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 |
|---|---|---|---|---|
| Assay of lap enzyme CPT 83670 | not published | not published | $9.81 – $18.91 | 3 |
| Assay of leflunomide CPT 80193 | $30.25 | $55.00 | $38.57 – $74.98 | 3 |
| Assay of lrh hormone CPT 83727 | not published | not published | $17.19 – $33.77 | 3 |
| Assay of methemalbumin CPT 83857 | not published | not published | $10.74 – $20.94 | 3 |
| Assay of neonatal thyroxine CPT 84437 | not published | not published | $6.47 – $12.83 | 3 |
| Assay of osteocalcin CPT 83937 | $63.25 | $115.00 | $25.45 – $58.09 | 3 |
| Assay of phenylketones CPT 84035 | not published | not published | $3.98 – $8.10 | 3 |
| Assay of pregnanediol CPT 84135 | not published | not published | $21.27 – $41.21 | 3 |
| Assay of pregnanetriol CPT 84138 | not published | not published | $21.05 – $41.21 | 3 |
| Assay of procainamide w/metab CPT 80192 | $59.95 | $109.00 | $16.75 – $32.42 | 3 |
| Assay of progesterone CPT 84234 | not published | not published | $64.88 – $126.32 | 3 |
| Assay of prostaglandin CPT 84150 | $253.00 | $460.00 | $34.64 – $81.74 | 3 |
| Assay of PSA complexed CPT 84152 | not published | not published | $18.39 – $35.81 | 3 |
| Assay of quinine CPT 84228 | not published | not published | $11.63 – $22.97 | 3 |
| Assay of rbc pg6d enzyme CPT 84085 | not published | not published | $9.36 – $18.24 | 3 |
| Assay of salicylate CPT 80179 | not published | not published | $18.64 – $36.48 | 3 |
| Assay of semen fructose CPT 82757 | not published | not published | $17.34 – $33.77 | 3 |
| Assay of sialic acid CPT 84275 | not published | not published | $13.44 – $26.34 | 3 |
| Assay of silica CPT 84285 | not published | not published | $25.21 – $49.31 | 3 |
| Assay of somatostatin CPT 84307 | $187.55 | $341.00 | $18.28 – $35.81 | 3 |
| Assay of thiocyanate CPT 84430 | $57.20 | $104.00 | $11.63 – $22.97 | 3 |
| Assay of troponin qual CPT 84512 | not published | not published | $9.06 – $19.59 | 3 |
| Assay of tyrosine CPT 84510 | $75.90 | $138.00 | $10.63 – $20.94 | 3 |
| Assay of urine sulfate CPT 84392 | $34.10 | $62.00 | $5.49 – $10.81 | 3 |
| Assay of urine urobilinogen CPT 84580 | not published | not published | $9.55 – $18.91 | 3 |
| Assay of urine urobilinogen CPT 84583 | not published | not published | $6.05 – $11.49 | 3 |
| Assay phosphatidylglycerol CPT 84081 | $266.20 | $484.00 | $16.52 – $32.42 | 3 |
| Assay phosphohexose enzymes CPT 84087 | not published | not published | $10.73 – $20.94 | 3 |
| Assay rbc glutathione CPT 82979 | not published | not published | $9.44 – $18.24 | 3 |
| Assay toxin or antitoxin CPT 87230 | $177.10 | $322.00 | $19.74 – $38.50 | 3 |
| Assess aphasia/interp/rpt/per hr 96105 CPT 96105 | not published | not published | $105.63 – $105.63 | 1 |
| Assess care plan pt w/cog impair 99483 CPT 99483 | not published | not published | $180.90 – $180.90 | 1 |
| Assess cyst contrast inject CPT 49424 | $629.04 | $1,143.71 | $40.29 – $3,868.00 | 4 |
| Assessment leukocyte fecal qualitative/semiquantitative CPT 89055 | $15.40 | $28.00 | $4.27 – $8.10 | 3 |
| Asses tinnit/pitch/loud/match/mask 92625 CPT 92625 | not published | not published | $63.61 – $63.61 | 1 |
| Assist-bilat spinal disk surgery add-on 63035 CPT 63035 | not published | not published | $205.09 – $11,867.00 | 5 |
| Assistive tech assessment, ot CPT 97755 | $194.19 | $353.08 | $36.43 – $36.43 | 1 |
| Assist oocyte fertilization CPT 89280 | not published | not published | $656.15 – $870.08 | 2 |
| Assist oocyte fertilization CPT 89281 | not published | not published | $149.16 – $198.02 | 2 |
| Ast/sgot CPT 84450 | $39.60 | $72.00 | $5.18 – $10.14 | 3 |
| Atezolizumab 60 mg/ml intravenous solution (wrapper) HCPCS J9022 | not published | not published | $64.99 – $169.44 | 3 |
| Athrectomy fem/pop/unilateral 37225 CPT 37225 | $24,424.26 | $44,407.75 | $664.00 – $13,266.00 | 6 |
| Athrectomy tib/pero/unilat/ini ves 37229 CPT 37229 | $24,424.26 | $44,407.75 | $774.89 – $13,266.00 | 6 |
| Atomic absorption CPT 82190 | not published | not published | $15.90 – $31.07 | 3 |
| Atropine 0.1 mg/ml injection syringe HCPCS J0461 | not published | not published | $0.08 – $0.19 | 2 |
| Attach bladder/urethra comp 51841 CPT 51841 | not published | not published | $803.95 – $4,510.00 | 6 |
| Attach bladder/urethra simple 51840 CPT 51840 | not published | not published | $680.64 – $4,510.00 | 6 |
| Attach ocular implant CPT 65140 | not published | not published | $815.17 – $4,510.00 | 7 |
| Attn at delivery+ 1 stabilization of newborn 99464 CPT 99464 | $344.43 | $626.23 | $76.22 – $76.22 | 1 |
| Aud brainstem implt programg CPT 92640 | not published | not published | $97.55 – $97.55 | 1 |
| Audiometry air + bone CPT 92553 | $237.38 | $431.60 | $36.43 – $36.43 | 1 |
| Auditory function 60 min CPT 92620 | not published | not published | $84.17 – $84.17 | 1 |
| Augmentation cheek bone CPT 21270 | not published | not published | $746.61 – $6,335.00 | 7 |
| Augmentation lower jaw bone CPT 21125 | not published | not published | $763.22 – $8,785.00 | 7 |
| Augmentation lower jaw bone CPT 21127 | not published | not published | $921.34 – $11,867.00 | 7 |
| Augmentation of facial bones CPT 21208 | not published | not published | $877.92 – $8,785.00 | 7 |
| Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body CPT 22515 | not published | not published | $240.19 – $9,268.00 | 5 |
| Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic CPT 22513 | not published | not published | $567.82 – $9,268.00 | 6 |
| Autgrft implnt knee w/scope CPT 29866 | not published | not published | $1,094.22 – $6,969.00 | 7 |
| Autochondrocyte implant knee CPT 27412 | not published | not published | $1,729.12 – $4,510.00 | 6 |
| Autoimmune rheumatoid arthr anl 12 mrk ia CPT 81490 | not published | not published | $602.48 – $1,640.82 | 3 |
| Autologous blood op salvage CPT 86891 | not published | not published | $131.94 – $656.15 | 3 |
| Autologous blood process CPT 86890 | $294.25 | $535.00 | $93.54 – $195.90 | 3 |
| Autolog prp diab wound ulcer HCPCS G0465 | not published | not published | $867.56 – $867.56 | 1 |
| Autolog prp not diab ulcer HCPCS G0460 | not published | not published | $131.34 – $131.34 | 1 |
| Automated diff wbc count CPT 85004 | not published | not published | $6.47 – $12.83 | 3 |
| Autonomic nrv adrenrg inervj CPT 95922 | not published | not published | $51.14 – $51.14 | 1 |
| Autonomic nrv parasym inervj CPT 95921 | not published | not published | $41.33 – $41.33 | 1 |
| Autonomic nrv syst funj test CPT 95923 | not published | not published | $143.55 – $143.55 | 1 |
| Avelumab 20 mg/ml intravenous solution HCPCS J9023 | not published | not published | $106.98 – $185.66 | 3 |
| Av fistula revision CPT 36833 | not published | not published | $870.27 – $5,560.00 | 7 |
| Av fuse uppr arm basilic CPT 36819 | not published | not published | $788.47 – $4,510.00 | 7 |
| Av fuse uppr arm cephalic CPT 36818 | not published | not published | $743.36 – $4,510.00 | 7 |
| Av fusion direct any site CPT 36821 | not published | not published | $713.56 – $4,510.00 | 7 |
| Av fusion/forearm vein 36820 CPT 36820 | not published | not published | $782.74 – $4,510.00 | 7 |
| Avul nail plate addl CPT 11732 | $338.91 | $616.20 | $21.11 – $1,486.00 | 3 |
| Avulsion nail plate partial/complete simple single nail plate CPT 11730 | $369.66 | $672.10 | $52.40 – $3,886.00 | 7 |
| Axatilimab-csfr 22 mg/0.44ml soln 0.44 ml vial HCPCS J9038 | not published | not published | $14.09 – $103.23 | 2 |
| Axicabtagene ciloleucel car+ HCPCS Q2041 | not published | not published | $0.01 – $989,141.97 | 3 |
| Axillary lymphadenect/superficial 38740 CPT 38740 | not published | not published | $725.26 – $4,229.00 | 7 |
| Azacitidine injection HCPCS J9025 | not published | not published | $0.24 – $1.05 | 2 |
| Azathioprine 50 mg tablet HCPCS J7500 | not published | not published | $0.12 – $2.49 | 2 |
| Azathioprine parenteral HCPCS J7501 | not published | not published | $2.52 – $377.80 | 2 |
| Azithromycin 500 mg intravenous solution HCPCS J0456 | not published | not published | $3.03 – $3.78 | 2 |
| Aztreonam 1 gram solution for injection HCPCS J0457 | not published | not published | $3.07 – $4.70 | 2 |
| Baclofen 2,000 mcg/ml intrathecal solution (wrapper) HCPCS J0475 | not published | not published | $66.31 – $336.17 | 3 |
| Baclofen 50 mcg/ml intrathecal solution (wrapper) HCPCS J0476 | not published | not published | $78.05 – $92.66 | 2 |
| Baclofen eval charges CPT 97750 | not published | not published | $33.35 – $33.35 | 1 |
| Bacterial meningitis antigen CPT 86403 | $99.00 | $180.00 | $11.54 – $22.30 | 3 |
| Bacterial vaginosis pcr CPT 87801 | $172.70 | $314.00 | $70.20 – $137.13 | 3 |
| Bactericidal level serum CPT 87197 | not published | not published | $15.02 – $29.05 | 3 |
| #bac vag cand-c. albicans naa CPT 87481 | not published | not published | $35.09 – $68.23 | 3 |
| Bag urine leg fbrc strap 32oz flipflo anti-reflux valve HCPCS A4358 | not published | not published | $4.85 – $4.85 | 1 |
| Balloon dilate urtrl strix CPT 50706 | $3,876.73 | $7,048.60 | $196.56 – $2,109.00 | 4 |
| Barrier film 1.0ml wipe HCPCS A5120 | not published | not published | $0.20 – $0.20 | 1 |
| Barrier film 28ml spray no stng cavilon HCPCS A4369 | not published | not published | $1.75 – $1.75 | 1 |
| Barrier skin flat ctf 2.75in HCPCS A4408 | not published | not published | $8.38 – $8.38 | 1 |
| Barrier skin flextend 2.25in floating flang new image HCPCS A4409 | not published | not published | $5.28 – $5.28 | 1 |
| Barrier skin flxtnd ctf 3.5in flt flang 4in w/tape cut to ft HCPCS A4414 | not published | not published | $4.18 – $4.18 | 1 |
| Barrier skn ft cx ff red 2.25 ctf new image w/tape HCPCS A4407 | not published | not published | $7.44 – $7.44 | 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.