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 |
|---|---|---|---|---|
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $89.10 | $162.00 | $13.91 – $27.02 | 3 |
| Ghs sedimentation rate CPT 85651 | not published | not published | $4.27 – $8.10 | 3 |
| Ghs semen analysis fert CPT 89320 | not published | not published | $12.31 – $24.32 | 3 |
| Ghs semen analysis, post-vas CPT 89300 | not published | not published | $9.84 – $18.91 | 3 |
| Ghs sensitivity (per antimicro) CPT 87184 | $31.35 | $57.00 | $7.48 – $14.86 | 3 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $539.82 | $981.50 | $103.41 – $3,935.00 | 7 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $738.60 | $1,342.90 | $139.17 – $3,935.00 | 7 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $632.78 | $1,150.50 | $125.62 – $3,935.00 | 7 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | not published | not published | $161.33 – $3,935.00 | 7 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $526.96 | $958.10 | $82.29 – $3,868.00 | 6 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $501.93 | $912.60 | $76.43 – $3,868.00 | 6 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $632.78 | $1,150.50 | $102.72 – $3,868.00 | 6 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $925.92 | $1,683.50 | $156.51 – $3,935.00 | 7 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | not published | not published | $183.28 – $3,935.00 | 7 |
| Ghs sleep study unattended CPT 95800 | not published | not published | $126.04 – $126.04 | 1 |
| Ghs somatosensory testing lower extremit CPT 95926 | $845.84 | $1,537.90 | $115.22 – $115.22 | 1 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $980.26 | $1,782.30 | $291.68 – $291.68 | 1 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | not published | not published | $53.72 – $53.72 | 1 |
| Ghs sphenopalatine ganglion block CPT 64505 | not published | not published | $89.79 – $3,868.00 | 6 |
| Ghs spont nystagmus CPT 92541 | not published | not published | $1.43 – $1.43 | 1 |
| Ghs sp train/fitting sp device - kx CPT 92609 | not published | not published | $111.79 – $111.79 | 1 |
| Ghs st - eval for alt comm CPT 92567 | $72.60 | $132.00 | $11.21 – $11.21 | 1 |
| Ghs strapping shoulder - 29240 CPT 29240 | $308.16 | $560.30 | $19.25 – $3,868.00 | 6 |
| Ghs st - re-eval for alt comm CPT 92597 | $314.10 | $571.09 | $73.29 – $73.29 | 1 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | not published | not published | $15.37 – $15.37 | 1 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | not published | not published | $192.26 – $192.26 | 1 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $1,583.01 | $2,878.20 | $194.84 – $3,886.00 | 7 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $2,321.60 | $4,221.10 | $143.24 – $3,886.00 | 7 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | not published | not published | $234.82 – $3,886.00 | 7 |
| Ghs trypsin (fecal) CPT 84488 | not published | not published | $7.30 – $14.18 | 3 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $632.78 | $1,150.50 | $277.99 – $3,886.00 | 7 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $246.27 – $3,868.00 | 6 |
| Ghs urine, hydroxproline total CPT 83505 | not published | not published | $24.30 – $47.29 | 3 |
| Ghs urine, porphyrins quant CPT 84120 | $107.80 | $196.00 | $14.71 – $29.05 | 3 |
| Ghs vaginal delivery only CPT 59409 | not published | not published | $864.46 – $4,510.00 | 6 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $3,467.20 | $6,304.00 | $730.27 – $730.27 | 1 |
| Ghs windowing of cast CPT 29730 | $301.73 | $548.60 | $46.32 – $3,868.00 | 6 |
| Giardia ag if CPT 87269 | $78.65 | $143.00 | $13.61 – $26.34 | 3 |
| Giardia lamblia antibody CPT 86674 | not published | not published | $14.72 – $29.05 | 3 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $67.86 – $414.23 | 3 |
| Gi inhouse confirmation CPT 87045 | $57.75 | $105.00 | $9.44 – $18.24 | 3 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $275.10 – $4,510.00 | 6 |
| Gi protein loss CPT 78282 | not published | not published | $92.80 – $678.82 | 3 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $3,286.25 | $5,975.00 | $694.90 – $5,020.00 | 5 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | $806.90 – $806.90 | 1 |
| Gi trc img intral esophagus CPT 91111 | $3,043.15 | $5,533.00 | $674.59 – $5,020.00 | 5 |
| Gi wireless capsule measure CPT 91112 | not published | not published | $967.60 – $5,020.00 | 5 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $101.12 – $197.25 | 3 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $61.52 – $120.24 | 3 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $35.00 – $68.23 | 3 |
| Glassia injection HCPCS J0257 | not published | not published | $0.61 – $10.46 | 3 |
| Glaucoma scrn hgh risk direc HCPCS G0117 | not published | not published | $54.35 – $54.35 | 1 |
| Glaucoma scrn hgh risk direc HCPCS G0118 | not published | not published | $44.76 – $44.76 | 1 |
| Glaucoma surgery CPT 66150 | not published | not published | $881.90 – $5,560.00 | 7 |
| Glaucoma surgery CPT 66155 | not published | not published | $886.08 – $5,560.00 | 7 |
| Glaucoma surgery CPT 66160 | not published | not published | $1,000.10 – $3,935.00 | 7 |
| Glaucoma surgery CPT 66170 | not published | not published | $1,215.71 – $5,560.00 | 7 |
| Glove finger flexion right lg xl HCPCS L3912 | not published | not published | $78.61 – $78.61 | 1 |
| Glucagon 1 mg solution for injection HCPCS J1610 | not published | not published | $12.96 – $338.44 | 3 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | not published | not published | $168.28 – $276.37 | 3 |
| Glucagon plasma - sendout CPT 82943 | not published | not published | $14.29 – $27.69 | 3 |
| Glucagon tolerance panel CPT 80422 | not published | not published | $46.07 – $89.84 | 3 |
| Glucagon tolerance panel CPT 80424 | not published | not published | $50.50 – $98.63 | 3 |
| Glucagon tolerance test CPT 82946 | not published | not published | $17.77 – $34.45 | 3 |
| Glucose 1 hr post dose CPT 82950 | $45.65 | $83.00 | $4.75 – $9.46 | 3 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | not published | not published | $6.05 – $11.49 | 3 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $89.10 | $162.00 | $3.25 – $6.08 | 3 |
| Glucose blood quantitative CPT 82947 | $30.80 | $56.00 | $3.93 – $7.43 | 3 |
| Glucose body fluid CPT 82945 | $21.45 | $39.00 | $3.93 – $7.43 | 3 |
| Glucose monitoring continual min 72hr pt CPT 95249 | not published | not published | $55.04 – $55.04 | 1 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $107.80 | $196.00 | $12.87 – $24.99 | 3 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $50.05 | $91.00 | $3.92 – $7.43 | 3 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | not published | not published | $0.50 – $0.96 | 3 |
| Gold sodium thiomaleate inj HCPCS J1600 | not published | not published | $0.01 – $0.01 | 1 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | not published | not published | $0.01 – $20.48 | 3 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $86.90 | $158.00 | $18.58 – $36.48 | 3 |
| Gonadotropin hormone panel CPT 80426 | not published | not published | $148.41 – $289.79 | 3 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $136.40 | $248.00 | $18.52 – $36.48 | 3 |
| Gonioscopy CPT 92020 | $126.25 | $229.54 | $21.29 – $21.29 | 1 |
| Goniotomy CPT 65820 | not published | not published | $756.37 – $3,886.00 | 7 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | not published | not published | $3.48 – $1,360.95 | 3 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | not published | not published | $30.29 – $56.08 | 2 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | not published | not published | $1,421.10 – $2,295.16 | 2 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | not published | not published | $73.19 – $124.79 | 2 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $901.33 – $4,510.00 | 7 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $920.16 | $1,673.01 | not published | 0 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $4,459.81 | $8,108.75 | not published | 0 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $2,174.78 | $3,954.15 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | not published | not published | $44.55 – $121.33 | 2 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | not published | not published | $112.25 – $187.41 | 2 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $1,143.29 – $7,415.00 | 6 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | not published | not published | $139.34 – $257.36 | 2 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | not published | not published | $40.27 – $97.85 | 2 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | not published | not published | $197.93 – $197.93 | 1 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $1,297.60 | $2,359.28 | not published | 0 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $658.75 | $1,197.73 | not published | 0 |
| Granisetron 1 mg tab HCPCS Q0166 | not published | not published | $0.41 – $0.41 | 1 |
| Granisetron hcl injection HCPCS J1626 | not published | not published | $0.27 – $0.34 | 2 |
| Granulocyte pheresis ea unit HCPCS P9050 | $2,209.31 | $4,016.93 | not published | 0 |
| Great toe-hand transfer CPT 26551 | not published | not published | $2,009.00 – $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.