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 |
|---|---|---|---|---|
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $605.00 | $1,100.00 | $104.14 – $188.49 | 8 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $467.50 | $850.00 | $104.14 – $188.49 | 8 |
| Prenatal Care Only (4-6 visits) CPT 59425 | not published | not published | $2,277.00 – $2,277.00 | 1 |
| Prenatal Care Only (7+ visits) CPT 59426 | not published | not published | $2,277.00 – $2,277.00 | 1 |
| Pre-op service lvrs 10-15dos HCPCS G0303 | not published | not published | $215.08 – $389.29 | 8 |
| Pre-op service lvrs 1-9 dos HCPCS G0304 | not published | not published | $371.70 – $672.77 | 8 |
| Pre-op service lvrs complete HCPCS G0302 | not published | not published | $371.70 – $672.77 | 8 |
| Preparation for bladder xray CPT 51605 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Preparation palate mold CPT 42280 | not published | not published | $537.23 – $2,277.00 | 9 |
| Prepare donor heart CPT 33944 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Prepare donor heart/lung CPT 33933 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Prepare donor intestine CPT 44715 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Prepare donor lung double CPT 32856 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Prepare donor lung single CPT 32855 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Prepare embryo for transfer CPT 89255 | not published | not published | $44.78 – $93.95 | 8 |
| Prepare fecal microbiota CPT 44705 | not published | not published | $2,277.00 – $2,277.00 | 1 |
| Prepare heart-aorta conduit CPT 33404 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Prepare penis study CPT 54230 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Prepare sperm duct x-ray CPT 55300 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Prep cadaver renal allograft CPT 50323 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Prep corneal endo allograft CPT 65757 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Prep donor intestine/artery CPT 44721 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Prep donor intestine/venous CPT 44720 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Prep donor liver 3-segment CPT 47144 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Prep donor liver/arterial CPT 47147 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Prep donor liver lobe split CPT 47145 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Prep donor liver/venous CPT 47146 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Prep donor liver whole CPT 47143 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Prep donor pancreas CPT 48551 | not published | not published | $2,277.00 – $2,277.00 | 1 |
| Prep donor pancreas/venous CPT 48552 | not published | not published | $2,277.00 – $2,277.00 | 1 |
| Prep donor renal graft CPT 50325 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Prepj skn cll ssp agrft 1st CPT 15013 | not published | not published | $2,277.00 – $12,794.84 | 9 |
| Prepj tum cav iort prtl mast CPT 19294 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Pre-plan 3d model w/ccta HCPCS C9793 | not published | not published | $855.40 – $1,548.23 | 8 |
| Prep renal graft/arterial CPT 50328 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Prep renal graft/ureteral CPT 50329 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Prep renal graft/venous CPT 50327 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Prep skin to 100cm2 other CPT 15004 | $1,138.53 | $2,070.05 | $404.93 – $2,277.00 | 10 |
| Prep skin to 100cm2 trk/ext CPT 15002 | $1,388.28 | $2,524.15 | $736.19 – $2,277.00 | 10 |
| Prep skn trk/ext adl 100cm2 CPT 15003 | $932.14 | $1,694.80 | $1,351.00 – $2,277.00 | 2 |
| Pressure max expiratory/inspiratory CPT 94799 | $551.28 | $1,002.33 | $128.17 – $231.99 | 8 |
| Pressure treatment esophagus CPT 43460 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Pressure velocity wire add ves CPT 93572 | $2,507.05 | $4,558.27 | $167.57 – $1,351.00 | 2 |
| Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 | $100.10 | $182.00 | $39.03 – $307.16 | 8 |
| Pretreat rbc absorption reference CPT 86978 | $160.60 | $292.00 | $30.46 – $106.36 | 8 |
| Pretreat rbc density gradient separation reference CPT 86972 | $57.20 | $104.00 | $45.62 – $307.16 | 8 |
| Pretreat rbc w chem/drugs reference CPT 86970 | $71.50 | $130.00 | $30.46 – $106.36 | 8 |
| Pretreat rbc w enzyme reference CPT 86971 | $100.10 | $182.00 | $26.39 – $307.16 | 8 |
| Pr evaluation psychiatric diagnostic w/medical services CPT 90792 | $151.04 | $274.62 | $176.80 – $320.01 | 8 |
| Pr exam init preventive phys new visit during 1st 12 mo of mcare enrollment HCPCS G0402 | $127.51 | $231.84 | $132.62 – $240.03 | 8 |
| Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm CPT 11420 | $1,205.16 | $2,191.20 | $1,325.00 – $2,977.67 | 10 |
| Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 | $213.95 | $389.00 | $1,325.00 – $2,977.67 | 10 |
| Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 | $559.02 | $1,016.40 | $404.93 – $2,277.00 | 10 |
| Pr gastrorrhaphy suture perforated duodenal or gastric ulcer/wound/ injury CPT 43840 | not published | not published | $2,277.00 – $6,951.05 | 9 |
| Prgrmg dev eval impltbl sys CPT 93260 | not published | not published | $36.51 – $67.29 | 8 |
| Prgrmg dev eval pm/ldls pm CPT 93279 | $28.54 | $51.89 | $29.24 – $67.29 | 8 |
| Prgrmg dev eval scrms ip CPT 93285 | not published | not published | $25.95 – $67.29 | 8 |
| Prgrmg eval implantable dfb CPT 93282 | not published | not published | $33.64 – $67.29 | 8 |
| Prgrmg eval implantable dfb CPT 93283 | not published | not published | $37.18 – $67.29 | 8 |
| Prgrmg eval implantable dfb CPT 93284 | not published | not published | $37.18 – $67.29 | 8 |
| Prgr stim/pace a/iv drug CPT 93623 | not published | not published | $394.85 – $10,988.00 | 3 |
| Pr hospital ip/obs care initial high level per day CPT 99223 | $436.15 | $793.00 | not published | 0 |
| Pr hospital ip/obs care initial moderate level per day CPT 99222 | $184.80 | $336.00 | not published | 0 |
| Pr hospital ip/obs care initial straightforward or low level per day CPT 99221 | $136.40 | $248.00 | not published | 0 |
| Pr hospital ip/obs care subsequent high level per day CPT 99233 | $154.00 | $280.00 | not published | 0 |
| Pr hospital ip/obs care subsequent moderate level per day CPT 99232 | $108.35 | $197.00 | not published | 0 |
| Pr hospital ip/obs care subsequent straightforward or low level per day CPT 99231 | $66.55 | $121.00 | not published | 0 |
| Prim art mech thrmbc non-intracranial CPT 37184 | $7,072.56 | $12,859.20 | $2,277.00 – $33,050.22 | 10 |
| Prim art mech thrmbc non-intracranial add-on CPT 37185 | $8,044.93 | $14,627.15 | $1,351.00 – $2,277.00 | 2 |
| Prin care mgmt staff 1st 30 CPT 99426 | not published | not published | $101.19 – $183.16 | 8 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $1,226.28 | $2,229.60 | $404.93 – $2,277.00 | 10 |
| Pr incision & drainage abscess simple/single CPT 10060 | $826.98 | $1,503.60 | $199.85 – $2,277.00 | 9 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $224.40 | $408.00 | $303.54 – $2,277.00 | 10 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $906.18 | $1,647.60 | $404.93 – $2,277.00 | 9 |
| Pr management transitional care high w/in 7 days of discharge CPT 99496 | $203.54 | $370.08 | $132.62 – $240.03 | 8 |
| Pr management transitional care moderate w/in 14 days of discharge CPT 99495 | $150.48 | $273.60 | $132.62 – $240.03 | 8 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $185.46 | $337.20 | $23.03 – $23.03 | 1 |
| Pr neuroplasty and/or transposition ulnar nerve at elbow CPT 64718 | not published | not published | $1,778.00 – $3,520.58 | 10 |
| Probe cryo 1150mm endo flex ster disp HCPCS C2618 | $2,176.69 | $3,957.61 | not published | 0 |
| Probe nasolacrimal duct CPT 68810 | not published | not published | $316.17 – $2,277.00 | 10 |
| Probe nasolacrimal duct CPT 68811 | not published | not published | $1,778.00 – $4,286.38 | 10 |
| Probe nasolacrimal duct CPT 68815 | not published | not published | $1,778.00 – $4,286.38 | 10 |
| Probe nl duct w/balloon CPT 68816 | not published | not published | $2,277.00 – $4,286.38 | 10 |
| Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 | not published | not published | $194.01 – $531.65 | 8 |
| Procalcitonin CPT 84145 | $138.05 | $251.00 | $24.50 – $49.00 | 8 |
| Proctectomy combined abd pull-thru px 45112 CPT 45112 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Proctectomy complete abd w/clst 45110 CPT 45110 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Proctosigmoidoscopy ablate CPT 45320 | not published | not published | $1,325.00 – $5,004.26 | 10 |
| Proctosigmoidoscopy control bleed 45317 CPT 45317 | not published | not published | $1,191.98 – $2,277.00 | 10 |
| Proctosigmoidoscopy dilate 45303 CPT 45303 | not published | not published | $1,191.98 – $2,277.00 | 10 |
| Proctosigmoidoscopy dx 45300 CPT 45300 | not published | not published | $926.34 – $2,277.00 | 10 |
| Proctosigmoidoscopy removal CPT 45308 | not published | not published | $1,325.00 – $5,004.26 | 10 |
| Proctosigmoidoscopy removal CPT 45309 | not published | not published | $1,191.98 – $2,277.00 | 10 |
| Proctosigmoidoscopy tumor removal 45315 CPT 45315 | not published | not published | $1,191.98 – $2,277.00 | 10 |
| Proctosigmoidoscopy volvul CPT 45321 | not published | not published | $1,325.00 – $5,004.26 | 10 |
| Proctosigmoidoscopy w/bx 45305 CPT 45305 | not published | not published | $1,191.98 – $2,277.00 | 10 |
| Proctosigmoidoscopy w/fb remove 45307 CPT 45307 | not published | not published | $1,325.00 – $5,004.26 | 10 |
| Proctosigmoidoscopy w/stent CPT 45327 | not published | not published | $1,325.00 – $10,945.26 | 10 |
| Progenamatrix, per sq cm HCPCS Q4222 | not published | not published | $123.96 – $224.36 | 8 |
| Progesterone CPT 84144 | $103.40 | $188.00 | $18.77 – $37.55 | 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.