SSM Health Saint Louis University Hospital
1201 S Grand Blvd, Saint Louis, MO · SSM Health · · NPI 1942685920
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 |
|---|---|---|---|---|
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $353.10 | $642.00 | $32.02 – $138.39 | 9 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $392.70 | $714.00 | $38.58 – $138.39 | 9 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $478.50 | $870.00 | $46.36 – $138.39 | 9 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $212.30 | $386.00 | $22.99 – $104.60 | 9 |
| X-ray humerus >= 2 views left CPT 73060 | $214.50 | $390.00 | $20.19 – $104.60 | 9 |
| X-ray joint survey 1 view CPT 77077 | $151.25 | $275.00 | $23.90 – $138.39 | 9 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $220.00 | $400.00 | $22.66 – $104.60 | 9 |
| X-ray knee 3 views (both sides) CPT 73562 | $269.50 | $490.00 | $28.01 – $104.60 | 9 |
| X-ray knee ap standing bilateral CPT 73565 | $275.00 | $500.00 | $26.78 – $104.60 | 9 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | not published | not published | $21.84 – $104.60 | 9 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $101.20 | $184.00 | $32.54 – $138.39 | 9 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $418.00 | $760.00 | $37.47 – $138.39 | 9 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $518.65 | $943.00 | $52.29 – $138.39 | 9 |
| X-ray male genital tract CPT 74440 | not published | not published | $70.40 – $292.27 | 9 |
| X-ray mandible complete > 4 views CPT 70110 | $448.80 | $816.00 | $28.84 – $138.39 | 9 |
| X-ray mandible ltd <4 views CPT 70100 | $392.70 | $714.00 | $27.18 – $104.60 | 9 |
| X-ray measurement of pelvis CPT 74710 | not published | not published | $41.15 – $47.07 | 2 |
| X-ray nasal bones complete > 3 views CPT 70160 | $291.50 | $530.00 | $27.18 – $104.60 | 9 |
| X-ray neck soft tissue CPT 70360 | $212.30 | $386.00 | $22.26 – $104.60 | 9 |
| X-ray nose to rectum for foreign body child CPT 76010 | not published | not published | $19.37 – $104.60 | 9 |
| X-ray of mammary ducts CPT 77054 | not published | not published | $61.35 – $292.27 | 9 |
| X-ray optic foramina CPT 70190 | not published | not published | $27.18 – $104.60 | 9 |
| X-ray pelvis 1-2 views CPT 72170 | $236.50 | $430.00 | $21.02 – $138.39 | 9 |
| X-ray pelvis complete > 3 views CPT 72190 | $342.10 | $622.00 | $30.89 – $138.39 | 9 |
| Xray place dist ext thor ao CPT 75959 | $1,665.40 | $3,028.00 | $212.60 – $443.49 | 2 |
| Xray place prox ext thor ao CPT 75958 | $1,665.40 | $3,028.00 | $243.79 – $505.29 | 2 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $499.40 | $908.00 | $90.88 – $467.51 | 9 |
| X-ray ribs 2 views left CPT 71100 | $229.90 | $418.00 | $21.84 – $104.60 | 9 |
| X-ray ribs 3 views bilateral CPT 71110 | $240.90 | $438.00 | $26.78 – $138.39 | 9 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $336.60 | $612.00 | $25.95 – $138.39 | 9 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $398.20 | $724.00 | $35.42 – $138.39 | 9 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $258.50 | $470.00 | $26.78 – $138.39 | 9 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $268.95 | $489.00 | $21.84 – $104.60 | 9 |
| X-ray scapula complete (both sides) CPT 73010 | $286.00 | $520.00 | $23.49 – $138.39 | 9 |
| X-ray sella turcica CPT 70240 | not published | not published | $22.66 – $104.60 | 9 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $145.75 | $265.00 | $17.32 – $104.60 | 9 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $286.00 | $520.00 | $28.01 – $104.60 | 9 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $660.00 | $1,200.00 | $32.95 – $656.76 | 9 |
| X-ray skull < 4 views CPT 70250 | $286.00 | $520.00 | $26.37 – $138.39 | 9 |
| X-ray skull > 4 views complete CPT 70260 | $359.15 | $653.00 | $31.72 – $138.39 | 9 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $398.75 | $725.00 | $69.57 – $147.12 | 9 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $310.20 | $564.00 | $92.20 – $226.76 | 9 |
| X-ray small intestine follow-through study CPT 74248 | $310.20 | $564.00 | $55.71 – $55.71 | 1 |
| X-ray spine single view CPT 72020 | $263.45 | $479.00 | $16.08 – $104.60 | 9 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $123.20 | $224.00 | $28.01 – $104.60 | 9 |
| X-ray sternum > 2 views CPT 71120 | $151.25 | $275.00 | $21.84 – $104.60 | 9 |
| X-ray surgical specimen CPT 76098 | $743.60 | $1,352.00 | $9.50 – $656.76 | 9 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $368.50 | $670.00 | $116.48 – $251.52 | 9 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $268.95 | $489.00 | $39.13 – $104.60 | 9 |
| X-ray thoracic spine 2 views CPT 72070 | $258.50 | $470.00 | $22.66 – $138.39 | 9 |
| X-ray thoracic spine 3 views CPT 72072 | $330.00 | $600.00 | $26.78 – $138.39 | 9 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $231.00 | $420.00 | $24.73 – $104.60 | 9 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $280.50 | $510.00 | $29.14 – $104.60 | 9 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $336.60 | $612.00 | $52.92 – $138.39 | 9 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $231.00 | $420.00 | $20.19 – $104.60 | 9 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $212.85 | $387.00 | $24.31 – $104.60 | 9 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $574.20 | $1,044.00 | $106.19 – $226.76 | 9 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $482.35 | $877.00 | $90.15 – $226.76 | 9 |
| X-ray upper gi delay w/kub CPT 74241 | not published | not published | $202.78 – $202.78 | 1 |
| X-ray upper gi&small intest CPT 74245 | not published | not published | $307.19 – $307.19 | 1 |
| X-ray wrist 2 views (both sides) CPT 73100 | $214.50 | $390.00 | $23.49 – $104.60 | 9 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | not published | not published | $68.34 – $226.76 | 9 |
| Xtrnl ecg rec>48hr<7d CPT 93241 | not published | not published | $226.75 – $226.75 | 1 |
| Xtrnl ecg rec up to 48 hrs CPT 93224 | $469.15 | $853.00 | $107.70 – $107.70 | 1 |
| Xwrap 1 sq cm HCPCS Q4204 | not published | not published | $122.15 – $6,848.92 | 7 |
| Xylose absorption test blood &/or urine CPT 84620 | not published | not published | $12.65 – $25.31 | 9 |
| Xyntha inj HCPCS J7185 | not published | not published | $1.34 – $3.10 | 8 |
| Yersinia antibody CPT 86793 | not published | not published | $12.93 – $28.16 | 9 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | not published | not published | $55,688.06 – $68,189.46 | 7 |
| Zenith amniotic membrane psc HCPCS Q4253 | not published | not published | $122.15 – $149.57 | 7 |
| Ziconotide injection HCPCS J2278 | not published | not published | $9.78 – $18.81 | 8 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | not published | not published | $1.48 – $2.81 | 7 |
| Zidovudine, oral, 100 mg HCPCS S0104 | not published | not published | $3.25 – $3.25 | 1 |
| Zika virus dna/rna amp probe CPT 87662 | $165.00 | $300.00 | $50.28 – $109.60 | 9 |
| Zika virus igm antibody CPT 86794 | not published | not published | $16.51 – $35.98 | 9 |
| Zinc paste band w >=3"<5"/yd HCPCS A6456 | not published | not published | $1.27 – $1.27 | 1 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | not published | not published | $6.75 – $12.66 | 3 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | not published | not published | $7.98 – $14.62 | 8 |
| Zolbetuximab-clzb 100 mg intravenous solution HCPCS J1326 | not published | not published | $33.25 – $62.53 | 7 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | not published | not published | $9.38 – $18.45 | 3 |
| Zoster vaccine-live inj CPT 90736 | not published | not published | $0.02 – $0.02 | 1 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $189.38 – $325.86 | 8 |
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.