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 |
|---|---|---|---|---|
| Complement antigen each component c3 CPT 86160 | $423.50 | $605.00 | not published | 0 |
| Complex repair trunk 1.1-2.5cm 13120 CPT 13120 | $2,576.00 | $3,680.00 | not published | 0 |
| Complex repair trunk 2.6-7.5cm 13101 CPT 13101 | $1,581.30 | $2,259.00 | not published | 0 |
| Complx repair enel 1.1-2.5 cm 13151 CPT 13151 | $1,575.70 | $2,251.00 | not published | 0 |
| Complx repair fccmnaxghf 13133 CPT 13133 | $1,933.40 | $2,762.00 | not published | 0 |
| Comprehensive hearing test CPT 92557 | $256.90 | $367.00 | not published | 0 |
| Computed tomographic angiography head and neck with contrast CPT 70471 | $7,464.10 | $10,663.00 | not published | 0 |
| Concentration infection agents any type CPT 87015 | $46.20 | $66.00 | not published | 0 |
| Consultation pathology during surgery cytological exam initial site CPT 88333 | $618.80 | $884.00 | not published | 0 |
| Consultation/report referred material w/preparation of slides CPT 88323 | $226.10 | $323.00 | not published | 0 |
| Consultation/report referred slides prepared elsewhere CPT 88321 | $456.40 | $652.00 | not published | 0 |
| Consult comp w/report rfrd material CPT 88325 | $312.20 | $446.00 | not published | 0 |
| Contrast exam abdominl aorta 75625-26 CPT 75625 | $4,842.60 | $6,918.00 | not published | 0 |
| Contrast exam thoracic aorta CPT 75600 | $3,616.90 | $5,167.00 | not published | 0 |
| Contrast exam thoracic aorta 75605-26 CPT 75605 | $6,809.60 | $9,728.00 | not published | 0 |
| Contrast x-ray of ankle CPT 73615 | $1,136.80 | $1,624.00 | not published | 0 |
| Contrast x-ray of elbow CPT 73085 | $765.80 | $1,094.00 | not published | 0 |
| Contrast x-ray of hip CPT 73525 | $1,407.70 | $2,011.00 | not published | 0 |
| Contrast x-ray of knee joint CPT 73580 | $2,560.60 | $3,658.00 | not published | 0 |
| Contrast x-ray of wrist CPT 73115 | $1,440.60 | $2,058.00 | not published | 0 |
| Control oropharyngeal hemorr/simp 42960 CPT 42960 | $3,236.10 | $4,623.00 | not published | 0 |
| Convert nephrostomy catheter CPT 50434 | $4,249.00 | $6,070.00 | not published | 0 |
| Coombs direct CPT 86880 | $94.50 | $135.00 | not published | 0 |
| Coombs indirect titer reference CPT 86886 | $153.30 | $219.00 | not published | 0 |
| Copper cu 64 dotatate diag HCPCS A9592 | $3,836.00 | $5,480.00 | not published | 0 |
| Coronary catheterization w/angiography supervision & interpretation CPT 93454 | $14,802.20 | $21,146.00 | not published | 0 |
| Cortisol total am CPT 82533 | $135.10 | $193.00 | not published | 0 |
| Co-treatment - group 15 mins, st CPT 92508 | $156.10 | $223.00 | not published | 0 |
| Coveredge 32 lead kit 40cm 48 HCPCS C1897 | $3,141.60 | $4,488.00 | not published | 0 |
| Cover eye w/membrane CPT 65778 | $3,536.40 | $5,052.00 | not published | 0 |
| Covid-19 administration immunization im inj 1st/only component CPT 90480 | $61.60 | $88.00 | not published | 0 |
| Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose HCPCS M0249 | $1,575.00 | $2,250.00 | not published | 0 |
| #covid19rsv-rsv CPT 87634 | $156.10 | $223.00 | not published | 0 |
| #coxa-coxsackie a serotype a16 CPT 86658 | $79.10 | $113.00 | not published | 0 |
| C-peptide CPT 84681 | $108.50 | $155.00 | not published | 0 |
| C-reactive protein CPT 86140 | $92.40 | $132.00 | not published | 0 |
| C-reactive protein high sensitivity CPT 86141 | $92.40 | $132.00 | not published | 0 |
| C-reactive protein, quantitative CPT 86406 | $254.10 | $363.00 | not published | 0 |
| Creatine kinase CPT 82550 | $25.20 | $36.00 | not published | 0 |
| Creatine kinase mb CPT 82553 | $123.90 | $177.00 | not published | 0 |
| Creatine - sendout CPT 82540 | $37.10 | $53.00 | not published | 0 |
| Creatinine CPT 82565 | $55.30 | $79.00 | not published | 0 |
| Creatinine 24 hour urine CPT 82570 | $69.30 | $99.00 | not published | 0 |
| Creatinine clearance urine CPT 82575 | $94.50 | $135.00 | not published | 0 |
| #creutz-prot.,western blot CPT 84182 | $859.60 | $1,228.00 | not published | 0 |
| Cryofibrinogen qualitative - sendout CPT 82585 | $40.60 | $58.00 | not published | 0 |
| Cryoprecipitate each unit HCPCS P9012 | $338.80 | $484.00 | not published | 0 |
| Cryptococcus abs qn - sendout CPT 86641 | $73.50 | $105.00 | not published | 0 |
| Crystal identification light microscopy CPT 89060 | $81.90 | $117.00 | not published | 0 |
| Csf leakage imaging CPT 78650 | $4,918.90 | $7,027.00 | not published | 0 |
| Cstb gene full gene sequence CPT 81189 | $634.20 | $906.00 | not published | 0 |
| CT 3d report other modality w/workstation CPT 76377 | $791.00 | $1,130.00 | not published | 0 |
| Cta abdomen without & /or w/contrast CPT 74175 | $4,312.70 | $6,161.00 | not published | 0 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $3,889.90 | $5,557.00 | not published | 0 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $3,359.30 | $4,799.00 | not published | 0 |
| Cta neck without &/or w/contrast CPT 70498 | $3,808.00 | $5,440.00 | not published | 0 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $5,420.10 | $7,743.00 | not published | 0 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $3,502.80 | $5,004.00 | not published | 0 |
| CT Angiogram of the Head CPT 70496 | $3,656.10 | $5,223.00 | not published | 0 |
| CT angio hrt w/3d image CPT 75574 | $3,641.40 | $5,202.00 | not published | 0 |
| CT angio pelvis CPT 72191 | $3,382.40 | $4,832.00 | not published | 0 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $3,026.10 | $4,323.00 | not published | 0 |
| CT cerebral perf w cont & prcssng CPT 70473 | $2,937.20 | $4,196.00 | not published | 0 |
| CT guidance for needle placement CPT 77012 | $2,842.00 | $4,060.00 | not published | 0 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $1,484.70 | $2,121.00 | not published | 0 |
| CT guid cryo ablat intramuscular CPT 20999 | $7,770.70 | $11,101.00 | not published | 0 |
| CT guid parench tis ablat CPT 77013 | $2,307.90 | $3,297.00 | not published | 0 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $539.70 | $771.00 | not published | 0 |
| CT hrt w/3d image CPT 75572 | $3,439.10 | $4,913.00 | not published | 0 |
| CT limited or localized follow-up study CPT 76380 | $1,053.50 | $1,505.00 | not published | 0 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $2,975.70 | $4,251.00 | not published | 0 |
| CT lower extremity without contrast (both sides) CPT 73700 | $2,622.90 | $3,747.00 | not published | 0 |
| CT lwr extremity w/o&w/dye CPT 73702 | $3,378.90 | $4,827.00 | not published | 0 |
| CT neck soft tissue w/contrast CPT 70491 | $3,250.80 | $4,644.00 | not published | 0 |
| CT neck soft tissue without contrast CPT 70490 | $2,566.20 | $3,666.00 | not published | 0 |
| CT neck soft tissue without & w/contrast CPT 70492 | $3,704.40 | $5,292.00 | not published | 0 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $3,813.60 | $5,448.00 | not published | 0 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $3,572.10 | $5,103.00 | not published | 0 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $3,287.90 | $4,697.00 | not published | 0 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | $573.30 | $819.00 | not published | 0 |
| CT scan for localization CPT 77011 | $1,456.00 | $2,080.00 | not published | 0 |
| CT scan for therapy guide CPT 77014 | $1,496.60 | $2,138.00 | not published | 0 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $7,105.70 | $10,151.00 | not published | 0 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $6,049.40 | $8,642.00 | not published | 0 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $4,802.00 | $6,860.00 | not published | 0 |
| CT thoracic spine w/contrast CPT 72129 | $2,947.00 | $4,210.00 | not published | 0 |
| CT thoracic spine without contrast CPT 72128 | $2,811.90 | $4,017.00 | not published | 0 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $781.20 | $1,116.00 | not published | 0 |
| CT t-spine w /wo contrast CPT 72130 | $3,208.80 | $4,584.00 | not published | 0 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $2,812.60 | $4,018.00 | not published | 0 |
| CT upper extremity without contrast (both sides) CPT 73200 | $2,563.40 | $3,662.00 | not published | 0 |
| CT uppr extremity w/o&w/dye CPT 73202 | $3,768.10 | $5,383.00 | not published | 0 |
| Cultr oocyte/embryo <4 days CPT 89251 | $441.00 | $630.00 | not published | 0 |
| Culture aerobic additional method definitive id each CPT 87077 | $78.40 | $112.00 | not published | 0 |
| Culture afb any source CPT 87116 | $141.40 | $202.00 | not published | 0 |
| Culture anaerobic additional method definitive id each CPT 87076 | $88.20 | $126.00 | not published | 0 |
| Culture anaerobic except blood CPT 87075 | $146.30 | $209.00 | not published | 0 |
| Culture bact stool aero addl path ea CPT 87046 | $63.70 | $91.00 | not published | 0 |
| Culture body fluid CPT 87070 | $132.30 | $189.00 | not published | 0 |
| Culture fungi definitive id mold CPT 87107 | $84.00 | $120.00 | 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.