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 |
|---|---|---|---|---|
| Drain ovarn cyst abd CPT 58805 | not published | not published | $413.81 – $4,510.00 | 6 |
| Drain ovary abscess open CPT 58820 | not published | not published | $318.70 – $4,510.00 | 7 |
| Drain pancreatic pseudocyst 48510 CPT 48510 | not published | not published | $1,150.72 – $4,510.00 | 6 |
| Drain penis lesion CPT 54015 | not published | not published | $317.71 – $5,560.00 | 7 |
| Drain shoulder bone lesion CPT 23035 | not published | not published | $705.68 – $4,510.00 | 7 |
| Drain shoulder bursa 23031 CPT 23031 | not published | not published | $227.57 – $4,510.00 | 7 |
| Drain shoulder lesion CPT 23030 | not published | not published | $265.22 – $3,886.00 | 7 |
| Drain thigh/knee lesion 27301 CPT 27301 | $2,418.13 | $4,396.60 | $513.24 – $4,510.00 | 7 |
| Drain thyroid/tongue cyst CPT 60000 | not published | not published | $147.90 – $3,886.00 | 7 |
| Drain to peritoneal cavity CPT 49062 | not published | not published | $776.59 – $4,510.00 | 6 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $424.71 | $772.20 | $115.93 – $3,935.00 | 7 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $422.56 | $768.30 | $55.67 – $3,868.00 | 6 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $691.40 | $1,257.10 | $136.98 – $3,935.00 | 7 |
| Dressing change not for burn w/anes 15852 CPT 15852 | $698.56 | $1,270.10 | $49.41 – $3,868.00 | 6 |
| Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm HCPCS Q4108 | not published | not published | $37.77 – $71.50 | 2 |
| Drill hole evac+/drg subdural hematoma 61108 CPT 61108 | not published | not published | $974.11 – $4,510.00 | 6 |
| Drill hole implt ventricular cath/device 61107 CPT 61107 | $762.90 | $1,387.10 | $340.74 – $4,510.00 | 6 |
| Drng appendix abscess open 44900 CPT 44900 | not published | not published | $813.30 – $4,510.00 | 6 |
| Drng hand tendon sheath 26020 CPT 26020 | not published | not published | $444.92 – $3,935.00 | 7 |
| Drng of eyelid abscess 67700 CPT 67700 | $823.68 | $1,497.60 | $117.74 – $3,868.00 | 6 |
| Drng of finger abscess comp 26011 CPT 26011 | $1,412.84 | $2,568.80 | $190.26 – $3,886.00 | 7 |
| Drng of hydrocele 55000 CPT 55000 | $1,105.39 | $2,009.80 | $88.57 – $3,868.00 | 6 |
| Drng of mouth lesion 40801 CPT 40801 | not published | not published | $234.41 – $3,935.00 | 7 |
| Drng of ovarian cyst(s) 58800 CPT 58800 | not published | not published | $305.26 – $4,510.00 | 7 |
| Drng of palm multi bursas 26030 CPT 26030 | not published | not published | $505.72 – $3,935.00 | 7 |
| Drng of palm single bursa 26025 CPT 26025 | not published | not published | $434.02 – $3,886.00 | 7 |
| Drng of pelvic abscess transrectal 45000 CPT 45000 | not published | not published | $438.61 – $3,886.00 | 7 |
| Drng of salivary cyst 42409 CPT 42409 | not published | not published | $232.04 – $4,510.00 | 7 |
| Drng of scrotum abscess 55100 CPT 55100 | not published | not published | $172.19 – $3,886.00 | 7 |
| Drng open retroperitoneal abscess 49060 CPT 49060 | not published | not published | $1,153.78 – $4,510.00 | 6 |
| Drng open subdiaphragmatic/subphrenic absc 49040 CPT 49040 | not published | not published | $1,049.93 – $4,510.00 | 6 |
| Drng ovary abscess perqt 58822 CPT 58822 | not published | not published | $718.51 – $4,510.00 | 6 |
| Drng peritoneal abscess open 49020 CPT 49020 | not published | not published | $1,672.82 – $4,510.00 | 6 |
| Drng salivary gland simple 42300 CPT 42300 | not published | not published | $159.81 – $3,886.00 | 7 |
| Drng salivary gland submax/subling 42310 CPT 42310 | not published | not published | $129.99 – $3,886.00 | 7 |
| Dronabinol 2.5mg oral HCPCS Q0167 | not published | not published | $1.95 – $2.51 | 2 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | not published | not published | $6.23 – $14.16 | 2 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $541.17 | $983.95 | not published | 0 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | not published | not published | $23.17 – $23.17 | 1 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | not published | not published | $11.05 – $22.04 | 2 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | not published | not published | $4.61 – $4.61 | 1 |
| Drsg sht 5.625x4.625in std HCPCS A6025 | not published | not published | $12.80 – $12.80 | 1 |
| Drsg surg adh 11x11 3/4 occl drap wnd 28x30 HCPCS A6259 | not published | not published | $9.29 – $9.29 | 1 |
| Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm HCPCS A2008 | not published | not published | $87.33 – $87.33 | 1 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | not published | not published | $37.77 – $94.61 | 2 |
| Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm HCPCS A2007 | not published | not published | $79.18 – $79.18 | 1 |
| Drug admin & hemodynmic meas CPT 93463 | $233.92 | $425.30 | $102.38 – $540.00 | 2 |
| Drug assay caffeine CPT 80155 | $34.65 | $63.00 | $19.64 – $74.98 | 3 |
| Drug assay posaconazole CPT 80187 | $78.65 | $143.00 | $27.11 – $52.69 | 3 |
| Drug assay rufinamide CPT 80210 | $39.05 | $71.00 | $27.11 – $52.69 | 3 |
| Drug assay vedolizumab CPT 80280 | $312.95 | $569.00 | $38.57 – $74.98 | 3 |
| Drug assay voriconazole CPT 80285 | $127.60 | $232.00 | $27.11 – $52.69 | 3 |
| Drug asy hydroxychloroquine CPT 80220 | not published | not published | $18.64 – $24.24 | 3 |
| Drug of abuse screen urine CPT 80305 | not published | not published | $12.60 – $24.32 | 3 |
| Drug screen quant tiagabine CPT 80199 | $95.70 | $174.00 | $25.07 – $52.69 | 3 |
| Drug test def 15-21 classes HCPCS G0482 | not published | not published | $169.37 – $387.75 | 3 |
| Drug test def 1-7 classes HCPCS G0480 | $210.65 | $383.00 | $81.55 – $223.60 | 3 |
| Drug test def 22+ classes HCPCS G0483 | not published | not published | $219.56 – $482.32 | 3 |
| Drug test def 8-14 classes HCPCS G0481 | not published | not published | $125.46 – $305.34 | 3 |
| Drug test prsmv instrmnt CPT 80306 | $108.90 | $198.00 | $17.14 – $33.77 | 3 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $302.50 | $550.00 | $62.14 – $121.59 | 3 |
| Drvvt confirm - quest CPT 85597 | $32.45 | $59.00 | $17.98 – $35.13 | 3 |
| Dstrj extensive retinopathy CPT 67227 | not published | not published | $579.16 – $3,886.00 | 7 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | $4,056.91 | $7,376.20 | $1,486.00 – $2,939.00 | 6 |
| Dstr mal les s/n/h/f/g >4.0 CPT 17276 | not published | not published | $217.51 – $3,868.00 | 6 |
| Dstr mal ls f/e/e/n/l/m2.1-3 CPT 17283 | not published | not published | $184.91 – $3,868.00 | 6 |
| Dstr mal ls f/e/e/n/l/m3.1-4 CPT 17284 | not published | not published | $216.77 – $3,868.00 | 6 |
| Dstr mal ls f/e/e/n/l/m>4.0 CPT 17286 | not published | not published | $292.55 – $3,868.00 | 6 |
| Dstry eye lesn,fdr vssl tech HCPCS G0186 | not published | not published | $852.07 – $1,716.00 | 3 |
| Ductogram sgl duct CPT 77053 | not published | not published | $39.23 – $414.23 | 3 |
| Duodenal motility study CPT 91022 | $1,170.46 | $2,128.10 | $93.49 – $1,486.00 | 3 |
| Duplex scan bilateral study 93985 CPT 93985 | not published | not published | $229.15 – $434.11 | 2 |
| Duplex scan unilateral study 93986 CPT 93986 | not published | not published | $110.83 – $255.22 | 2 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $363.94 | $661.70 | $131.30 – $252.53 | 2 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | not published | not published | $146.73 – $271.31 | 2 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $1,345.63 | $2,446.60 | $168.08 – $322.65 | 2 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | not published | not published | $57.68 – $157.90 | 3 |
| Dxa bone density axl vrt fx CPT 77085 | $464.75 | $845.00 | $40.28 – $196.15 | 3 |
| Dx aly aud oi snd prcsr 1st CPT 92622 | $328.44 | $597.16 | $63.62 – $63.62 | 1 |
| Dx bronchoscope/brush 31623 CPT 31623 | $1,425.60 | $2,592.00 | $153.49 – $3,935.00 | 7 |
| Dx bronchoscope/lavage 31624 CPT 31624 | $2,247.30 | $4,086.00 | $154.89 – $3,935.00 | 7 |
| Dx bronchoscope/wash 31622 CPT 31622 | $2,710.40 | $4,928.00 | $152.40 – $3,886.00 | 7 |
| Dx dark adaptation exam i&r CPT 92284 | not published | not published | $49.04 – $49.04 | 1 |
| Dx duod intub w/asp spec 43756 CPT 43756 | not published | not published | $54.41 – $2,939.00 | 6 |
| Dx duod intub w/asp specs CPT 43757 | not published | not published | $83.06 – $2,939.00 | 6 |
| Dx gastr intub w/asp spec CPT 43754 | not published | not published | $37.68 – $2,939.00 | 6 |
| Dx gastr intub w/asp specs CPT 43755 | not published | not published | $65.15 – $2,939.00 | 6 |
| Dx laryngoscopy newborn CPT 31520 | $744.15 | $1,353.00 | $164.10 – $3,868.00 | 6 |
| Dx laryngoscopy w/oper scope CPT 31526 | not published | not published | $164.47 – $3,935.00 | 7 |
| Dynamic cavernosometry CPT 54231 | not published | not published | $121.23 – $4,510.00 | 6 |
| Dynamic surface emg CPT 96002 | not published | not published | $22.45 – $22.45 | 1 |
| Ear and throat examination CPT 92502 | $556.13 | $1,011.14 | $99.01 – $3,868.00 | 3 |
| Ear canal biopsy 69105 CPT 69105 | not published | not published | $65.78 – $4,510.00 | 6 |
| Ear cartilage graft CPT 21235 | $5,112.80 | $9,296.00 | $585.79 – $8,785.00 | 7 |
| Ear irrigation 69209 CPT 69209 | $319.00 | $580.00 | $12.58 – $2,109.00 | 6 |
| Ear protector evaluation CPT 92596 | not published | not published | $41.33 – $41.33 | 1 |
| Ecallantide injection HCPCS J1290 | not published | not published | $0.14 – $1,075.84 | 3 |
| Ecg 12 lead tracing only CPT 93005 | $270.60 | $492.00 | $8.43 – $8.43 | 1 |
| Ecg/1-3 leads/interp & report only 93042 CPT 93042 | not published | not published | $7.27 – $7.27 | 1 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | $152.35 | $277.00 | $5.63 – $5.63 | 1 |
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.