SSM Health St. Joseph Hospital- Wentzville
500 Medical Drive, Wentzville, MO · SSM Health · · NPI 1851833305
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 |
|---|---|---|---|---|
| Diagnostic laryngoscopy 31505 CPT 31505 | $325.60 | $592.00 | $51.39 – $2,444.00 | 6 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $621.50 | $1,130.00 | $81.48 – $2,302.00 | 7 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $357.50 | $650.00 | $121.62 – $369.77 | 4 |
| Diagnostic Mammogram (one breast) CPT 77065 | $232.10 | $422.00 | $95.07 – $289.54 | 4 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $146.01 – $161.80 | 2 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $2,830.85 | $5,147.00 | $191.74 – $2,302.00 | 4 |
| Dialysis one evaluation CPT 90945 | $719.95 | $1,309.00 | $89.59 – $89.59 | 1 |
| Diathermy eg microwave CPT 97024 | not published | not published | $6.58 – $6.58 | 1 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | not published | not published | $0.08 – $0.15 | 2 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | not published | not published | $7.19 – $9.57 | 2 |
| Dicyclomine injection HCPCS J0500 | not published | not published | $13.61 – $43.69 | 2 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.21 – $0.24 | 2 |
| Diffusing capacity CPT 94729 | $475.75 | $865.00 | $45.90 – $45.90 | 1 |
| Digital analysis of eeg CPT 95957 | not published | not published | $212.57 – $212.57 | 1 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | not published | not published | $4.66 – $16.47 | 2 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | not published | not published | $5,788.40 – $8,365.47 | 3 |
| Digoxin total therapeutic drug level CPT 80162 | $56.65 | $103.00 | $13.28 – $54.74 | 4 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | not published | not published | $74.09 – $113.09 | 2 |
| Dilate biliary duct/ampulla CPT 47542 | $3,647.60 | $6,632.00 | $144.30 – $2,167.00 | 5 |
| Dilate esophagus CPT 43453 | not published | not published | $100.96 – $3,886.00 | 7 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $93.90 – $3,886.00 | 7 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | $892.65 | $1,623.00 | $466.33 – $3,632.00 | 6 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | $1,042.25 | $1,895.00 | $233.52 – $3,632.00 | 6 |
| Dilate ic vasospasm init CPT 61640 | $1,936.00 | $3,520.00 | $662.72 – $3,071.00 | 6 |
| Dilate tear duct opening CPT 68801 | not published | not published | $110.76 – $2,444.00 | 6 |
| Dilate urethra stricture CPT 53600 | $454.30 | $826.00 | $68.35 – $2,302.00 | 6 |
| Dilate urethra stricture CPT 53601 | not published | not published | $57.13 – $2,302.00 | 6 |
| Dilate urethra stricture CPT 53605 | not published | not published | $69.22 – $3,886.00 | 7 |
| Dilate urethra stricture CPT 53621 | not published | not published | $76.86 – $2,302.00 | 6 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $44.03 – $2,302.00 | 6 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $180.36 – $3,886.00 | 7 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $51.76 – $2,727.00 | 6 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $207.47 – $3,886.00 | 7 |
| Dilation of salivary duct CPT 42660 | not published | not published | $95.98 – $2,302.00 | 6 |
| Dilation of urethra CPT 53661 | not published | not published | $42.61 – $2,444.00 | 6 |
| Dilation of urethra CPT 53665 | not published | not published | $41.66 – $3,886.00 | 7 |
| Dilation of vagina CPT 57400 | not published | not published | $140.42 – $3,886.00 | 7 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $62.87 – $2,363.00 | 6 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $3,234.00 | $5,880.00 | $93.16 – $3,071.00 | 6 |
| Dilator fascial 10fx20cm HCPCS C2627 | $266.65 | $484.82 | not published | 0 |
| Dilat xst trc ndurlgc px CPT 50436 | $2,739.00 | $4,980.00 | $162.09 – $8,775.00 | 6 |
| Dilat xst trc new access rcs CPT 50437 | $4,143.70 | $7,534.00 | $271.86 – $3,379.00 | 6 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | not published | not published | $0.05 – $0.05 | 1 |
| Dimecaprol injection HCPCS J0470 | not published | not published | $54.55 – $54.55 | 1 |
| Dimenhydrinate injection HCPCS J1240 | not published | not published | $9.02 – $15.66 | 2 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | not published | not published | $865.48 – $1,191.43 | 3 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | not published | not published | $0.02 – $0.02 | 1 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | not published | not published | $1.05 – $1.41 | 2 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | not published | not published | $67.16 – $67.16 | 1 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $25.47 – $25.47 | 1 |
| Disability dlco CPT 94727 | $482.90 | $878.00 | $30.13 – $30.13 | 1 |
| Disaccharidases CPT 82657 | $283.25 | $515.00 | $22.17 – $74.45 | 4 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $484.87 – $3,886.00 | 7 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | not published | not published | $1,630.78 – $8,028.00 | 6 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $206.60 – $8,028.00 | 6 |
| Discography cerv/thor spine CPT 72285 | $3,406.70 | $6,194.00 | $52.71 – $3,508.78 | 4 |
| Dise eval slp do brth flx dx CPT 42975 | not published | not published | $117.96 – $2,167.00 | 6 |
| Dissolve clot heart vessel CPT 92975 | $1,042.25 | $1,895.00 | $424.00 – $2,302.00 | 3 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $1,262.58 – $4,464.00 | 6 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $844.26 – $3,864.00 | 6 |
| Division of fallopian tube 58605 CPT 58605 | not published | not published | $345.75 – $3,071.00 | 6 |
| #d/lmeth-l-methamphetamine CPT 80374 | not published | not published | $24.66 – $40.59 | 3 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | $739.75 | $1,345.00 | $326.03 – $5,327.00 | 6 |
| Dmd dup/delet analysis CPT 81161 | not published | not published | $146.35 – $931.86 | 4 |
| Dmpk gene detc abnor allele CPT 81234 | not published | not published | $137.00 – $457.58 | 4 |
| Dna antibody native/double stranded CPT 86225 | $94.60 | $172.00 | $13.74 – $56.68 | 4 |
| Dna gardnerella CPT 87510 | not published | not published | $20.05 – $82.70 | 4 |
| Dna probe chlamydia CPT 87490 | not published | not published | $22.75 – $82.70 | 4 |
| Dna probe gc CPT 87590 | not published | not published | $26.88 – $89.78 | 4 |
| Dna trichomonas CPT 87660 | not published | not published | $20.05 – $82.70 | 4 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | not published | not published | $9.30 – $17.23 | 2 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | not published | not published | $0.44 – $1.74 | 2 |
| Docetaxel (docivyx), 1 mg HCPCS J9172 | not published | not published | $50.49 – $86.15 | 2 |
| Dolasetron mesylate HCPCS J1260 | not published | not published | $0.01 – $0.01 | 1 |
| Dolasetron mesylate oral HCPCS Q0180 | not published | not published | $61.52 – $61.52 | 1 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | not published | not published | $0.77 – $1.35 | 2 |
| Doppler echo complete CPT 93320 | $1,187.45 | $2,159.00 | $36.58 – $36.58 | 1 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $6,612.10 | $12,022.00 | $206.28 – $541.00 | 2 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $1,009.80 | $1,836.00 | $117.93 – $182.91 | 2 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $528.00 | $960.00 | $78.16 – $120.02 | 2 |
| Doripenem 50 mg/ml inj 10 ml HCPCS J1267 | not published | not published | $0.01 – $0.01 | 1 |
| Dornase alfa non-comp unit HCPCS J7639 | not published | not published | $64.26 – $91.14 | 2 |
| Dornhoffer fixed part w/window HCPCS L8614 | $18,352.24 | $33,367.70 | not published | 0 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | not published | not published | $284.05 – $408.19 | 3 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | not published | not published | $3.17 – $5.73 | 2 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | not published | not published | $127.31 – $224.48 | 3 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | not published | not published | $0.14 – $0.14 | 1 |
| Dpyd gene common variants CPT 81232 | not published | not published | $174.81 – $583.87 | 4 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $1,022.45 | $1,859.00 | $141.26 – $2,444.00 | 6 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $818.40 | $1,488.00 | $149.73 – $2,302.00 | 6 |
| Drainage external ear complex 69005 CPT 69005 | $2,726.90 | $4,958.00 | $166.83 – $3,071.00 | 6 |
| Drainage external ear simple 69000 CPT 69000 | $818.40 | $1,488.00 | $125.23 – $2,302.00 | 6 |
| Drainage lymph node lesion 38300 CPT 38300 | not published | not published | $195.51 – $3,886.00 | 7 |
| Drainage lymph node lesion 38305 CPT 38305 | not published | not published | $493.55 – $3,886.00 | 7 |
| Drainage mouth roof lesion CPT 42000 | $595.65 | $1,083.00 | $110.86 – $3,886.00 | 7 |
| Drainage of arm bursa 23931 CPT 23931 | $1,685.75 | $3,065.00 | $168.49 – $3,886.00 | 7 |
| Drainage of bladder abscess CPT 51080 | not published | not published | $432.20 – $3,886.00 | 7 |
| Drainage of eye CPT 65800 | $1,123.10 | $2,042.00 | $96.04 – $3,886.00 | 7 |
| Drainage of eye CPT 65810 | not published | not published | $482.96 – $3,886.00 | 7 |
| Drainage of eye CPT 65815 | not published | not published | $495.44 – $3,886.00 | 7 |
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.