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 |
|---|---|---|---|---|
| Exc intracard tumor/resect/bypass 33120 CPT 33120 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Exc ischial pr ulcer w/ostc musc/myoq flap/skin 15946 CPT 15946 | $1,804.44 | $3,280.80 | $2,055.25 – $3,719.90 | 10 |
| Exc ischial pr ulc prim sutr CPT 15940 | not published | not published | $2,034.00 – $5,236.93 | 10 |
| Exc isch pr ulc prm sut ostc CPT 15941 | not published | not published | $2,034.00 – $5,236.93 | 10 |
| Exc isch pr ulc skn flp clsr CPT 15944 | not published | not published | $2,034.00 – $6,389.00 | 10 |
| Exc isch pr ulc skn flp ostc CPT 15945 | not published | not published | $2,055.25 – $3,719.90 | 10 |
| Excise anal ext tag/papilla CPT 46220 | not published | not published | $1,191.98 – $2,277.00 | 10 |
| Excise epiphyseal bar CPT 20150 | not published | not published | $2,277.00 – $5,899.11 | 9 |
| Excise foot tendon sheath CPT 28086 | not published | not published | $1,778.00 – $5,899.11 | 10 |
| Excise foot tendon sheath CPT 28088 | not published | not published | $1,778.00 – $5,899.11 | 10 |
| Excise ileoanal reservior CPT 45136 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excise inferior turbinate CPT 30130 | not published | not published | $2,034.00 – $5,977.46 | 10 |
| Excise intestine lesion(s) 44110 CPT 44110 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excise intraspinl lesion crv CPT 63265 | not published | not published | $2,277.00 – $13,082.27 | 10 |
| Excise intrspinl lesion crvl CPT 63270 | not published | not published | $2,277.00 – $10,305.00 | 3 |
| Excise intrspinl lesion lmbr CPT 63267 | not published | not published | $2,277.00 – $13,082.27 | 10 |
| Excise intrspinl lesion lmbr CPT 63272 | not published | not published | $2,277.00 – $10,305.00 | 3 |
| Excise intrspinl lesion scrl CPT 63268 | not published | not published | $2,277.00 – $13,082.27 | 10 |
| Excise intrspinl lesion scrl CPT 63273 | not published | not published | $2,277.00 – $10,305.00 | 3 |
| Excise intrspinl lesion thrc CPT 63271 | not published | not published | $2,277.00 – $10,305.00 | 3 |
| Excise lesion testis CPT 54512 | not published | not published | $1,778.00 – $6,355.21 | 10 |
| Excise lip or cheek fold CPT 40819 | not published | not published | $1,325.00 – $2,797.36 | 10 |
| Excise lwr jaw cyst w/repair CPT 21047 | not published | not published | $1,778.00 – $10,672.90 | 10 |
| Excise mandible lesion CPT 21040 | not published | not published | $1,778.00 – $5,977.46 | 10 |
| Excise max/zygoma b9 tumor CPT 21030 | not published | not published | $2,277.00 – $10,672.90 | 9 |
| Excise max/zygoma mal tumor CPT 21034 | not published | not published | $2,034.00 – $10,672.90 | 10 |
| Excise oral mucosa for graft 40818 CPT 40818 | not published | not published | $537.23 – $2,277.00 | 10 |
| Excise parotid gland/lesion CPT 42410 | not published | not published | $2,034.00 – $10,672.90 | 10 |
| Excise parotid gland/lesion CPT 42415 | not published | not published | $2,277.00 – $10,672.90 | 10 |
| Excise parotid gland/lesion CPT 42420 | not published | not published | $2,277.00 – $10,672.90 | 10 |
| Excise parotid gland/lesion CPT 42425 | not published | not published | $2,277.00 – $10,672.90 | 10 |
| Excise parotid gland/lesion CPT 42426 | not published | not published | $2,277.00 – $3,480.00 | 2 |
| Excise pharynx lesion CPT 42808 | not published | not published | $1,778.00 – $5,977.46 | 10 |
| Excise/repair mouth lesion CPT 40812 | not published | not published | $1,545.54 – $2,797.36 | 9 |
| Excise sacral spine tumor CPT 49215 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excise sublingual gland CPT 42450 | not published | not published | $1,778.00 – $10,672.90 | 10 |
| Excise submaxillary gland CPT 42440 | not published | not published | $2,034.00 – $10,672.90 | 10 |
| Excise subq tumor/abd wall <3 cm 22902 CPT 22902 | not published | not published | $1,645.17 – $3,962.00 | 10 |
| Excise tendon forearm/wrist CPT 25109 | not published | not published | $2,034.00 – $5,899.11 | 10 |
| Excise wrist tendon sheath CPT 25118 | not published | not published | $1,601.73 – $2,899.06 | 10 |
| Excision addl breast lesion 19126 CPT 19126 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Excision aural polyp CPT 69540 | not published | not published | $1,545.54 – $2,797.36 | 9 |
| Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm CPT 11441 | $169.95 | $309.00 | $705.37 – $2,277.00 | 10 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | $1,754.94 | $3,190.80 | $1,325.00 – $2,977.67 | 10 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | $721.60 | $1,312.00 | $705.37 – $2,277.00 | 10 |
| Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 | $2,561.35 | $4,657.00 | $1,645.17 – $2,977.67 | 10 |
| Excision breast lesion CPT 19125 | not published | not published | $2,034.00 – $7,059.16 | 10 |
| Excision coa w/graft CPT 33845 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excision floor mouth lesion 41116 CPT 41116 | not published | not published | $1,325.00 – $5,977.46 | 10 |
| Excision graft abdomen CPT 35907 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excision graft extremity CPT 35903 | not published | not published | $2,277.00 – $5,692.64 | 9 |
| Excision graft neck CPT 35901 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excision graft thorax 35905 CPT 35905 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excision gum each quadrant CPT 41820 | not published | not published | $1,325.00 – $5,977.46 | 10 |
| Excision hand/finger tendon CPT 26415 | not published | not published | $2,277.00 – $5,899.11 | 10 |
| Excision lesion mouth roof CPT 42106 | not published | not published | $1,778.00 – $5,977.46 | 10 |
| Excision lesion mouth roof CPT 42107 | not published | not published | $1,778.00 – $10,672.90 | 10 |
| Excision nasal polyp(s) simple 30110 CPT 30110 | not published | not published | $1,545.54 – $2,797.36 | 9 |
| Excision of anal lesion(s) CPT 46922 | not published | not published | $1,325.00 – $5,004.26 | 10 |
| Excision of bile duct cyst CPT 47715 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excision of bile duct tumor CPT 47711 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excision of bile duct tumor CPT 47712 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excision of bowel lesion(s) CPT 44111 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excision of brain tumor CPT 61545 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excision of esophagus lesion CPT 43100 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excision of esophagus lesion CPT 43101 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excision of gum flap CPT 41821 | not published | not published | $1,325.00 – $2,797.36 | 10 |
| Excision of gum lesion CPT 41822 | not published | not published | $1,545.54 – $2,797.36 | 9 |
| Excision of gum lesion CPT 41823 | not published | not published | $2,277.00 – $10,672.90 | 9 |
| Excision of gum lesion CPT 41826 | not published | not published | $2,277.00 – $5,977.46 | 9 |
| Excision of gum lesion CPT 41827 | not published | not published | $1,778.00 – $10,672.90 | 10 |
| Excision of gum lesion CPT 41828 | not published | not published | $1,545.54 – $2,797.36 | 9 |
| Excision of gum lesion 41825 CPT 41825 | not published | not published | $2,277.00 – $5,977.46 | 9 |
| Excision of lesion of mesentery 44820 CPT 44820 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excision of lingual tonsil CPT 42870 | not published | not published | $2,034.00 – $10,672.90 | 10 |
| Excision of meckels diverticulum 44800 CPT 44800 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excision of mouth lesion complex 40816 CPT 40816 | not published | not published | $1,778.00 – $5,977.46 | 10 |
| Excision of neck cyst CPT 42815 | not published | not published | $2,277.00 – $10,672.90 | 10 |
| Excision of neck cyst confined 42810 CPT 42810 | not published | not published | $2,034.00 – $5,977.46 | 10 |
| Excision of penis lesion(s) 54060 CPT 54060 | not published | not published | $1,325.00 – $3,719.90 | 10 |
| Excision of rectal lesion CPT 45160 | not published | not published | $1,778.00 – $5,004.26 | 10 |
| Excision of rectal prolapse CPT 45135 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excision of rectal stricture CPT 45150 | not published | not published | $1,191.98 – $2,277.00 | 10 |
| Excision of salivary cyst CPT 42408 | not published | not published | $2,034.00 – $5,977.46 | 10 |
| Excision of skull/sutures CPT 61558 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excision of skull/sutures CPT 61559 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excision of skull tumor CPT 61563 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excision of skull tumor CPT 61564 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excision of stomach lesion CPT 43610 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excision of stomach lesion CPT 43611 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excision of tongue lesion CPT 41112 | not published | not published | $1,778.00 – $5,977.46 | 10 |
| Excision of tongue lesion CPT 41114 | not published | not published | $1,778.00 – $5,977.46 | 10 |
| Excision of tongue lesion w/closure 41113 CPT 41113 | not published | not published | $1,778.00 – $5,977.46 | 10 |
| Excision of tonsil tags CPT 42860 | not published | not published | $2,034.00 – $5,977.46 | 10 |
| Excision of umbilicus 49250 CPT 49250 | not published | not published | $2,277.00 – $6,455.13 | 10 |
| Excision of uvula CPT 42140 | not published | not published | $1,778.00 – $5,977.46 | 10 |
| Excision of vaginal septum 57130 CPT 57130 | not published | not published | $1,778.00 – $5,836.23 | 10 |
| Excision olecranon bursa CPT 24105 | not published | not published | $2,034.00 – $5,899.11 | 10 |
| Excision perinephric cyst CPT 50290 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Excision radial head CPT 24130 | not published | not published | $2,034.00 – $5,899.11 | 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.