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 |
|---|---|---|---|---|
| Gstr rstcv px shrt roux-en-y CPT 43846 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Gstr rstcv px sm int rcnstj CPT 43847 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Gstr rstcv px v-banded gstp CPT 43842 | not published | not published | $3,233.00 – $7,496.00 | 2 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $1,911.43 – $3,459.61 | 9 |
| G-tube reposition CPT 43761 | $450.12 | $818.40 | $248.88 – $2,277.00 | 10 |
| Gu dilat ureter/urethra s&i CPT 74485 | $1,980.66 | $3,601.20 | $119.39 – $3,768.77 | 8 |
| Guided cath fluid drainage 10030 CPT 10030 | $3,079.56 | $5,599.20 | $705.37 – $2,277.00 | 9 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $4,138.75 | $7,525.00 | not published | 0 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $930.63 | $1,692.05 | not published | 0 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $166.09 | $301.98 | not published | 0 |
| Guid loc target vol rad tx CPT 77387 | $484.68 | $881.23 | $107.13 – $107.13 | 1 |
| Gum graft CPT 41870 | not published | not published | $1,545.54 – $2,797.36 | 9 |
| Gw stiffened micro access kit HCPCS C1894 | $2,365.00 | $4,300.00 | not published | 0 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $2,277.00 – $7,059.16 | 10 |
| Hair analysis HCPCS P2031 | not published | not published | $4.46 – $11.60 | 2 |
| Hair removal by electrolysis 17380 CPT 17380 | not published | not published | $736.19 – $2,277.00 | 9 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $404.93 – $2,277.00 | 10 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $404.93 – $2,277.00 | 10 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | $17.05 | $31.00 | $5.02 – $11.03 | 2 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $2,034.00 – $5,899.11 | 10 |
| Hand tendon reconstruction CPT 26500 | $822.80 | $1,496.00 | $2,277.00 – $13,082.27 | 10 |
| Hand tendon reconstruction CPT 26502 | $942.70 | $1,714.00 | $2,277.00 – $5,899.11 | 10 |
| Hand X-ray CPT 73130 | $247.50 | $450.00 | $40.78 – $156.90 | 8 |
| Haptoglobin quantitative CPT 83010 | $78.65 | $143.00 | $11.32 – $22.64 | 8 |
| Harvest allogeneic stem cell CPT 38205 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Harvest auto stem cells CPT 38206 | not published | not published | $1,551.36 – $2,807.89 | 9 |
| Harvest cultured skin graft 15040 CPT 15040 | not published | not published | $1,778.00 – $3,719.90 | 10 |
| Harvest eye tissue alograft CPT 68371 | not published | not published | $1,778.00 – $4,286.38 | 10 |
| Harvest femoropopliteal vein 35572 CPT 35572 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Harvest stem cell concentrte CPT 38215 | not published | not published | $439.46 – $2,277.00 | 10 |
| Harvest vein for bypass 35500 CPT 35500 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Hast w/i&r phys/qhp CPT 94452 | not published | not published | $75.95 – $239.87 | 8 |
| Hast w/oxygen titrate CPT 94453 | not published | not published | $109.50 – $239.87 | 8 |
| Hba1/hba2 full gene sequence CPT 81259 | not published | not published | $540.00 – $1,080.00 | 8 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | not published | not published | $182.16 – $364.32 | 8 |
| Hba1/hba2 gene fam vrnt CPT 81258 | not published | not published | $337.73 – $675.45 | 8 |
| Hbb full gene sequence CPT 81364 | not published | not published | $292.12 – $584.24 | 8 |
| Hbb gene com variants CPT 81361 | not published | not published | $157.33 – $314.66 | 8 |
| Hbb gene dup/del variants CPT 81363 | not published | not published | $182.16 – $364.32 | 8 |
| Hbb gene known fam variant CPT 81362 | not published | not published | $337.73 – $675.45 | 8 |
| Hb glycosylated a1c home dev CPT 83037 | not published | not published | $8.74 – $17.48 | 8 |
| Hbot, full body chamber, 30m HCPCS G0277 | $522.50 | $950.00 | $76.49 – $248.10 | 8 |
| Hc ea ha check monaural CPT 92594 | not published | not published | $34.84 – $34.84 | 1 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | $689.70 | $1,254.00 | $174.72 – $316.23 | 8 |
| Hcg free betachain test CPT 84704 | $20.90 | $38.00 | $13.76 – $27.52 | 8 |
| Hcg qualitative CPT 84703 | $43.45 | $79.00 | $6.77 – $13.54 | 8 |
| Hcg quantitative CPT 84702 | $103.40 | $188.00 | $13.55 – $27.09 | 8 |
| Hc hearing aid chck binaurl CPT 92593 | not published | not published | $61.05 – $61.05 | 1 |
| Hc hearing aid chck monarl CPT 92592 | not published | not published | $36.58 – $36.58 | 1 |
| Hc hearing aid exam both ears CPT 92591 | not published | not published | $116.75 – $116.75 | 1 |
| Hc hearing aid exam one ear CPT 92590 | not published | not published | $91.84 – $91.84 | 1 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $48.85 | $88.82 | not published | 0 |
| Hc metata joint dislocation anes CPT 28635 | not published | not published | $1,325.00 – $2,899.06 | 10 |
| Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks CPT 17311 | not published | not published | $736.19 – $2,277.00 | 10 |
| Hc mohs micrographic h/n/h/f/g each addl stage CPT 17312 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Hc mohs trunk/arm/leg 1st stage 5 blocks CPT 17313 | not published | not published | $736.19 – $2,277.00 | 10 |
| Hc mohs trunk/arm/leg ea addl block any stage CPT 17315 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Hc mohs trunk/arm/leg ea stage after 1st stage CPT 17314 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | not published | not published | $228.78 – $978.92 | 8 |
| Hc nm fusion spect CT unlisted CPT 78999 | not published | not published | $398.21 – $720.75 | 8 |
| Hc nm kidney imaging with flow CPT 78701 | $767.58 | $1,395.60 | $317.49 – $720.75 | 8 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | $808.50 | $1,470.00 | $306.50 – $978.92 | 8 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | $2,090.88 | $3,801.60 | $1,289.61 – $2,334.13 | 8 |
| Hc transcatheter placement and sbsq removal cepd perq CPT 33370 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | $1,607.15 | $2,922.09 | $358.21 – $1,255.68 | 8 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | $1,958.98 | $3,561.78 | $652.37 – $1,255.68 | 8 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | $2,251.70 | $4,094.00 | $693.76 – $1,255.68 | 8 |
| Hdr rdncl skn surf brachytx CPT 77767 | not published | not published | $277.45 – $695.37 | 8 |
| Hdr rdncl skn surf brachytx CPT 77768 | not published | not published | $384.19 – $695.37 | 8 |
| Head CT scan (with and without contrast) CPT 70470 | $1,191.96 | $2,167.20 | $174.72 – $316.23 | 8 |
| Head CT scan (with contrast) CPT 70460 | $1,043.46 | $1,897.20 | $174.72 – $316.23 | 8 |
| Head CT scan (without contrast) CPT 70450 | $819.72 | $1,490.40 | $104.14 – $188.49 | 8 |
| Hearing loss dup/del analys CPT 81431 | not published | not published | $611.61 – $1,223.23 | 8 |
| Hearing loss sequence analys CPT 81430 | not published | not published | $1,462.50 – $2,925.00 | 8 |
| Heart first pass add-on CPT 78496 | not published | not published | $35.29 – $35.29 | 1 |
| Heart first pass multiple CPT 78483 | not published | not published | $292.75 – $978.92 | 8 |
| Heart image spect CPT 78494 | not published | not published | $291.65 – $720.75 | 8 |
| Heart infarct image CPT 78466 | $605.22 | $1,100.40 | $272.42 – $720.75 | 8 |
| Heart infarct image (ef) CPT 78468 | not published | not published | $271.32 – $978.92 | 8 |
| Heart revascularize (tmr) CPT 33140 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Heart tmr w/other procedure 33141 CPT 33141 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Heavy metal qual any number CPT 83015 | not published | not published | $18.85 – $37.69 | 8 |
| Heinz bodies direct CPT 85441 | not published | not published | $3.78 – $7.56 | 8 |
| Heinz bodies induced CPT 85445 | not published | not published | $6.14 – $12.28 | 8 |
| Helicobacter pylori antibody igm CPT 86677 | $79.75 | $145.00 | $15.17 – $30.33 | 8 |
| Helicoll, per square cm HCPCS Q4164 | not published | not published | $123.96 – $224.36 | 8 |
| Hemagglutination inhibition CPT 86280 | not published | not published | $7.37 – $14.74 | 8 |
| Hematocrit CPT 85014 | $17.05 | $31.00 | $2.13 – $4.27 | 8 |
| Hematopoietic nuclear tx CPT 79403 | not published | not published | $132.79 – $420.68 | 8 |
| Hemicrt intrclry algrft prtl CPT 20933 | not published | not published | $2,277.00 – $10,305.00 | 2 |
| Hemiepiphyseal arrest CPT 24470 | not published | not published | $2,034.00 – $5,899.11 | 10 |
| Hemin 350 mg intravenous powder for solution HCPCS J1640 | not published | not published | $35.11 – $64.48 | 8 |
| Hemodialysis access study CPT 90940 | not published | not published | $98.19 – $98.19 | 1 |
| Hemodialysis one evaluation CPT 90935 | $896.28 | $1,629.60 | $130.00 – $1,237.36 | 8 |
| Hemodialysis repeated eval CPT 90937 | $832.26 | $1,513.20 | $185.87 – $185.87 | 1 |
| Hemoglobin CPT 85018 | $36.30 | $66.00 | $2.13 – $4.27 | 8 |
| Hemoglobin copper sulfate CPT 83026 | not published | not published | $3.61 – $7.22 | 8 |
| Hemoglobin fetal qualitative CPT 83033 | not published | not published | $7.20 – $14.40 | 8 |
| Hemoglobin f (fetal) chemical CPT 83030 | not published | not published | $9.67 – $19.33 | 8 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $114.40 | $208.00 | $7.38 – $14.76 | 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.