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PricedCare

OSF Holy Family Medical Center

1000 W Harlem Avenue, Monmouth, IL 61462 · (309) 734-3141

Critical Access HospitalsVoluntary non-profit - ChurchCMS rating 4/5

Price file

Prices published

File dated 2026-03-31

128 price rows for 31 procedures

Published prices

cash · negotiated range · list
Basic metabolic panel (blood test)

CPT 80048 · lowest of 2 lines

$181
cash
CT scan of the abdomen and pelvis, with contrast

CPT 74177 · lowest of 2 lines

$6,005
cash
CT scan of the head, no contrast

CPT 70450 · lowest of 2 lines

$2,498
cash
CT scan of the pelvis, with contrast

CPT 72193 · lowest of 2 lines

$2,962
cash
Chlamydia test (DNA)

CPT 87491 · lowest of 4 lines

$74
cash
Complete blood count (CBC) with differential

CPT 85025 · lowest of 2 lines

$119
cash
Comprehensive metabolic panel (blood test)

CPT 80053 · lowest of 2 lines

$289
cash
Diagnostic mammogram (both breasts)

CPT 77066 · lowest of 3 lines

$710
cash
Established patient office visit (about 40 minutes)

CPT 99215

$427
cash
Gonorrhea test (DNA)

CPT 87591 · lowest of 4 lines

$74
cash
Lipid panel (cholesterol test)

CPT 80061 · lowest of 2 lines

$182
cash
Liver function panel

CPT 80076

$218
cash
MRI of the brain, with and without contrast

CPT 70553 · lowest of 2 lines

$5,551
cash
MRI of the lower back (lumbar spine), no contrast

CPT 72148 · lowest of 2 lines

$4,058
cash
MRI of the neck (cervical spine), no contrast

CPT 72141 · lowest of 2 lines

$3,877
cash
New patient office visit (about 30 minutes)

CPT 99203

$242
cash
New patient office visit (about 45 minutes)

CPT 99204

$372
cash
New patient office visit (about 60 minutes)

CPT 99205

$486
cash
PSA test (prostate)

CPT 84153

$215
cash
Partial thromboplastin time (blood clotting test)

CPT 85730 · lowest of 3 lines

$53
cash
Pregnancy ultrasound (after first trimester)

CPT 76805

$1,754
cash
Prothrombin time (blood clotting test)

CPT 85610 · lowest of 8 lines

$30
cash
Psychotherapy, 30 minutes

CPT 90832

$135
cash
Screening mammogram (both breasts)

CPT 77067 · lowest of 4 lines

$312
cash
Sleep study (overnight, attended)

CPT 95810

$3,922
cash
Spinal injection, lower back, with imaging guidance

CPT 62323

$1,001
cash
TSH test (thyroid)

CPT 84443 · lowest of 4 lines

$43
cash
Transvaginal ultrasound

CPT 76830

$1,290
cash
Ultrasound of the abdomen (complete)

CPT 76700

$1,446
cash
Urinalysis with microscope

CPT 81001

$130
cash
X-ray of the lower spine (4 or more views)

CPT 72110

$542
cash

Source files

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