published | $6,314.00 – $6,314.00 | 1 |
| Troponin quantitative CPT 84484 | $317.60 | $397.00 | $12.47 – $12.72 | 3 |
| Tr retinal les preterm inf CPT 67229 | not published | not published | $589.39 – $3,541.00 | 4 |
| Trurl dstrj prst8 tiss rf wv CPT 53854 | not published | not published | $3,777.44 – $6,314.00 | 4 |
| Tte w or without contr, cont ecg HCPCS C8930 | not published | not published | $840.06 – $856.87 | 3 |
| Tte w or without fol w/con,stres HCPCS C8928 | not published | not published | $840.06 – $856.87 | 3 |
| Tte w or without fol w/cont, com HCPCS C8921 | not published | not published | $840.06 – $856.87 | 3 |
| Tte w or without fol w/cont, f/u HCPCS C8922 | not published | not published | $840.06 – $856.87 | 3 |
| Tubal Ligation (Laparoscopic) CPT 58670 | not published | not published | $6,478.50 – $8,908.00 | 4 |
| Tumor cell deplete of harvst CPT 38211 | not published | not published | $472.77 – $1,766.00 | 4 |
| Tvh >250 gms 58290 CPT 58290 | not published | not published | $7,946.52 – $9,024.00 | 4 |
| Tvh w/mmk 58267 CPT 58267 | not published | not published | $7,432.00 – $7,432.00 | 1 |
| Tx atrial fib pulm vein isol CPT 93656 | $20,607.20 | $25,759.00 | $11,338.00 – $28,570.01 | 4 |
| Tx closed distal humerus fx CPT 24999 | not published | not published | $264.33 – $1,766.00 | 4 |
| Tx closed hip disl traumatic without anes CPT 27250 | $540.00 | $675.00 | $264.33 – $1,766.00 | 4 |
| Tx closed tib fx proximal w/w/o manip w/skel trac CPT 27532 | not published | not published | $3,506.34 – $5,947.00 | 4 |
| Tx closed tib shaft fx without manip CPT 27750 | not published | not published | $264.33 – $1,766.00 | 4 |
| Tx contour defects >10.0 cc CPT 11954 | not published | not published | $792.00 – $3,541.00 | 4 |
| Tx contour defects 1.1-5.0cc 11951 CPT 11951 | not published | not published | $792.00 – $1,766.00 | 4 |
| Tx ectopic pregnancy abdl pregnancy 59130 CPT 59130 | not published | not published | $6,314.00 – $6,314.00 | 1 |
| Tx ectopic pregnancy ntrstl prtl rescj uter 59136 CPT 59136 | not published | not published | $6,314.00 – $6,314.00 | 1 |
| Tx l/r atrial fib addl CPT 93657 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Tx open art fx mcp/iphlngl jnt incl int fixtn ea CPT 26746 | not published | not published | $3,506.34 – $6,314.00 | 4 |
| Tx open dstl phlngl fx f/t internal fixation ea CPT 26765 | $13,283.20 | $16,604.00 | $3,506.34 – $6,314.00 | 4 |
| Tx open iphlngl jt disl internal fixation sngl CPT 26785 | not published | not published | $3,506.34 – $6,314.00 | 4 |
| Tx open nsl fx uncomp CPT 21325 | not published | not published | $3,552.91 – $6,314.00 | 4 |
| Tx open nsl sptl fx CPT 21336 | not published | not published | $3,506.34 – $6,314.00 | 4 |
| Tx phalangeal shaft fx open prox/middle ea CPT 26735 | not published | not published | $3,506.34 – $6,314.00 | 4 |
| Tx septic abortion surgical 59830 CPT 59830 | not published | not published | $6,314.00 – $6,314.00 | 1 |
| Tx tarsal bone fx without manip 28450 CPT 28450 | not published | not published | $264.33 – $1,766.00 | 4 |
| Tympanic membrane repair CPT 69610 | not published | not published | $1,662.71 – $6,314.00 | 4 |
| Tympanolysis transcanal 69450 CPT 69450 | not published | not published | $3,552.91 – $9,024.00 | 4 |
| Tympanometry & reflex thresh CPT 92550 | $304.80 | $381.00 | $231.39 – $236.02 | 3 |
| Tympanostomy/ven tube/loc/top anes 69433 CPT 69433 | not published | not published | $577.95 – $1,766.00 | 4 |
| Tympp antrt/mastoidotomy prosthesis torp 69637 CPT 69637 | not published | not published | $6,343.80 – $9,024.00 | 4 |
| Tympp antrt/mastoid without ossic chain recnst 69635 CPT 69635 | not published | not published | $6,343.80 – $9,024.00 | 4 |
| Tyms gene com variants CPT 81346 | not published | not published | $174.81 – $178.31 | 3 |
| U2af1 gene common variants CPT 81357 | not published | not published | $193.25 – $197.12 | 3 |
| Ua w/micro/comp poc CPT 81000 | not published | not published | $4.02 – $4.10 | 3 |
| Ugt1a1 gene analy common variants CPT 81350 | not published | not published | $234.00 – $238.68 | 3 |
| Ultrasound abdomen aorta screening study aaa CPT 76706 | $969.60 | $1,212.00 | $112.03 – $114.27 | 3 |
| Ultrasound bone density measure CPT 76977 | not published | not published | $112.03 – $114.27 | 3 |
| Ultrasound breast complete CPT 76641 | $963.20 | $1,204.00 | $112.03 – $114.27 | 3 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $867.20 | $1,084.00 | $93.26 – $95.12 | 3 |
| Ultrasound chest CPT 76604 | $756.00 | $945.00 | $112.03 – $114.27 | 3 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | not published | not published | $112.03 – $114.27 | 3 |
| Ultrasound dx ophth b-scan CPT 76512 | not published | not published | $112.03 – $114.27 | 3 |
| Ultrasound elastography parenchyma CPT 76981 | $485.60 | $607.00 | $112.03 – $114.27 | 3 |
| Ultrasound encephalogram CPT 76506 | not published | not published | $112.03 – $114.27 | 3 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $1,221.60 | $1,527.00 | $112.03 – $114.27 | 3 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $868.80 | $1,086.00 | $112.03 – $114.27 | 3 |
| Ultrasound guidance for vascular access CPT 76937 | $1,188.00 | $1,485.00 | not published | 0 |
| Ultrasound guided needle placement supervision & interpretation CPT 76942 | $1,188.00 | $1,485.00 | not published | 0 |
| Ultrasound hips infant dynamic CPT 76885 | not published | not published | $93.26 – $95.12 | 3 |
| Ultrasound infant hips ltd without stress CPT 76886 | not published | not published | $93.26 – $95.12 | 3 |
| Ultrasound joint complete left CPT 76881 | $1,564.80 | $1,956.00 | $112.03 – $114.27 | 3 |
| Ultrasound joint/nonvascular extremity limited left CPT 76882 | $1,144.80 | $1,431.00 | $112.03 – $114.27 | 3 |
| Ultrasound nrv&acc strux 1xtr compre CPT 76883 | not published | not published | $112.03 – $114.27 | 3 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $1,296.00 | $1,620.00 | not published | 0 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $687.20 | $859.00 | not published | 0 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $1,544.00 | $1,930.00 | $255.69 – $260.80 | 3 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $1,241.60 | $1,552.00 | $112.03 – $114.27 | 3 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | $868.80 | $1,086.00 | $112.03 – $114.27 | 3 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | $754.40 | $943.00 | $112.03 – $114.27 | 3 |
| Ultrasound prostate/transrectal CPT 76872 | not published | not published | $112.03 – $114.27 | 3 |
| Ultrasound retroperitoneal limited CPT 76775 | $1,099.20 | $1,374.00 | $112.03 – $114.27 | 3 |
| Ultrasound scrotum and contents CPT 76870 | $1,207.20 | $1,509.00 | $112.03 – $114.27 | 3 |
| Ultrasound spinal canal and contents CPT 76800 | not published | not published | $112.03 – $114.27 | 3 |
| Ultrasound transabd ea addl gest CPT 76812 | $1,128.80 | $1,411.00 | not published | 0 |
| Ultrasound transvaginal non obstetric CPT 76830 | $1,081.60 | $1,352.00 | $112.03 – $114.27 | 3 |
| Ultrasound trgt dyn mbubb 1st les CPT 76978 | not published | not published | $373.86 – $381.34 | 3 |
| Ultraviolet therapy CPT 97028 | $36.80 | $46.00 | $8.07 – $8.23 | 3 |
| Umbilical artery cath newborn 36660 CPT 36660 | not published | not published | $6,314.00 – $6,314.00 | 1 |
| Umbilical cord occlud w/us CPT 59072 | not published | not published | $326.55 – $1,766.00 | 4 |
| Umbilicoplasty 15847 CPT 15847 | not published | not published | $1,766.00 – $1,766.00 | 1 |
| Unlistd noninvas vasc dx std CPT 93998 | not published | not published | $30.99 – $31.61 | 3 |
| Unlisted all/immlg svc/px CPT 95199 | not published | not published | $30.99 – $31.61 | 3 |
| Unlisted chemotherapy px CPT 96549 | not published | not published | $50.18 – $51.18 | 3 |
| Unlisted cranfcl&maxlfcl px CPT 21299 | not published | not published | $253.81 – $1,766.00 | 4 |
| Unlisted CT procedure CPT 76497 | not published | not published | $93.26 – $95.12 | 3 |
| Unlisted cv px dx nuc med CPT 78499 | not published | not published | $428.40 – $436.97 | 3 |
| Unlisted cytogenetic study CPT 88299 | $1,600.00 | $2,000.00 | $55.84 – $56.96 | 3 |
| Unlisted cytopathology px CPT 88199 | not published | not published | $55.84 – $56.96 | 3 |
| Unlisted dx gi procedure CPT 91299 | not published | not published | $137.89 – $1,766.00 | 4 |
| Unlisted endocrine px dx nuc CPT 78099 | not published | not published | $428.40 – $436.97 | 3 |
| Unlisted fetal invas px w/us CPT 59897 | not published | not published | $216.65 – $1,766.00 | 4 |
| Unlisted fluoroscopic px CPT 76496 | not published | not published | $93.26 – $95.12 | 3 |
| Unlisted gi px dx nuc med CPT 78299 | not published | not published | $428.40 – $436.97 | 3 |
| Unlisted gu px dx nuc med CPT 78799 | not published | not published | $428.40 – $436.97 | 3 |
| Unlisted hystsc px uterus CPT 58579 | not published | not published | $216.65 – $1,766.00 | 4 |
| Unlisted laparoscopic liver biopy 47379 CPT 47379 | not published | not published | $6,478.50 – $9,024.00 | 4 |
| Unlisted laparoscopic procedure 49659 CPT 49659 | not published | not published | $6,478.50 – $9,024.00 | 4 |
| Unlisted laparoscopic reduction intestine 44238 CPT 44238 | not published | not published | $6,478.50 – $9,024.00 | 4 |
| Unlisted laparoscopy procedure biliary tract 47579 CPT 47579 | not published | not published | $6,478.50 – $9,024.00 | 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.