St Francis Hospital Sisters of the Third Order of St Francis
St Francis Hospital Sisters of the Third Order of St Francis in Litchfield, IL publishes cash prices for 36 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.
1215 FRANCISCAN DRIVE, LITCHFIELD, IL 62056 Collected Sep 22, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN/PELVIS W/CONTRAST | $4,990.32 | $6,931.00 | 28% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN/PELVIS W/CONTRAST | $4,990.32 | $6,931.00 | 28% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD/BRAIN W/O CONTRAST | $1,914.48 | $2,659.00 | 28% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD/BRAIN W/O CONTRAST | $1,914.48 | $2,659.00 | 28% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W/CONTRAST | $2,167.92 | $3,011.00 | 28% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W/CONTRAST | $2,167.92 | $3,011.00 | 28% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI | $537.84 | $747.00 | 28% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DX MAMMO INCL CAD BI | $537.84 | $747.00 | 28% |
| Diagnostic mammogram, one breast CPT 77065 DX MAMMO INCL CAD UNI | $498.96 | $693.00 | 28% |
| Diagnostic mammogram, one breast inpatient CPT 77065 DX MAMMO INCL CAD UNI | $498.96 | $693.00 | 28% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LWR EXT JOINT W/O CONTRAST | $3,006.00 | $4,175.00 | 28% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LWR EXT JOINT W/O CONTRAST | $3,006.00 | $4,175.00 | 28% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LWR EXT JOINT W&W/O CONTRAST | $3,672.00 | $5,100.00 | 28% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LWR EXT JOINT W&W/O CONTRAST | $3,672.00 | $5,100.00 | 28% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN W/O CONTRAST | $3,088.08 | $4,289.00 | 28% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN W/O CONTRAST | $3,088.08 | $4,289.00 | 28% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN STEM W/O & W/DYE | $4,044.24 | $5,617.00 | 28% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN STEM W/O & W/DYE | $4,044.24 | $5,617.00 | 28% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI L-SPINE W/O CONTRAST | $3,158.64 | $4,387.00 | 28% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI L-SPINE W/O CONTRAST | $3,158.64 | $4,387.00 | 28% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US PREGNANCY >14 WEEKS SGL | $809.28 | $1,124.00 | 28% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US PREGNANCY >14 WEEKS SGL | $809.28 | $1,124.00 | 28% |
| Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD | $460.08 | $639.00 | 28% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 SCR MAMMO BI INCL CAD | $460.08 | $639.00 | 28% |
| Sleep study in a lab (polysomnography) CPT 95810 HC SLEEP STUDY | $4,026.24 | $5,592.00 | 28% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC SLEEP STUDY | $4,026.24 | $5,592.00 | 28% |
| Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL | $714.24 | $992.00 | 28% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL | $714.24 | $992.00 | 28% |
| Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMEN CMPL | $1,254.24 | $1,742.00 | 28% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOMEN CMPL | $1,254.24 | $1,742.00 | 28% |
| X-ray of the lower back, 4 or more views CPT 72110 HC XR L-SPINE 4+V | $917.28 | $1,274.00 | 28% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC XR L-SPINE 4+V | $917.28 | $1,274.00 | 28% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL | $181.44 | $252.00 | 28% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL | $181.44 | $252.00 | 28% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $120.96 | $168.00 | 28% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL | $120.96 | $168.00 | 28% |
| Complete blood count (CBC) with differential CPT 85025 HC CBC AUTO W/AUTO DIFF | $122.40 | $170.00 | 28% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC AUTO W/AUTO DIFF | $122.40 | $170.00 | 28% |
| Complete blood count (CBC), no differential CPT 85027 HC CBC W/O DIFF | $108.72 | $151.00 | 28% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC CBC W/O DIFF | $108.72 | $151.00 | 28% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE METABOL PANEL | $219.60 | $305.00 | 28% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE METABOL PANEL | $219.60 | $305.00 | 28% |
| Kidney function blood test panel CPT 80069 HC RENAL PANEL | $198.72 | $276.00 | 28% |
| Kidney function blood test panel inpatient CPT 80069 HC RENAL PANEL | $198.72 | $276.00 | 28% |
| Liver function blood test panel CPT 80076 HC LIVER (HEPATIC) PANEL | $191.52 | $266.00 | 28% |
| Liver function blood test panel inpatient CPT 80076 HC LIVER (HEPATIC) PANEL | $191.52 | $266.00 | 28% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA TOTAL | $146.16 | $203.00 | 28% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA TOTAL | $146.16 | $203.00 | 28% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT | $102.96 | $143.00 | 28% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT | $102.96 | $143.00 | 28% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME (PT) | $61.92 | $86.00 | 28% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME (PT) | $61.92 | $86.00 | 28% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORM | $138.96 | $193.00 | 28% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORM | $138.96 | $193.00 | 28% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS AUTO W/MICRO | $82.80 | $115.00 | 28% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS AUTO W/MICRO | $82.80 | $115.00 | 28% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Knee arthroscopy with meniscus trim CPT 29881 HC ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG | $7,008.48 | $9,734.00 | 28% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 HC ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG | $7,008.48 | $9,734.00 | 28% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 HC LASER (YAG) POST CATARACT | $1,606.32 | $2,231.00 | 28% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 HC LASER (YAG) POST CATARACT | $1,606.32 | $2,231.00 | 28% |
| Prostate biopsy CPT 55700 HC BX PROSTATE NEEDLE/PUNCH | $4,425.12 | $6,146.00 | 28% |
| Prostate biopsy inpatient CPT 55700 HC BX PROSTATE NEEDLE/PUNCH | $4,425.12 | $6,146.00 | 28% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 HC SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS | $5,505.12 | $7,646.00 | 28% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 HC SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS | $5,505.12 | $7,646.00 | 28% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| New patient office visit, about 30 minutes CPT 99203 HC CLINIC VISIT INTERM NEW | $424.80 | $590.00 | 28% |
| New patient office visit, about 45 minutes CPT 99204 HC CLINIC VISIT COMPLEX NEW | $567.36 | $788.00 | 28% |
| New patient office visit, about 60 minutes CPT 99205 HC CLINIC VISIT COMPREH NEW | $705.60 | $980.00 | 28% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERA EXER; EA 15 MIN | $149.76 | $208.00 | 28% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERA EXER; EA 15 MIN | $149.76 | $208.00 | 28% |