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 |
|---|---|---|---|---|
| Synch audio-only est high 40 CPT 98015 | not published | not published | $236.75 – $236.75 | 1 |
| Synch audio-only est low 20 CPT 98013 | not published | not published | $111.04 – $111.04 | 1 |
| Synch audio-only est mod 30 CPT 98014 | not published | not published | $162.64 – $162.64 | 1 |
| Synch audio-only est sf 10 CPT 98012 | not published | not published | $63.41 – $63.41 | 1 |
| Synch audio-only new high 60 CPT 98011 | not published | not published | $287.44 – $287.44 | 1 |
| Synch audio-only new low 30 CPT 98009 | not published | not published | $141.64 – $141.64 | 1 |
| Synch audio-only new mod 45 CPT 98010 | not published | not published | $220.94 – $220.94 | 1 |
| Synch audio-only new sf 15 CPT 98008 | not published | not published | $85.09 – $85.09 | 1 |
| Synthetic sentence id test CPT 92576 | not published | not published | $37.21 – $67.34 | 8 |
| Synvisc or synvisc-one HCPCS J7325 | not published | not published | $5.98 – $10.83 | 8 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $69.85 | $127.00 | $3.96 – $7.92 | 8 |
| System cardiomems hosp electronics HCPCS C2624 | $33,951.94 | $61,730.80 | not published | 0 |
| System pacing micra av HCPCS C1786 | $9,566.65 | $17,393.91 | not published | 0 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $5,321.84 | $9,676.08 | not published | 0 |
| T3 (triiodothyronine) free CPT 84481 | $78.10 | $142.00 | $15.25 – $30.49 | 8 |
| T3 (triiodothyronine) total CPT 84480 | $86.35 | $157.00 | $12.76 – $25.52 | 8 |
| T4 (thyroxine) free CPT 84439 | $51.70 | $94.00 | $8.12 – $16.24 | 8 |
| T4 (thyroxine) total CPT 84436 | $33.00 | $60.00 | $6.18 – $12.37 | 8 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | not published | not published | $266.70 – $482.72 | 8 |
| Tacrolimus therapeutic drug level CPT 80197 | $124.30 | $226.00 | $12.36 – $24.71 | 8 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | not published | not published | $14.35 – $25.97 | 8 |
| Tah rad debulk/lymph remove 58954 CPT 58954 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Tah rad dissect for debulk 58953 CPT 58953 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Tah w/mmk 58152 CPT 58152 | not published | not published | $2,277.00 – $8,722.00 | 2 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | not published | not published | $74.59 – $139.21 | 8 |
| Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 | not published | not published | $74.17 – $138.10 | 8 |
| Talymed HCPCS Q4127 | not published | not published | $123.96 – $224.36 | 8 |
| Tap block bilat cont infusion 64489 CPT 64489 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Tap block uni by cont infusion 64487 CPT 64487 | not published | not published | $1,351.00 – $2,277.00 | 2 |
| Target gsa panel hmtlmph neop CPT 81450 | not published | not published | $683.58 – $1,367.15 | 8 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $1,833.15 | $3,333.00 | $2,627.64 – $5,255.28 | 8 |
| Target gsa panel organ neop CPT 81445 | not published | not published | $538.12 – $1,076.24 | 8 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | not published | not published | $1,603.55 – $2,902.36 | 8 |
| Tas congenital car anomal CPT 33741 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | not published | not published | $736.19 – $2,277.00 | 9 |
| Tavr perq femoral CPT 33361 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | not published | not published | $0.23 – $0.42 | 8 |
| Tbp gene detc abnor alleles CPT 81344 | not published | not published | $123.30 – $246.60 | 8 |
| Tbs dxa cal w/i&r fx risk CPT 77089 | not published | not published | $69.06 – $93.44 | 2 |
| Tbs i&r fx rsk qhp CPT 77092 | not published | not published | $18.72 – $23.36 | 2 |
| Tbs techl calculation only CPT 77091 | not published | not published | $46.43 – $156.90 | 8 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $3.91 – $156.90 | 8 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | not published | not published | $90.00 – $180.00 | 8 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $261.25 | $475.00 | $55.78 – $111.56 | 8 |
| Tc-99m arcitumomab HCPCS A9568 | not published | not published | $858.08 – $858.08 | 1 |
| Tc-99m bicisate HCPCS A9557 | not published | not published | $724.83 – $1,395.94 | 8 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | not published | not published | $928.99 – $1,681.43 | 8 |
| Tc-99m exametazime diag HCPCS A9521 | $471.30 | $856.90 | $850.48 – $850.48 | 1 |
| Tc-99m graphite crucible HCPCS A9506 | not published | not published | $326.79 – $591.48 | 8 |
| Tc-99m labeled rbc HCPCS A9560 | $201.16 | $365.75 | not published | 0 |
| Tc-99m maa HCPCS A9540 | $97.71 | $177.65 | not published | 0 |
| Tc-99m mebrofenin HCPCS A9537 | $80.46 | $146.30 | not published | 0 |
| Tc-99m medronate HCPCS A9503 | $68.97 | $125.40 | not published | 0 |
| Tc-99m mertiatide HCPCS A9562 | $574.75 | $1,045.00 | not published | 0 |
| Tc-99m non-heu per study dose HCPCS Q9969 | $18.39 | $33.44 | $10.60 – $10.60 | 1 |
| Tc-99m oxidronate HCPCS A9561 | $68.97 | $125.40 | not published | 0 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $143.11 | $260.20 | not published | 0 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $3.45 | $6.27 | not published | 0 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $44.25 | $80.46 | not published | 0 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $258.64 | $470.25 | not published | 0 |
| Tc-99m sulfur colloid HCPCS A9541 | $155.18 | $282.15 | not published | 0 |
| Tc-99m tilmanocept diag HCPCS A9520 | $804.65 | $1,463.00 | not published | 0 |
| Tca peel dermal 15789 CPT 15789 | not published | not published | $736.19 – $2,277.00 | 9 |
| Tcd emboli detect w/inj CPT 93893 | not published | not published | $104.14 – $188.49 | 8 |
| Tcd emboli detect without inj CPT 93892 | not published | not published | $104.14 – $188.49 | 8 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $439.46 – $2,277.00 | 10 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $304.70 | $554.00 | $42.28 – $84.56 | 8 |
| T cells absolute cd 4 count CPT 86361 | $50.60 | $92.00 | $23.94 – $48.20 | 8 |
| T cells total count CPT 86359 | $61.60 | $112.00 | $33.96 – $67.91 | 8 |
| Tcranial magn stim tx deli CPT 90868 | not published | not published | $62.23 – $389.29 | 8 |
| Tcranial magn stim tx plan CPT 90867 | not published | not published | $207.46 – $389.29 | 8 |
| Tcran magn stim redetemine CPT 90869 | not published | not published | $165.96 – $389.29 | 8 |
| Tdh sdrl/ventr pnxr CPT 61105 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Teaec w/wo patch graft iliofemoral CPT 35355 | not published | not published | $2,277.00 – $3,233.00 | 2 |
| Team conf without pat by phys CPT 99367 | $117.72 | $214.04 | not published | 0 |
| Team conf w/pat by hc prof CPT 99366 | $77.09 | $140.16 | not published | 0 |
| Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution HCPCS J9274 | not published | not published | $226.75 – $410.41 | 8 |
| Tee w or without fol w/cont,cong HCPCS C8926 | not published | not published | $780.87 – $1,413.34 | 8 |
| Tee w or without fol w/cont, mon HCPCS C8927 | not published | not published | $780.87 – $1,413.34 | 8 |
| Telavancin injection HCPCS J3095 | not published | not published | $7.44 – $13.47 | 8 |
| Telehealth original site facility fee HCPCS Q3014 | $38.50 | $70.00 | $43.45 – $43.45 | 1 |
| Telethx isodose plan cplx CPT 77307 | $514.51 | $935.48 | $217.71 – $675.06 | 8 |
| Telethx isodose plan simple CPT 77306 | $289.90 | $527.10 | $118.65 – $675.06 | 8 |
| Temozolomide 100 mg intravenous solution HCPCS J9328 | not published | not published | $10.35 – $18.73 | 8 |
| Temperature gradient studies CPT 93740 | not published | not published | $15.62 – $231.99 | 8 |
| Temple bne implnt w/stimulat CPT 69715 | not published | not published | $2,277.00 – $2,277.00 | 1 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | not published | not published | $31.29 – $58.83 | 8 |
| Tendon lengthening CPT 26476 | not published | not published | $1,325.00 – $5,899.11 | 10 |
| Tendon lngth upr a/e ea tdn CPT 24305 | not published | not published | $2,277.00 – $5,899.11 | 10 |
| Tendon shortening CPT 26477 | not published | not published | $1,325.00 – $5,899.11 | 10 |
| Tendon transfer with graft CPT 26492 | not published | not published | $2,034.00 – $5,899.11 | 10 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | not published | not published | $172.18 – $391.36 | 8 |
| Tenodesis biceps tdn at elbw CPT 24340 | not published | not published | $2,034.00 – $13,082.27 | 10 |
| Tenolysis extensor tendon hand/finger each CPT 26445 | $748.55 | $1,361.00 | $2,034.00 – $5,899.11 | 10 |
| Tenolysis triceps CPT 24332 | not published | not published | $2,034.00 – $5,899.11 | 10 |
| Tenoplasty elbow to sho 1 CPT 24320 | not published | not published | $2,034.00 – $13,082.27 | 10 |
| Tenosynovectomy radic 26145 CPT 26145 | not published | not published | $1,601.73 – $2,899.06 | 10 |
| Tenotomy hip flexor open CPT 27005 | not published | not published | $2,277.00 – $5,899.11 | 9 |
| Tenotomy length/rls abductor hallucis musc 28240 CPT 28240 | not published | not published | $1,778.00 – $5,899.11 | 10 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | $5,765.76 | $10,483.20 | $1,601.73 – $2,899.06 | 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.