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 |
|---|---|---|---|---|
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $969.54 | $1,762.80 | $199.85 – $2,277.00 | 10 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $798.60 | $1,452.00 | $199.85 – $2,277.00 | 10 |
| Ghs sleep study unattended CPT 95800 | not published | not published | $212.28 – $389.29 | 8 |
| Ghs somatosensory testing lower extremit CPT 95926 | not published | not published | $215.08 – $389.29 | 8 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | not published | not published | $466.99 – $1,548.23 | 8 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | not published | not published | $46.33 – $83.86 | 8 |
| Ghs sphenopalatine ganglion block CPT 64505 | not published | not published | $305.76 – $2,277.00 | 10 |
| Ghs spont nystagmus CPT 92541 | $163.77 | $297.77 | $16.06 – $239.87 | 8 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $202.99 | $369.08 | $99.49 – $180.07 | 8 |
| Ghs st - eval for alt comm CPT 92567 | $368.16 | $669.39 | $19.08 – $67.34 | 8 |
| Ghs strapping shoulder - 29240 CPT 29240 | $150.48 | $273.60 | $132.53 – $2,277.00 | 9 |
| Ghs st - re-eval for alt comm CPT 92597 | $175.06 | $318.29 | $69.35 – $125.51 | 8 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $81.95 | $149.00 | $29.88 – $84.42 | 8 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $215.05 | $391.00 | $211.87 – $383.48 | 8 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $1,734.48 | $3,153.60 | $736.19 – $2,277.00 | 10 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $768.90 | $1,398.00 | $404.93 – $2,277.00 | 10 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | not published | not published | $1,325.00 – $2,797.36 | 10 |
| Ghs trypsin (fecal) CPT 84488 | not published | not published | $6.57 – $13.14 | 8 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $557.70 | $1,014.00 | $245.71 – $2,277.00 | 9 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $184.80 | $336.00 | $245.71 – $2,277.00 | 9 |
| Ghs urine, hydroxproline total CPT 83505 | not published | not published | $21.87 – $43.74 | 8 |
| Ghs urine, porphyrins quant CPT 84120 | $405.90 | $738.00 | $13.24 – $26.48 | 8 |
| Ghs vaginal delivery only CPT 59409 | $1,749.85 | $3,181.55 | $2,277.00 – $5,836.23 | 9 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | not published | not published | $371.70 – $672.77 | 8 |
| Ghs windowing of cast CPT 29730 | not published | not published | $161.87 – $2,277.00 | 9 |
| Giardia ag if CPT 87269 | $32.45 | $59.00 | $12.25 – $24.50 | 8 |
| Giardia lamblia antibody CPT 86674 | not published | not published | $13.25 – $26.50 | 8 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $105.82 – $430.18 | 8 |
| Gi inhouse confirmation CPT 87045 | $47.85 | $87.00 | $8.50 – $16.99 | 8 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $2,277.00 – $5,977.46 | 9 |
| Gi protein loss CPT 78282 | not published | not published | $368.57 – $720.75 | 8 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | not published | not published | $903.45 – $3,329.00 | 9 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | $926.34 – $1,676.63 | 8 |
| Gi trc img intral esophagus CPT 91111 | not published | not published | $903.45 – $3,329.00 | 9 |
| Gi wireless capsule measure CPT 91112 | not published | not published | $903.45 – $3,329.00 | 9 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $91.01 – $182.02 | 8 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $55.37 – $110.74 | 8 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $31.50 – $63.00 | 8 |
| Glassia injection HCPCS J0257 | not published | not published | $5.55 – $10.05 | 8 |
| Glaucoma scrn hgh risk direc HCPCS G0117 | not published | not published | $28.81 – $52.15 | 8 |
| Glaucoma scrn hgh risk direc HCPCS G0118 | not published | not published | $37.21 – $67.34 | 8 |
| Glaucoma surgery CPT 66150 | not published | not published | $2,277.00 – $7,452.17 | 10 |
| Glaucoma surgery CPT 66155 | not published | not published | $2,277.00 – $7,452.17 | 10 |
| Glaucoma surgery CPT 66160 | not published | not published | $1,778.00 – $4,160.79 | 10 |
| Glaucoma surgery CPT 66170 | not published | not published | $2,277.00 – $4,160.79 | 10 |
| Glucagon 1 mg solution for injection HCPCS J1610 | not published | not published | $116.69 – $211.20 | 8 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | not published | not published | $118.62 – $232.71 | 8 |
| Glucagon plasma - sendout CPT 82943 | $44.55 | $81.00 | $12.86 – $25.72 | 8 |
| Glucagon tolerance panel CPT 80422 | not published | not published | $41.46 – $82.93 | 8 |
| Glucagon tolerance panel CPT 80424 | not published | not published | $45.45 – $90.90 | 8 |
| Glucagon tolerance test CPT 82946 | not published | not published | $15.99 – $31.99 | 8 |
| Glucose 1 hr post dose CPT 82950 | $52.25 | $95.00 | $4.28 – $8.55 | 8 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | not published | not published | $5.45 – $10.89 | 8 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $13.75 | $25.00 | $2.95 – $5.90 | 8 |
| Glucose blood quantitative CPT 82947 | $33.55 | $61.00 | $3.54 – $7.07 | 8 |
| Glucose body fluid CPT 82945 | $59.95 | $109.00 | $3.54 – $7.07 | 8 |
| Glucose monitoring continual min 72hr pt CPT 95249 | not published | not published | $58.76 – $106.36 | 8 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $69.30 | $126.00 | $11.58 – $23.17 | 8 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $51.15 | $93.00 | $3.53 – $7.06 | 8 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | not published | not published | $0.61 – $0.61 | 1 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | not published | not published | $10.97 – $19.86 | 8 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $86.35 | $157.00 | $16.72 – $33.44 | 8 |
| Gonadotropin hormone panel CPT 80426 | not published | not published | $133.57 – $267.14 | 8 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $95.70 | $174.00 | $16.67 – $33.34 | 8 |
| Gonioscopy CPT 92020 | not published | not published | $38.52 – $239.87 | 8 |
| Goniotomy CPT 65820 | not published | not published | $1,325.00 – $7,452.17 | 10 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | not published | not published | $745.24 – $745.24 | 1 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | not published | not published | $63.77 – $224.36 | 8 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | not published | not published | $123.96 – $224.36 | 8 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | not published | not published | $122.90 – $224.36 | 8 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $2,034.00 – $5,899.11 | 10 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $10,412.48 | $18,931.78 | $52.22 – $224.36 | 8 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | not published | not published | $637.60 – $637.60 | 1 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $4,287.74 | $7,795.90 | not published | 0 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $754.19 | $1,371.26 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | not published | not published | $55.51 – $224.36 | 8 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $10,524.25 | $19,135.00 | $98.01 – $224.36 | 8 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $2,277.00 – $10,305.00 | 2 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | not published | not published | $123.96 – $224.36 | 8 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | not published | not published | $35.73 – $224.36 | 8 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | not published | not published | $123.96 – $224.36 | 8 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $377.18 | $685.79 | not published | 0 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $513.30 | $933.28 | not published | 0 |
| Great toe-hand transfer CPT 26551 | not published | not published | $2,277.00 – $13,082.27 | 9 |
| Great toe with reduction 28495 CPT 28495 | $764.28 | $1,389.60 | $245.71 – $2,277.00 | 9 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | $642.95 | $1,169.00 | $2,055.25 – $5,340.00 | 10 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | $635.80 | $1,156.00 | $2,277.00 – $6,389.00 | 10 |
| Grfg autol fat lipo ea addl CPT 15772 | $191.95 | $349.00 | $1,351.00 – $2,277.00 | 2 |
| Grfg autol soft tiss dir exc CPT 15769 | not published | not published | $2,277.00 – $6,389.00 | 10 |
| Group behave couns 2-10 HCPCS G0473 | not published | not published | $21.55 – $67.55 | 8 |
| Group mnt 2 or more 30 mins HCPCS G0271 | not published | not published | $11.77 – $21.31 | 8 |
| Group train without patient HCPCS G0543 | not published | not published | $28.81 – $52.15 | 8 |
| Growth hormone antibody CPT 86277 | not published | not published | $14.17 – $28.33 | 8 |
| Growth hormone panel CPT 80428 | not published | not published | $60.03 – $120.06 | 8 |
| Growth hormone panel CPT 80430 | not published | not published | $116.40 – $232.79 | 8 |
| Growth stimulation gene 2 CPT 83006 | not published | not published | $56.82 – $136.08 | 8 |
| Grp adapt bhv tx by phy/qhp CPT 97158 | not published | not published | $8.94 – $67.55 | 8 |
| Grp adapt bhv tx by tech CPT 97154 | not published | not published | $7.80 – $67.55 | 8 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Gstr rstcv oth/thn v-band CPT 43843 | not published | not published | $2,277.00 – $5,246.00 | 2 |
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.