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 |
|---|---|---|---|---|
| Small bowel endoscopy >2nd w/remove 44363 CPT 44363 | $3,824.80 | $5,464.00 | not published | 0 |
| Small bowel endoscopy 44365 CPT 44365 | $3,395.00 | $4,850.00 | not published | 0 |
| Small bowel endoscopy br/wa CPT 44381 | $2,164.40 | $3,092.00 | not published | 0 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $74.20 | $106.00 | not published | 0 |
| Smear gram stain CPT 87205 | $61.60 | $88.00 | not published | 0 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $71.40 | $102.00 | not published | 0 |
| Smpd1 gene common variants CPT 81330 | $114.10 | $163.00 | not published | 0 |
| Snrpn/ube3a gene CPT 81331 | $610.40 | $872.00 | not published | 0 |
| So cap design without jnts cf HCPCS L3671 | $596.40 | $852.00 | not published | 0 |
| Sodium 24 hour urine CPT 84300 | $56.00 | $80.00 | not published | 0 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $29.05 | $41.50 | not published | 0 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $31.15 | $44.50 | not published | 0 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $54.25 | $77.50 | not published | 0 |
| Sodium serum/plasma/whole blood CPT 84295 | $52.50 | $75.00 | not published | 0 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $20.47 | $29.25 | not published | 0 |
| So neo gsap dna mcrstl ins CPT 81457 | $1,831.90 | $2,617.00 | not published | 0 |
| Speech audiometry complete CPT 92556 | $89.60 | $128.00 | not published | 0 |
| Sperm antibody test CPT 89325 | $262.50 | $375.00 | not published | 0 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $664.30 | $949.00 | not published | 0 |
| Splint finger fold over sm HCPCS L3924 | $158.20 | $226.00 | not published | 0 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $369.60 | $528.00 | not published | 0 |
| Split blood or products CPT 86985 | $125.30 | $179.00 | not published | 0 |
| Srs cranial lesion complex CPT 61798 | $9,470.30 | $13,529.00 | not published | 0 |
| Srs cranial lesion simple CPT 61796 | $6,274.10 | $8,963.00 | not published | 0 |
| Srs cran les simple addl CPT 61797 | $1,498.70 | $2,141.00 | not published | 0 |
| Srs linear based CPT 77372 | $25,706.80 | $36,724.00 | not published | 0 |
| Srs multisource CPT 77371 | $65,189.60 | $93,128.00 | not published | 0 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $328.30 | $469.00 | not published | 0 |
| Staph a dna amp probe CPT 87640 | $159.60 | $228.00 | not published | 0 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $343.00 | $490.00 | not published | 0 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $2,068.50 | $2,955.00 | not published | 0 |
| Sterile water/saline, 10 ml HCPCS A4216 | $7.52 | $10.75 | not published | 0 |
| Sterile water/saline, 500 ml HCPCS A4217 | $247.97 | $354.25 | not published | 0 |
| St evaluate speech sound production CPT 92522 | $381.50 | $545.00 | not published | 0 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | $578.90 | $827.00 | not published | 0 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $597.80 | $854.00 | not published | 0 |
| St evaluation swallow function CPT 92610 | $597.80 | $854.00 | not published | 0 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $592.90 | $847.00 | not published | 0 |
| Strapping of hand or finger CPT 29280 | $337.40 | $482.00 | not published | 0 |
| Strep b dna amp probe CPT 87653 | $131.60 | $188.00 | not published | 0 |
| Stress tte complete CPT 93351 | $4,490.50 | $6,415.00 | not published | 0 |
| Str markers spec anal addl CPT 81266 | $703.50 | $1,005.00 | not published | 0 |
| Str markers specimen anal CPT 81265 | $1,036.70 | $1,481.00 | not published | 0 |
| St treatment speech individual CPT 92507 | $312.20 | $446.00 | not published | 0 |
| St treatment swallow dysfunction/oral CPT 92526 | $191.80 | $274.00 | not published | 0 |
| Sugars single quant CPT 84378 | $202.30 | $289.00 | not published | 0 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $167.82 | $239.75 | not published | 0 |
| Sulfonylurea screen qn-sendout CPT 80377 | $246.40 | $352.00 | not published | 0 |
| Surg dx exam anorectal CPT 45990 | $7,100.10 | $10,143.00 | not published | 0 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $207.90 | $297.00 | not published | 0 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $251.30 | $359.00 | not published | 0 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $5,142.20 | $7,346.00 | not published | 0 |
| Susceptibility agar dilution per agent CPT 87181 | $114.10 | $163.00 | not published | 0 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $86.80 | $124.00 | not published | 0 |
| Susceptibility mic per plate CPT 87186 | $744.10 | $1,063.00 | not published | 0 |
| Svc venogram s&i CPT 75827 | $2,644.60 | $3,778.00 | not published | 0 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $47.60 | $68.00 | not published | 0 |
| T3 (triiodothyronine) free CPT 84481 | $125.30 | $179.00 | not published | 0 |
| T3 (triiodothyronine) total CPT 84480 | $113.40 | $162.00 | not published | 0 |
| T4 (thyroxine) free CPT 84439 | $121.10 | $173.00 | not published | 0 |
| T4 (thyroxine) total CPT 84436 | $75.60 | $108.00 | not published | 0 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $30.10 | $43.00 | not published | 0 |
| Tacrolimus therapeutic drug level CPT 80197 | $179.20 | $256.00 | not published | 0 |
| Target gsa panel hmtlmph neop CPT 81450 | $2,246.30 | $3,209.00 | not published | 0 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $7,585.20 | $10,836.00 | not published | 0 |
| Target gsa panel organ neop CPT 81445 | $1,923.60 | $2,748.00 | not published | 0 |
| Tas congenital car anomal CPT 33741 | $11,511.50 | $16,445.00 | not published | 0 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $1,173.72 | $1,676.75 | not published | 0 |
| Tbp gene detc abnor alleles CPT 81344 | $316.40 | $452.00 | not published | 0 |
| Tbs techl calculation only CPT 77091 | $196.00 | $280.00 | not published | 0 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $227.50 | $325.00 | not published | 0 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $182.00 | $260.00 | not published | 0 |
| Tc-99m bicisate HCPCS A9557 | $5,133.10 | $7,333.00 | not published | 0 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | $4,007.50 | $5,725.00 | not published | 0 |
| Tc-99m exametazime diag HCPCS A9521 | $4,383.40 | $6,262.00 | not published | 0 |
| Tc-99m labeled rbc HCPCS A9560 | $581.00 | $830.00 | not published | 0 |
| Tc-99m maa HCPCS A9540 | $1,454.60 | $2,078.00 | not published | 0 |
| Tc-99m mebrofenin HCPCS A9537 | $275.10 | $393.00 | not published | 0 |
| Tc-99m medronate HCPCS A9503 | $220.50 | $315.00 | not published | 0 |
| Tc-99m mertiatide HCPCS A9562 | $2,244.20 | $3,206.00 | not published | 0 |
| Tc-99m non-heu per study dose HCPCS Q9969 | $9.10 | $13.00 | not published | 0 |
| Tc-99m oxidronate HCPCS A9561 | $256.20 | $366.00 | not published | 0 |
| Tc-99m pentetate dtpa HCPCS A9539 | $1,134.70 | $1,621.00 | not published | 0 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $4.20 | $6.00 | not published | 0 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $333.90 | $477.00 | not published | 0 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $581.00 | $830.00 | not published | 0 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $1,318.10 | $1,883.00 | not published | 0 |
| Tc-99m sulfur colloid HCPCS A9541 | $1,098.30 | $1,569.00 | not published | 0 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $339.50 | $485.00 | not published | 0 |
| Tc-99m tilmanocept diag HCPCS A9520 | $985.60 | $1,408.00 | not published | 0 |
| Tcd emboli detect w/inj CPT 93893 | $1,429.40 | $2,042.00 | not published | 0 |
| Tcd emboli detect without inj CPT 93892 | $835.10 | $1,193.00 | not published | 0 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $214.20 | $306.00 | not published | 0 |
| T cells total count CPT 86359 | $141.40 | $202.00 | not published | 0 |
| Teaec w/wo patch graft iliofemoral CPT 35355 | $8,627.50 | $12,325.00 | not published | 0 |
| Temozolomide HCPCS J8700 | $255.67 | $365.25 | not published | 0 |
| Temperature gradient studies CPT 93740 | $614.60 | $878.00 | not published | 0 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | $3,664.50 | $5,235.00 | not published | 0 |
| Tert gene targeted seq alys CPT 81345 | $428.40 | $612.00 | not published | 0 |
| Test for chlorohydrocarbons CPT 82441 | $136.50 | $195.00 | 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.