Northwestern Medicine Marianjoy Rehabilitation Hospital
26W171 Roosevelt Road, Wheaton, IL · Nm · · NPI 1083660658
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 |
|---|---|---|---|---|
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $6,411.65 | $9,159.50 | $102.42 – $102.42 | 2 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $2,972.90 | $4,247.00 | $121.39 – $121.39 | 2 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $2,898.00 | $4,140.00 | $112.37 – $112.37 | 2 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $911.40 | $1,302.00 | not published | 0 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $196.00 | $280.00 | not published | 0 |
| Injection treatment of eye CPT 66030 | $4,273.50 | $6,105.00 | not published | 0 |
| Injection treatment of nerve CPT 64610 | $4,208.40 | $6,012.00 | not published | 0 |
| Inject sacroiliac joint CPT 27096 | $781.90 | $1,117.00 | not published | 0 |
| Inj epidural sgl cerv-thor without img CPT 62320 | $2,876.30 | $4,109.00 | not published | 0 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $2,927.40 | $4,182.00 | not published | 0 |
| Inj hrt cath w/s&i sel hrt ang CPT 93563 | $3,314.50 | $4,735.00 | not published | 0 |
| Inj hrt cath w/s&i sel left vent CPT 93565 | $1,657.60 | $2,368.00 | not published | 0 |
| Inj hrt cath w/s&i sel right vent CPT 93566 | $1,657.60 | $2,368.00 | not published | 0 |
| Inj/inf neurolyt sbst spinal canal lesion 62282 CPT 62282 | $5,803.00 | $8,290.00 | not published | 0 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | $371.00 | $530.00 | not published | 0 |
| Inj, meropenem (b. braun) HCPCS J2184 | $283.15 | $404.50 | not published | 0 |
| Inj nephrosto/ureterogram w/img exstng access CPT 50431 | $2,810.50 | $4,015.00 | not published | 0 |
| Inj peritoneal venous shunt CPT 49427 | $1,262.80 | $1,804.00 | not published | 0 |
| Inj proc ankle arthr CPT 27648 | $128.80 | $184.00 | not published | 0 |
| Inj proc sialogram CPT 42550 | $1,299.20 | $1,856.00 | not published | 0 |
| Inj scleros sol sgl vein CPT 36470 | $465.50 | $665.00 | not published | 0 |
| Inj testostero enanthate 1mg HCPCS J3121 | $0.01 | $0.01 | not published | 0 |
| Inj testosterone cypionate HCPCS J1071 | $29.40 | $42.00 | not published | 0 |
| Inj thrc fascial pln blk bi w/wo image CPT 64468 | $3,438.40 | $4,912.00 | not published | 0 |
| Inj thrc fascial pln blk uni w/wo image CPT 64466 | $5,999.70 | $8,571.00 | not published | 0 |
| Inj vancomycin (xellia) 10mg HCPCS J3375 | $132.30 | $189.00 | not published | 0 |
| Ins cath ren art 2nd+ bi CPT 36254 | $6,309.80 | $9,014.00 | not published | 0 |
| Insert intrauterine device iud CPT 58300 | $2,375.80 | $3,394.00 | not published | 0 |
| Insertion catheter bladder non indwelling CPT 51701 | $173.60 | $248.00 | not published | 0 |
| Insertion catheter bladder temporary simple CPT 51702 | $228.20 | $326.00 | not published | 0 |
| Insertion intra-aortic circulation dev 33970 CPT 33970 | $2,826.60 | $4,038.00 | not published | 0 |
| Insertion nontunneled centrally inserted central venous catheter >= 5 years old CPT 36556 | $3,535.70 | $5,051.00 | not published | 0 |
| Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years CPT 36569 | $2,634.10 | $3,763.00 | not published | 0 |
| Insertion picc without port or pump with imaging guidance=>5y CPT 36573 | $3,103.10 | $4,433.00 | not published | 0 |
| Insert pessary/other device CPT 57160 | $343.00 | $490.00 | not published | 0 |
| Insert/repl sq defib w/eltrd CPT 33270 | $74,400.20 | $106,286.00 | not published | 0 |
| Insert sq defib electrode CPT 33271 | $18,418.40 | $26,312.00 | not published | 0 |
| Insert tunneled cv cath CPT 36560 | $7,725.20 | $11,036.00 | not published | 0 |
| Ins icd gen exist mlt leads CPT 33231 | $54,215.70 | $77,451.00 | not published | 0 |
| Ins icd gen exist sgl lead CPT 33240 | $12,433.40 | $17,762.00 | not published | 0 |
| Insitu hybridization (fish) CPT 88366 | $659.40 | $942.00 | not published | 0 |
| Insitu hybridization manual CPT 88368 | $459.20 | $656.00 | not published | 0 |
| In situ hybridization per specimen each additional single probe stain CPT 88364 | $711.90 | $1,017.00 | not published | 0 |
| In situ hybridization per specimen initial single probe stain CPT 88365 | $1,144.50 | $1,635.00 | not published | 0 |
| Insj perq vad r hrt venous CPT 33995 | $7,254.80 | $10,364.00 | not published | 0 |
| Ins mark thor for right perq CPT 32553 | $1,250.90 | $1,787.00 | not published | 0 |
| Ins pm gen exist dual lead CPT 33230 | $13,707.40 | $19,582.00 | not published | 0 |
| Ins pm gen w/exist mlt leads CPT 33221 | $32,985.40 | $47,122.00 | not published | 0 |
| Ins/rplc spi npg/rcvr pocket CPT 63685 | $14,517.30 | $20,739.00 | not published | 0 |
| Ins/rpl pm gen exist sgl lead CPT 33212 | $11,116.00 | $15,880.00 | not published | 0 |
| Ins/rpl prph sac/gstr npg/r CPT 64590 | $9,175.60 | $13,108.00 | not published | 0 |
| Instillation anticarcinogenic agent bladder CPT 51720 | $3,056.90 | $4,367.00 | not published | 0 |
| Ins tun cv cath wo subq prt/pm CPT 36557 | $10,021.20 | $14,316.00 | not published | 0 |
| Ins tun intraperit dia cath CPT 49421 | $3,597.30 | $5,139.00 | not published | 0 |
| Insulin total CPT 83525 | $76.30 | $109.00 | not published | 0 |
| Intens behave ther cardio dx HCPCS G0446 | $47.60 | $68.00 | not published | 0 |
| Interrogate subq defib CPT 93261 | $157.50 | $225.00 | not published | 0 |
| Int hrhc lig 2+hroid without img CPT 46946 | $10,749.90 | $15,357.00 | not published | 0 |
| Intra-atrial pacing CPT 93610 | $16,191.00 | $23,130.00 | not published | 0 |
| Intracranial angioplasty CPT 61630 | $4,699.10 | $6,713.00 | not published | 0 |
| Intracranial complete study CPT 93886 | $2,235.10 | $3,193.00 | not published | 0 |
| Intracranial limited study CPT 93888 | $869.40 | $1,242.00 | not published | 0 |
| Intrauterine transfusion ftl CPT 36460 | $550.20 | $786.00 | not published | 0 |
| Intraventricular pacing CPT 93612 | $6,409.90 | $9,157.00 | not published | 0 |
| Intro long gi tube w/mult fluo CPT 74340 | $508.90 | $727.00 | not published | 0 |
| Intro windpipe wire/tube CPT 31730 | $2,944.90 | $4,207.00 | not published | 0 |
| Intrvasc Ultrasound noncoronary 1st vessel CPT 37252 | $2,452.80 | $3,504.00 | not published | 0 |
| Intrvasc Ultrasound noncoronary addl vessel CPT 37253 | $952.70 | $1,361.00 | not published | 0 |
| Iodine i-123 sod iodide mil HCPCS A9509 | $1,405.60 | $2,008.00 | not published | 0 |
| Ionm in operatng room 15 min CPT 95940 | $300.30 | $429.00 | not published | 0 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $374.50 | $535.00 | not published | 0 |
| Iron CPT 83540 | $79.10 | $113.00 | not published | 0 |
| Iron binding capacity CPT 83550 | $73.50 | $105.00 | not published | 0 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $217.87 | $311.25 | not published | 0 |
| Irradiation of blood product each unit reference CPT 86945 | $27.30 | $39.00 | not published | 0 |
| Ivc venogram s&i CPT 75825 | $3,923.50 | $5,605.00 | not published | 0 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $260.40 | $372.00 | not published | 0 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $1,164.80 | $1,664.00 | not published | 0 |
| Jak2 targeted sequence analysis CPT 81279 | $428.40 | $612.00 | not published | 0 |
| Ketamine and metabolite screen - quest CPT 80357 | $26.60 | $38.00 | not published | 0 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $57.40 | $82.00 | not published | 0 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $1,474.20 | $2,106.00 | not published | 0 |
| Kit gene analys d816 variant CPT 81273 | $630.00 | $900.00 | not published | 0 |
| Kit lead specify 5-6-5 HCPCS C1778 | $24,505.60 | $35,008.00 | not published | 0 |
| Knee MRI (with and without contrast) CPT 73723 | $4,428.90 | $6,327.00 | not published | 0 |
| Knee MRI (with contrast) CPT 73722 | $4,038.30 | $5,769.00 | not published | 0 |
| Knee MRI (without contrast) CPT 73721 | $3,835.30 | $5,479.00 | not published | 0 |
| Knee X-ray CPT 73564 | $724.50 | $1,035.00 | not published | 0 |
| Kras gene addl variants CPT 81276 | $456.40 | $652.00 | not published | 0 |
| Kras gene variants exon 2 CPT 81275 | $536.20 | $766.00 | not published | 0 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $40.77 | $58.25 | not published | 0 |
| Lactate dehydrogenase (ldh) CPT 83615 | $81.20 | $116.00 | not published | 0 |
| Lactated ringers intravenous solution HCPCS J7120 | $41.47 | $59.25 | not published | 0 |
| Lactic acid CPT 83605 | $191.10 | $273.00 | not published | 0 |
| Lactoferrin fecal qualitative CPT 83630 | $95.90 | $137.00 | not published | 0 |
| Lactoferrin fecal quant CPT 83631 | $150.50 | $215.00 | not published | 0 |
| Laparo cholecystectomy/graph CPT 47563 | $14,162.40 | $20,232.00 | not published | 0 |
| Lap myotomy heller CPT 43279 | $2,136.40 | $3,052.00 | not published | 0 |
| Largsc w/njx augmentation CPT 31574 | $4,148.20 | $5,926.00 | not published | 0 |
| Largsc w/rmvl foreign bdy(s) CPT 31577 | $879.90 | $1,257.00 | not published | 0 |
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.