Osf Saint Paul Medical Center

Mendota, IL · Critical Access Hospital

Posts prices for 38 of the 66 common shoppable procedures we track. Price file retrieved 2026-10-01.

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ProcedurePosted cashPosted gross× Medicare
Epidural injection, lumbar/sacral (with imaging) (62322) $1,107.20 $1,384 1.2×
Transforaminal epidural injection, lumbar/sacral (64483)
range across 3 matching MRF lines
$1,393.60–$2,092 $1,742–$2,615 varies
CT head/brain without contrast (70450) $1,640 $2,050 14.6×
MRI brain without contrast (70551) $2,808.80 $3,511 11.0×
MRI brain with contrast (70552) $2,956.80 $3,696 7.9×
MRI brain without and with contrast (70553) $3,823.20 $4,779 10.2×
X-ray lower spine, 4+ views (72110) $542.40 $678 4.8×
MRI lumbar spine without contrast (72148) $3,571.20 $4,464 14.0×
CT pelvis with contrast (72193) $2,105.60 $2,632 11.2×
MRI lower-extremity joint without contrast (73721)
range across 3 matching MRF lines
$3,086.40–$4,629.60 $3,858–$5,787 varies
CT abdomen and pelvis with contrast (74177) $5,717.60 $7,147 15.3×
Ultrasound, abdomen complete (76700) $1,175.20 $1,469 10.5×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $848.80 $1,061 7.6×
Ultrasound, transvaginal (76830) $924.80 $1,156 8.3×
Mammography, one breast (diagnostic) (77065) $396 $495 4.6×
Mammography, both breasts (diagnostic) (77066) $475.20 $594 4.3×
Mammography, screening (bilateral) (77067)
range across 6 matching MRF lines
$312–$468.80 $390–$586 varies
Basic metabolic panel (80048) $186.40 $233 22.0×
Comprehensive metabolic panel (80053) $297.60 $372 28.2×
Lipid panel (80061) $214.40 $268 16.0×
Renal function panel (80069) $234.40 $293 27.0×
Hepatic function panel (80076) $228 $285 27.9×
Urinalysis, non-automated, with microscopy (81000) $122.40 $153 30.4×
Urinalysis, non-automated, without microscopy (81002)
range across 2 matching MRF lines
$29.60–$30.40 $37–$38 varies
PSA, total (84153) $200.80 $251 10.9×
Thyroid stimulating hormone (TSH) (84443) $192 $240 11.4×
CBC with automated differential (85025) $122.40 $153 15.8×
CBC, automated (85027) $73.60 $92 11.4×
Prothrombin time (PT) (85610) $95.20 $119 22.2×
Partial thromboplastin time (PTT) (85730)
range across 3 matching MRF lines
$48–$120 $60–$150 varies
Psychotherapy, 30 minutes (90832) $135.20 $169 0.7×
Sleep study (attended polysomnography) (95810)
range across 2 matching MRF lines
$4,249.60–$5,449.60 $5,312–$6,812 varies
Physical therapy, therapeutic exercise (per 15 min) (97110) $140 $175 4.8×
Office visit, new patient (low complexity, ~30 min) (99203)
range across 2 matching MRF lines
$241.60–$345.60 $302–$432 varies
Office visit, new patient (moderate complexity, ~45 min) (99204)
range across 2 matching MRF lines
$372–$437.60 $465–$547 varies
Office visit, new patient (high complexity, ~60 min) (99205)
range across 2 matching MRF lines
$486.40–$546.40 $608–$683 varies
Office consultation (low complexity, ~30 min) (99243) $513.60 $642 3.6×
Office consultation (moderate complexity, ~40 min) (99244) $663.20 $829 4.6×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.

As a Critical Access Hospital, Medicare pays this facility about 101% of its own costs. The × Medicare column compares the cash price against that cost-based benchmark, not a standard rate.

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Download the machine-readable file (JSON, 8.8 MB) ↓ — captured 2026-10-01

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