Loyola Gottlieb Memorial Hospital

701 West North Ave, Melrose Park, IL 60160 · (708) 681-3200

Acute Care HospitalsVoluntary non-profit - PrivateCMS rating 3/5Chicago, IL-IN metro Part of Trinity Health · 52 hospitals Website ↗

Price file

Prices published

File dated 2026-03-31

2,585 price rows for 66 procedures

Published prices

cash · negotiated range · list

Basic metabolic panel (blood test)

CPT 80048 · lowest of 2 lines · metro median $83

cash

$7 to $220

31 negotiated rates

$19

list

CT scan of the abdomen and pelvis, with contrast

CPT 74177 · metro median $3,050

$1,101

cash

$316 to $4,230

24 negotiated rates

$5,795

list

CT scan of the head, no contrast

CPT 70450 · metro median $1,250

$475

cash

$103 to $2,544

24 negotiated rates

$2,501

list

CT scan of the pelvis, with contrast

CPT 72193 · metro median $1,580

$566

cash

$173 to $2,544

24 negotiated rates

$2,979

list

Cataract surgery with lens implant

CPT 66984

—

cash

$1,700 to $6,644

15 negotiated rates

—

list

Cesarean delivery with prenatal and postpartum care

CPT 59510

—

cash

$2,609 to $2,609

2 negotiated rates

—

list

Cesarean section hospital stay, no complications

MS-DRG 788

—

cash

$5,852 to $11,957

21 negotiated rates

—

list

Chlamydia test (DNA)

CPT 87491 · lowest of 3 lines · metro median $123

cash

$15 to $189

39 negotiated rates

$35

list

Colonoscopy (diagnostic)

CPT 45378 · lowest of 3 lines · metro median $2,525

$630

cash

$684 to $3,374

72 negotiated rates

$3,314

list

Colonoscopy with biopsy

CPT 45380 · metro median $2,744

$1,019

cash

$745 to $3,914

24 negotiated rates

$5,362

list

Colonoscopy with polyp removal

CPT 45385 · lowest of 2 lines · metro median $3,949

$811

cash

$944 to $3,266

48 negotiated rates

$4,271

list

Complete blood count (CBC) with differential

CPT 85025 · metro median $75

$29

cash

$5 to $127

18 negotiated rates

$151

list

Comprehensive metabolic panel (blood test)

CPT 80053 · lowest of 2 lines · metro median $108

$15

cash

$7 to $268

31 negotiated rates

$79

list

Diagnostic mammogram (both breasts)

CPT 77066 · lowest of 3 lines · metro median $283

$167

cash

$46 to $2,544

39 negotiated rates

$877

list

Electrocardiogram (ECG) with interpretation

CPT 93000

—

cash

$26 to $26

2 negotiated rates

—

list

Established patient office visit (about 40 minutes)

CPT 99215 · lowest of 5 lines · metro median $208

$47

cash

$82 to $552

53 negotiated rates

$246

list

Family psychotherapy with the patient

CPT 90847

—

cash

$152 to $209

13 negotiated rates

—

list

Family psychotherapy without the patient

CPT 90846

—

cash

$152 to $209

13 negotiated rates

—

list

Gallbladder removal (laparoscopic)

CPT 47562

—

cash

$3,578 to $10,960

15 negotiated rates

—

list

Gonorrhea test (DNA)

CPT 87591 · lowest of 3 lines · metro median $144

cash

$15 to $204

39 negotiated rates

$35

list

Group psychotherapy

CPT 90853 · metro median $83

$53

cash

$83 to $248

24 negotiated rates

$277

list

Hip or knee replacement, no major complications

MS-DRG 470

—

cash

$14,351 to $26,442

21 negotiated rates

—

list

Hospital stay for digestive disorders, no complications

MS-DRG 392

—

cash

$6,118 to $10,943

21 negotiated rates

—

list

Hysterectomy for non-cancer reasons, no complications

MS-DRG 743

—

cash

$9,318 to $16,811

21 negotiated rates

—

list

Inguinal hernia repair (age 5 and up)

CPT 49505 · metro median $11,905

$2,066

cash

$1,894 to $7,937

24 negotiated rates

$10,873

list

Knee arthroscopy with meniscus repair

CPT 29881

—

cash

$2,136 to $5,480

15 negotiated rates

—

list

Laser treatment after cataract surgery (YAG)

CPT 66821 · metro median $395

$317

cash

$452 to $3,266

24 negotiated rates

$1,668

list

Left heart catheterization

CPT 93452 · metro median $5,550

$1,774

cash

$2,435 to $8,783

48 negotiated rates

$9,338

list

Lipid panel (cholesterol test)

CPT 80061 · metro median $91

$49

cash

$7 to $215

18 negotiated rates

$256

list

Liver function panel

CPT 80076 · metro median $85

$50

cash

$7 to $221

18 negotiated rates

$264

list

MRI of the brain, with and without contrast

CPT 70553 · lowest of 4 lines · metro median $2,750

$995

cash

$346 to $3,822

96 negotiated rates

$5,236

list

MRI of the knee or other lower joint, no contrast

CPT 73721 · lowest of 3 lines · metro median $1,790

$822

cash

$234 to $4,739

72 negotiated rates

$4,328

list

MRI of the lower back (lumbar spine), no contrast

CPT 72148 · metro median $1,765

$783

cash

$234 to $3,010

24 negotiated rates

$4,123

list

MRI of the neck (cervical spine), no contrast

CPT 72141 · metro median $1,765

$754

cash

$234 to $2,899

24 negotiated rates

$3,971

list

Neck (cervical) spinal fusion, no complications

MS-DRG 473

—

cash

$17,883 to $33,200

21 negotiated rates

—

list

Nerve block injection, lower back, with imaging guidance

CPT 64483 · lowest of 2 lines · metro median $1,220

$458

cash

$417 to $2,252

72 negotiated rates

$2,413

list

New patient office visit (about 30 minutes)

CPT 99203 · lowest of 2 lines · metro median $148

$25

cash

$56 to $313

20 negotiated rates

$132

list

New patient office visit (about 45 minutes)

CPT 99204 · lowest of 2 lines · metro median $178

$32

cash

$71 to $511

20 negotiated rates

$166

list

New patient office visit (about 60 minutes)

CPT 99205 · lowest of 5 lines · metro median $208

$10

cash

$22 to $693

50 negotiated rates

$52

list

PSA test (prostate)

CPT 84153 · lowest of 2 lines · metro median $92

$40

cash

$10 to $194

31 negotiated rates

$212

list

Partial thromboplastin time (blood clotting test)

CPT 85730 · lowest of 2 lines · metro median $48

$24

cash

$4 to $107

31 negotiated rates

$128

list

Physical therapy, therapeutic exercise (15 minutes)

CPT 97110 · lowest of 3 lines · metro median $85

$41

cash

$35 to $219

39 negotiated rates

$214

list

Pregnancy ultrasound (after first trimester)

CPT 76805 · lowest of 2 lines · metro median $590

$224

cash

$98 to $2,544

72 negotiated rates

$1,177

list

Prostate biopsy

CPT 55700 · lowest of 3 lines · metro median $2,110

$823

cash

$491 to $3,266

96 negotiated rates

$4,334

list

Prostate removal (laparoscopic)

CPT 55866

—

cash

$4,451 to $13,566

15 negotiated rates

—

list

Prothrombin time (blood clotting test)

CPT 85610 · lowest of 2 lines · metro median $28

$24

cash

$4 to $105

31 negotiated rates

$125

list

Psychotherapy, 30 minutes

CPT 90832

—

cash

$128 to $209

13 negotiated rates

—

list

Psychotherapy, 45 minutes

CPT 90834

—

cash

$144 to $209

13 negotiated rates

—

list

Psychotherapy, 60 minutes

CPT 90837

—

cash

$144 to $209

13 negotiated rates

—

list

Removal of a breast lump (biopsy by excision)

CPT 19120 · metro median $1,747

$716

cash

$1,022 to $4,990

24 negotiated rates

$3,771

list

Screening mammogram (both breasts)

CPT 77067 · lowest of 2 lines · metro median $238

$132

cash

$46 to $2,544

26 negotiated rates

$696

list

Shoulder arthroscopy with decompression

CPT 29826

—

cash

$2,136 to $2,136

2 negotiated rates

—

list

Sleep study (overnight, attended)

CPT 95810 · metro median $2,105

$1,059

cash

$755 to $4,068

24 negotiated rates

$5,572

list

Spinal injection, lower back, no imaging guidance

CPT 62322 · metro median $996

$320

cash

$300 to $2,252

96 negotiated rates

$1,686

list

Spinal injection, lower back, with imaging guidance

CPT 62323 · metro median $1,145

$376

cash

$375 to $2,252

96 negotiated rates

$1,977

list

TSH test (thyroid)

CPT 84443 · lowest of 2 lines · metro median $80

$56

cash

$11 to $247

31 negotiated rates

$295

list

Tonsils and adenoids removal (under age 12)

CPT 42820

—

cash

$2,124 to $7,708

13 negotiated rates

—

list

Transvaginal ultrasound

CPT 76830 · lowest of 2 lines · metro median $570

$219

cash

$103 to $2,544

48 negotiated rates

$1,151

list

Ultrasound of the abdomen (complete)

CPT 76700 · lowest of 3 lines · metro median $740

$344

cash

$103 to $2,544

72 negotiated rates

$1,811

list

Upper endoscopy (EGD)

CPT 43235 · lowest of 2 lines · metro median $2,216

$583

cash

$453 to $2,429

72 negotiated rates

$3,070

list

Upper endoscopy with biopsy

CPT 43239 · lowest of 2 lines · metro median $2,258

$652

cash

$512 to $3,266

48 negotiated rates

$3,434

list

Urinalysis with microscope

CPT 81001 · metro median $35

$53

cash

$2 to $235

13 negotiated rates

$281

list

Vaginal delivery after a previous cesarean

CPT 59610

—

cash

$2,359 to $2,359

2 negotiated rates

—

list

Vaginal delivery hospital stay, no complications

MS-DRG 807

—

cash

$4,551 to $8,423

21 negotiated rates

—

list

Vaginal delivery with prenatal and postpartum care

CPT 59400

—

cash

$2,359 to $2,359

2 negotiated rates

—

list

X-ray of the lower spine (4 or more views)

CPT 72110 · lowest of 3 lines · metro median $478

$191

cash

$55 to $2,544

91 negotiated rates

$1,004

list

Source files

The machine-readable files this hospital lists in its cms-hpt.txt. Every price above comes from one of them.

https://trinityhealth.pt.panaceainc.com/MRFDownload/trinityhealth/gottliebmemorialhospital
Gottlieb Memorial Hospital · parsed · tall v3.0.0 · file dated 2026-03-31 · 12 MB · 2585 price rows read · read Nov 2026