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 |
|---|---|---|---|---|
| Low cost skin substitute app HCPCS C5273 | $3,913.20 | $7,114.90 | $1,978.00 – $11,867.00 | 3 |
| Low cost skin substitute app HCPCS C5275 | $1,167.60 | $2,122.90 | $540.00 – $2,939.00 | 3 |
| Low cost skin substitute app HCPCS C5277 | $1,167.60 | $2,122.90 | $540.00 – $2,939.00 | 3 |
| Low cost skin substitute app HCPCS C5272 | $190.90 | $347.10 | $540.00 – $1,486.00 | 2 |
| Low cost skin substitute app HCPCS C5274 | $190.90 | $347.10 | $540.00 – $1,486.00 | 2 |
| Low cost skin substitute app HCPCS C5276 | $190.90 | $347.10 | $540.00 – $1,486.00 | 2 |
| Low cost skin substitute app HCPCS C5278 | $190.90 | $347.10 | $540.00 – $1,486.00 | 2 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,030.60 | $3,692.00 | $202.01 – $321.39 | 2 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $1,785.36 | $3,246.10 | $163.15 – $662.62 | 2 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $858.00 | $1,560.00 | $116.94 – $196.15 | 2 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $3,192.75 | $5,805.00 | $256.65 – $662.62 | 2 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,445.30 | $4,446.00 | $224.41 – $662.62 | 2 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,428.90 | $2,598.00 | $143.91 – $414.23 | 2 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $355.85 | $647.00 | $22.78 – $196.15 | 3 |
| Lower jaw bone graft CPT 21215 | not published | not published | $940.85 – $8,785.00 | 7 |
| Low frequency non-thermal Ultrasound CPT 97610 | not published | not published | $18.61 – $18.61 | 1 |
| Loxapine for inhalation 1 mg HCPCS J2062 | not published | not published | $1.55 – $1.55 | 1 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $737.62 – $11,867.00 | 6 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $853.10 – $11,867.00 | 6 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $843.33 – $11,867.00 | 6 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $931.98 – $11,867.00 | 6 |
| Lso corset front HCPCS L0972 | not published | not published | $71.66 – $71.66 | 1 |
| Lso flex no ri stays pre ots HCPCS L0628 | not published | not published | $61.13 – $61.13 | 1 |
| Lso full corset HCPCS L0976 | not published | not published | $121.99 – $121.99 | 1 |
| Lso r post pnl sj-t9 pre cst HCPCS L0630 | not published | not published | $117.99 – $117.99 | 1 |
| Lso sag-coronal panel custom HCPCS L0638 | not published | not published | $961.09 – $961.09 | 1 |
| Lso sag-co shell pnl pre ots HCPCS L0651 | not published | not published | $867.91 – $867.91 | 1 |
| Lso sag ctr rigi pos pre ots HCPCS L0643 | not published | not published | $117.99 – $117.99 | 1 |
| Lso sagit rigid panel prefab HCPCS L0635 | not published | not published | $732.90 – $732.90 | 1 |
| Lso sagittal rigid panel cus HCPCS L0636 | not published | not published | $1,205.52 – $1,205.52 | 1 |
| Lso sc r pos/lat pnl pre cst HCPCS L0633 | not published | not published | $208.95 – $208.95 | 1 |
| Lso sc r pos/lat pnl pre ots HCPCS L0649 | not published | not published | $208.95 – $208.95 | 1 |
| Lso s/c shell/panel custom HCPCS L0640 | not published | not published | $762.52 – $762.52 | 1 |
| Lso s/c shell/panel prefab HCPCS L0639 | not published | not published | $867.91 – $867.91 | 1 |
| L/s ratio fetal lung CPT 83661 | $276.65 | $503.00 | $21.99 – $43.23 | 3 |
| Lubricant per ounce HCPCS A4402 | not published | not published | $1.31 – $1.31 | 1 |
| Lumbar bolster pad HCPCS L1030 | not published | not published | $43.56 – $43.56 | 1 |
| Lumbar derotation pad HCPCS L1240 | not published | not published | $53.17 – $53.17 | 1 |
| Lumbar diskogram s&i CPT 72295 | $3,779.46 | $6,871.75 | $53.59 – $3,157.90 | 3 |
| Lumbar or lumbar rib pad HCPCS L1040 | not published | not published | $53.99 – $53.99 | 1 |
| Lumbar sling HCPCS L1090 | not published | not published | $63.40 – $63.40 | 1 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $1,676.48 – $7,415.00 | 6 |
| Lumizyme injection HCPCS J0221 | not published | not published | $0.01 – $332.71 | 3 |
| Lung function test (mbc/mvv) CPT 94200 | not published | not published | $19.63 – $19.63 | 1 |
| Lung Function Test (Spirometry) CPT 94010 | $368.22 | $669.50 | $27.33 – $27.33 | 1 |
| Lung perfusion imaging CPT 78580 | $1,346.95 | $2,449.00 | $206.23 – $678.82 | 3 |
| Lung transplant double CPT 32853 | not published | not published | $2,009.00 – $4,880.01 | 6 |
| Lung transplant single CPT 32851 | not published | not published | $2,009.00 – $4,510.00 | 6 |
| Lung transplant with bypass CPT 32852 | not published | not published | $2,009.00 – $4,510.00 | 6 |
| Lung transplant with bypass CPT 32854 | not published | not published | $2,009.00 – $5,180.04 | 6 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $1,560.95 – $4,510.00 | 6 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | not published | not published | $0.01 – $384.22 | 3 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | not published | not published | $10.60 – $77.88 | 3 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | not published | not published | $299.32 – $488.81 | 2 |
| Lutetium lu 177 vipivotide HCPCS A9607 | not published | not published | $242.58 – $398.00 | 2 |
| Lvad shower bag heartmate HCPCS Q0501 | not published | not published | $372.86 – $372.86 | 1 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $33.41 – $3,868.00 | 6 |
| Lwr ext dynamic prosth pylon HCPCS L5985 | not published | not published | $205.98 – $205.98 | 1 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $20.05 – $39.18 | 3 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $735.19 – $4,510.00 | 6 |
| Lymphatics/lymph node imaging CPT 78195 | $1,262.25 | $2,295.00 | $303.26 – $880.92 | 3 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $36.56 – $78.37 | 3 |
| Lymphocyte transformation mitogen CPT 86353 | $279.95 | $509.00 | $49.03 – $95.92 | 3 |
| Lymphocytotoxicity assay CPT 86805 | $145.75 | $265.00 | $72.59 – $370.18 | 3 |
| Lymphocytotoxicity assay CPT 86806 | not published | not published | $47.59 – $93.22 | 3 |
| Lymph vessel x-ray arm/leg CPT 75801 | $579.86 | $1,054.30 | $239.62 – $974.92 | 3 |
| Lymph vessel x-ray arms/legs CPT 75803 | $1,159.73 | $2,108.60 | $239.62 – $2,531.05 | 3 |
| Lymph vessel x-ray trunk CPT 75805 | $2,118.54 | $3,851.90 | $270.18 – $5,150.99 | 3 |
| Lymph vessel x-ray trunk CPT 75807 | $2,118.54 | $3,851.90 | $405.30 – $5,150.99 | 3 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $140.22 – $3,935.00 | 7 |
| Lysis of labial adhesions CPT 56441 | $2,505.36 | $4,555.20 | $143.35 – $3,886.00 | 7 |
| Lysis penil circumic lesion CPT 54162 | $5,038.00 | $9,160.00 | $206.32 – $3,935.00 | 7 |
| Lyumjev for insulin pump use HCPCS J1813 | not published | not published | $1.70 – $28.05 | 2 |
| Macro exam dissect molec study ea CPT 88387 | not published | not published | $8.03 – $15.47 | 3 |
| Macroscopic exam arthropod CPT 87168 | $84.70 | $154.00 | $4.27 – $8.10 | 3 |
| Macroscopic exam parasite CPT 87169 | $67.65 | $123.00 | $4.31 – $8.10 | 3 |
| Magnesium CPT 83735 | $42.35 | $77.00 | $6.70 – $12.83 | 3 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | not published | not published | $0.42 – $0.89 | 2 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $279.05 – $414.23 | 2 |
| Makena, 10 mg HCPCS J1726 | not published | not published | $20.62 – $22.80 | 2 |
| Malaria antibody CPT 86750 | not published | not published | $13.19 – $25.67 | 3 |
| Male sling procedure CPT 53440 | not published | not published | $782.00 – $5,082.00 | 7 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $2,009.00 – $4,510.00 | 6 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $338.13 – $3,868.00 | 6 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $425.14 – $4,510.00 | 6 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $166.60 | $302.90 | $28.38 – $28.38 | 1 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $200.92 | $365.30 | $25.95 – $25.95 | 1 |
| Manipulation of hip joint CPT 27275 | not published | not published | $188.74 – $3,935.00 | 7 |
| Manipulation of spine CPT 22505 | not published | not published | $138.13 – $3,935.00 | 7 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $77.20 – $3,886.00 | 7 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | not published | not published | $2.60 – $2.60 | 1 |
| Mannitol for inhaler HCPCS J7665 | not published | not published | $0.46 – $0.46 | 1 |
| Man's shoe oxford brace HCPCS L3225 | not published | not published | $57.25 – $57.25 | 1 |
| Manual diff wbc count b-coat CPT 85009 | not published | not published | $5.07 – $10.14 | 3 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | $626.34 | $1,138.80 | $86.14 – $86.14 | 1 |
| Mapping io sentinel lymph node CPT 38900 | not published | not published | $145.28 – $2,109.00 | 4 |
| Map tachycard site(s) CPT 93609 | $7,159.38 | $13,017.06 | $121.47 – $7,786.00 | 5 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | not published | not published | $58.60 – $97.36 | 3 |
| Marker biop eviva buckle ss HCPCS A4648 | $406.19 | $738.52 | not published | 0 |
| Marker lymphatic sentimag magtrace 10 vial HCPCS A9697 | not published | not published | $1,877.63 – $1,877.63 | 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.