HSHS Good Shepherd Hospital
200 S Cedar St, Shelbyville, IL · Hshs · · NPI 1053348532
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 |
|---|---|---|---|---|
| Rubeola antibody igg CPT 86765 | $72.00 | $100.00 | $29.57 – $32.53 | 3 |
| Russell viper venom diluted CPT 85613 | $36.00 | $50.00 | $11.37 – $12.51 | 3 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $1,703.52 | $2,366.00 | $533.41 – $586.76 | 3 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $267.12 | $371.00 | $371.00 – $533.41 | 3 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $668.88 | $929.00 | $533.41 – $586.76 | 3 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $668.88 | $929.00 | $346.21 – $380.83 | 3 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $1,033.92 | $1,436.00 | $346.21 – $380.83 | 3 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $812.88 | $1,129.00 | $346.21 – $380.83 | 3 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $1,766.88 | $2,454.00 | $533.41 – $586.76 | 3 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $1,099.44 | $1,527.00 | $346.21 – $380.83 | 3 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $962.64 | $1,337.00 | $346.21 – $380.83 | 3 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0145 | $109.44 | $152.00 | $52.55 – $57.80 | 3 |
| Screening Colonoscopy (average risk) HCPCS G0121 | not published | not published | not published | 0 |
| Screening Colonoscopy (high risk) HCPCS G0105 | $2,499.12 | $3,471.00 | $3,121.56 – $3,433.71 | 3 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $65.52 | $91.00 | $29.57 – $32.53 | 3 |
| Screening Mammogram CPT 77067 | $327.60 | $455.00 | $75.12 – $208.68 | 11 |
| Screening prostate cancer PSA HCPCS G0103 | $209.52 | $291.00 | $29.57 – $32.53 | 3 |
| Sedimentation rate erythrocyte automated CPT 85652 | $76.32 | $106.00 | $15.24 – $16.76 | 3 |
| Semen analysis presence/motility CPT 89321 | $70.56 | $98.00 | $12.74 – $14.01 | 3 |
| Serpina1 gene CPT 81332 | $338.40 | $470.00 | $119.65 – $131.61 | 3 |
| Shoulder MRI (with and without contrast) CPT 73223 | $3,960.72 | $5,501.00 | $1,289.52 – $2,862.00 | 4 |
| Shoulder MRI (with contrast) CPT 73222 | $3,857.04 | $5,357.00 | $1,289.52 – $2,862.00 | 4 |
| Shoulder MRI (without contrast) CPT 73221 | $2,881.44 | $4,002.00 | $764.30 – $2,862.00 | 4 |
| Shoulder X-ray CPT 73030 | $412.56 | $573.00 | $177.88 – $195.67 | 3 |
| Sickling rbc CPT 85660 | $52.56 | $73.00 | $15.24 – $16.76 | 3 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $236.16 | $328.00 | $181.71 – $328.00 | 5 |
| Sinus CT scan (with and without contrast) CPT 70488 | $2,024.64 | $2,812.00 | $962.88 – $2,290.00 | 4 |
| Sinus CT scan (with contrast) CPT 70487 | $1,565.28 | $2,174.00 | $962.88 – $2,174.00 | 4 |
| Sinus CT scan (without contrast) CPT 70486 | $1,177.20 | $1,635.00 | $338.02 – $1,635.00 | 4 |
| Sleep Study (Polysomnography) CPT 95810 | $4,579.20 | $6,360.00 | $2,503.75 – $2,754.13 | 3 |
| Sleep study unattended CPT 95806 | $337.68 | $469.00 | $469.00 – $480.87 | 3 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $92.16 | $128.00 | $27.07 – $29.78 | 3 |
| Smear gram stain CPT 87205 | $80.64 | $112.00 | $27.07 – $29.78 | 3 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $72.00 | $100.00 | $27.07 – $29.78 | 3 |
| Smear wet mount CPT 87210 | $74.16 | $103.00 | $27.07 – $29.78 | 3 |
| Sodium 24 hour urine CPT 84300 | $36.00 | $50.00 | $13.88 – $15.26 | 3 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $39.60 | $55.00 | $3.28 – $3.28 | 2 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $39.60 | $55.00 | $2.13 – $2.13 | 2 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $39.60 | $55.00 | $1.09 – $1.09 | 2 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $39.60 | $55.00 | $0.17 – $0.17 | 2 |
| Sodium serum/plasma/whole blood CPT 84295 | $63.36 | $88.00 | $13.88 – $15.26 | 3 |
| Specific gravity body fluid CPT 84315 | $78.48 | $109.00 | $13.88 – $15.26 | 3 |
| Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 | $672.48 | $934.00 | $326.87 – $359.56 | 3 |
| Sputum specimen collection CPT 89220 | $370.08 | $514.00 | $468.13 – $514.00 | 3 |
| Staph a dna amp probe CPT 87640 | $177.84 | $247.00 | $110.10 – $121.10 | 3 |
| St evaluate speech sound production CPT 92522 | $227.52 | $316.00 | $316.00 – $721.53 | 3 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | $469.44 | $652.00 | $652.00 – $721.53 | 3 |
| St evaluation swallow function CPT 92610 | $144.72 | $201.00 | $201.00 – $721.53 | 3 |
| Strep a ag ia CPT 87430 | $133.92 | $186.00 | $27.07 – $29.78 | 3 |
| Strep a dna quant CPT 87652 | $75.60 | $105.00 | $105.00 – $110.10 | 3 |
| Strep b dna amp probe CPT 87653 | $43.92 | $61.00 | $61.00 – $110.10 | 3 |
| Stress test pulmonary CPT 94618 | $241.92 | $336.00 | $182.43 – $200.67 | 3 |
| St treatment speech individual CPT 92507 | $296.64 | $412.00 | $412.00 – $721.53 | 3 |
| St treatment swallow dysfunction/oral CPT 92526 | $296.64 | $412.00 | $114.19 – $125.61 | 3 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $25.20 | $35.00 | $2.56 – $2.56 | 2 |
| Sugars single quant CPT 84378 | $145.44 | $202.00 | $30.71 – $33.78 | 3 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $25.20 | $35.00 | $35.00 – $35.00 | 2 |
| Surgical pathology level 1 gross examination only CPT 88300 | $76.32 | $106.00 | $102.13 – $106.00 | 3 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $116.64 | $162.00 | $102.13 – $112.35 | 3 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $131.76 | $183.00 | $102.13 – $112.35 | 3 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $156.96 | $218.00 | $102.13 – $112.35 | 3 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $453.60 | $630.00 | $416.72 – $458.40 | 3 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $1,029.60 | $1,430.00 | $416.72 – $458.40 | 3 |
| Susceptibility agar dilution per agent CPT 87181 | $69.84 | $97.00 | $27.07 – $29.78 | 3 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $29.52 | $41.00 | $27.07 – $29.78 | 3 |
| Susceptibility mic per plate CPT 87186 | $134.64 | $187.00 | $27.07 – $29.78 | 3 |
| Suscept studies macrobroth dilution ea CPT 87188 | $142.56 | $198.00 | $27.07 – $29.78 | 3 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $44.64 | $62.00 | $29.57 – $32.53 | 3 |
| T3 (triiodothyronine) free CPT 84481 | $135.36 | $188.00 | $33.89 – $37.28 | 3 |
| T3 (triiodothyronine) total CPT 84480 | $231.84 | $322.00 | $33.89 – $37.28 | 3 |
| T4 (thyroxine) free CPT 84439 | $82.08 | $114.00 | $33.89 – $37.28 | 3 |
| T4 (thyroxine) total CPT 84436 | $86.40 | $120.00 | $33.89 – $37.28 | 3 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $5.04 | $7.00 | $0.33 – $0.33 | 2 |
| Tacrolimus therapeutic drug level CPT 80197 | $189.36 | $263.00 | $31.16 – $34.28 | 3 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $165.60 | $230.00 | $104.86 – $115.35 | 3 |
| Tc-99m non-heu per study dose HCPCS Q9969 | $18.72 | $26.00 | $16.50 – $16.50 | 2 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $59.04 | $82.00 | $82.00 – $104.86 | 3 |
| T cells absolute cd 4 count CPT 86361 | $121.68 | $169.00 | $104.86 – $115.35 | 3 |
| T cells total count CPT 86359 | $185.04 | $257.00 | $104.86 – $115.35 | 3 |
| Telehealth original site facility fee HCPCS Q3014 | $66.96 | $93.00 | $44.58 – $49.04 | 3 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $439.60 | $610.56 | $308.50 – $14,041.89 | 5 |
| Test stress cardiovascular tracing only CPT 93017 | $1,351.44 | $1,877.00 | $262.50 – $288.75 | 3 |
| Tgsap so neo 5-50 rna alys CPT 81449 | $2,255.04 | $3,132.00 | $3,132.00 – $5,984.48 | 3 |
| Theophylline therapeutic drug level CPT 80198 | $727.20 | $1,010.00 | $31.16 – $34.28 | 3 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $90.00 | $125.00 | $30.01 – $525.91 | 11 |
| Ther/proph/diag inj ia CPT 96373 | $455.04 | $632.00 | $146.72 – $161.39 | 3 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $25.20 | $35.00 | $2.99 – $2.99 | 2 |
| Thrombin time CPT 85670 | $146.88 | $204.00 | $11.37 – $12.51 | 3 |
| Thromboplastin inhibition CPT 85705 | $434.16 | $603.00 | $11.37 – $12.51 | 3 |
| Thyroglobulin antibody CPT 86800 | $82.08 | $114.00 | $29.57 – $32.53 | 3 |
| Thyroid imaging CPT 78013 | $867.60 | $1,205.00 | $1,163.96 – $1,205.00 | 3 |
| Thyroid (TSH) Test CPT 84443 | $187.20 | $260.00 | $33.89 – $37.28 | 3 |
| Thyroid Ultrasound CPT 76536 | $668.88 | $929.00 | $173.10 – $190.41 | 3 |
| Thyroxine binding globulin (tbg) CPT 84442 | $85.68 | $119.00 | $33.89 – $37.28 | 3 |
| Tissue exam koh skin/hair/nails CPT 87220 | $69.84 | $97.00 | $27.07 – $29.78 | 3 |
| Tissue transglutaminase iga CPT 86364 | $95.76 | $133.00 | $29.57 – $32.53 | 3 |
| Tixagev and cilgav inj HCPCS M0220 | $325.44 | $452.00 | $146.72 – $161.39 | 3 |
| Tobramycin peak therapeutic drug level CPT 80200 | $1,384.56 | $1,923.00 | $31.16 – $34.28 | 3 |
| Tomosynthesis breast diagnostic left HCPCS G0279 | $122.40 | $170.00 | $151.27 – $166.39 | 3 |
| Tomosynthesis breast screen bilateral CPT 77063 | $109.44 | $152.00 | $19.22 – $152.00 | 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.