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 |
|---|---|---|---|---|
| X-ray exam of perineum CPT 74775 | not published | not published | $64.50 – $414.23 | 3 |
| X-ray exam of salivary gland CPT 70380 | not published | not published | $25.93 – $145.62 | 3 |
| X-ray exam of sinuses CPT 70210 | $249.57 | $453.76 | $20.33 – $145.62 | 3 |
| X-ray exam of tear duct CPT 70170 | not published | not published | $31.38 – $414.23 | 3 |
| X-ray exam of teeth CPT 70300 | $59.66 | $108.48 | $8.77 – $145.62 | 3 |
| X-ray exam of teeth CPT 70310 | $341.96 | $621.74 | $29.43 – $414.23 | 3 |
| X-ray exam si joints CPT 72200 | $300.89 | $547.08 | $18.93 – $196.15 | 3 |
| X-ray exam thorac spine4/>vw CPT 72074 | $415.09 | $754.71 | $27.33 – $196.15 | 3 |
| X-ray eye detection foreign body (both sides) CPT 70030 | not published | not published | $18.58 – $145.62 | 3 |
| X-ray facial bones complete > 3 views CPT 70150 | $451.66 | $821.20 | $27.33 – $196.15 | 3 |
| X-ray fallopian tube CPT 74742 | not published | not published | $56.96 – $56.96 | 1 |
| X-ray femur >=2 views (both sides) CPT 73552 | $315.15 | $573.00 | $22.35 – $145.62 | 3 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $221.10 | $402.00 | $23.48 – $145.62 | 3 |
| X-ray foot 2 views (both sides) CPT 73620 | $235.40 | $428.00 | $17.53 – $145.62 | 3 |
| X-ray forearm 2 views (both sides) CPT 73090 | $261.25 | $475.00 | $16.83 – $145.62 | 3 |
| X-ray hand 2 views (both sides) CPT 73120 | $263.04 | $478.26 | $17.18 – $196.15 | 3 |
| X-ray head for orthodontia CPT 70350 | not published | not published | $9.13 – $145.62 | 3 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $209.55 | $381.00 | $18.23 – $145.62 | 3 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $352.86 | $641.57 | $36.31 – $196.15 | 3 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $303.05 | $551.00 | $27.24 – $196.15 | 3 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $467.06 | $849.20 | $32.82 – $196.15 | 3 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $552.20 | $1,004.00 | $39.44 – $196.15 | 3 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $214.50 | $390.00 | $19.56 – $145.62 | 3 |
| X-ray humerus >= 2 views left CPT 73060 | $241.45 | $439.00 | $17.18 – $145.62 | 3 |
| X-ray joint survey 1 view CPT 77077 | $363.77 | $661.40 | $20.33 – $196.15 | 3 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $246.40 | $448.00 | $19.28 – $145.62 | 3 |
| X-ray knee 3 views (both sides) CPT 73562 | $327.80 | $596.00 | $23.83 – $145.62 | 3 |
| X-ray knee ap standing bilateral CPT 73565 | $320.14 | $582.07 | $22.78 – $145.62 | 3 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $249.57 | $453.76 | $18.58 – $145.62 | 3 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $382.37 | $695.22 | $27.69 – $196.15 | 3 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $470.25 | $855.00 | $31.88 – $196.15 | 3 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $554.31 | $1,007.84 | $44.49 – $196.15 | 3 |
| X-ray male genital tract CPT 74440 | not published | not published | $59.89 – $414.23 | 3 |
| X-ray mandible complete > 4 views CPT 70110 | $336.82 | $612.40 | $24.53 – $196.15 | 3 |
| X-ray mandible ltd <4 views CPT 70100 | $312.44 | $568.08 | $23.13 – $145.62 | 3 |
| X-ray measurement of pelvis CPT 74710 | not published | not published | $48.57 – $48.57 | 1 |
| X-ray nasal bones complete > 3 views CPT 70160 | $309.88 | $563.41 | $23.13 – $145.62 | 3 |
| X-ray neck soft tissue CPT 70360 | $272.21 | $494.92 | $18.93 – $145.62 | 3 |
| X-ray nose to rectum for foreign body child CPT 76010 | $238.73 | $434.06 | $16.47 – $145.62 | 3 |
| X-ray of mammary ducts CPT 77054 | not published | not published | $52.19 – $414.23 | 3 |
| X-ray optic foramina CPT 70190 | not published | not published | $23.13 – $145.62 | 3 |
| X-ray pelvis 1-2 views CPT 72170 | $346.50 | $630.00 | $17.88 – $196.15 | 3 |
| X-ray pelvis complete > 3 views CPT 72190 | $362.45 | $659.00 | $26.28 – $196.15 | 3 |
| Xray place dist ext thor ao CPT 75959 | not published | not published | $180.86 – $180.86 | 1 |
| Xray place prox ext thor ao CPT 75958 | not published | not published | $207.40 – $207.40 | 1 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $795.85 | $1,447.00 | $106.00 – $662.62 | 3 |
| X-ray ribs 2 views left CPT 71100 | $287.42 | $522.58 | $18.58 – $145.62 | 3 |
| X-ray ribs 3 views bilateral CPT 71110 | $363.77 | $661.40 | $22.78 – $196.15 | 3 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $394.56 | $717.39 | $22.07 – $196.15 | 3 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $478.61 | $870.20 | $30.13 – $196.15 | 3 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $341.00 | $620.00 | $22.78 – $196.15 | 3 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $330.41 | $600.74 | $18.58 – $145.62 | 3 |
| X-ray scapula complete (both sides) CPT 73010 | $303.46 | $551.75 | $19.98 – $196.15 | 3 |
| X-ray sella turcica CPT 70240 | not published | not published | $19.28 – $145.62 | 3 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $239.30 | $435.10 | $14.73 – $145.62 | 3 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $363.77 | $661.40 | $23.83 – $145.62 | 3 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $643.57 | $1,170.12 | $28.03 – $869.20 | 3 |
| X-ray skull < 4 views CPT 70250 | $320.65 | $583.00 | $22.43 – $196.15 | 3 |
| X-ray skull > 4 views complete CPT 70260 | $439.47 | $799.04 | $26.98 – $196.15 | 3 |
| X-ray slg plne bdy sect without urogr CPT 76100 | not published | not published | $59.19 – $196.15 | 3 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $477.46 | $868.11 | $78.44 – $321.39 | 3 |
| X-ray small intestine follow-through study CPT 74248 | $1,061.03 | $1,929.14 | $47.39 – $47.39 | 1 |
| X-ray spine single view CPT 72020 | $198.00 | $360.00 | $13.68 – $145.62 | 3 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $320.78 | $583.24 | $23.83 – $145.62 | 3 |
| X-ray sternum > 2 views CPT 71120 | $330.41 | $600.74 | $18.58 – $145.62 | 3 |
| X-ray surgical specimen CPT 76098 | not published | not published | $8.08 – $869.20 | 3 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $482.35 | $877.00 | $99.09 – $321.39 | 3 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $417.66 | $759.38 | $33.29 – $145.62 | 3 |
| X-ray thoracic spine 2 views CPT 72070 | $329.45 | $599.00 | $19.28 – $196.15 | 3 |
| X-ray thoracic spine 3 views CPT 72072 | $343.75 | $625.00 | $22.78 – $196.15 | 3 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $242.55 | $441.00 | $21.03 – $145.62 | 3 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $323.40 | $588.00 | $24.79 – $145.62 | 3 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $485.02 | $881.86 | $45.02 – $196.15 | 3 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $275.00 | $500.00 | $17.18 – $145.62 | 3 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $222.20 | $404.00 | $20.68 – $145.62 | 3 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | not published | not published | $90.34 – $321.39 | 3 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $626.45 | $1,139.00 | $76.69 – $321.39 | 3 |
| X-ray wrist 2 views (both sides) CPT 73100 | $234.85 | $427.00 | $19.98 – $145.62 | 3 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | $332.21 | $604.01 | $58.14 – $321.39 | 3 |
| Xtrnl ecg rec>48hr<7d CPT 93241 | not published | not published | $192.90 – $192.90 | 1 |
| Xtrnl ecg rec up to 48 hrs CPT 93224 | not published | not published | $91.63 – $91.63 | 1 |
| Xwrap 1 sq cm HCPCS Q4204 | not published | not published | $6,848.92 – $6,848.92 | 1 |
| Xylose absorption test blood &/or urine CPT 84620 | not published | not published | $12.91 – $24.99 | 3 |
| Xyntha inj HCPCS J7185 | not published | not published | $1.49 – $3.10 | 3 |
| Yersinia antibody CPT 86793 | not published | not published | $13.19 – $25.67 | 3 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | not published | not published | $63,005.77 – $93,760.51 | 2 |
| Zenith amniotic membrane psc HCPCS Q4253 | not published | not published | $140.59 – $457.27 | 2 |
| Ziconotide injection HCPCS J2278 | not published | not published | $11.77 – $18.81 | 3 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | not published | not published | $0.20 – $2.81 | 2 |
| Zidovudine, oral, 100 mg HCPCS S0104 | not published | not published | $1.55 – $1.55 | 1 |
| Zika virus dna/rna amp probe CPT 87662 | $35.20 | $64.00 | $51.31 – $99.98 | 3 |
| Zika virus igm antibody CPT 86794 | not published | not published | $16.85 – $33.10 | 3 |
| Zinc paste band w >=3"<5"/yd HCPCS A6456 | not published | not published | $1.08 – $1.08 | 1 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | not published | not published | $1.77 – $12.66 | 2 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | not published | not published | $8.20 – $14.62 | 3 |
| Zolbetuximab-clzb 100 mg intravenous solution HCPCS J1326 | not published | not published | $38.98 – $62.53 | 2 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | not published | not published | $3.69 – $9.38 | 2 |
| Zoster vaccine-live inj CPT 90736 | not published | not published | $0.01 – $0.01 | 1 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $193.25 – $376.94 | 3 |
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.