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 |
|---|---|---|---|---|
| Infect ag if hep delta agent CPT 87380 | not published | not published | $18.36 – $35.81 | 3 |
| Infect ag if influenza a CPT 87276 | $27.50 | $50.00 | $16.07 – $31.07 | 3 |
| Infect ag if influenza b CPT 87275 | $27.50 | $50.00 | $12.25 – $23.65 | 3 |
| Infect ag if legionella pneumophila CPT 87278 | $49.50 | $90.00 | $15.60 – $30.40 | 3 |
| Infect ag if nos ea CPT 87299 | $27.50 | $50.00 | $16.10 – $31.75 | 3 |
| Infect ag if pneumocystis carinii CPT 87281 | $52.25 | $95.00 | $11.98 – $23.65 | 3 |
| Infect ag if varicella zoster CPT 87290 | $96.25 | $175.00 | $13.42 – $26.34 | 3 |
| Infect ag na chlamydia trachomatis qnt CPT 87492 | not published | not published | $48.53 – $104.71 | 3 |
| Infect ag na hep b amp CPT 87516 | not published | not published | $35.09 – $68.23 | 3 |
| Infect ag na herpes simplex quant CPT 87530 | $349.80 | $636.00 | $42.84 – $83.76 | 3 |
| Infect ag na hpv high-risk types CPT 87624 | $79.75 | $145.00 | $35.09 – $68.23 | 3 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $164.45 | $299.00 | $95.80 – $187.12 | 3 |
| Infect ag na influenza revr/amp ea type CPT 87501 | not published | not published | $51.31 – $99.98 | 3 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | $63.80 | $116.00 | $51.17 – $52.34 | 2 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $836.00 | $1,520.00 | $416.78 – $813.31 | 3 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | $1,108.25 | $2,015.00 | $488.66 – $953.83 | 3 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | $59.40 | $108.00 | $26.07 – $50.66 | 3 |
| Infectious agent antigen immunoassay direct optical observation sars-cov-2 CPT 87811 | not published | not published | $41.52 – $42.21 | 2 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $83.60 | $152.00 | $11.98 – $23.65 | 3 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | not published | not published | $13.42 – $26.34 | 3 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $75.90 | $138.00 | $13.82 – $27.02 | 3 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $96.80 | $176.00 | $11.98 – $23.65 | 3 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $50.60 | $92.00 | $10.37 – $28.38 | 3 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $50.05 | $91.00 | $10.33 – $20.26 | 3 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $62.70 | $114.00 | $10.33 – $20.26 | 3 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $54.45 | $99.00 | $24.08 – $47.29 | 3 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $216.15 | $393.00 | $11.98 – $23.65 | 3 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $78.65 | $143.00 | $11.98 – $23.65 | 3 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $74.80 | $136.00 | $11.98 – $23.65 | 3 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $346.50 | $630.00 | $35.09 – $68.23 | 3 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $166.10 | $302.00 | $35.09 – $68.23 | 3 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $172.15 | $313.00 | $37.27 – $72.96 | 3 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $945.45 | $1,719.00 | $416.78 – $813.31 | 3 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $151.80 | $276.00 | $35.09 – $68.23 | 3 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $74.25 | $135.00 | $35.09 – $68.23 | 3 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $3,465.00 | $6,300.00 | $41.68 – $81.06 | 3 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $166.10 | $302.00 | $35.09 – $68.23 | 3 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $77.00 | $140.00 | $51.31 – $52.34 | 2 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $212.85 | $387.00 | $142.71 – $145.50 | 2 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $269.50 | $490.00 | $142.71 – $145.50 | 2 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $100.10 | $182.00 | $35.09 – $68.23 | 3 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $165.00 | $300.00 | $35.09 – $68.23 | 3 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $200.20 | $364.00 | $76.77 – $78.31 | 2 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $1,004.85 | $1,827.00 | $416.78 – $813.31 | 3 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | not published | not published | $128.29 – $250.62 | 3 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $151.80 | $276.00 | $262.99 – $513.39 | 3 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $422.40 | $768.00 | $42.84 – $83.76 | 3 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $212.30 | $386.00 | $42.84 – $83.76 | 3 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $181.50 | $330.00 | $42.84 – $83.76 | 3 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $361.90 | $658.00 | $85.10 – $166.17 | 3 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $261.25 | $475.00 | $142.63 – $278.31 | 3 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | not published | not published | $36.22 – $57.67 | 3 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | not published | not published | $24.26 – $37.85 | 3 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | not published | not published | $0.43 – $37.08 | 3 |
| Influenza dna amp prob addl CPT 87503 | not published | not published | $28.83 – $56.74 | 3 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | not published | not published | $96.97 – $182.09 | 3 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $33.53 – $55.12 | 3 |
| Inf lwr xtr fscl pln blk uni w/wo image CPT 64474 | not published | not published | $215.84 – $2,776.00 | 4 |
| Infratemporal approach/skull CPT 61591 | not published | not published | $2,009.00 – $4,510.00 | 6 |
| Infratemporal approach/skull CPT 61590 | not published | not published | $2,009.00 – $4,510.00 | 6 |
| Inf thrc fascial pln blk bi w/wo image CPT 64469 | not published | not published | $332.01 – $2,776.00 | 4 |
| Inf thrc fascial pln blk uni w/wo image CPT 64467 | not published | not published | $218.46 – $2,776.00 | 4 |
| Infuse radioactive materials CPT 77750 | not published | not published | $110.02 – $253.69 | 2 |
| Ingest challenge ea addl 60 min CPT 95079 | $495.50 | $900.90 | $68.54 – $68.54 | 1 |
| Ingest challenge ini 120 min CPT 95076 | $1,379.24 | $2,507.70 | $74.71 – $74.71 | 1 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $376.09 | $683.80 | $13.19 – $13.19 | 1 |
| Init ak ischal plstr direct HCPCS L5505 | not published | not published | $1,436.76 – $1,436.76 | 1 |
| Init bk ptb plaster direct HCPCS L5500 | not published | not published | $1,227.31 – $1,227.31 | 1 |
| Initial care training 30 m HCPCS G0539 | not published | not published | $52.20 – $52.20 | 1 |
| Initial custom socket insert HCPCS L5683 | not published | not published | $960.38 – $960.38 | 1 |
| Initial foot exam pt lops HCPCS G0245 | not published | not published | $43.94 – $43.94 | 1 |
| Initial hosp neonate 28 d/less than not critically ill 99477 CPT 99477 | not published | not published | $368.82 – $368.82 | 1 |
| Initial nursing facility care/day 35 minutes CPT 99305 | not published | not published | $133.08 – $133.08 | 1 |
| Initial nursing facility care/day 45 minutes CPT 99306 | not published | not published | $169.71 – $169.71 | 1 |
| Initial nursing facility care/day low severity 99304 CPT 99304 | not published | not published | $93.31 – $93.31 | 1 |
| Initiation & management bipap/cpap initial day CPT 94660 | $669.96 | $1,218.10 | $38.84 – $38.84 | 1 |
| Init nb em per day non-fac CPT 99461 | not published | not published | $64.22 – $64.22 | 1 |
| Init pm e/m new pat 65+ yrs CPT 99387 | not published | not published | $131.63 – $131.63 | 1 |
| Init/sub psych care m 1st 30 HCPCS G2214 | not published | not published | $39.06 – $39.06 | 1 |
| Inj, abilify asimtufii, 1 mg HCPCS J0402 | not published | not published | $7.00 – $11.18 | 3 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | not published | not published | $0.01 – $13.50 | 3 |
| Inj acetaminoph 10mg/ibu 3mg HCPCS J0138 | not published | not published | $0.06 – $0.08 | 2 |
| Inj, acetaminophen (b braun) HCPCS J0136 | not published | not published | $0.06 – $0.09 | 2 |
| Inj acetaminophen -fresenius HCPCS J0134 | not published | not published | $0.04 – $0.10 | 2 |
| Inj, acetaminophen (hikma) HCPCS J0137 | not published | not published | $0.06 – $0.09 | 2 |
| Inj. acthar gel to 40 units HCPCS J0801 | not published | not published | $0.01 – $7,669.72 | 2 |
| Inj, adalimumab, 1 mg HCPCS J0139 | not published | not published | $151.35 – $151.35 | 1 |
| Inj adalimumab-ryvk, 1 mg HCPCS Q5142 | not published | not published | $12.81 – $17.39 | 2 |
| Inj, adstiladrin, per tx dos HCPCS J9029 | not published | not published | $110.62 – $117,499.93 | 3 |
| Inj, aducanumab-avwa, 2 mg HCPCS J0172 | not published | not published | $0.54 – $11.09 | 3 |
| Inj, adzynma, 10 iu HCPCS J7171 | not published | not published | $41.34 – $66.01 | 3 |
| Inj, aflibercept-ayyh, 1 mg HCPCS Q5147 | not published | not published | $89.53 – $1,594.12 | 2 |
| Inj, aflibercept hd, 1 mg HCPCS J0177 | not published | not published | $4.87 – $577.61 | 3 |
| Inj, afstyla, 1 i.u HCPCS J7210 | not published | not published | $1.39 – $2.92 | 3 |
| Inj allopurinol sodium 1 mg HCPCS J0206 | not published | not published | $0.01 – $8.76 | 3 |
| Inj, alyglo, 500 mg HCPCS J1552 | not published | not published | $16.70 – $242.37 | 3 |
| Inj alymsys 10 mg HCPCS Q5126 | not published | not published | $0.48 – $96.08 | 3 |
| Inj, amisulpride, 1 mg HCPCS J0184 | not published | not published | $9.18 – $14.98 | 2 |
| Inj andexxa, 10 mg HCPCS J7169 | not published | not published | $3.50 – $217.47 | 2 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | not published | not published | $21.02 – $33.54 | 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.