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 |
|---|---|---|---|---|
| Partial removal of radius CPT 25230 | not published | not published | $2,277.00 – $5,899.11 | 10 |
| Partial removal of rectum CPT 45111 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Partial removal of rectum CPT 45114 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Partial removal of rectum CPT 45116 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Partial removal of rib CPT 21600 | not published | not published | $1,778.00 – $13,082.27 | 10 |
| Partial removal of sternum CPT 21620 | not published | not published | $2,277.00 – $5,899.11 | 9 |
| Partial removal of thyroid CPT 60220 | not published | not published | $1,778.00 – $10,899.52 | 10 |
| Partial removal of thyroid CPT 60225 | not published | not published | $2,034.00 – $10,899.52 | 10 |
| Partial removal of tibia CPT 27640 | not published | not published | $1,778.00 – $5,899.11 | 10 |
| Partial removal of toe CPT 28160 | not published | not published | $2,034.00 – $5,899.11 | 10 |
| Partial removal of tongue CPT 41120 | not published | not published | $2,277.00 – $10,672.90 | 10 |
| Partial removal of tongue CPT 41130 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Partial removal of ulna CPT 25119 | not published | not published | $2,034.00 – $5,899.11 | 10 |
| Partial removal of ulna CPT 25150 | not published | not published | $1,778.00 – $5,899.11 | 10 |
| Partial removal of ulna CPT 25240 | not published | not published | $2,277.00 – $5,899.11 | 10 |
| Partial removal of vaginal wall 57106 CPT 57106 | not published | not published | $2,277.00 – $5,836.23 | 9 |
| Partial removal tear gland CPT 68505 | not published | not published | $2,034.00 – $7,087.94 | 10 |
| Partial thyroid excision CPT 60210 | not published | not published | $2,277.00 – $10,899.52 | 9 |
| Partial thyroid lobect w/contratlat stot lobec 60212 CPT 60212 | not published | not published | $2,277.00 – $10,899.52 | 9 |
| Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 | not published | not published | $3.85 – $3.85 | 1 |
| Part removal hip bone deep CPT 27071 | not published | not published | $2,277.00 – $5,899.11 | 9 |
| Part removal of metatarsal CPT 28110 | not published | not published | $2,034.00 – $5,899.11 | 10 |
| Part removal of metatarsal CPT 28113 | not published | not published | $2,034.00 – $5,899.11 | 10 |
| Part removal of metatarsal 28112 CPT 28112 | not published | not published | $2,034.00 – $5,899.11 | 10 |
| Part remove hip bone super CPT 27070 | not published | not published | $2,277.00 – $5,899.11 | 9 |
| Path clin consltj high 41-60 CPT 80505 | not published | not published | $137.09 – $307.16 | 8 |
| Path clin consltj mod 21-40 CPT 80504 | not published | not published | $86.57 – $307.16 | 8 |
| Path clin consltj prolng svc CPT 80506 | not published | not published | $38.93 – $77.68 | 2 |
| Path clin consltj sf 5-20 CPT 80503 | not published | not published | $40.53 – $93.95 | 8 |
| Patient recorded spirometry CPT 94014 | not published | not published | $85.48 – $805.40 | 8 |
| Patient recorded spirometry CPT 94015 | not published | not published | $41.33 – $389.29 | 8 |
| Pca3/klk3 antigen CPT 81313 | not published | not published | $229.55 – $459.09 | 8 |
| Pcv21 vaccine im CPT 90684 | not published | not published | $347.56 – $347.56 | 1 |
| Pdgfra gene CPT 81314 | $265.10 | $482.00 | $296.56 – $593.12 | 8 |
| Pdt dstr prmlg les phys/qhp CPT 96573 | not published | not published | $199.85 – $361.72 | 8 |
| Pedcle fh/ch/ch/m/n/ax/g/h/f CPT 15574 | $999.35 | $1,817.00 | $2,034.00 – $3,719.90 | 10 |
| Ped home apnea mntr att only CPT 94775 | not published | not published | $82.90 – $231.99 | 8 |
| Ped home apnea mntr dl&alys CPT 94776 | not published | not published | $128.17 – $231.99 | 8 |
| Pedicle enel/ntroral 15576 CPT 15576 | $874.50 | $1,590.00 | $2,034.00 – $3,719.90 | 10 |
| Pegaspargase injection HCPCS J9266 | not published | not published | $28,694.76 – $53,395.14 | 8 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | not published | not published | $21.18 – $257.82 | 8 |
| Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe HCPCS Q5122 | not published | not published | $124.03 – $246.44 | 8 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | not published | not published | $143.68 – $268.44 | 8 |
| Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5127 | not published | not published | $142.88 – $258.61 | 8 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | not published | not published | $66.66 – $120.64 | 8 |
| Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5130 | not published | not published | $104.53 – $189.20 | 8 |
| Pegloticase 8 mg/ml intravenous solution HCPCS J2507 | not published | not published | $3,763.05 – $7,072.81 | 8 |
| Pegunigalsidase alfa-iwxj HCPCS J2508 | not published | not published | $224.42 – $406.20 | 9 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $1,085.70 | $1,974.00 | $174.72 – $316.23 | 8 |
| Pelvic CT scan (with contrast) CPT 72193 | $882.20 | $1,604.00 | $174.72 – $316.23 | 8 |
| Pelvic CT scan (without contrast) CPT 72192 | $746.35 | $1,357.00 | $104.14 – $188.49 | 8 |
| Pelvic exenteration CPT 45126 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Pelvic MRI (with and without contrast) CPT 72197 | $1,552.32 | $2,822.40 | $347.51 – $628.99 | 8 |
| Pelvic MRI (with contrast) CPT 72196 | $1,304.16 | $2,371.20 | $347.51 – $628.99 | 8 |
| Pelvic MRI (without contrast) CPT 72195 | $1,180.08 | $2,145.60 | $237.67 – $430.18 | 8 |
| Pelvic ring fracture uni/bil HCPCS G0413 | not published | not published | $1,921.73 – $13,082.27 | 8 |
| Pelvic ring fx treat int fix HCPCS G0414 | not published | not published | $1,798.09 – $13,082.27 | 8 |
| Pelvic Ultrasound (complete) CPT 76856 | $547.80 | $996.00 | $104.14 – $188.49 | 8 |
| Pelvic Ultrasound (limited) CPT 76857 | $283.80 | $516.00 | $104.14 – $188.49 | 8 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | not published | not published | $60.31 – $109.16 | 8 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | not published | not published | $5.59 – $12.51 | 8 |
| Peng benzathine/procaine inj HCPCS J0558 | not published | not published | $18.41 – $35.14 | 8 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | not published | not published | $28.43 – $58.67 | 8 |
| Penicillin g procaine inj HCPCS J2510 | not published | not published | $50.02 – $50.02 | 1 |
| Penile injection CPT 54235 | $278.52 | $506.40 | $248.88 – $2,277.00 | 9 |
| Penile vascular study CPT 93980 | $539.92 | $981.67 | $104.14 – $188.49 | 8 |
| Penile vascular study CPT 93981 | $438.16 | $796.66 | $104.14 – $188.49 | 8 |
| Penile venous occlusion CPT 37790 | not published | not published | $2,034.00 – $6,355.21 | 10 |
| Penis plastic surgery CPT 54360 | not published | not published | $2,034.00 – $6,355.21 | 10 |
| Penis study CPT 54240 | not published | not published | $215.08 – $2,277.00 | 9 |
| Pentostatin 10 mg intravenous solution HCPCS J9268 | not published | not published | $2,683.15 – $4,856.38 | 8 |
| Perc cryo ablate renal tum CPT 50593 | $10,216.14 | $18,574.80 | $2,277.00 – $19,164.59 | 10 |
| Perc d-e cor revasc chro add HCPCS C9608 | $8,396.05 | $15,265.55 | $14,326.00 – $14,326.00 | 1 |
| Perc d-e cor revasc chro sin HCPCS C9607 | $9,804.19 | $17,825.80 | $14,326.00 – $33,050.22 | 8 |
| Perc d-e cor revasc t cabg b HCPCS C9605 | $9,513.16 | $17,296.65 | $14,326.00 – $14,326.00 | 1 |
| Perc d-e cor revasc t cabg s HCPCS C9604 | $8,772.25 | $15,949.55 | $11,499.23 – $20,813.09 | 8 |
| Perc d-e cor stent ather br HCPCS C9603 | $8,396.05 | $15,265.55 | $14,326.00 – $14,326.00 | 1 |
| Perc d-e cor stent ather s HCPCS C9602 | $9,287.96 | $16,887.20 | $14,326.00 – $33,050.22 | 8 |
| Perc drug-el cor stent bran HCPCS C9601 | $8,255.50 | $15,010.00 | $14,326.00 – $14,326.00 | 1 |
| Perc drug-el cor stent sing HCPCS C9600 | $7,223.56 | $13,133.75 | $11,499.23 – $20,813.09 | 8 |
| Perc rf ablate renal tumor CPT 50592 | not published | not published | $1,325.00 – $10,899.52 | 10 |
| Percut ablate liver rf CPT 47382 | not published | not published | $2,277.00 – $10,899.52 | 9 |
| Percutaneous islet celltrans HCPCS G0341 | not published | not published | $651.95 – $651.95 | 1 |
| Pericardial drain w/cath pq w/ct guid CPT 33019 | $321.34 | $584.25 | $2,277.00 – $3,233.00 | 2 |
| Pericardiectomy/sub or com/w bypas 33031 CPT 33031 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Pericardiocentesis wwo imaging CPT 33016 | $1,991.25 | $3,620.45 | $1,568.02 – $3,962.00 | 10 |
| Pericardiotomy/clot/for bod remove 33020 CPT 33020 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Peri-implt capslc brst compl CPT 19371 | not published | not published | $2,277.00 – $7,059.16 | 10 |
| Perineoplasty rpr per nonob CPT 56810 | not published | not published | $2,277.00 – $5,836.23 | 10 |
| Peripheral vascular rehab CPT 93668 | not published | not published | $32.54 – $106.36 | 8 |
| Peri-proc device eval icd CPT 93287 | not published | not published | $21.55 – $21.55 | 1 |
| Peri-proc device eval pm CPT 93286 | not published | not published | $19.34 – $19.34 | 1 |
| Peritoneal cath sub q resv per CPT 49419 | not published | not published | $1,325.00 – $10,032.25 | 10 |
| Peritoneogram rs&i CPT 74190 | not published | not published | $90.02 – $985.13 | 8 |
| Perit-vens shunt pat tst CPT 78291 | $807.84 | $1,468.80 | $358.70 – $720.75 | 8 |
| Perq art m-thrombect &/nfs CPT 61645 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Perq clsr tcat l atr apndge CPT 33340 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Perq dev breast 1st mr guide CPT 19287 | $468.16 | $851.20 | $705.37 – $2,277.00 | 10 |
| Perq dev breast 1st strtctc CPT 19283 | $273.79 | $497.80 | $705.37 – $2,277.00 | 10 |
| Perq nl/pl lithotrp cplx>2cm CPT 50081 | not published | not published | $5,110.00 – $17,067.14 | 9 |
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.