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 |
|---|---|---|---|---|
| Dest mal lesion feenlm 1.1 - 2.0 cm 17282 CPT 17282 | not published | not published | $199.85 – $2,277.00 | 9 |
| Dest mal lesion snhfg <0.5cm 17270 CPT 17270 | not published | not published | $199.85 – $2,277.00 | 9 |
| Dest mal lesion snhfg 0.6-1cm 17271 CPT 17271 | not published | not published | $199.85 – $2,277.00 | 9 |
| Dest mal lesion snhfg 1.1-2cm 17272 CPT 17272 | not published | not published | $199.85 – $2,277.00 | 9 |
| Dest mal lesion tal <0.5 17260 CPT 17260 | not published | not published | $199.85 – $2,277.00 | 9 |
| Dest mal lesion tal 0.6-1.0cm 17261 CPT 17261 | not published | not published | $199.85 – $2,277.00 | 9 |
| Dest mal lesion tal 1.1-2.0cm 17262 CPT 17262 | not published | not published | $199.85 – $2,277.00 | 9 |
| Dest mal lesion tal 2.1-3.0cm 17263 CPT 17263 | not published | not published | $199.85 – $2,277.00 | 9 |
| Destroy cervthor facet jnt 64633 CPT 64633 | $323.14 | $587.52 | $1,325.00 – $3,520.58 | 10 |
| Destroy cth facet jnt addl 64634 CPT 64634 | $179.04 | $325.53 | $1,351.00 – $2,277.00 | 2 |
| Destroy internal hemorrhoids destroy 46930 CPT 46930 | not published | not published | $1,191.98 – $2,857.00 | 10 |
| Destroy premlg lesns;1st lesn 17000 CPT 17000 | $77.62 | $141.12 | $199.85 – $2,277.00 | 9 |
| Destroy vulva lesion extensive 56515 CPT 56515 | not published | not published | $2,034.00 – $3,719.90 | 10 |
| Destroy vulva lesion simple 56501 CPT 56501 | not published | not published | $2,055.25 – $3,719.90 | 9 |
| Destruct ben lesion 15/> 17111 CPT 17111 | not published | not published | $199.85 – $2,277.00 | 9 |
| Destruct cut vasl lesions 10-50cm 17107 CPT 17107 | not published | not published | $736.19 – $2,277.00 | 10 |
| Destruct cut vasl lesions <10cm 17106 CPT 17106 | not published | not published | $404.93 – $2,277.00 | 10 |
| Destruct cut vasl lesions >50cm 17108 CPT 17108 | $693.55 | $1,261.00 | $1,325.00 – $3,719.90 | 10 |
| Destruction 2-14 lesions 17003 CPT 17003 | $8.71 | $15.84 | $1,351.00 – $2,277.00 | 2 |
| Destruction anal lesion(s) CPT 46910 | not published | not published | $2,055.25 – $3,719.90 | 9 |
| Destruction anal lesion(s) CPT 46924 | not published | not published | $1,325.00 – $5,004.26 | 10 |
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | not published | not published | $404.93 – $2,277.00 | 10 |
| Destruction benign lesions < 14 lesions CPT 17110 | $181.50 | $330.00 | $199.85 – $2,277.00 | 9 |
| Destruction by injection tx of nerve 64630 CPT 64630 | not published | not published | $881.03 – $2,277.00 | 10 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | $177.16 | $322.10 | $1,351.00 – $2,277.00 | 2 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | $325.10 | $591.10 | $1,945.12 – $3,520.58 | 10 |
| Destruction ciliary body CPT 66700 | not published | not published | $1,778.00 – $4,160.79 | 10 |
| Destruction ciliary body CPT 66720 | not published | not published | $1,778.00 – $4,286.38 | 10 |
| Destruction ciliary body CPT 66740 | not published | not published | $1,778.00 – $4,286.38 | 10 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | not published | not published | $199.85 – $2,277.00 | 9 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | not published | not published | $1,325.00 – $5,004.26 | 10 |
| Destruction les conjunctiva CPT 68135 | not published | not published | $1,325.00 – $4,286.38 | 10 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | $404.93 – $2,277.00 | 9 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | $404.93 – $2,277.00 | 10 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | not published | not published | $404.93 – $2,277.00 | 9 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | not published | not published | $404.93 – $2,277.00 | 10 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | not published | not published | $404.93 – $2,277.00 | 9 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | $1,325.00 – $3,719.90 | 10 |
| Destruction premal lesions 15/> 17004 CPT 17004 | not published | not published | $404.93 – $2,277.00 | 10 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $2,277.00 – $5,340.00 | 10 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $1,325.00 – $5,836.23 | 10 |
| Destruction vag lesions simple 57061 CPT 57061 | not published | not published | $2,277.00 – $5,836.23 | 9 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $2,055.25 – $3,719.90 | 9 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $27.03 – $54.05 | 8 |
| Detect agnt mult dna direc CPT 87800 | not published | not published | $39.30 – $78.61 | 8 |
| Developmental screen/score/document 96110 CPT 96110 | not published | not published | $14.96 – $14.96 | 1 |
| Devel tst phys/qhp 1st hr CPT 96112 | not published | not published | $128.17 – $231.99 | 8 |
| Device ablt adv novasure HCPCS C1886 | $5,004.93 | $9,099.88 | not published | 0 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $2,690.19 | $4,891.25 | not published | 0 |
| Device tiss remov myosure reach HCPCS C1782 | $1,111.99 | $2,021.80 | not published | 0 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | not published | not published | $108.91 – $108.91 | 1 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $166.98 | $303.60 | $28.68 – $156.90 | 8 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $202.54 – $366.58 | 8 |
| Dexmedetomidine film, 1 mcg HCPCS J1105 | not published | not published | $0.69 – $0.69 | 1 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | not published | not published | $41.21 – $74.59 | 8 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $205.15 | $373.00 | $20.01 – $40.01 | 8 |
| Diabetes (HbA1c) Test CPT 83036 | $58.30 | $106.00 | $8.74 – $17.48 | 8 |
| Diabetes training group per 30 min g0109 HCPCS G0136 | not published | not published | $15.57 – $67.55 | 8 |
| Diab manage trn ind/group HCPCS G0109 | $71.50 | $130.00 | $14.93 – $27.02 | 8 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $1,772.97 – $3,208.99 | 10 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $4,383.00 – $10,899.52 | 10 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $444.98 – $2,277.00 | 10 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $1,191.98 – $2,514.00 | 10 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $71.06 | $129.20 | $132.53 – $2,277.00 | 9 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $103.00 | $187.28 | $151.45 – $263.00 | 2 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $51.50 | $93.64 | $192.90 – $205.70 | 2 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $239.30 | $435.10 | $198.83 – $2,277.00 | 9 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $171.90 | $312.55 | $198.83 – $2,277.00 | 9 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $330.00 | $600.00 | $103.27 – $186.91 | 8 |
| Diagnostic Mammogram (one breast) CPT 77065 | $165.00 | $300.00 | $73.91 – $133.78 | 8 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $74.32 – $156.90 | 8 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $3,301.68 | $6,003.05 | $1,351.00 – $2,277.00 | 2 |
| Dialysis one evaluation CPT 90945 | $768.24 | $1,396.80 | $152.76 – $752.28 | 8 |
| Diathermy eg microwave CPT 97024 | not published | not published | $6.99 – $12.65 | 8 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.14 – $0.14 | 1 |
| Diffusing capacity CPT 94729 | $617.05 | $1,121.91 | $85.86 – $85.86 | 1 |
| Digital analysis of eeg CPT 95957 | not published | not published | $586.04 – $586.04 | 1 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | not published | not published | $5,353.71 – $9,689.98 | 8 |
| Digoxin total therapeutic drug level CPT 80162 | $75.90 | $138.00 | $11.95 – $23.90 | 8 |
| Dilate biliary duct/ampulla CPT 47542 | $2,908.95 | $5,289.00 | $1,351.00 – $2,277.00 | 2 |
| Dilate esophagus CPT 43453 | $5,083.32 | $9,242.40 | $1,325.00 – $3,459.61 | 10 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $903.45 – $2,277.00 | 10 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | not published | not published | $1,778.00 – $3,233.00 | 3 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | not published | not published | $1,778.00 – $3,233.00 | 3 |
| Dilate ic vasospasm init CPT 61640 | not published | not published | $2,034.00 – $3,233.00 | 3 |
| Dilate tear duct opening CPT 68801 | not published | not published | $444.98 – $2,277.00 | 9 |
| Dilate urethra stricture CPT 53600 | $604.56 | $1,099.20 | $248.88 – $2,277.00 | 10 |
| Dilate urethra stricture CPT 53601 | not published | not published | $132.53 – $2,277.00 | 10 |
| Dilate urethra stricture CPT 53605 | not published | not published | $1,778.00 – $6,355.21 | 10 |
| Dilate urethra stricture CPT 53621 | not published | not published | $248.88 – $2,277.00 | 10 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $128.17 – $2,277.00 | 9 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $1,191.98 – $2,277.00 | 10 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $1,325.00 – $5,836.23 | 10 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $1,191.98 – $2,277.00 | 10 |
| Dilation of salivary duct CPT 42660 | not published | not published | $537.23 – $2,277.00 | 9 |
| Dilation of urethra CPT 53661 | not published | not published | $132.53 – $2,277.00 | 9 |
| Dilation of urethra CPT 53665 | not published | not published | $1,325.00 – $3,768.77 | 10 |
| Dilation of vagina CPT 57400 | not published | not published | $1,778.00 – $5,836.23 | 10 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $1,325.00 – $2,797.36 | 10 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $3,533.64 | $6,424.80 | $694.58 – $2,277.00 | 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.