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 |
|---|---|---|---|---|
| Mopath procedure level 1 CPT 81400 | $442.08 | $614.00 | $119.65 – $131.61 | 3 |
| Mopath procedure level 3 CPT 81402 | $189.36 | $263.00 | $263.00 – $423.09 | 3 |
| Mopath procedure level 5 CPT 81404 | $662.40 | $920.00 | $423.09 – $465.40 | 3 |
| Mopath procedure level 6 CPT 81405 | $1,188.72 | $1,651.00 | $423.09 – $465.40 | 3 |
| Mopath procedure level 7 CPT 81406 | $2,078.64 | $2,887.00 | $423.09 – $465.40 | 3 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $25.20 | $35.00 | $5.02 – $5.02 | 2 |
| Morphine 4 mg/ml injection (wrapper)|discarded drug not administered HCPCS J2272 | $25.20 | $35.00 | $11.17 – $11.17 | 2 |
| Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 | $771.84 | $1,072.00 | $416.72 – $458.40 | 3 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $717.12 | $996.00 | $416.72 – $458.40 | 3 |
| MRA w/cont, abd HCPCS C8900 | $3,276.00 | $4,550.00 | $1,557.48 – $2,862.00 | 4 |
| MRA without cont, abd HCPCS C8901 | $3,215.52 | $4,466.00 | $1,557.48 – $2,862.00 | 4 |
| MRA without fol w/cont, abd HCPCS C8902 | $3,898.80 | $5,415.00 | $1,557.48 – $2,862.00 | 4 |
| MRI chest without & w/contrast CPT 71552 | $4,079.52 | $5,666.00 | $1,289.52 – $2,862.00 | 4 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $2,881.44 | $4,002.00 | $764.30 – $2,862.00 | 4 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $3,745.44 | $5,202.00 | $1,289.52 – $2,862.00 | 4 |
| MRI orbit/face/neck without contrast CPT 70540 | $2,967.84 | $4,122.00 | $764.30 – $2,862.00 | 4 |
| MRI orbit/face/neck without & w/contrast CPT 70543 | $3,960.72 | $5,501.00 | $1,289.52 – $2,862.00 | 4 |
| MRI orbit fac&nck w IV cont CPT 70542 | $3,620.16 | $5,028.00 | $1,289.52 – $2,862.00 | 4 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $2,881.44 | $4,002.00 | $764.30 – $2,862.00 | 4 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $3,857.04 | $5,357.00 | $1,289.52 – $2,862.00 | 4 |
| MRI upper extremity w/dye CPT 73219 | $3,412.08 | $4,739.00 | $1,289.52 – $2,862.00 | 4 |
| Mthfr gene analy common variants CPT 81291 | $406.80 | $565.00 | $119.65 – $131.61 | 3 |
| Mumps antibody igg CPT 86735 | $176.40 | $245.00 | $29.57 – $32.53 | 3 |
| Mycophenolate mofetil 250 mg capsule HCPCS J7517 | $3.24 | $4.50 | $0.25 – $0.25 | 2 |
| Mycoplasma antibody igm CPT 86738 | $150.48 | $209.00 | $29.57 – $32.53 | 3 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $141.12 | $196.00 | $30.71 – $33.78 | 3 |
| Naloxone 0.4 mg/ml injection (wrapper) HCPCS J2312 | $0.29 | $0.40 | $0.12 – $0.12 | 2 |
| Naltrexone, depot form HCPCS J2315 | $7.47 | $10.37 | $7.00 – $3,063.33 | 5 |
| Natriuretic peptide CPT 83880 | $268.56 | $373.00 | $72.34 – $79.57 | 3 |
| Natural killer cells total count CPT 86357 | $246.24 | $342.00 | $104.86 – $115.35 | 3 |
| Ndl insj without njx 1 or 2 musc CPT 20560 | $0.01 | $0.01 | $0.01 – $95.99 | 3 |
| Ndl insj without njx 3+ musc CPT 20561 | $80.64 | $112.00 | $95.99 – $105.59 | 3 |
| Neck (Cervical Spine) CT scan (with and without contrast) CPT 72127 | $2,931.84 | $4,072.00 | $962.88 – $2,290.00 | 4 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | $2,366.64 | $3,287.00 | $962.88 – $2,290.00 | 4 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $1,974.96 | $2,743.00 | $338.02 – $2,290.00 | 4 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $4,568.40 | $6,345.00 | $1,289.52 – $2,862.00 | 4 |
| Neck (Cervical Spine) MRI (with contrast) CPT 72142 | $3,880.80 | $5,390.00 | $1,289.52 – $2,862.00 | 4 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $3,620.16 | $5,028.00 | $382.15 – $2,862.00 | 4 |
| Neck MRA (blood vessel MRI, with and without contrast) CPT 70549 | $3,850.56 | $5,348.00 | $1,557.48 – $2,862.00 | 4 |
| Neck MRA (blood vessel MRI, with contrast) CPT 70548 | $3,505.68 | $4,869.00 | $1,557.48 – $2,862.00 | 4 |
| Neck MRA (blood vessel MRI, without contrast) CPT 70547 | $2,854.08 | $3,964.00 | $1,557.48 – $2,862.00 | 4 |
| Nerve conduction 7-8 studies CPT 95910 | $672.48 | $934.00 | $419.91 – $461.90 | 3 |
| Nerve conduction studies 11-12 CPT 95912 | $1,146.24 | $1,592.00 | $419.91 – $461.90 | 3 |
| Nerve conduction studies 1-2 CPT 95907 | $730.80 | $1,015.00 | $419.91 – $461.90 | 3 |
| Nerve conduction studies 13+ CPT 95913 | $1,146.24 | $1,592.00 | $419.91 – $461.90 | 3 |
| Nerve conduction studies 5-6 CPT 95909 | $672.48 | $934.00 | $419.91 – $461.90 | 3 |
| Nerve conduction studies 9-10 CPT 95911 | $1,146.24 | $1,592.00 | $419.91 – $461.90 | 3 |
| Neuromuscular junction testing ea nerve any 1 method CPT 95937 | $337.68 | $469.00 | $419.91 – $461.90 | 3 |
| Nicardipine 25 mg/10 ml intravenous solution HCPCS J2404 | $108.00 | $150.00 | $0.12 – $307.08 | 5 |
| Nm imaging bone/joint 3 phase study CPT 78315 | $1,710.00 | $2,375.00 | $1,163.96 – $1,280.35 | 3 |
| Nm imaging bone/joint whole body CPT 78306 | $1,531.44 | $2,127.00 | $1,163.96 – $1,280.35 | 3 |
| Nm imaging cardiac blood pooling planar single study at rest or stress CPT 78472 | $1,518.48 | $2,109.00 | $1,163.96 – $1,280.35 | 3 |
| Nm imaging gastric emptying study CPT 78264 | $1,988.64 | $2,762.00 | $1,163.96 – $1,280.35 | 3 |
| Nm imaging gastrointestinal acute blood loss CPT 78278 | $1,006.56 | $1,398.00 | $1,398.00 – $2,787.86 | 3 |
| Nm imaging hepatobiliary system w/pharmacologic intervention CPT 78227 | $1,170.00 | $1,625.00 | $1,163.96 – $1,280.35 | 3 |
| Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention CPT 78708 | $2,029.68 | $2,819.00 | $1,163.96 – $1,280.35 | 3 |
| Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s) CPT 78014 | $867.60 | $1,205.00 | $1,163.96 – $1,205.00 | 3 |
| Nuclear Stress Test (Heart) CPT 78452 | $5,333.04 | $7,407.00 | $2,787.86 – $3,066.65 | 3 |
| Observation direct referral from physician office for admission HCPCS G0379 | $460.80 | $640.00 | not published | 0 |
| Observation per hour HCPCS G0378 | $66.24 | $92.00 | not published | 0 |
| Ocrelizumab 30 mg/ml intravenous solution HCPCS J2350 | $193.20 | $268.33 | $97.88 – $68,018.01 | 5 |
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | $25.20 | $35.00 | $1.09 – $1.09 | 2 |
| Optx acrclv dslc aq/chrn grf CPT 23552 | $15,430.32 | $21,431.00 | $16,709.19 – $18,380.11 | 3 |
| Organic acids total quant ea spec CPT 83918 | $275.04 | $382.00 | $31.62 – $34.78 | 3 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | $27.00 | $37.50 | $10.54 – $10.54 | 2 |
| Osmolality blood CPT 83930 | $120.96 | $168.00 | $13.88 – $15.26 | 3 |
| Osmolality urine CPT 83935 | $105.84 | $147.00 | $13.88 – $15.26 | 3 |
| Ot evaluation high complexity patient/family CPT 97167 | $305.28 | $424.00 | $300.00 – $657.61 | 4 |
| Ot evaluation low complexity patient/family CPT 97165 | $214.56 | $298.00 | $298.00 – $657.61 | 4 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $244.08 | $339.00 | $300.00 – $657.61 | 4 |
| Oth resp proc, group HCPCS G0239 | $128.16 | $178.00 | $108.28 – $119.10 | 3 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $113.76 | $158.00 | $114.19 – $158.00 | 4 |
| Ot re-evaluation patient/family CPT 97168 | $145.44 | $202.00 | $202.00 – $657.61 | 4 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $123.12 | $171.00 | $114.19 – $171.00 | 4 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $131.76 | $183.00 | $114.19 – $183.00 | 4 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $123.12 | $171.00 | $114.19 – $171.00 | 4 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $120.24 | $167.00 | $95.99 – $167.00 | 4 |
| Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 | $5.22 | $7.25 | $0.94 – $0.94 | 2 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $36.00 | $50.00 | $4.44 – $4.44 | 2 |
| Paliperidone 117 mg/0.75 ml inj HCPCS J2426 | $26.36 | $36.61 | $24.93 – $3,063.33 | 5 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $25.20 | $35.00 | $14.34 – $14.34 | 2 |
| Parathormone (pth) intact CPT 83970 | $113.76 | $158.00 | $89.85 – $98.84 | 3 |
| Parathyroid planar imaging CPT 78070 | $867.60 | $1,205.00 | $1,205.00 – $2,787.86 | 3 |
| Parathyroid planar img w/tomo spect CPT 78071 | $867.60 | $1,205.00 | $1,163.96 – $1,205.00 | 3 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $3,160.08 | $4,389.00 | $962.88 – $2,290.00 | 4 |
| Pelvic CT scan (with contrast) CPT 72193 | $2,674.08 | $3,714.00 | $962.88 – $2,290.00 | 4 |
| Pelvic CT scan (without contrast) CPT 72192 | $2,143.44 | $2,977.00 | $338.02 – $2,290.00 | 4 |
| Pelvic MRI (with and without contrast) CPT 72197 | $4,373.28 | $6,074.00 | $1,289.52 – $2,862.00 | 4 |
| Pelvic MRI (with contrast) CPT 72196 | $3,600.00 | $5,000.00 | $1,289.52 – $2,862.00 | 4 |
| Pelvic MRI (without contrast) CPT 72195 | $3,044.16 | $4,228.00 | $764.30 – $2,862.00 | 4 |
| Pelvic Ultrasound (complete) CPT 76856 | $837.36 | $1,163.00 | $533.41 – $586.76 | 3 |
| Pelvic Ultrasound (limited) CPT 76857 | $668.88 | $929.00 | $346.21 – $380.83 | 3 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $48.36 | $67.17 | $52.75 – $307.08 | 5 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $440.46 | $611.75 | $66.35 – $66.35 | 2 |
| Ph body fluid CPT 83986 | $61.20 | $85.00 | $13.88 – $15.26 | 3 |
| Phencyclidine (pcp) CPT 83992 | $97.92 | $136.00 | $31.62 – $34.78 | 3 |
| Phenobarbital therapeutic drug level CPT 80184 | $113.76 | $158.00 | $31.16 – $34.28 | 3 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $25.20 | $35.00 | $0.02 – $0.02 | 2 |
| Phenytoin total therapeutic drug level CPT 80185 | $2,078.64 | $2,887.00 | $31.16 – $34.28 | 3 |
| Phlebotomy therapeutic CPT 99195 | $278.64 | $387.00 | $237.93 – $261.73 | 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.