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 |
|---|---|---|---|---|
| Destroy vulva lesion simple 56501 CPT 56501 | not published | not published | $117.62 – $4,510.00 | 6 |
| Destruct ben lesion 15/> 17111 CPT 17111 | $567.71 | $1,032.20 | $86.94 – $3,868.00 | 6 |
| Destruct cut vasl lesions 10-50cm 17107 CPT 17107 | not published | not published | $353.66 – $3,868.00 | 6 |
| Destruct cut vasl lesions <10cm 17106 CPT 17106 | $560.56 | $1,019.20 | $282.47 – $3,868.00 | 6 |
| Destruct cut vasl lesions >50cm 17108 CPT 17108 | not published | not published | $542.00 – $3,868.00 | 6 |
| Destruction 2-14 lesions 17003 CPT 17003 | $122.98 | $223.60 | $2.54 – $1,486.00 | 3 |
| Destruction anal lesion(s) CPT 46910 | $4,222.79 | $7,677.80 | $138.74 – $4,510.00 | 6 |
| Destruction anal lesion(s) CPT 46924 | not published | not published | $192.02 – $3,886.00 | 7 |
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | not published | not published | $142.84 – $3,868.00 | 6 |
| Destruction benign lesions < 14 lesions CPT 17110 | $283.14 | $514.80 | $70.30 – $3,868.00 | 6 |
| Destruction by injection tx of nerve 64630 CPT 64630 | not published | not published | $200.82 – $3,935.00 | 7 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | not published | not published | $62.71 – $3,886.00 | 5 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | not published | not published | $232.82 – $6,335.00 | 7 |
| Destruction ciliary body CPT 66700 | not published | not published | $398.70 – $3,935.00 | 7 |
| Destruction ciliary body CPT 66720 | not published | not published | $428.90 – $3,935.00 | 7 |
| Destruction ciliary body CPT 66740 | not published | not published | $398.35 – $3,935.00 | 7 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | not published | not published | $147.64 – $3,868.00 | 6 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | not published | not published | $137.57 – $3,886.00 | 7 |
| Destruction les conjunctiva CPT 68135 | not published | not published | $153.66 – $3,868.00 | 6 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | $148.76 – $3,868.00 | 6 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | $181.31 – $3,868.00 | 6 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | $652.08 | $1,185.60 | $141.90 – $3,868.00 | 6 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | $672.82 | $1,223.30 | $166.47 – $3,868.00 | 6 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | not published | not published | $108.25 – $3,886.00 | 7 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | $178.15 – $3,886.00 | 7 |
| Destruction premal lesions 15/> 17004 CPT 17004 | $524.10 | $952.90 | $101.77 – $3,868.00 | 6 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $723.30 – $11,867.00 | 7 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $180.53 – $3,886.00 | 7 |
| Destruction vag lesions simple 57061 CPT 57061 | not published | not published | $100.97 – $4,510.00 | 6 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $95.56 – $4,510.00 | 6 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $27.84 – $58.77 | 3 |
| Detect agnt mult dna direc CPT 87800 | not published | not published | $43.67 – $85.12 | 3 |
| Developmental screen/score/document 96110 CPT 96110 | $154.73 | $281.33 | $9.48 – $9.48 | 1 |
| Devel tst phys/qhp 1st hr CPT 96112 | $271.91 | $494.39 | $132.75 – $132.75 | 1 |
| Device ablt adv novasure HCPCS C1886 | $4,974.19 | $9,043.98 | not published | 0 |
| Device intraute mirena HCPCS J7298 | not published | not published | $1,095.06 – $1,095.06 | 1 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | $116.53 | $211.88 | $60.18 – $60.18 | 1 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $322.71 | $586.74 | $16.83 – $145.62 | 3 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | not published | not published | $1.35 – $190.94 | 2 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | not published | not published | $1.17 – $1.17 | 1 |
| Dexamethasone 4 mg tablet HCPCS J8540 | not published | not published | $0.02 – $0.03 | 2 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | not published | not published | $0.14 – $0.17 | 2 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $238.43 – $379.55 | 3 |
| Dexmedetomidine film, 1 mcg HCPCS J1105 | not published | not published | $1.07 – $1.07 | 1 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | not published | not published | $0.11 – $133.45 | 3 |
| Dextran 40 infusion HCPCS J7100 | not published | not published | $3.57 – $3.57 | 1 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | not published | not published | $1.58 – $2.62 | 2 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | not published | not published | $2.89 – $2.89 | 1 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | not published | not published | $0.83 – $3.35 | 2 |
| Dextrose 5 % IV bolus HCPCS J7070 | not published | not published | $2.39 – $5.77 | 2 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $160.05 | $291.00 | $22.23 – $43.23 | 3 |
| Diabetes (HbA1c) Test CPT 83036 | $67.65 | $123.00 | $9.71 – $18.91 | 3 |
| Diabetes training group per 30 min g0109 HCPCS G0136 | not published | not published | $8.78 – $8.78 | 1 |
| Diab manage trn ind/group HCPCS G0109 | not published | not published | $14.44 – $14.44 | 1 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $185.11 – $3,935.00 | 7 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $339.48 – $22,871.00 | 7 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $97.11 – $2,939.00 | 6 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $131.11 – $5,560.00 | 6 |
| Diagnostic anoscopy spx 46600 CPT 46600 | not published | not published | $42.05 – $1,992.00 | 5 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | not published | not published | $117.30 – $225.57 | 3 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | not published | not published | $91.82 – $176.93 | 3 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $259.05 | $471.00 | $50.20 – $3,868.00 | 6 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $349.25 | $635.00 | $79.59 – $3,868.00 | 7 |
| Diagnostic Mammogram (both breasts) CPT 77066 | not published | not published | $118.80 – $225.57 | 3 |
| Diagnostic Mammogram (one breast) CPT 77065 | not published | not published | $92.87 – $176.93 | 3 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $145.62 – $159.49 | 2 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $3,235.39 | $5,882.53 | $187.30 – $3,868.00 | 4 |
| Dialysis one evaluation CPT 90945 | $1,086.80 | $1,976.00 | $87.51 – $87.51 | 1 |
| Diathermy eg microwave CPT 97024 | not published | not published | $6.43 – $6.43 | 1 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | not published | not published | $0.08 – $0.14 | 2 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | not published | not published | $7.17 – $13.63 | 2 |
| Dicyclomine injection HCPCS J0500 | not published | not published | $13.57 – $21.07 | 2 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.04 – $0.21 | 2 |
| Diffusing capacity CPT 94729 | $374.66 | $681.20 | $44.83 – $44.83 | 1 |
| Digital analysis of eeg CPT 95957 | not published | not published | $207.64 – $207.64 | 1 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | not published | not published | $0.01 – $16.79 | 2 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | not published | not published | $4.70 – $9,587.06 | 3 |
| Digoxin total therapeutic drug level CPT 80162 | $69.30 | $126.00 | $13.28 – $25.67 | 3 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | not published | not published | $0.14 – $111.31 | 2 |
| Dilate biliary duct/ampulla CPT 47542 | $2,261.54 | $4,111.90 | $140.96 – $2,776.00 | 4 |
| Dilate esophagus CPT 43453 | not published | not published | $98.62 – $3,886.00 | 7 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $91.73 – $3,886.00 | 7 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | $1,407.84 | $2,559.70 | $455.53 – $6,026.00 | 6 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | $1,396.40 | $2,538.90 | $228.10 – $6,026.00 | 6 |
| Dilate ic vasospasm init CPT 61640 | $2,620.48 | $4,764.50 | $647.37 – $4,510.00 | 6 |
| Dilate tear duct opening CPT 68801 | not published | not published | $108.19 – $3,868.00 | 6 |
| Dilate urethra stricture CPT 53600 | not published | not published | $66.77 – $3,868.00 | 6 |
| Dilate urethra stricture CPT 53601 | not published | not published | $55.81 – $3,868.00 | 6 |
| Dilate urethra stricture CPT 53605 | not published | not published | $67.61 – $3,935.00 | 7 |
| Dilate urethra stricture CPT 53621 | not published | not published | $75.08 – $3,868.00 | 6 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $43.01 – $3,868.00 | 6 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $176.18 – $3,886.00 | 7 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $50.56 – $3,868.00 | 6 |
| Dilation of rectal stricture 45910 CPT 45910 | $3,261.12 | $5,929.30 | $202.66 – $3,886.00 | 7 |
| Dilation of salivary duct CPT 42660 | not published | not published | $93.76 – $3,868.00 | 6 |
| Dilation of urethra CPT 53661 | not published | not published | $41.62 – $3,868.00 | 6 |
| Dilation of urethra CPT 53665 | not published | not published | $40.69 – $3,886.00 | 7 |
| Dilation of vagina CPT 57400 | not published | not published | $137.16 – $3,935.00 | 7 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $61.41 – $3,868.00 | 6 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $91.00 – $4,510.00 | 6 |
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.