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 |
|---|---|---|---|---|
| X-ray mandible complete > 4 views CPT 70110 | $387.20 | $484.00 | $112.03 – $114.27 | 3 |
| X-ray mandible ltd <4 views CPT 70100 | $554.40 | $693.00 | $93.26 – $95.12 | 3 |
| X-ray nasal bones complete > 3 views CPT 70160 | $564.00 | $705.00 | $93.26 – $95.12 | 3 |
| X-ray neck soft tissue CPT 70360 | $546.40 | $683.00 | $93.26 – $95.12 | 3 |
| X-ray nose to rectum for foreign body child CPT 76010 | $484.80 | $606.00 | $93.26 – $95.12 | 3 |
| X-ray of mammary ducts CPT 77054 | not published | not published | $255.69 – $260.80 | 3 |
| X-ray optic foramina CPT 70190 | not published | not published | $93.26 – $95.12 | 3 |
| X-ray pelvis 1-2 views CPT 72170 | $436.00 | $545.00 | $112.03 – $114.27 | 3 |
| X-ray pelvis complete > 3 views CPT 72190 | $536.80 | $671.00 | $112.03 – $114.27 | 3 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $1,053.60 | $1,317.00 | $373.86 – $381.34 | 3 |
| X-ray ribs 2 views left CPT 71100 | $508.00 | $635.00 | $93.26 – $95.12 | 3 |
| X-ray ribs 3 views bilateral CPT 71110 | $638.40 | $798.00 | $112.03 – $114.27 | 3 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $638.40 | $798.00 | $112.03 – $114.27 | 3 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $716.80 | $896.00 | $112.03 – $114.27 | 3 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $536.80 | $671.00 | $112.03 – $114.27 | 3 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $536.80 | $671.00 | $93.26 – $95.12 | 3 |
| X-ray scapula complete (both sides) CPT 73010 | $436.00 | $545.00 | $112.03 – $114.27 | 3 |
| X-ray sella turcica CPT 70240 | not published | not published | $93.26 – $95.12 | 3 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $661.60 | $827.00 | $93.26 – $95.12 | 3 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $564.00 | $705.00 | $93.26 – $95.12 | 3 |
| X-ray sinus tract/fistula/abscess CPT 76080 | not published | not published | $585.55 – $597.26 | 3 |
| X-ray skull < 4 views CPT 70250 | $564.00 | $705.00 | $112.03 – $114.27 | 3 |
| X-ray skull > 4 views complete CPT 70260 | $638.40 | $798.00 | $112.03 – $114.27 | 3 |
| X-ray slg plne bdy sect without urogr CPT 76100 | not published | not published | $112.03 – $114.27 | 3 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $964.80 | $1,206.00 | $187.96 – $191.72 | 3 |
| X-ray small intestine follow-through study CPT 74248 | $671.20 | $839.00 | not published | 0 |
| X-ray spine single view CPT 72020 | $432.00 | $540.00 | $93.26 – $95.12 | 3 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $528.00 | $660.00 | $93.26 – $95.12 | 3 |
| X-ray sternum > 2 views CPT 71120 | $508.00 | $635.00 | $93.26 – $95.12 | 3 |
| X-ray surgical specimen CPT 76098 | $635.20 | $794.00 | $585.55 – $597.26 | 3 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $772.00 | $965.00 | $187.96 – $191.72 | 3 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $638.40 | $798.00 | $93.26 – $95.12 | 3 |
| X-ray thoracic spine 2 views CPT 72070 | $540.00 | $675.00 | $112.03 – $114.27 | 3 |
| X-ray thoracic spine 3 views CPT 72072 | $620.80 | $776.00 | $112.03 – $114.27 | 3 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $264.00 | $330.00 | $93.26 – $95.12 | 3 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $347.20 | $434.00 | $93.26 – $95.12 | 3 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $402.40 | $503.00 | $112.03 – $114.27 | 3 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $873.60 | $1,092.00 | $93.26 – $95.12 | 3 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $541.60 | $677.00 | $93.26 – $95.12 | 3 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $1,001.60 | $1,252.00 | $187.96 – $191.72 | 3 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $1,020.00 | $1,275.00 | $187.96 – $191.72 | 3 |
| X-ray wrist 2 views (both sides) CPT 73100 | $862.40 | $1,078.00 | $93.26 – $95.12 | 3 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | not published | not published | $187.96 – $191.72 | 3 |
| Xylose absorption test blood &/or urine CPT 84620 | $398.40 | $498.00 | $12.91 – $13.17 | 3 |
| Xyntha inj HCPCS J7185 | not published | not published | $1.49 – $1.52 | 3 |
| Yersinia antibody CPT 86793 | not published | not published | $13.19 – $13.45 | 3 |
| Zika virus dna/rna amp probe CPT 87662 | $866.40 | $1,083.00 | $51.31 – $52.34 | 3 |
| Zika virus igm antibody CPT 86794 | $652.80 | $816.00 | $16.85 – $17.19 | 3 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | not published | not published | $8.61 – $8.78 | 3 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | not published | not published | $50.40 – $50.40 | 1 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $193.25 – $197.12 | 3 |
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.