SSM Health Cardinal Glennon Children's Hospital
1465 S Grand Blvd, Saint Louis, MO · SSM Health · · NPI 1508935891
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 |
|---|---|---|---|---|
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $729.46 | $1,326.29 | $64.50 – $414.23 | 3 |
| Urethrlys transvag with scope CPT 53500 | not published | not published | $777.28 – $4,510.00 | 6 |
| Urethrocystography void s&i CPT 74455 | $861.85 | $1,567.00 | $63.74 – $414.23 | 3 |
| Uric acid blood CPT 84550 | $24.75 | $45.00 | $4.52 – $8.78 | 3 |
| Uric acid urine CPT 84560 | $113.85 | $207.00 | $4.79 – $10.14 | 3 |
| Urinalysis glass test CPT 81020 | not published | not published | $4.70 – $9.46 | 3 |
| Urinalysis microscopic only CPT 81015 | $20.35 | $37.00 | $3.05 – $6.08 | 3 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | not published | not published | $2.17 – $4.06 | 3 |
| Urinalysis (with microscopy) CPT 81001 | $18.70 | $34.00 | $3.17 – $6.08 | 3 |
| Urinalysis (without microscopy) CPT 81003 | $14.85 | $27.00 | $2.25 – $4.73 | 3 |
| Urinary bldr retent nuc study CPT 78730 | $268.95 | $489.00 | $70.04 – $129.63 | 2 |
| Urinary pouch on barr w/flng HCPCS A5073 | not published | not published | $2.70 – $2.70 | 1 |
| Urinary pouch w/barrier HCPCS A5071 | not published | not published | $5.10 – $5.10 | 1 |
| Urinary reflex study CPT 51792 | not published | not published | $153.38 – $3,868.00 | 6 |
| Urinary suspensory HCPCS A5105 | not published | not published | $32.90 – $32.90 | 1 |
| Urine Culture Test CPT 87086 | $38.50 | $70.00 | $8.07 – $15.53 | 3 |
| Urine flow measurement 51736 CPT 51736 | $203.06 | $369.20 | $7.03 – $3,868.00 | 6 |
| Urine ost pouch w faucet/tap HCPCS A4428 | not published | not published | $5.53 – $5.53 | 1 |
| Urine pregnancy test CPT 81025 | $38.50 | $70.00 | $8.61 – $16.89 | 3 |
| Urine screen for bacteria CPT 81007 | not published | not published | $3.56 – $58.77 | 3 |
| Urine shunt to intestine CPT 50815 | not published | not published | $1,271.45 – $4,510.00 | 6 |
| Urine specimen collect mult HCPCS P9615 | not published | not published | $3.00 – $1,486.00 | 4 |
| Urofollitropin, 75 iu HCPCS J3355 | not published | not published | $0.01 – $0.01 | 1 |
| Urography, antegrade CPT 74425 | $531.78 | $966.87 | $57.81 – $662.62 | 3 |
| Urography inf drip &/or bolus CPT 74410 | not published | not published | $80.89 – $321.39 | 3 |
| Urokinase 250,000 iu inj HCPCS J3365 | not published | not published | $0.01 – $0.01 | 1 |
| Urokinase 5000 iu injection HCPCS J3364 | not published | not published | $0.01 – $0.01 | 1 |
| Use 1st target lesion CPT 76982 | $254.54 | $462.80 | $65.96 – $196.15 | 3 |
| User adjustable heel height HCPCS L5990 | not published | not published | $1,324.59 – $1,324.59 | 1 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | not published | not published | $15.44 – $24.10 | 3 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | not published | not published | $0.01 – $257.20 | 2 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | not published | not published | $187.76 – $299.86 | 3 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | not published | not published | $170.81 – $272.80 | 3 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | not published | not published | $181.08 – $312.32 | 3 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | not published | not published | $101.96 – $175.86 | 3 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | not published | not published | $76.14 – $108.16 | 2 |
| Vaccine dtap < 7 years im CPT 90700 | not published | not published | $28.99 – $28.99 | 1 |
| Vaccine dtap-hep b-ipv im CPT 90723 | not published | not published | $99.29 – $99.29 | 1 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | not published | not published | $61.80 – $61.80 | 1 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | not published | not published | $153.10 – $153.10 | 1 |
| Vaccine dtap-ipv/hib im CPT 90698 | not published | not published | $116.18 – $116.18 | 1 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | not published | not published | $31.06 – $31.06 | 1 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | not published | not published | $12.29 – $12.29 | 1 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | not published | not published | $84.42 – $136.89 | 2 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | not published | not published | $128.47 – $128.47 | 1 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | not published | not published | $38.64 – $38.64 | 1 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $87.29 – $139.39 | 3 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | not published | not published | $81.75 – $130.55 | 3 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | not published | not published | $206.24 – $329.36 | 3 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | not published | not published | $36.78 – $58.75 | 3 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | not published | not published | $313.63 – $313.63 | 1 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | not published | not published | $0.01 – $0.01 | 1 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | not published | not published | $96.97 – $182.09 | 3 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | not published | not published | $96.97 – $182.09 | 3 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | not published | not published | $25.39 – $40.94 | 3 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | not published | not published | $25.96 – $43.06 | 3 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | not published | not published | $18.68 – $18.68 | 1 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | not published | not published | $69.22 – $69.22 | 1 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | not published | not published | $0.01 – $0.01 | 1 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | not published | not published | $20.00 – $20.00 | 1 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | not published | not published | $9.34 – $9.34 | 1 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | not published | not published | $24.86 – $50.14 | 2 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | not published | not published | $65.67 – $65.67 | 1 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | not published | not published | $42.80 – $91.81 | 3 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | not published | not published | $12.70 – $20.47 | 3 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | not published | not published | $228.10 – $228.10 | 1 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | not published | not published | $193.94 – $193.94 | 1 |
| Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 | not published | not published | $170.20 – $170.20 | 1 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | not published | not published | $160.37 – $160.37 | 1 |
| Vaccine mmr live subcutaneous CPT 90707 | not published | not published | $93.96 – $93.96 | 1 |
| Vaccine mmrv live subcutaneous CPT 90710 | not published | not published | $283.21 – $283.21 | 1 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | not published | not published | $155.03 – $247.59 | 3 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | not published | not published | $299.66 – $478.57 | 3 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | not published | not published | $303.33 – $484.43 | 3 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | not published | not published | $363.43 – $580.43 | 3 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | not published | not published | $43.37 – $43.37 | 1 |
| Vaccine rabies im CPT 90675 | not published | not published | $362.42 – $581.87 | 3 |
| Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 | not published | not published | $300.90 – $300.90 | 1 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 | not published | not published | $530.15 – $530.15 | 1 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im CPT 90381 | not published | not published | $530.15 – $530.15 | 1 |
| Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im CPT 90679 | not published | not published | $299.88 – $299.88 | 1 |
| Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 | not published | not published | $141.39 – $141.39 | 1 |
| Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 | not published | not published | $100.67 – $100.67 | 1 |
| Vaccine tdap >=7 years im CPT 90715 | not published | not published | $46.12 – $73.85 | 2 |
| Vaccine td preservative free >= 7 years im CPT 90714 | not published | not published | $42.24 – $69.32 | 2 |
| Vaccine typhoid vicps im CPT 90691 | not published | not published | $142.38 – $142.38 | 1 |
| Vaccine varicella live subcutaneous CPT 90716 | not published | not published | $186.53 – $186.53 | 1 |
| Vaccine yellow fever live subcutaneous CPT 90717 | not published | not published | $209.58 – $209.58 | 1 |
| Vaccinia vrs vac 0.3 ml perq CPT 90622 | not published | not published | $0.01 – $0.02 | 2 |
| Vacuum drain bottle/tube kit HCPCS A7048 | not published | not published | $47.66 – $47.66 | 1 |
| Vad battery clip set hmii 14-v li-ion HCPCS Q0497 | not published | not published | $341.80 – $341.80 | 1 |
| Vad cable power module dc input HCPCS Q0478 | not published | not published | $178.86 – $178.86 | 1 |
| Vad univ batt charger hm 1440 HCPCS Q0495 | not published | not published | $3,049.76 – $3,049.76 | 1 |
| Vag hys/<250g/rmv tube/rpr entero 58263 CPT 58263 | not published | not published | $1,017.99 – $11,867.00 | 6 |
| Vag hyst incl t/o complex CPT 58291 | not published | not published | $1,280.61 – $4,510.00 | 6 |
| Vag hyst including t/o CPT 58262 | not published | not published | $949.79 – $11,867.00 | 6 |
| Vag hyst t/o & repair compl CPT 58292 | not published | not published | $1,351.04 – $4,510.00 | 6 |
| Vag hyst w/enterocele compl 58294 CPT 58294 | not published | not published | $1,251.92 – $4,510.00 | 6 |
| Vag hyst w/enterocele repair CPT 58270 | not published | not published | $907.90 – $11,867.00 | 6 |
| Vag hyst w/uro repair compl 58293 CPT 58293 | not published | not published | $2,009.00 – $4,510.00 | 4 |
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.