SSM Health St. Mary's Hospital - Jefferson City
2505 Mission Drive, Jefferson City, MO · SSM Health · · NPI 1518065523
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Adh-sendout CPT 84588 | $776.60 | $1,412.00 | $30.55 – $61.09 | 8 |
| Adj gastric band via subq port CPT 43999 | not published | not published | $903.45 – $2,277.00 | 9 |
| Adjmt/revj ext fixj sys anes CPT 20693 | not published | not published | $2,034.00 – $13,082.27 | 10 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | $1,009.80 | $1,836.00 | $2,034.00 – $3,719.90 | 10 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $184.80 | $336.00 | $51.41 – $129.81 | 8 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $414.48 | $753.60 | $71.72 – $129.81 | 8 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $533.50 | $970.00 | $234.66 – $595.51 | 8 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $260.70 | $474.00 | $183.71 – $595.51 | 8 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $236.94 | $430.80 | $54.71 – $129.81 | 8 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $236.94 | $430.80 | $71.72 – $129.81 | 8 |
| Administration immunization 1 vaccine CPT 90471 | $25.85 | $47.00 | $43.53 – $129.81 | 8 |
| Administration immunization each additional component CPT 90461 | not published | not published | $21.89 – $21.89 | 1 |
| Administration immunization each additional vaccine CPT 90472 | $26.95 | $49.00 | $21.89 – $21.89 | 1 |
| Administration immunization first component each vaccine CPT 90460 | $32.45 | $59.00 | $43.53 – $43.53 | 1 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $23.10 | $42.00 | $43.53 – $129.81 | 8 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | not published | not published | $21.89 – $21.89 | 1 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | not published | not published | $37.84 – $37.84 | 1 |
| Administration vaccine hepatitis b HCPCS G0010 | $60.50 | $110.00 | $43.53 – $84.42 | 8 |
| Administration vaccine influenza virus HCPCS G0008 | $38.50 | $70.00 | $43.53 – $84.42 | 8 |
| Administration vaccine pneumococcal HCPCS G0009 | $33.00 | $60.00 | $43.53 – $84.42 | 8 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | not published | not published | $32.60 – $32.60 | 1 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | not published | not published | $43.39 – $78.53 | 8 |
| Adrenal cortex & medulla img CPT 78075 | not published | not published | $658.93 – $2,334.13 | 8 |
| Adrenalectomy expl w/exc retro tumor 60545 CPT 60545 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Advance care planning each additional 30 min 99498 CPT 99498 | $115.50 | $210.00 | not published | 0 |
| Aep hearing status deter i&r CPT 92651 | not published | not published | $157.59 – $389.29 | 8 |
| Aep neurodiagnostic i&r CPT 92653 | not published | not published | $151.87 – $389.29 | 8 |
| Aep thrshld est mlt freq i&r CPT 92652 | not published | not published | $208.14 – $389.29 | 8 |
| Afamelanotide implant, 1 mg HCPCS J7352 | not published | not published | $2,927.23 – $5,298.16 | 8 |
| _afb id by dna probe rflx ast CPT 87149 | $106.70 | $194.00 | $18.05 – $36.09 | 8 |
| #afb mycobacteria suscep. #1 CPT 87190 | not published | not published | $1.71 – $13.16 | 8 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $139.70 | $254.00 | $103.82 – $207.65 | 8 |
| Aflibercept injection HCPCS J0178 | not published | not published | $739.52 – $1,338.49 | 8 |
| After cataract laser surgery CPT 66821 | not published | not published | $547.86 – $2,277.00 | 10 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | not published | not published | $231.44 – $418.90 | 9 |
| Air conduction bilat CPT 92552 | not published | not published | $52.32 – $239.87 | 8 |
| Air injection into abdomen 49400 CPT 49400 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | not published | not published | $53.42 – $231.99 | 8 |
| Albumin body fluid quantitative each specimen CPT 82042 | $51.70 | $94.00 | $7.00 – $14.00 | 8 |
| Albumin, human 25 % intravenous solution HCPCS P9046 | not published | not published | $21.21 – $38.39 | 8 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | not published | not published | $52.79 – $95.54 | 8 |
| Albumin ischemia modified CPT 82045 | not published | not published | $30.55 – $61.09 | 8 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $38.50 | $70.00 | $5.20 – $10.40 | 8 |
| Albumin serum plasma or whole blood CPT 82040 | $38.50 | $70.00 | $4.46 – $8.91 | 8 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | not published | not published | $15.54 – $31.09 | 8 |
| Alcohol/sub misuse assess HCPCS G2011 | not published | not published | $28.81 – $52.15 | 8 |
| Alcohol/subs interv >30 min HCPCS G0397 | not published | not published | $121.14 – $320.01 | 8 |
| Aldesleukin injection HCPCS J9015 | not published | not published | $3,320.51 – $6,009.97 | 8 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | not published | not published | $2,530.94 – $4,580.89 | 9 |
| Alkaline phosphatase CPT 84075 | $34.10 | $62.00 | $4.66 – $9.32 | 8 |
| Allergen alpha lactalbumin ige CPT 86008 | $43.45 | $79.00 | $16.14 – $32.27 | 8 |
| Allergen egg white ige CPT 86003 | $52.80 | $96.00 | $4.70 – $9.40 | 8 |
| Allergen specific ige qual multi scrn ea CPT 86005 | $125.95 | $229.00 | $7.17 – $14.35 | 8 |
| Allergy injections; 2 or more 95117 CPT 95117 | not published | not published | $17.69 – $84.42 | 8 |
| Allergy injection; single 95115 CPT 95115 | not published | not published | $15.51 – $84.42 | 8 |
| Allergy Skin Testing CPT 95004 | not published | not published | $11.20 – $1,548.23 | 8 |
| Allg patch or app # of tests 95044 CPT 95044 | not published | not published | $9.45 – $1,548.23 | 8 |
| Allgrft implnt knee w/scope CPT 29867 | not published | not published | $2,277.00 – $23,146.94 | 9 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | not published | not published | $120.45 – $224.36 | 8 |
| Allograft amnioexcel plus 17mm disk HCPCS Q4137 | not published | not published | $123.96 – $224.36 | 8 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | not published | not published | $50.06 – $224.36 | 8 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | not published | not published | $123.96 – $224.36 | 8 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | not published | not published | $123.96 – $224.36 | 8 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | not published | not published | $123.96 – $224.36 | 8 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | not published | not published | $123.96 – $224.36 | 8 |
| Alloskin HCPCS Q4115 | not published | not published | $13.19 – $224.36 | 8 |
| All tstg perq&iq drugs/biol CPT 95018 | not published | not published | $13.00 – $67.34 | 8 |
| All tstg perq&iq w/venoms CPT 95017 | not published | not published | $6.83 – $52.15 | 8 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | not published | not published | $5.10 – $9.24 | 8 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | $240.35 | $437.00 | $57.97 – $115.94 | 8 |
| Alpha-fetoprotein amniotic CPT 82106 | not published | not published | $15.30 – $30.60 | 8 |
| Alpha-fetoprotein tumor marker CPT 82105 | $156.20 | $284.00 | $15.09 – $30.19 | 8 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | not published | not published | $96.97 – $177.46 | 8 |
| Alt/sgpt CPT 84460 | $46.75 | $85.00 | $4.77 – $9.54 | 8 |
| Altuviiio per factor viii iu HCPCS J7214 | not published | not published | $4.61 – $8.34 | 8 |
| Aluminum - quest CPT 82108 | $73.15 | $133.00 | $22.93 – $45.86 | 8 |
| Alveoloplasty each quadrant CPT 41874 | not published | not published | $2,277.00 – $5,977.46 | 9 |
| Alys cplx sp/pn npgt w/prgrm CPT 95972 | not published | not published | $94.70 – $171.40 | 8 |
| Amantadine (symmetrel)-sendout CPT 80375 | $276.10 | $502.00 | $40.87 – $40.87 | 1 |
| Ambl bp mntr w/sw a/r CPT 93788 | not published | not published | $9.45 – $239.87 | 8 |
| Amino acid screen, urine CPT 82128 | not published | not published | $12.48 – $24.97 | 8 |
| Amino acid single qual CPT 82127 | not published | not published | $12.76 – $25.52 | 8 |
| Amino acids quant 2-5 CPT 82136 | not published | not published | $17.65 – $35.30 | 8 |
| Aminolevulinic acid, 10% gel HCPCS J7345 | not published | not published | $1.82 – $3.33 | 8 |
| Aminolevulinic acid delta CPT 82135 | $102.30 | $186.00 | $14.81 – $29.61 | 8 |
| Aminolevulinic acid hcl top HCPCS J7308 | not published | not published | $387.14 – $700.70 | 8 |
| Amitriptyline (elavil) -sendout CPT 80335 | $355.85 | $647.00 | $9.49 – $9.49 | 1 |
| Amivantamab-vmjw 50 mg/ml intravenous solution HCPCS J9061 | not published | not published | $22.85 – $41.79 | 9 |
| Ammonia CPT 82140 | $95.70 | $174.00 | $13.11 – $26.23 | 8 |
| Amniocentesisdiagnostic 59000 CPT 59000 | $600.60 | $1,092.00 | $917.46 – $2,277.00 | 9 |
| Amniocentesis therapeutic CPT 59001 | $660.00 | $1,200.00 | $303.54 – $2,277.00 | 9 |
| Amniotic fluid scan CPT 82143 | not published | not published | $8.42 – $16.83 | 8 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | $9,922.44 | $18,040.80 | $2,277.00 – $5,899.11 | 10 |
| Amphetamine confirm urine -sendout CPT 80324 | $121.00 | $220.00 | $28.78 – $28.78 | 1 |
| Amphetamines 5 or more CPT 80326 | $195.25 | $355.00 | $17.52 – $17.52 | 1 |
| Amphotericin b lipid complex HCPCS J0287 | not published | not published | $10.92 – $10.92 | 1 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | not published | not published | $19.74 – $35.72 | 8 |
| Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 | not published | not published | $236.69 – $473.38 | 8 |
| Amp metatarsal w/toe single 28810 CPT 28810 | $575.85 | $1,047.00 | $1,778.00 – $5,899.11 | 10 |
| Amp thigh through femur re-amp 27596 CPT 27596 | not published | not published | $2,277.00 – $5,899.11 | 9 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.