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 |
|---|---|---|---|---|
| Full thick gft/scalp/arm/leg/20sqcm or< 15220 CPT 15220 | $3,000.72 | $5,455.85 | $1,778.00 – $3,719.90 | 10 |
| Full thick gft/scalp/arm/leg/add 20sqcm 15221 CPT 15221 | $1,357.46 | $2,468.10 | $1,351.00 – $2,277.00 | 2 |
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | $2,824.64 | $5,135.70 | $2,034.00 – $3,719.90 | 10 |
| Functional brain mapping CPT 96020 | not published | not published | $160.62 – $160.62 | 1 |
| Fundus photography with i&r 92250 CPT 92250 | not published | not published | $78.16 – $239.87 | 8 |
| Fuse bile ducts and bowel 47785 CPT 47785 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Fuse esophagus & intestine CPT 43340 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Fuse esophagus & intestine CPT 43341 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Fuse esophagus & stomach CPT 43320 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Fuse gallbladder & bowel CPT 47740 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Fuse gallbladder & bowel CPT 47741 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Fuse/graft added joint CPT 26863 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Fuse liver duct & intestine CPT 47802 | not published | not published | $2,277.00 – $2,277.00 | 1 |
| Fuse liver ducts & bowel CPT 47765 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Fuse pancreas and bowel CPT 48548 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Fuse pancreas cyst and bowel CPT 48540 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Fuse pancreas cyst and bowel 48520 CPT 48520 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Fuse upper gi structures CPT 47721 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Fusion/graft of finger joint CPT 26862 | not published | not published | $2,277.00 – $5,899.11 | 10 |
| Fusion/graft of hand joint CPT 26844 | not published | not published | $2,034.00 – $13,082.27 | 10 |
| Fusion of ankle joint open CPT 27870 | not published | not published | $2,277.00 – $23,146.94 | 10 |
| Fusion of big toe joint CPT 28750 | not published | not published | $2,277.00 – $13,082.27 | 10 |
| Fusion of big toe joint CPT 28755 | not published | not published | $2,277.00 – $13,082.27 | 10 |
| Fusion of facial/other nerve CPT 64866 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Fusion of finger jnt add-on CPT 26861 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Fusion of finger joint CPT 26860 | $744.70 | $1,354.00 | $2,034.00 – $5,899.11 | 10 |
| Fusion of finger tendons CPT 26471 | not published | not published | $1,778.00 – $5,899.11 | 10 |
| Fusion of finger tendons CPT 26474 | not published | not published | $1,601.73 – $2,899.06 | 10 |
| Fusion of foot bones CPT 28730 | not published | not published | $2,277.00 – $23,146.94 | 10 |
| Fusion of foot bones CPT 28735 | not published | not published | $2,277.00 – $23,146.94 | 10 |
| Fusion of foot bones CPT 28740 | not published | not published | $2,277.00 – $13,082.27 | 10 |
| Fusion of hand joint CPT 26843 | not published | not published | $2,034.00 – $13,082.27 | 10 |
| Fusion of knee CPT 27580 | not published | not published | $2,277.00 – $23,146.94 | 9 |
| Fusion of knuckle CPT 26850 | not published | not published | $2,277.00 – $13,082.27 | 10 |
| Fusion of knuckle joint CPT 26516 | not published | not published | $1,325.00 – $5,899.11 | 10 |
| Fusion of knuckle joints CPT 26517 | not published | not published | $2,034.00 – $5,899.11 | 10 |
| Fusion of knuckle joints CPT 26518 | not published | not published | $2,034.00 – $13,082.27 | 10 |
| Fusion of knuckle with graft CPT 26852 | not published | not published | $2,277.00 – $13,082.27 | 10 |
| Fusion of skull arteries CPT 61711 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Fusion of spermatic ducts CPT 54900 | not published | not published | $2,082.24 – $3,768.77 | 10 |
| Fusion of spermatic ducts CPT 54901 | not published | not published | $2,277.00 – $6,355.21 | 10 |
| Fusion of tendons at wrist CPT 25300 | not published | not published | $2,034.00 – $5,899.11 | 10 |
| Fusion of tendons at wrist CPT 25301 | not published | not published | $2,034.00 – $5,899.11 | 10 |
| Fusion of thumb CPT 26841 | not published | not published | $2,277.00 – $13,082.27 | 10 |
| Fusion of tibiofibular joint CPT 27871 | not published | not published | $2,277.00 – $23,146.94 | 10 |
| Fusion of toes CPT 28280 | not published | not published | $1,778.00 – $5,899.11 | 10 |
| Fusion of ureter & bowel CPT 50810 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Fusion of ureter & kidney CPT 50740 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Fusion of ureter & kidney CPT 50750 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Fxn gene charac alleles CPT 81285 | not published | not published | $247.35 – $494.69 | 8 |
| Fxn gene detc abnor alleles CPT 81284 | not published | not published | $123.30 – $246.60 | 8 |
| Fxn gene full gene sequence CPT 81286 | not published | not published | $247.35 – $494.69 | 8 |
| Fxn gene known famil variant CPT 81289 | not published | not published | $166.68 – $333.36 | 8 |
| G0180 home health certification HCPCS G0180 | not published | not published | $92.64 – $92.64 | 1 |
| G6pc gene CPT 81250 | not published | not published | $52.64 – $105.28 | 8 |
| G6pd full gene sequence CPT 81249 | $1,320.00 | $2,400.00 | $540.00 – $1,080.00 | 8 |
| G6pd gene alys cmn variant CPT 81247 | not published | not published | $157.33 – $314.66 | 8 |
| G6pd known familial variant CPT 81248 | not published | not published | $337.73 – $675.45 | 8 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | $44.25 | $80.46 | not published | 0 |
| Ga-68 gallium 68 dotatate HCPCS A9587 | not published | not published | $49.36 – $89.33 | 8 |
| Gabapentin non-blood CPT 80355 | $175.45 | $319.00 | $17.43 – $17.43 | 1 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | $343.20 | $624.00 | $18.96 – $37.93 | 8 |
| Galactokinase - sendout CPT 82759 | $622.05 | $1,131.00 | $19.33 – $38.66 | 8 |
| Galactose transferase test CPT 82776 | $78.10 | $142.00 | $10.57 – $21.13 | 8 |
| Galectin-3 CPT 82777 | $121.55 | $221.00 | $33.79 – $79.65 | 8 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $5,257.00 – $10,899.52 | 10 |
| Gallium ga-68 dotatoc HCPCS C9067 | not published | not published | $3.59 – $6.50 | 8 |
| Gallium ga-68 psma-11, ucla HCPCS A9594 | not published | not published | $361.50 – $654.30 | 8 |
| Gallium ga-68 psma-11 ucsf HCPCS A9593 | not published | not published | $547.10 – $990.23 | 8 |
| Gallium illuccix 1 millicure HCPCS A9596 | not published | not published | $475.89 – $861.34 | 8 |
| Gallium locametz 1 millicuri HCPCS A9800 | not published | not published | $360.51 – $652.50 | 8 |
| Galsulfase injection HCPCS J1458 | not published | not published | $523.07 – $946.74 | 9 |
| Gamma globulin > 10 cc inj HCPCS J1560 | not published | not published | $161.63 – $292.53 | 8 |
| Gamma globulin 1 cc inj HCPCS J1460 | not published | not published | $48.61 – $87.97 | 8 |
| Gammaglobulin iga CPT 82784 | $84.70 | $154.00 | $8.37 – $16.74 | 8 |
| Gammaglobulin ige CPT 82785 | $101.20 | $184.00 | $14.81 – $29.63 | 8 |
| Gamma glutamyltransferase CPT 82977 | $35.75 | $65.00 | $6.48 – $12.96 | 8 |
| Gammagraft HCPCS Q4111 | not published | not published | $11.54 – $224.36 | 8 |
| Gammaplex injection HCPCS J1557 | not published | not published | $60.18 – $119.29 | 8 |
| Gamunex-c/gammaked HCPCS J1561 | not published | not published | $48.74 – $88.23 | 8 |
| Gardner vag dna amp probe CPT 87511 | not published | not published | $31.58 – $63.16 | 8 |
| Gardner vag dna quant CPT 87512 | not published | not published | $37.58 – $75.17 | 8 |
| Gastric analy w/ph ea spec CPT 82930 | $178.75 | $325.00 | $6.04 – $12.08 | 8 |
| Gastric emptying imag study CPT 78265 | not published | not published | $398.21 – $720.75 | 8 |
| Gastric emptying imag study CPT 78266 | not published | not published | $540.86 – $978.92 | 8 |
| Gastric motility studies CPT 91020 | not published | not published | $283.73 – $672.77 | 8 |
| Gastric mucosa imaging CPT 78261 | not published | not published | $366.96 – $720.75 | 8 |
| Gastrin test CPT 82938 | not published | not published | $15.92 – $31.84 | 8 |
| Gastroduodenostomy CPT 43810 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Gastroesophageal reflux study CPT 78262 | not published | not published | $365.86 – $720.75 | 8 |
| Gastroesophageal reflux test CPT 91034 | not published | not published | $244.15 – $672.77 | 8 |
| Gastrointestinal repair CPT 43360 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Gastrointestinal repair CPT 43361 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Gastrojejunostomy;w/o vagotomy 43820 CPT 43820 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Gastrojejunostomy w/vagotomy CPT 43825 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Gastro/jejuno tube, std HCPCS B4087 | $156.28 | $284.14 | not published | 0 |
| Gastroplasty duodenal switch CPT 43845 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Gastrostomy open neonatal CPT 43831 | not published | not published | $903.45 – $2,277.00 | 9 |
| Gated heart multiple CPT 78473 | not published | not published | $376.85 – $720.75 | 8 |
| Gba gene CPT 81251 | not published | not published | $42.53 – $85.05 | 8 |
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.