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 |
|---|---|---|---|---|
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $119.35 | $217.00 | $31.58 – $63.16 | 8 |
| Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae CPT 87494 | not published | not published | $69.79 – $126.32 | 8 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $200.20 | $364.00 | $69.09 – $138.19 | 8 |
| Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets CPT 87627 | not published | not published | $676.03 – $1,223.59 | 8 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $458.70 | $834.00 | $375.10 – $750.20 | 8 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $548.90 | $998.00 | $115.46 – $230.92 | 8 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $683.65 | $1,243.00 | $236.69 – $473.38 | 8 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $320.65 | $583.00 | $38.56 – $77.11 | 8 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $278.30 | $506.00 | $38.56 – $77.11 | 8 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $427.90 | $778.00 | $38.56 – $77.11 | 8 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $354.75 | $645.00 | $76.59 – $153.18 | 8 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $331.10 | $602.00 | $128.37 – $256.73 | 8 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | not published | not published | $31.31 – $56.66 | 8 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | not published | not published | $21.02 – $55.49 | 8 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | not published | not published | $12.24 – $49.88 | 8 |
| Influenza dna amp prob addl CPT 87503 | $53.90 | $98.00 | $26.30 – $52.60 | 8 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | not published | not published | $88.50 – $88.50 | 1 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $30.60 – $30.60 | 1 |
| Inf lwr xtr fscl pln blk uni w/wo image CPT 64474 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Infratemporal approach/skull CPT 61591 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Infratemporal approach/skull CPT 61590 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Inf thrc fascial pln blk bi w/wo image CPT 64469 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Inf thrc fascial pln blk uni w/wo image CPT 64467 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Infuse radioactive materials CPT 77750 | $379.97 | $690.86 | $182.82 – $695.37 | 8 |
| Ingest challenge ea addl 60 min CPT 95079 | not published | not published | $120.47 – $120.47 | 1 |
| Ingest challenge ini 120 min CPT 95076 | not published | not published | $130.97 – $672.77 | 8 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $99.00 | $180.00 | $21.49 – $394.80 | 8 |
| Initial care training 30 m HCPCS G0539 | not published | not published | $38.70 – $70.04 | 8 |
| Initial foot exam pt lops HCPCS G0245 | not published | not published | $76.64 – $240.03 | 8 |
| Initiation & management bipap/cpap initial day CPT 94660 | $328.65 | $597.55 | $68.32 – $394.80 | 8 |
| Init/sub psych care m 1st 30 HCPCS G2214 | not published | not published | $70.11 – $183.16 | 8 |
| Inj, abilify asimtufii, 1 mg HCPCS J0402 | not published | not published | $6.15 – $11.13 | 8 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | not published | not published | $7.42 – $13.43 | 8 |
| Inj, adalimumab, 1 mg HCPCS J0139 | not published | not published | $97.23 – $97.23 | 1 |
| Inj adalimumab-ryvk, 1 mg HCPCS Q5142 | not published | not published | $11.17 – $11.17 | 1 |
| Inj, adstiladrin, per tx dos HCPCS J9029 | not published | not published | $63,977.79 – $115,796.91 | 8 |
| Inj, aducanumab-avwa, 2 mg HCPCS J0172 | not published | not published | $6.34 – $6.34 | 1 |
| Inj, adzynma, 10 iu HCPCS J7171 | not published | not published | $36.01 – $65.19 | 8 |
| Inj, aflibercept hd, 1 mg HCPCS J0177 | not published | not published | $297.04 – $537.63 | 8 |
| Inj, afstyla, 1 i.u HCPCS J7210 | not published | not published | $1.61 – $2.91 | 8 |
| Inj allopurinol sodium 1 mg HCPCS J0206 | not published | not published | $4.05 – $7.33 | 8 |
| Inj, alyglo, 500 mg HCPCS J1552 | not published | not published | $120.88 – $218.78 | 8 |
| Inj alymsys 10 mg HCPCS Q5126 | not published | not published | $61.72 – $143.90 | 8 |
| Inj, amisulpride, 1 mg HCPCS J0184 | not published | not published | $9.52 – $17.22 | 8 |
| Inj andexxa, 10 mg HCPCS J7169 | not published | not published | $130.44 – $236.10 | 8 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | not published | not published | $18.41 – $33.31 | 8 |
| Inj, aponvie, 1 mg HCPCS C9145 | not published | not published | $1.97 – $1.97 | 1 |
| Inj., aristada initio, 1 mg HCPCS J1943 | not published | not published | $3.32 – $6.23 | 8 |
| Inj, artesunate, 1mg HCPCS J0391 | not published | not published | $51.54 – $93.29 | 8 |
| Inj. asceniv HCPCS J1554 | not published | not published | $506.34 – $916.45 | 8 |
| Inj, aspara, rylaze, 0.1 mg HCPCS J9021 | not published | not published | $57.39 – $105.66 | 8 |
| Inj avacincaptad pegol 0.1mg HCPCS J2782 | not published | not published | $102.64 – $185.77 | 8 |
| Inj aval alfa-nqpt 4mg HCPCS J0219 | not published | not published | $82.53 – $151.10 | 9 |
| Inj belantamab mafodot blmf HCPCS J9037 | not published | not published | $44.23 – $44.23 | 1 |
| Inj., benralizumab, 1 mg HCPCS J0517 | not published | not published | $164.65 – $298.01 | 8 |
| Inj, betibeglogene autotemce HCPCS J3393 | not published | not published | $2,914,143.91 – $5,274,468.62 | 8 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | not published | not published | $39.61 – $71.68 | 8 |
| Inj bimatoprost itc imp1mcg HCPCS J7351 | not published | not published | $212.58 – $384.76 | 8 |
| Inj, bortezomib, dr. reddy's HCPCS J9046 | not published | not published | $3.44 – $6.23 | 8 |
| Inj, bortezomib freseniuskab HCPCS J9048 | not published | not published | $6.93 – $12.55 | 8 |
| Inj, brixadi, 7 days or less HCPCS J0577 | not published | not published | $428.21 – $775.04 | 8 |
| Inj brixadi, more than 7 day HCPCS J0578 | not published | not published | $1,712.83 – $3,100.15 | 8 |
| Inj, brolucizumab-dbll, 1 mg HCPCS J0179 | not published | not published | $357.73 – $647.48 | 8 |
| Inj, bupivacaine liposome HCPCS J0666 | not published | not published | $1.45 – $2.62 | 8 |
| Inj, bupivacaine (posimir) HCPCS C9144 | not published | not published | $0.53 – $0.53 | 1 |
| Inj. byooviz, 0.1 mg HCPCS Q5124 | not published | not published | $179.35 – $433.75 | 8 |
| Inj, carmustine (accord) HCPCS J9052 | not published | not published | $0.05 – $0.05 | 1 |
| Inj cefazolin sodium, hikma HCPCS J0688 | not published | not published | $1.06 – $1.06 | 1 |
| Inj cefazolin (wg crit care) HCPCS J0687 | not published | not published | $1.18 – $1.18 | 1 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | not published | not published | $2.42 – $4.59 | 8 |
| Inj ceftolozane tazobactam HCPCS J0695 | not published | not published | $8.64 – $18.07 | 8 |
| Inj. cetirizine hcl 0.5mg HCPCS J1201 | not published | not published | $16.67 – $30.88 | 8 |
| Inj, cimerli, 0.1 mg HCPCS Q5128 | not published | not published | $82.07 – $148.55 | 8 |
| Inj, cipaglucosidase, 5 mg HCPCS J1203 | not published | not published | $94.74 – $173.34 | 9 |
| Inj, clevidipine butyrate HCPCS C9248 | not published | not published | $2.97 – $2.97 | 1 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $308.22 | $560.40 | $1,351.00 – $2,277.00 | 2 |
| Inj., copanlisib, 1 mg HCPCS J9057 | not published | not published | $94.51 – $94.51 | 1 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | not published | not published | $1,088.80 – $1,088.80 | 1 |
| Inj, crovalimab-akkz, 10 mg HCPCS J1307 | not published | not published | $548.48 – $992.72 | 8 |
| Inj cuvitru, 100 mg HCPCS J1555 | not published | not published | $17.61 – $32.66 | 8 |
| Inj cyclophosphamd auromedic HCPCS J9071 | not published | not published | $0.49 – $0.88 | 8 |
| Inj cyclophosphamd (ingenus) HCPCS J9073 | not published | not published | $0.50 – $0.90 | 8 |
| Inj, cyclophosphamd, sandoz HCPCS J9074 | not published | not published | $3.42 – $6.19 | 8 |
| Inj daptomycin (xellia) HCPCS J0873 | not published | not published | $0.04 – $0.04 | 1 |
| Inj daxibotulinumtoxina-lanm HCPCS J0589 | not published | not published | $3.05 – $5.52 | 8 |
| Inj delandistrogene mox rokl HCPCS J1413 | not published | not published | $3,298,654.19 – $5,970,414.82 | 8 |
| Inj disk cerv-thor ea lev CPT 62291 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Inj, donanemab-azbt, 2 mg HCPCS J0175 | not published | not published | $4.14 – $7.50 | 8 |
| Inj dupuytren cord w/enzyme CPT 20527 | not published | not published | $305.76 – $2,277.00 | 9 |
| Inj, durolane 1 mg HCPCS J7318 | not published | not published | $6.20 – $11.23 | 8 |
| Inj dx for sinogram CPT 20501 | $166.32 | $302.40 | $1,351.00 – $2,277.00 | 2 |
| Inject for sacroiliac joint HCPCS G0259 | not published | not published | $1,351.00 – $1,351.00 | 1 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | $163.55 | $297.36 | $703.13 – $2,277.00 | 10 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $223.74 | $406.80 | $1,351.00 – $2,277.00 | 2 |
| Injection, belinostat, 10mg HCPCS J9032 | not published | not published | $53.30 – $98.00 | 8 |
| Injection, burosumab-twza 1m HCPCS J0584 | not published | not published | $497.91 – $924.07 | 8 |
| Injection, cangrelor HCPCS C9460 | not published | not published | $19.95 – $36.50 | 8 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | $64.94 | $118.08 | $305.76 – $2,277.00 | 10 |
| Injection, daratumumab 10 mg HCPCS J9145 | not published | not published | $69.24 – $132.79 | 8 |
| Injection during cath supravalvular aortography CPT 93567 | $2,786.49 | $5,066.35 | $87.73 – $1,351.00 | 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.