Does Passavant Area Hospital publish its standard charges and chargemaster?

Yes. Passavant Area Hospital publishes a machine-readable file with 6,264 standard-charge rows — gross charges, cash prices, and payer-negotiated rates, earning a CMS price transparency compliance grade of B. Browse the negotiated rates by procedure and payer on this page.

How much does Passavant Area Hospital charge for procedures?

Passavant Area Hospital (Jacksonville, IL) publishes a separately negotiated rate for each insurance payer, plus a discounted cash price and a gross (list) charge, for every procedure in its price transparency file. This page compares each procedure's negotiated median against the national median so you can see whether a price is above or below market.

▸ Hospital · IL · CCN 140058

Passavant Area Hospital

Jacksonville, IL, 62650

106 beds2

Compliance grade

86/100

Rates published

6,264

last crawl 2026-05-23

Procedures tracked

143

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All IL hospitalsJSON

The report bundles all published codes × every payer rate + compliance grade as a downloadable PDF + CSV with a data-version manifest.

Source MRF: https://memorial.health/Resources/452b1df1-ad01-4063-a729-31a091660635/370661220_Springfield_Memorial_Hospital_standardcharges.csv?v=2 · CSV

Procedures & rates

vs nat'l shows this hospital's negotiated median against the national median for that code (green = at/below market, amber = 1–1.5×, red = >1.5× the national median).

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	vs nat'l	Neg max
behavioral
Psychoses	MS-DRG	885	0	—	—	—	—	—	—
emergency
ED visit level 1	CPT	99281	0	$450	$450	—	—	—	—
ED visit level 2	CPT	99282	0	$791	$791	—	—	—	—
ED visit level 3	CPT	99283	0	$1,300	$1,300	—	—	—	—
ED visit level 4	CPT	99284	0	$1,904	$1,904	—	—	—	—
ED visit level 5	CPT	99285	0	$2,463	$2,463	—	—	—	—
Critical care, first hour	CPT	99291	0	$3,852	$3,852	—	—	—	—
imaging
CT head without contrast	CPT	70450	0	$3,138	$3,138	—	—	—	—
CT head with contrast	CPT	70460	0	$3,304	$3,304	—	—	—	—
CT head with and without contrast	CPT	70470	0	$3,859	$3,859	—	—	—	—
CT neck with contrast	CPT	70491	0	$4,206	$4,206	—	—	—	—
MRI brain without contrast	CPT	70551	0	$4,012	$4,012	—	—	—	—
MRI brain with contrast	CPT	70552	0	$5,193	$5,193	—	—	—	—
MRI brain with and without contrast	CPT	70553	0	$7,994	$7,994	—	—	—	—
Chest X-ray single view	CPT	71045	0	$604	$604	—	—	—	—
Chest X-ray 2 views	CPT	71046	0	$667	$667	—	—	—	—
Chest X-ray 3 views	CPT	71047	0	$686	$686	—	—	—	—
CT chest without contrast	CPT	71250	0	$4,443	$4,443	—	—	—	—
CT chest with contrast	CPT	71260	0	$4,742	$4,742	—	—	—	—
CT chest with and without contrast	CPT	71270	0	$4,760	$4,760	—	—	—	—
MRI chest without contrast	CPT	71550	0	$5,065	$5,065	—	—	—	—
MRI chest with contrast	CPT	71551	0	$5,502	$5,502	—	—	—	—
MRI chest with and without contrast	CPT	71552	0	$6,887	$6,887	—	—	—	—
Lumbosacral spine X-ray	CPT	72100	0	$890	$890	—	—	—	—
CT cervical spine without contrast	CPT	72125	0	$4,681	$4,681	—	—	—	—
CT thoracic spine without contrast	CPT	72128	0	$4,569	$4,569	—	—	—	—
CT lumbar spine without contrast	CPT	72131	0	$4,706	$4,706	—	—	—	—
MRI cervical spine without contrast	CPT	72141	0	$6,218	$6,218	—	—	—	—
MRI thoracic spine without contrast	CPT	72146	0	$5,186	$5,186	—	—	—	—
MRI lumbar spine without contrast	CPT	72148	0	$6,922	$6,922	—	—	—	—
MRI lumbar spine with and without contrast	CPT	72149	0	$7,911	$7,911	—	—	—	—
MRI cervical spine with and without contrast	CPT	72156	0	$9,224	$9,224	—	—	—	—
MRI lumbar spine with contrast	CPT	72158	0	$8,886	$8,886	—	—	—	—
CT pelvis without contrast	CPT	72192	0	$2,971	$2,971	—	—	—	—
CT pelvis with contrast	CPT	72193	0	$4,521	$4,521	—	—	—	—
Shoulder X-ray	CPT	73030	0	$769	$769	—	—	—	—
Humerus X-ray	CPT	73060	0	$749	$749	—	—	—	—
Hand X-ray 3 views	CPT	73130	0	$786	$786	—	—	—	—
MRI upper extremity joint without contrast	CPT	73221	0	$6,707	$6,707	—	—	—	—
MRI upper extremity joint with and without contrast	CPT	73223	0	$7,940	$7,940	—	—	—	—
Knee X-ray 1-2 views	CPT	73560	0	$730	$730	—	—	—	—
Ankle X-ray 3 views	CPT	73610	0	$854	$854	—	—	—	—
MRI lower extremity joint without contrast	CPT	73721	0	$6,327	$6,327	—	—	—	—
MRI lower extremity joint with and without contrast	CPT	73723	0	$7,407	$7,407	—	—	—	—
CT abdomen without contrast	CPT	74150	0	$3,948	$3,948	—	—	—	—
CT abdomen with contrast	CPT	74160	0	$4,883	$4,883	—	—	—	—
CT abdomen with and without contrast	CPT	74170	0	$5,529	$5,529	—	—	—	—
CT abdomen and pelvis without contrast	CPT	74176	0	$6,425	$6,425	—	—	—	—
CT abdomen and pelvis with contrast	CPT	74177	0	$7,822	$7,822	—	—	—	—
CT abdomen and pelvis with and without contrast	CPT	74178	0	$8,657	$8,657	—	—	—	—
MRI abdomen without contrast	CPT	74181	0	$5,697	$5,697	—	—	—	—
MRI abdomen with and without contrast	CPT	74183	0	$7,777	$7,777	—	—	—	—
Abdominal ultrasound complete	CPT	76700	0	$2,096	$2,096	—	—	—	—
Abdominal ultrasound limited	CPT	76705	0	$1,643	$1,643	—	—	—	—
Retroperitoneal ultrasound complete	CPT	76770	0	$1,976	$1,976	—	—	—	—
Obstetric ultrasound first trimester	CPT	76801	0	$1,404	$1,404	—	—	—	—
Obstetric ultrasound after first trimester	CPT	76805	0	$1,561	$1,561	—	—	—	—
Obstetric ultrasound with fetal anatomy	CPT	76811	0	$1,037	$1,037	—	—	—	—
Transvaginal ultrasound	CPT	76830	0	$1,387	$1,387	—	—	—	—
Pelvic ultrasound complete	CPT	76856	0	$1,858	$1,858	—	—	—	—
Scrotal ultrasound	CPT	76870	0	$1,490	$1,490	—	—	—	—
Diagnostic mammography unilateral	CPT	77065	0	$546	$546	—	—	—	—
Diagnostic mammography bilateral	CPT	77066	0	$696	$696	—	—	—	—
Screening mammography bilateral	CPT	77067	0	$578	$578	—	—	—	—
EKG tracing only	CPT	93005	0	$522	$522	—	—	—	—
Transthoracic echocardiogram complete	CPT	93306	0	$4,479	$4,479	—	—	—	—
Stress echocardiogram	CPT	93350	0	$3,246	$3,246	—	—	—	—
inpatient
Respiratory infections & inflammations w MCC	MS-DRG	177	0	—	—	—	—	—	—
COPD w MCC	MS-DRG	190	0	—	—	—	—	—	—
COPD w CC	MS-DRG	191	0	—	—	—	—	—	—
COPD w/o CC/MCC	MS-DRG	192	0	—	—	—	—	—	—
Simple pneumonia & pleurisy w CC	MS-DRG	194	0	—	—	—	—	—	—
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	0	—	—	—	—	—	—
AMI discharged alive w MCC	MS-DRG	280	0	—	—	—	—	—	—
AMI discharged alive w CC	MS-DRG	281	0	—	—	—	—	—	—
AMI discharged alive w/o CC/MCC	MS-DRG	282	0	—	—	—	—	—	—
Heart failure & shock w MCC	MS-DRG	291	0	—	—	—	—	—	—
Heart failure & shock w CC	MS-DRG	292	0	—	—	—	—	—	—
Heart failure & shock w/o CC/MCC	MS-DRG	293	0	—	—	—	—	—	—
Cardiac arrhythmia w MCC	MS-DRG	308	0	—	—	—	—	—	—
Cardiac arrhythmia w CC	MS-DRG	309	0	—	—	—	—	—	—
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	0	—	—	—	—	—	—
GI hemorrhage w CC	MS-DRG	378	0	—	—	—	—	—	—
GI hemorrhage w/o CC/MCC	MS-DRG	379	0	—	—	—	—	—	—
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	0	—	—	—	—	—	—
Fractures of femur w/o MCC	MS-DRG	533	0	—	—	—	—	—	—
Kidney/UTI w MCC	MS-DRG	689	0	—	—	—	—	—	—
Kidney/UTI w/o MCC	MS-DRG	690	0	—	—	—	—	—	—
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	0	—	—	—	—	—	—
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	0	—	—	—	—	—	—
lab
Basic metabolic panel (BMP)	CPT	80048	0	$210	$210	—	—	—	—
General health panel	CPT	80050	0	$765	$765	—	—	—	—
Electrolyte panel	CPT	80051	0	$171	$171	—	—	—	—
Comprehensive metabolic panel	CPT	80053	0	$243	$243	—	—	—	—
Lipid panel	CPT	80061	0	$332	$332	—	—	—	—
Renal function panel	CPT	80069	0	$127	$127	—	—	—	—
Hepatic function panel	CPT	80076	0	$228	$228	—	—	—	—
Urinalysis non-automated	CPT	81002	0	$88	$88	—	—	—	—
Urinalysis automated	CPT	81003	0	$97	$97	—	—	—	—
Glucose quantitative	CPT	82947	0	$104	$104	—	—	—	—
Hemoglobin A1c	CPT	83036	0	$219	$219	—	—	—	—
Thyroid stimulating hormone (TSH)	CPT	84443	0	$337	$337	—	—	—	—
Complete blood count with automated differential	CPT	85025	0	$163	$163	—	—	—	—
Complete blood count without differential	CPT	85027	0	$151	$151	—	—	—	—
Urine culture bacterial	CPT	87086	0	$254	$254	—	—	—	—
Urine culture identification	CPT	87088	0	$173	$173	—	—	—	—
Tissue exam by pathologist level IV	CPT	88305	0	$748	$748	—	—	—	—
maternity
Fetal non-stress test	CPT	59025	0	$942	$942	—	—	—	—
Vaginal delivery only	CPT	59409	0	$6,449	$6,449	—	—	—	—
office
Office visit, new patient, 15-29 min	CPT	99202	0	$336	$336	—	—	—	—
Office visit, new patient, 30-44 minutes	CPT	99203	0	$359	$359	—	—	—	—
Office visit, new patient, 45-59 min	CPT	99204	0	$384	$384	—	—	—	—
Office visit, new patient, 60-74 min	CPT	99205	0	$407	$407	—	—	—	—
Office visit, established patient, 5 min	CPT	99211	0	$249	$249	—	—	—	—
Office visit, established patient, 10-19 min	CPT	99212	0	$288	$288	—	—	—	—
Office visit, established patient, 20-29 minutes	CPT	99213	0	$311	$311	—	—	—	—
Office visit, established patient, 30-39 minutes	CPT	99214	0	$338	$338	—	—	—	—
Office visit, established patient, 40-54 min	CPT	99215	0	$361	$361	—	—	—	—
preventive
Upper GI endoscopy with biopsy	CPT	43239	0	$1,900	$1,900	—	—	—	—
surgery
Major small/large bowel procedures w MCC	MS-DRG	329	0	—	—	—	—	—	—
Major small/large bowel procedures w CC	MS-DRG	330	0	—	—	—	—	—	—
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	0	—	—	—	—	—	—
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	0	—	—	—	—	—	—
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	0	—	—	—	—	—	—
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	0	—	—	—	—	—	—
Spinal fusion (non-cervical) w MCC	MS-DRG	459	0	—	—	—	—	—	—
Spinal fusion (non-cervical) w/o MCC	MS-DRG	460	0	—	—	—	—	—	—
Major joint replacement w MCC	MS-DRG	469	0	—	—	—	—	—	—
Major joint replacement w/o MCC	MS-DRG	470	0	—	—	—	—	—	—
Hip & femur procedures except major joint w MCC	MS-DRG	480	0	—	—	—	—	—	—
Hip & femur procedures except major joint w CC	MS-DRG	481	0	—	—	—	—	—	—
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	0	—	—	—	—	—	—
OR procedure for obesity w MCC	MS-DRG	619	0	—	—	—	—	—	—
OR procedure for obesity w CC	MS-DRG	620	0	—	—	—	—	—	—
OR procedure for obesity w/o CC/MCC	MS-DRG	621	0	—	—	—	—	—	—
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	0	—	—	—	—	—	—
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	0	—	—	—	—	—	—
PCI single major coronary artery	CPT	92920	0	$11,776	$11,776	—	—	—	—
PCI with drug-eluting stent	CPT	92928	0	$17,235	$17,235	—	—	—	—
PCI bypass graft	CPT	92937	0	$23,146	$23,146	—	—	—	—
Left heart catheterization	CPT	93452	0	$10,461	$10,461	—	—	—	—
Coronary angiography with cath	CPT	93455	0	$13,934	$13,934	—	—	—	—
Coronary angiography with bypass cath	CPT	93458	0	$14,250	$14,250	—	—	—	—

Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

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