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 |
|---|---|---|---|---|
| Hlth bhv ivntj grp 1st 30 CPT 96164 | not published | not published | $16.78 – $67.55 | 8 |
| Hlth bhv ivntj indiv 1st 30 CPT 96158 | not published | not published | $114.80 – $320.01 | 8 |
| Home health care supervision HCPCS G0181 | not published | not published | $188.70 – $188.70 | 1 |
| Home health re-certification physician g0179 HCPCS G0179 | not published | not published | $71.72 – $71.72 | 1 |
| Home sleep test/type 2 porta HCPCS G0398 | not published | not published | $209.93 – $389.29 | 8 |
| Home sleep test/type 3 porta HCPCS G0399 | $1,160.59 | $2,110.17 | $209.93 – $389.29 | 8 |
| Home sleep test/type 4 porta HCPCS G0400 | not published | not published | $209.93 – $389.29 | 8 |
| Home vent mgmt supervision CPT 94005 | not published | not published | $164.50 – $164.50 | 1 |
| Homocysteine CPT 83090 | $79.75 | $145.00 | $16.13 – $32.26 | 8 |
| Homogenization tissue CPT 87176 | $31.35 | $57.00 | $5.29 – $10.58 | 8 |
| Homovanillic acid (hva) CPT 83150 | $72.60 | $132.00 | $20.17 – $40.34 | 8 |
| Hopd covid-19 spec collect HCPCS C9803 | $46.20 | $84.00 | not published | 0 |
| Hopd mntl hlt, 30-60 min HCPCS C7901 | not published | not published | $101.19 – $183.16 | 8 |
| Hpa-15 genotyping CPT 81112 | not published | not published | $110.00 – $220.00 | 8 |
| Hpa-1 genotyping CPT 81105 | not published | not published | $110.00 – $220.00 | 8 |
| Hpa-2 genotyping CPT 81106 | not published | not published | $110.00 – $220.00 | 8 |
| Hpa-3 genotyping CPT 81107 | not published | not published | $110.00 – $220.00 | 8 |
| Hpa-4 genotyping CPT 81108 | not published | not published | $110.00 – $220.00 | 8 |
| Hpa-5 genotyping CPT 81109 | not published | not published | $110.00 – $220.00 | 8 |
| Hpa-6 genotyping CPT 81110 | not published | not published | $110.00 – $220.00 | 8 |
| Hpa-9 genotyping CPT 81111 | not published | not published | $110.00 – $220.00 | 8 |
| Hpv combo assay ca screen HCPCS G0476 | not published | not published | $31.58 – $63.16 | 8 |
| Hpv low-risk types CPT 87623 | not published | not published | $31.58 – $63.16 | 8 |
| Hpv types 16 & 18 only CPT 87625 | $119.35 | $217.00 | $36.50 – $72.99 | 8 |
| H pylori ag ia CPT 87339 | not published | not published | $14.40 – $28.80 | 8 |
| H pylori (c-13) blood CPT 83009 | not published | not published | $60.62 – $121.25 | 8 |
| H pylori (c-13) breath CPT 83013 | $553.85 | $1,007.00 | $60.62 – $121.25 | 8 |
| H pylori drug admin CPT 83014 | not published | not published | $7.07 – $14.15 | 8 |
| Hrdtry brst ca-rlatd do 5+ CPT 81432 | not published | not published | $611.15 – $2,347.11 | 8 |
| Hrdtry cardmypy gene panel CPT 81439 | not published | not published | $526.41 – $1,052.82 | 8 |
| Hrdtry perph neurphy panel CPT 81448 | not published | not published | $526.41 – $1,052.82 | 8 |
| Hrv skn cll ssp agrft 1st 25 CPT 15011 | not published | not published | $2,055.25 – $3,719.90 | 9 |
| Hsv dna dir probe CPT 87528 | not published | not published | $18.05 – $36.09 | 8 |
| Htt gene charac alleles CPT 81274 | not published | not published | $247.35 – $494.69 | 8 |
| Htt gene detc abnor alleles CPT 81271 | $109.45 | $199.00 | $123.30 – $246.60 | 8 |
| Human epididymis protein 4 (he4) CPT 86305 | $171.05 | $311.00 | $18.73 – $37.46 | 8 |
| Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution HCPCS J7165 | not published | not published | $1.72 – $3.12 | 8 |
| Hydration IV infusion each additional hour CPT 96361 | $209.00 | $380.00 | $25.70 – $84.42 | 8 |
| Hydration IV infusion initial 31minutes - 1 hour CPT 96360 | $316.25 | $575.00 | $96.51 – $383.48 | 8 |
| Hydrocolld drg >16<=48 without b HCPCS A6235 | $15.37 | $27.95 | not published | 0 |
| Hydrocolld drg <=16 without bdr HCPCS A6234 | $4.73 | $8.60 | not published | 0 |
| Hydrocolld drg filler paste HCPCS A6240 | $11.23 | $20.42 | not published | 0 |
| Hydrogel drsg gel filler HCPCS A6248 | $14.78 | $26.88 | not published | 0 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | not published | not published | $0.10 – $0.10 | 1 |
| Hydroxocobalamin im 10mcg HCPCS J3425 | not published | not published | $0.01 – $0.01 | 1 |
| Hydrxycorticsterds 17- (17-ohcs) CPT 83491 | $52.25 | $95.00 | $16.11 – $32.22 | 8 |
| Hymenotomy CPT 56442 | not published | not published | $1,325.00 – $5,836.23 | 10 |
| Hymovis injection 1 mg HCPCS J7322 | not published | not published | $18.03 – $32.64 | 8 |
| Hyoid myotomy & suspension CPT 21685 | not published | not published | $1,325.00 – $10,672.90 | 10 |
| Hyperbaric oxygen therapy CPT 99183 | not published | not published | $218.89 – $218.89 | 1 |
| #hypersens-actinomyces ab CPT 86602 | not published | not published | $9.16 – $18.32 | 8 |
| Hyperthermia ext gen deep CPT 77605 | not published | not published | $693.76 – $1,255.68 | 8 |
| Hyperthermia ext gen supfc CPT 77600 | not published | not published | $384.19 – $695.37 | 8 |
| Hyperthermia gen intrcv prb CPT 77620 | not published | not published | $550.39 – $996.18 | 8 |
| Hyperthermia ntrstl prb 5/< CPT 77610 | not published | not published | $550.39 – $996.18 | 8 |
| Hyperthermia ntrstl prb>5 CPT 77615 | not published | not published | $550.39 – $996.18 | 8 |
| Hypnotherapy CPT 90880 | not published | not published | $101.19 – $183.16 | 8 |
| Hypothermia ill neonate CPT 99184 | not published | not published | $432.28 – $432.28 | 1 |
| Hyqvia 100mg immuneglobulin HCPCS J1575 | not published | not published | $18.25 – $33.02 | 8 |
| Hysterectomy/bladder repair CPT 51925 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Hysterectomy/revise vagina 58275 CPT 58275 | not published | not published | $2,277.00 – $8,722.00 | 2 |
| Hysterectomy/revise vagina 58280 CPT 58280 | not published | not published | $2,277.00 – $8,722.00 | 2 |
| Hysteroplasty 58540 CPT 58540 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Hysterorrhaphy of ruptured uterus 59350 CPT 59350 | not published | not published | $2,277.00 – $2,277.00 | 1 |
| Hysterosalpingography s&i CPT 74740 | $1,044.78 | $1,899.60 | $99.04 – $430.18 | 8 |
| Hysteroscopy ablation CPT 58563 | not published | not published | $4,373.00 – $9,018.95 | 10 |
| Hysteroscopy biopsy CPT 58558 | not published | not published | $2,034.00 – $5,836.23 | 10 |
| Hysteroscopy dx sep proc CPT 58555 | not published | not published | $1,325.00 – $5,836.23 | 10 |
| Hysteroscopy lysis CPT 58559 | not published | not published | $1,778.00 – $9,018.95 | 10 |
| Hysteroscopy remove fb CPT 58562 | not published | not published | $2,034.00 – $5,836.23 | 10 |
| Hysteroscopy remove myoma CPT 58561 | not published | not published | $2,034.00 – $9,018.95 | 10 |
| Hysteroscopy resect septum CPT 58560 | not published | not published | $2,034.00 – $9,018.95 | 10 |
| Hysterotomy abdominal 59100 CPT 59100 | not published | not published | $2,034.00 – $9,018.95 | 10 |
| I-123 iobenguane diag HCPCS A9582 | not published | not published | $2,199.30 – $4,171.50 | 8 |
| I-123 ioflupane diag HCPCS A9584 | not published | not published | $1,380.11 – $2,497.93 | 8 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | $86.21 | $156.75 | not published | 0 |
| I-131 iobenguane sulf diag mibg HCPCS A9508 | $2,451.88 | $4,457.97 | not published | 0 |
| I131 iodide cap, rx HCPCS A9517 | $51.73 | $94.05 | $23.94 – $43.33 | 8 |
| I131 iodide sol, rx HCPCS A9530 | $95.41 | $173.47 | $20.66 – $37.39 | 8 |
| Iaadi respiratory synctial virus CPT 87280 | not published | not published | $12.08 – $24.16 | 8 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | not published | not published | $31.58 – $63.16 | 8 |
| Ia infect ag ab qual/semiquant sgl step CPT 86318 | not published | not published | $16.28 – $32.56 | 8 |
| Ia nfct ab sarscov2 covid19 CPT 86328 | not published | not published | $40.75 – $81.50 | 8 |
| Ibmfs seq alys pnl 30 genes CPT 81441 | not published | not published | $2,203.70 – $4,407.41 | 8 |
| Ibutilide fumarate 0.1 mg/ml intravenous solution HCPCS J1742 | not published | not published | $174.92 – $316.60 | 8 |
| Icatibant injection HCPCS J1744 | not published | not published | $143.16 – $143.16 | 1 |
| Icd cobalt xt dr MRI is1 df1 HCPCS C1721 | $11,174.62 | $20,317.50 | not published | 0 |
| Icd crtd cobalt hf MRI is1 df1 HCPCS C1882 | $15,934.19 | $28,971.25 | not published | 0 |
| Icg angiography i&r uni/bi CPT 92240 | not published | not published | $215.08 – $389.29 | 8 |
| Icut allergy test-delayed CPT 95028 | not published | not published | $23.75 – $67.34 | 8 |
| Icut allergy test drug/bug CPT 95024 | not published | not published | $1.86 – $106.36 | 8 |
| Icut allergy titrate-airborn CPT 95027 | not published | not published | $8.45 – $52.15 | 8 |
| I&d abscess posterior spine l/s/ls-22015 CPT 22015 | not published | not published | $2,277.00 – $13,082.27 | 9 |
| I&d abscss rtrphryngl/paraphryngl intraorl apprch CPT 42720 | not published | not published | $1,325.00 – $5,977.46 | 10 |
| I&d/bursa/foot 28001 CPT 28001 | not published | not published | $1,645.17 – $2,977.67 | 9 |
| Idecabtagene vicleucel car HCPCS Q2055 | not published | not published | $560,011.18 – $1,022,360.00 | 8 |
| Identify sperm tissue CPT 89264 | not published | not published | $44.78 – $93.95 | 8 |
| Idet 1 or more levels CPT 22527 | not published | not published | $4,373.00 – $7,389.00 | 3 |
| Idet single level CPT 22526 | not published | not published | $4,373.00 – $7,389.00 | 3 |
| I&d frarm&/wrst deep absc/hematoma CPT 25028 | $6,378.24 | $11,596.80 | $1,325.00 – $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.