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 |
|---|---|---|---|---|
| Epidrm a-grft face/nck/hf/g 15115 CPT 15115 | $3,000.72 | $5,455.85 | $1,778.00 – $3,719.90 | 10 |
| Epidrm a-grft f/n/hf/g addl CPT 15116 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Epidrm agrft t/a/l 1st 100 CPT 15110 | $3,182.55 | $5,786.45 | $1,778.00 – $3,719.90 | 10 |
| Epidrm autogrft t/a/l add-on CPT 15111 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Epidural/lumbar/sacral/ea add level64484 CPT 64484 | $287.10 | $522.00 | $1,351.00 – $2,277.00 | 2 |
| Epidural lysis mult sessions CPT 62263 | not published | not published | $881.03 – $2,277.00 | 10 |
| Epidural lysis on single day 62264 CPT 62264 | $3,662.34 | $6,658.80 | $881.03 – $2,277.00 | 10 |
| Epiglottidectomy CPT 31420 | not published | not published | $1,778.00 – $10,672.90 | 10 |
| Epilepsy gen seq alys panel CPT 81419 | not published | not published | $2,203.70 – $4,407.41 | 8 |
| Ep induct arrhy by elect pacing CPT 93618 | not published | not published | $274.85 – $7,666.00 | 9 |
| Epiphysl arrst dstl rds&ulna CPT 25455 | not published | not published | $2,034.00 – $5,899.11 | 10 |
| Epiphysl arrst dstl rds/ulna CPT 25450 | not published | not published | $2,034.00 – $5,899.11 | 10 |
| Episiotomy/vag rpr oth/thn attending phys 59300 CPT 59300 | $7,207.20 | $13,104.00 | $2,277.00 – $5,836.23 | 9 |
| Epoetin alfa-epbx 40,000 unit/ml injection solution HCPCS Q5106 | not published | not published | $7.92 – $14.34 | 8 |
| Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr HCPCS J0885 | not published | not published | $6.84 – $12.38 | 8 |
| Epoetin beta non esrd HCPCS J0888 | not published | not published | $1.28 – $1.28 | 1 |
| Epstein barr early antigen antibody CPT 86663 | $306.90 | $558.00 | $11.81 – $23.62 | 8 |
| Epstein barr nuclear antigen antibody CPT 86664 | $62.15 | $113.00 | $13.76 – $27.52 | 8 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $88.00 | $160.00 | $16.33 – $32.65 | 8 |
| Eptinezumab-jjmr 100 mg/ml intravenous solution HCPCS J3032 | not published | not published | $20.48 – $37.98 | 8 |
| Ercp biliary & pancreas CPT 74330 | $1,269.84 | $2,308.80 | $217.23 – $217.23 | 1 |
| Ercp bil/panc duct; each stent plcmt 43274 CPT 43274 | not published | not published | $2,277.00 – $10,945.26 | 10 |
| Ercp ea duct/ampulla dilate CPT 43277 | not published | not published | $2,277.00 – $6,951.05 | 10 |
| Ercp lesion ablate w/dilate 43278 CPT 43278 | not published | not published | $2,277.00 – $6,951.05 | 10 |
| Ercp lithotripsy calculi CPT 43265 | not published | not published | $1,778.00 – $10,945.26 | 10 |
| Ercp remove duct calculi 43264 CPT 43264 | not published | not published | $1,778.00 – $6,951.05 | 10 |
| Ercp remove forgn body duct 43275 CPT 43275 | not published | not published | $1,911.43 – $5,340.00 | 10 |
| Ercp sphincter pressure meas CPT 43263 | not published | not published | $1,778.00 – $3,459.61 | 10 |
| Ercp stent exchange w/dilate CPT 43276 | not published | not published | $2,277.00 – $10,945.26 | 10 |
| Ercp w/specimen collection CPT 43260 | not published | not published | $1,778.00 – $6,951.05 | 10 |
| Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution HCPCS J9179 | not published | not published | $59.65 – $107.96 | 8 |
| ER Visit (level 1, minor) CPT 99281 | $190.46 | $346.30 | $84.00 – $152.03 | 8 |
| ER Visit (level 2) CPT 99282 | $379.77 | $690.49 | $152.95 – $276.83 | 8 |
| ER Visit (level 3) CPT 99283 | $751.41 | $1,366.20 | $271.91 – $492.15 | 8 |
| ER Visit (level 4) CPT 99284 | $1,239.18 | $2,253.06 | $415.64 – $752.28 | 8 |
| ER Visit (level 5, high severity) CPT 99285 | $1,735.09 | $3,154.71 | $593.21 – $1,073.69 | 8 |
| Esd endoscopy or colonoscopy HCPCS C9779 | not published | not published | $3,480.00 – $6,951.05 | 8 |
| Esophageal dilat s&i CPT 74360 | $877.80 | $1,596.00 | $217.23 – $217.23 | 1 |
| Esophageal lengthening add on code 43338 CPT 43338 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Esophageal motility CPT 78258 | not published | not published | $317.49 – $720.75 | 8 |
| Esophageal recording CPT 93615 | not published | not published | $22.19 – $7,666.00 | 9 |
| Esophageal recording CPT 93616 | not published | not published | $274.85 – $7,666.00 | 9 |
| Esophag muc integ w/eso egd HCPCS C9777 | not published | not published | $3,480.00 – $6,951.05 | 8 |
| Esophagomyotomy abdominal 43330 CPT 43330 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Esophagomyotomy thoracic 43331 CPT 43331 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Esophagosc dilate balloon 30 CPT 43214 | not published | not published | $1,911.43 – $3,459.61 | 10 |
| Esophagosc flex trnsn biopsy CPT 43198 | not published | not published | $903.45 – $2,277.00 | 10 |
| Esophagoscop mucosal resect CPT 43211 | not published | not published | $1,911.43 – $3,459.61 | 10 |
| Esophagoscop stent placement CPT 43212 | not published | not published | $2,277.00 – $10,945.26 | 10 |
| Esophagoscop ultrasound exam CPT 43231 | not published | not published | $1,778.00 – $3,459.61 | 10 |
| Esophagoscopy balloon <30mm CPT 43220 | not published | not published | $1,325.00 – $3,459.61 | 10 |
| Esophagoscopy control bleed CPT 43227 | not published | not published | $1,778.00 – $3,459.61 | 10 |
| Esophagoscopy flex biopsy CPT 43202 | not published | not published | $1,325.00 – $3,459.61 | 10 |
| Esophagoscopy/flex/diagnostic 43200 CPT 43200 | not published | not published | $903.45 – $2,277.00 | 10 |
| Esophagoscopy flex dx brush CPT 43197 | not published | not published | $903.45 – $2,277.00 | 10 |
| Esophagoscopy flex remove fb CPT 43215 | $362.09 | $658.35 | $1,325.00 – $3,459.61 | 10 |
| Esophagoscopy lesion ablate CPT 43229 | not published | not published | $2,277.00 – $6,951.05 | 10 |
| Esophagoscopy lesion removal CPT 43216 | not published | not published | $1,325.00 – $3,459.61 | 10 |
| Esophagoscopy retro balloon CPT 43213 | not published | not published | $1,911.43 – $3,459.61 | 10 |
| Esophagoscopy rigid balloon CPT 43195 | not published | not published | $2,277.00 – $6,951.05 | 10 |
| Esophagoscopy/rigid/diagnostic 43191 CPT 43191 | not published | not published | $1,911.43 – $3,459.61 | 10 |
| Esophagoscopy rigid trnso 43180 CPT 43180 | not published | not published | $2,277.00 – $10,672.90 | 10 |
| Esophagoscopy snare les remv CPT 43217 | not published | not published | $1,325.00 – $3,459.61 | 10 |
| Esophagoscopy w/us needle bx CPT 43232 | not published | not published | $1,778.00 – $3,459.61 | 10 |
| Esophagoscp guide wire dilat 43196 CPT 43196 | not published | not published | $1,911.43 – $3,459.61 | 10 |
| Esophagoscp rig trnso biopsy CPT 43193 | not published | not published | $1,911.43 – $3,459.61 | 10 |
| Esophagoscp rig trnso inject CPT 43192 | not published | not published | $1,911.43 – $3,459.61 | 10 |
| Esophagoscp rig trnso rem fb CPT 43194 | not published | not published | $1,911.43 – $3,459.61 | 10 |
| Esophagus endoscopy/ligation CPT 43205 | not published | not published | $1,325.00 – $3,459.61 | 10 |
| Esophagus motility study CPT 91010 | not published | not published | $193.60 – $672.77 | 8 |
| Esoph balloon distension tst CPT 91040 | not published | not published | $371.70 – $672.77 | 8 |
| Esoph egd dilation <30 mm CPT 43249 | not published | not published | $1,647.00 – $3,459.61 | 10 |
| Esoph endoscopy dilation CPT 43226 | not published | not published | $1,325.00 – $3,459.61 | 10 |
| Esoph fundoplasty lap 43327 CPT 43327 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Esoph fundoplasty thor 43328 CPT 43328 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Esophgl motil w/stim/perfus CPT 91013 | not published | not published | $25.40 – $1,351.00 | 2 |
| Esoph imped function test CPT 91037 | not published | not published | $194.68 – $389.29 | 8 |
| Esoph imped funct test > 1hr CPT 91038 | not published | not published | $371.70 – $672.77 | 8 |
| Esoph optical endomicroscopy CPT 43206 | not published | not published | $1,911.43 – $3,459.61 | 10 |
| Esoph scope w/sclerosis inj CPT 43204 | not published | not published | $1,325.00 – $3,459.61 | 10 |
| Esoph scope w/submucous inj CPT 43201 | not published | not published | $1,325.00 – $3,459.61 | 10 |
| Esphg dstl 2/3 w/laps moblj 43287 CPT 43287 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Essure 58565 CPT 58565 | not published | not published | $2,277.00 – $9,018.95 | 10 |
| Establish access to aorta CPT 36160 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Establish access to artery CPT 36100 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Establish brain cavity shunt CPT 62223 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Established Patient Office Visit (level 1) CPT 99211 | $109.96 | $199.92 | not published | 0 |
| Established Patient Office Visit (level 2) CPT 99212 | $115.93 | $210.78 | not published | 0 |
| Established Patient Office Visit (level 3) CPT 99213 | $131.45 | $239.00 | not published | 0 |
| Established Patient Office Visit (level 4) CPT 99214 | $166.65 | $303.00 | not published | 0 |
| Established Patient Office Visit (level 5) CPT 99215 | $189.20 | $344.00 | not published | 0 |
| Estradiol total CPT 82670 | $196.90 | $358.00 | $25.15 – $50.29 | 8 |
| Estrogens total-sendout CPT 82672 | not published | not published | $19.53 – $39.06 | 8 |
| Etanercept injection HCPCS J1438 | not published | not published | $838.23 – $838.23 | 1 |
| Ethanolamine oleate 100 mg HCPCS J1430 | not published | not published | $521.15 – $985.09 | 8 |
| Ethmoidectomy extranasal total 31205 CPT 31205 | not published | not published | $2,034.00 – $5,977.46 | 10 |
| Ethylene glycol -sendout CPT 82693 | $133.10 | $242.00 | $13.41 – $26.82 | 8 |
| Euflexxa inj per dose HCPCS J7323 | not published | not published | $97.60 – $176.65 | 8 |
| Euglobulin lysis CPT 85360 | not published | not published | $7.57 – $15.14 | 8 |
| Evacuate mole of uterus CPT 59870 | not published | not published | $2,277.00 – $5,836.23 | 10 |
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.