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 |
|---|---|---|---|---|
| Drng hand tendon sheath 26020 CPT 26020 | not published | not published | $1,778.00 – $5,899.11 | 10 |
| Drng of eyelid abscess 67700 CPT 67700 | $627.00 | $1,140.00 | $316.17 – $2,277.00 | 10 |
| Drng of finger abscess comp 26011 CPT 26011 | $1,135.20 | $2,064.00 | $1,325.00 – $2,977.67 | 10 |
| Drng of hydrocele 55000 CPT 55000 | not published | not published | $705.37 – $2,277.00 | 9 |
| Drng of mouth lesion 40801 CPT 40801 | not published | not published | $537.23 – $2,277.00 | 10 |
| Drng of ovarian cyst(s) 58800 CPT 58800 | not published | not published | $2,034.00 – $5,836.23 | 10 |
| Drng of palm multi bursas 26030 CPT 26030 | not published | not published | $1,778.00 – $5,899.11 | 10 |
| Drng of palm single bursa 26025 CPT 26025 | not published | not published | $1,325.00 – $5,899.11 | 10 |
| Drng of pelvic abscess transrectal 45000 CPT 45000 | not published | not published | $1,191.98 – $2,277.00 | 10 |
| Drng of salivary cyst 42409 CPT 42409 | not published | not published | $2,034.00 – $5,977.46 | 10 |
| Drng of scrotum abscess 55100 CPT 55100 | $1,596.54 | $2,902.80 | $1,325.00 – $2,977.67 | 10 |
| Drng open retroperitoneal abscess 49060 CPT 49060 | $1,556.00 | $2,829.10 | $2,277.00 – $3,233.00 | 2 |
| Drng open subdiaphragmatic/subphrenic absc 49040 CPT 49040 | $1,490.17 | $2,709.40 | $2,277.00 – $3,233.00 | 2 |
| Drng ovary abscess perqt 58822 CPT 58822 | not published | not published | $2,277.00 – $4,373.00 | 2 |
| Drng peritoneal abscess open 49020 CPT 49020 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Drng salivary gland simple 42300 CPT 42300 | not published | not published | $1,325.00 – $2,797.36 | 10 |
| Drng salivary gland submax/subling 42310 CPT 42310 | $1,567.50 | $2,850.00 | $537.23 – $2,277.00 | 10 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $843.34 | $1,533.34 | not published | 0 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | not published | not published | $13.19 – $224.36 | 8 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | not published | not published | $13.19 – $224.36 | 8 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | not published | not published | $14.85 – $224.36 | 8 |
| Drsg wnd hyalomatrix 10x10cm -cost per sq cm HCPCS Q4117 | not published | not published | $14.29 – $224.36 | 8 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | not published | not published | $30.22 – $224.36 | 8 |
| Drug admin & hemodynmic meas CPT 93463 | not published | not published | $194.53 – $1,351.00 | 2 |
| Drug assay caffeine CPT 80155 | not published | not published | $34.71 – $69.43 | 8 |
| Drug assay posaconazole CPT 80187 | not published | not published | $24.40 – $48.80 | 8 |
| Drug assay rufinamide CPT 80210 | not published | not published | $24.40 – $48.80 | 8 |
| Drug assay vedolizumab CPT 80280 | not published | not published | $34.71 – $69.43 | 8 |
| Drug assay voriconazole CPT 80285 | not published | not published | $24.40 – $48.80 | 8 |
| Drug asy hydroxychloroquine CPT 80220 | not published | not published | $16.78 – $33.55 | 8 |
| Drug of abuse screen urine CPT 80305 | not published | not published | $11.34 – $22.68 | 8 |
| Drug screen quant tiagabine CPT 80199 | $107.80 | $196.00 | $24.40 – $48.80 | 8 |
| Drug test def 15-21 classes HCPCS G0482 | not published | not published | $178.87 – $357.73 | 8 |
| Drug test def 1-7 classes HCPCS G0480 | $319.55 | $581.00 | $102.99 – $205.97 | 8 |
| Drug test def 22+ classes HCPCS G0483 | not published | not published | $222.23 – $444.46 | 8 |
| Drug test def 8-14 classes HCPCS G0481 | not published | not published | $140.93 – $281.86 | 8 |
| Drug test prsmv instrmnt CPT 80306 | $112.20 | $204.00 | $15.43 – $30.85 | 8 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $610.50 | $1,110.00 | $55.93 – $111.85 | 8 |
| Drvvt confirm - quest CPT 85597 | $325.60 | $592.00 | $16.18 – $32.36 | 8 |
| Dstrj extensive retinopathy CPT 67227 | not published | not published | $1,325.00 – $7,087.94 | 10 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | $297.00 | $540.00 | $1,325.00 – $3,520.58 | 10 |
| Dstr mal les s/n/h/f/g >4.0 CPT 17276 | not published | not published | $404.93 – $2,277.00 | 10 |
| Dstr mal ls f/e/e/n/l/m2.1-3 CPT 17283 | not published | not published | $404.93 – $2,277.00 | 9 |
| Dstr mal ls f/e/e/n/l/m3.1-4 CPT 17284 | not published | not published | $736.19 – $2,277.00 | 10 |
| Dstr mal ls f/e/e/n/l/m>4.0 CPT 17286 | not published | not published | $736.19 – $2,277.00 | 9 |
| Dstry eye lesn,fdr vssl tech HCPCS G0186 | not published | not published | $547.86 – $991.59 | 8 |
| Ductogram sgl duct CPT 77053 | $273.45 | $497.19 | $69.37 – $430.18 | 8 |
| Duodenal motility study CPT 91022 | not published | not published | $169.96 – $672.77 | 8 |
| Duplex scan bilateral study 93985 CPT 93985 | not published | not published | $237.67 – $430.18 | 8 |
| Duplex scan unilateral study 93986 CPT 93986 | not published | not published | $104.14 – $188.49 | 8 |
| Dup scan/hemodialysis access 93990 CPT 93990 | not published | not published | $104.14 – $188.49 | 8 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $1,406.90 | $2,558.00 | $215.08 – $389.29 | 8 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $1,040.94 | $1,892.61 | $237.67 – $430.18 | 8 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | not published | not published | $87.47 – $158.31 | 8 |
| Dxa bone density axl vrt fx CPT 77085 | not published | not published | $66.60 – $188.49 | 8 |
| Dx aly aud oi snd prcsr 1st CPT 92622 | not published | not published | $112.40 – $231.99 | 8 |
| Dx bronchoscope/brush 31623 CPT 31623 | $1,254.00 | $2,280.00 | $1,772.97 – $3,208.99 | 10 |
| Dx bronchoscope/lavage 31624 CPT 31624 | $1,254.00 | $2,280.00 | $1,772.97 – $3,208.99 | 10 |
| Dx bronchoscope/wash 31622 CPT 31622 | $1,442.10 | $2,622.00 | $1,325.00 – $3,208.99 | 10 |
| Dx dark adaptation exam i&r CPT 92284 | not published | not published | $83.66 – $805.40 | 8 |
| Dx duod intub w/asp spec 43756 CPT 43756 | not published | not published | $903.45 – $2,277.00 | 10 |
| Dx duod intub w/asp specs CPT 43757 | not published | not published | $903.45 – $2,277.00 | 10 |
| Dx gastr intub w/asp spec CPT 43754 | not published | not published | $215.08 – $2,277.00 | 10 |
| Dx gastr intub w/asp specs CPT 43755 | not published | not published | $128.17 – $2,277.00 | 10 |
| Dx laryngoscopy newborn CPT 31520 | not published | not published | $389.60 – $2,277.00 | 9 |
| Dx laryngoscopy w/oper scope CPT 31526 | not published | not published | $1,772.97 – $3,208.99 | 10 |
| Dynamic cavernosometry CPT 54231 | not published | not published | $248.88 – $2,277.00 | 9 |
| Dynamic surface emg CPT 96002 | not published | not published | $38.90 – $389.29 | 8 |
| Ear and throat examination CPT 92502 | not published | not published | $172.51 – $972.36 | 8 |
| Ear canal biopsy 69105 CPT 69105 | not published | not published | $1,545.54 – $2,797.36 | 9 |
| Ear cartilage graft CPT 21235 | not published | not published | $2,277.00 – $10,672.90 | 10 |
| Ear irrigation 69209 CPT 69209 | $435.60 | $792.00 | $58.76 – $2,277.00 | 9 |
| Ear protector evaluation CPT 92596 | not published | not published | $37.21 – $67.34 | 8 |
| Ecallantide injection HCPCS J1290 | not published | not published | $592.67 – $1,072.70 | 8 |
| Ecg 12 lead tracing only CPT 93005 | $184.25 | $335.00 | $16.59 – $106.36 | 8 |
| Ecg/1-3 leads/interp & report only 93042 CPT 93042 | not published | not published | $13.10 – $13.10 | 1 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | not published | not published | $10.00 – $106.36 | 8 |
| Ecg < 30 days transmission & analysis CPT 93271 | not published | not published | $94.70 – $171.40 | 8 |
| Ecg external < 48 hours recording CPT 93225 | $382.66 | $695.74 | $45.73 – $239.87 | 8 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | not published | not published | $58.76 – $106.36 | 8 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | not published | not published | $24.81 – $67.34 | 8 |
| Ecg external >7 days up to 15 days recording CPT 93246 | not published | not published | $24.81 – $67.34 | 8 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $2,077.18 | $3,776.70 | $206.22 – $985.13 | 8 |
| Echocardiography doppler color flow mapping CPT 93325 | $725.86 | $1,319.75 | $26.50 – $26.50 | 1 |
| Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 | $2,631.10 | $4,783.82 | $780.87 – $1,413.34 | 8 |
| Echocardiography transthoracic 2d followup/limited CPT 93308 | $835.49 | $1,519.07 | $122.14 – $430.18 | 8 |
| Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast HCPCS C8924 | $1,315.55 | $2,391.91 | $347.51 – $628.99 | 8 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $480.64 | $873.89 | $27.05 – $27.05 | 1 |
| Echo exam of eye CPT 76516 | not published | not published | $81.46 – $188.49 | 8 |
| Echo exam of eye CPT 76519 | not published | not published | $90.80 – $188.49 | 8 |
| Echo exam of eye CPT 76529 | not published | not published | $79.81 – $156.90 | 8 |
| Echo exam of eye thickness CPT 76514 | not published | not published | $9.45 – $52.15 | 8 |
| Echo exam of fetal heart CPT 76825 | not published | not published | $227.68 – $985.13 | 8 |
| Echo exam of fetal heart CPT 76826 | not published | not published | $150.71 – $430.18 | 8 |
| Echo exam of fetal heart CPT 76827 | not published | not published | $52.87 – $188.49 | 8 |
| Echo exam of fetal heart CPT 76828 | not published | not published | $28.68 – $188.49 | 8 |
| Echo exam uterus 76831- CPT 76831 | not published | not published | $150.71 – $430.18 | 8 |
| Echograp trans r pros study CPT 76873 | $615.34 | $1,118.80 | $104.14 – $188.49 | 8 |
| Echo guidance radiotherapy CPT 76965 | $769.18 | $1,398.50 | $39.70 – $39.70 | 1 |
| Echo guide for amniocentesis CPT 76946 | $675.80 | $1,228.72 | $22.65 – $22.65 | 1 |
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.