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 |
|---|---|---|---|---|
| MRI brain without dye CPT 70557 | not published | not published | $544.29 – $985.13 | 8 |
| MRI brain without & w/dye CPT 70559 | not published | not published | $174.72 – $316.23 | 8 |
| MRI breast c- unilateral CPT 77046 | $467.28 | $849.60 | $237.67 – $430.18 | 8 |
| MRI breast c-+ w/cad uni CPT 77048 | not published | not published | $482.55 – $639.07 | 2 |
| MRI breast without cont bi CPT 77047 | $778.80 | $1,416.00 | $237.67 – $430.18 | 8 |
| MRI breast w IV cont bi CPT 77049 | not published | not published | $480.20 – $635.92 | 2 |
| MRI cardiac morph & func wo IV cont CPT 75557 | not published | not published | $237.67 – $430.18 | 8 |
| MRI cardiac morph & func wwo IV cont CPT 75561 | not published | not published | $347.51 – $628.99 | 8 |
| MRI cardiac morph & func wwo IV cont w/stress img CPT 75563 | not published | not published | $703.66 – $1,413.34 | 8 |
| MRI chest without contrast CPT 71550 | $1,149.06 | $2,089.20 | $237.67 – $430.18 | 8 |
| MRI chest without & w/contrast CPT 71552 | $1,521.96 | $2,767.20 | $347.51 – $628.99 | 8 |
| MRI chest w IV cont CPT 71551 | $1,304.16 | $2,371.20 | $722.91 – $1,413.34 | 8 |
| MRI fetal ea addl gestation CPT 74713 | not published | not published | $228.89 – $228.89 | 1 |
| MRI fetal sngl/1st gestation CPT 74712 | not published | not published | $237.67 – $430.18 | 8 |
| MRI guid ndl plc s&i CPT 77021 | $1,133.22 | $2,060.40 | $514.03 – $514.03 | 1 |
| MRI guid parenchymal tiss ablation CPT 77022 | not published | not published | $596.78 – $596.78 | 1 |
| MRI hyperpolarized xenon129 HCPCS C9791 | not published | not published | $1,219.22 – $2,206.74 | 8 |
| MRI loex nonjt w IV cont CPT 73719 | $1,304.16 | $2,371.20 | $347.51 – $628.99 | 8 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $1,180.08 | $2,145.60 | $237.67 – $430.18 | 8 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $1,552.32 | $2,822.40 | $347.51 – $628.99 | 8 |
| MRI orbit/face/neck without contrast CPT 70540 | $957.66 | $1,741.20 | $237.67 – $430.18 | 8 |
| MRI orbit/face/neck without & w/contrast CPT 70543 | $1,842.72 | $3,350.40 | $347.51 – $628.99 | 8 |
| MRI orbit fac&nck w IV cont CPT 70542 | $1,326.60 | $2,412.00 | $347.51 – $628.99 | 8 |
| MRI tmj CPT 70336 | $1,149.06 | $2,089.20 | $237.67 – $430.18 | 8 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $1,180.08 | $2,145.60 | $237.67 – $430.18 | 8 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $1,552.32 | $2,822.40 | $347.51 – $628.99 | 8 |
| MRI upper extremity w/dye CPT 73219 | not published | not published | $347.51 – $628.99 | 8 |
| MRI w/cont, breast, bi HCPCS C8906 | $1,280.40 | $2,328.00 | $347.51 – $628.99 | 8 |
| MRI w/cont, breast, uni HCPCS C8903 | $745.14 | $1,354.80 | $174.72 – $316.23 | 8 |
| MRI without fol w/cont, breast HCPCS C8908 | $1,707.20 | $3,104.00 | $347.51 – $628.99 | 8 |
| MRI without fol w/cont, brst, un HCPCS C8905 | $993.30 | $1,806.00 | $347.51 – $628.99 | 8 |
| Mr safety determination physician/other qhp CPT 76016 | not published | not published | $71.87 – $156.90 | 8 |
| Mr safety implant elec prepj CPT 76018 | not published | not published | $94.70 – $171.40 | 8 |
| Mr safety implant&/fb assmt clin staff ea add 30 CPT 76015 | not published | not published | $84.23 – $84.23 | 1 |
| Mr safety implt pos&/immoblj CPT 76019 | not published | not published | $58.76 – $106.36 | 8 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | not published | not published | $17.48 – $52.15 | 8 |
| Mr sfty med physics xm cstmz CPT 76017 | not published | not published | $237.67 – $430.18 | 8 |
| Mr spectroscopy CPT 76390 | not published | not published | $86.69 – $156.90 | 8 |
| Msh2 gene dup/delete variant CPT 81297 | not published | not published | $191.97 – $383.94 | 8 |
| Msh2 gene full seq CPT 81295 | not published | not published | $343.53 – $687.06 | 8 |
| Msh2 gene known variants CPT 81296 | not published | not published | $178.34 – $607.91 | 8 |
| Msh6 gene dup/delete variant CPT 81300 | not published | not published | $214.20 – $428.40 | 8 |
| Msh6 gene full seq CPT 81298 | not published | not published | $577.67 – $1,155.33 | 8 |
| Msh6 gene known variants CPT 81299 | not published | not published | $178.34 – $554.40 | 8 |
| Mt bone graft microvasc CPT 20957 | not published | not published | $2,277.00 – $13,082.27 | 9 |
| Mthfr gene analy common variants CPT 81291 | $551.10 | $1,002.00 | $58.81 – $117.61 | 8 |
| M.tuberculo dna dir probe CPT 87555 | not published | not published | $24.19 – $48.38 | 8 |
| M.tuberculo dna quant CPT 87557 | not published | not published | $38.56 – $77.11 | 8 |
| Mucin synovial fluid CPT 83872 | not published | not published | $5.27 – $10.55 | 8 |
| Mucopolysaccharides CPT 83864 | not published | not published | $25.65 – $51.30 | 8 |
| Mucormycosis antibody CPT 86732 | not published | not published | $13.50 – $27.00 | 8 |
| Mult fam adapt bhv tx gdn CPT 97157 | not published | not published | $37.32 – $67.55 | 8 |
| Multi family grp psychotherapy CPT 90849 | not published | not published | $52.19 – $320.01 | 8 |
| Multifocal erg w/i&r CPT 92274 | not published | not published | $95.74 – $231.99 | 8 |
| Multiple sleep latency test CPT 95805 | $1,650.00 | $3,000.00 | $601.22 – $1,548.23 | 8 |
| Mumps antibody igg CPT 86735 | $133.10 | $242.00 | $11.75 – $23.49 | 8 |
| Muscle-skin graft arm CPT 15736 | $1,630.75 | $2,965.00 | $2,034.00 – $3,719.90 | 10 |
| Muscle-skin graft leg CPT 15738 | $1,736.35 | $3,157.00 | $2,034.00 – $6,389.00 | 10 |
| Muscle-skin graft trunk CPT 15734 | $2,030.05 | $3,691.00 | $2,034.00 – $6,389.00 | 10 |
| Muscle test cran nerv unilat CPT 95867 | not published | not published | $119.94 – $389.29 | 8 |
| Muscle test hemidiaphragm CPT 95866 | not published | not published | $118.84 – $231.99 | 8 |
| Muscle test larynx CPT 95865 | not published | not published | $90.25 – $239.87 | 8 |
| Muscle test one fiber CPT 95872 | not published | not published | $85.31 – $389.29 | 8 |
| Muscle transfers CPT 23397 | not published | not published | $2,277.00 – $13,082.27 | 10 |
| Muscle transfer shoulder/arm CPT 23395 | not published | not published | $2,277.00 – $13,082.27 | 10 |
| Musc myoq/fscq flp h&n pedcl CPT 15733 | $1,390.40 | $2,528.00 | $2,277.00 – $6,389.00 | 10 |
| Musc/tdn transfer upr a/e 1 CPT 24301 | not published | not published | $2,277.00 – $13,082.27 | 10 |
| Mycobacteria dna amp probe CPT 87551 | not published | not published | $43.42 – $86.83 | 8 |
| Mycobacteria dna dir probe CPT 87550 | not published | not published | $18.05 – $36.09 | 8 |
| Mycobacteria dna quant CPT 87552 | not published | not published | $38.56 – $77.11 | 8 |
| Mycoplasma antibody igm CPT 86738 | $138.60 | $252.00 | $11.92 – $23.83 | 8 |
| Myd88 gene p.leu265pro vrnt CPT 81305 | not published | not published | $157.86 – $315.72 | 8 |
| Myelogphy 2/> spine regions CPT 72270 | $979.44 | $1,780.80 | $220.52 – $1,413.34 | 8 |
| Myelography l-s spine CPT 72265 | $815.10 | $1,482.00 | $143.58 – $1,413.34 | 8 |
| Myelography neck spine CPT 72240 | $938.52 | $1,706.40 | $141.37 – $1,413.34 | 8 |
| Myelography thoracic spine CPT 72255 | $938.52 | $1,706.40 | $130.93 – $1,413.34 | 8 |
| Myelography via inj w/s&i 2+ regions CPT 62305 | $2,395.14 | $4,354.80 | $780.87 – $2,514.00 | 10 |
| Myelography via inj w/s&i cervical CPT 62302 | $1,482.36 | $2,695.20 | $780.87 – $2,514.00 | 10 |
| Myelography via inj w/s&i lumbosacral CPT 62304 | $2,395.14 | $4,354.80 | $780.87 – $2,514.00 | 10 |
| Myelography via inj w/s&i thoracic CPT 62303 | $1,453.98 | $2,643.60 | $780.87 – $2,514.00 | 10 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $342.10 | $622.00 | $10.38 – $20.75 | 8 |
| Myocardial resection 33542 CPT 33542 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Myocrd img pet 1std rst/strs CPT 78491 | not published | not published | $904.32 – $2,578.06 | 8 |
| Myocrd img pet 1 std w/ct CPT 78429 | not published | not published | $23.52 – $2,578.06 | 8 |
| Myocrd img pet 2rtracer CPT 78432 | not published | not published | $1,511.72 – $2,736.14 | 8 |
| Myocrd img pet 2rtracer CT CPT 78433 | not published | not published | $2,194.21 – $3,971.42 | 8 |
| Myocrd img pet mlt rst&strs CPT 78492 | not published | not published | $1,424.38 – $2,578.06 | 8 |
| Myocrd img pet rst&strs CT CPT 78431 | not published | not published | $2,194.21 – $3,971.42 | 8 |
| Myocrd img pet rst/strs w/ct CPT 78430 | not published | not published | $23.52 – $2,578.06 | 8 |
| Myomectomy abdom complex CPT 58146 | not published | not published | $2,277.00 – $4,373.00 | 2 |
| Myomectomy abdom method CPT 58140 | not published | not published | $2,277.00 – $4,373.00 | 2 |
| Myomectomy vag method CPT 58145 | not published | not published | $2,277.00 – $5,836.23 | 10 |
| Myown harv prep proc sq cm HCPCS Q4226 | not published | not published | $630.08 – $630.08 | 1 |
| Myringoplasty CPT 69620 | not published | not published | $1,778.00 – $5,977.46 | 10 |
| Naltrexone, depot form HCPCS J2315 | not published | not published | $4.37 – $8.14 | 8 |
| Narcosynthesis CPT 90865 | not published | not published | $176.80 – $320.01 | 8 |
| Nasal endoscopy dx uni/bi separate proc CPT 31231 | $225.20 | $409.45 | $198.83 – $2,277.00 | 9 |
| Nasal endoscopy with removal of nasal foreign body CPT 30999 | $111.82 | $203.30 | $235.93 – $2,277.00 | 9 |
| Nasal function studies CPT 92512 | not published | not published | $51.26 – $389.29 | 8 |
| Nasal/sinus endoscopy surg CPT 31287 | not published | not published | $2,034.00 – $12,723.94 | 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.