SSM Health St. Anthony Hospital - Midwest
2825 Parklawn Drive, Midwest City, OK · SSM Health · · NPI 1700471497
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 |
|---|---|---|---|---|
| T cells absolute cd4/cd8 including ratio CPT 86360 | $343.06 | $623.75 | $46.98 – $100.54 | 9 |
| T cells absolute cd 4 count CPT 86361 | $226.88 | $412.50 | $19.00 – $57.31 | 9 |
| T cells total count CPT 86359 | $184.94 | $336.25 | $37.73 – $80.74 | 9 |
| Tcranial magn stim tx deli CPT 90868 | not published | not published | $207.67 – $482.67 | 8 |
| Tcranial magn stim tx plan CPT 90867 | not published | not published | $207.67 – $482.67 | 8 |
| Tcran magn stim redetemine CPT 90869 | not published | not published | $207.67 – $482.67 | 8 |
| Tdh sdrl/ventr pnxr CPT 61105 | not published | not published | $707.29 – $4,386.82 | 3 |
| Teaec w/wo patch graft iliofemoral CPT 35355 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Team conf without pat by hc pro CPT 99368 | not published | not published | $53.89 – $53.89 | 1 |
| Team conf without pat by phys CPT 99367 | not published | not published | $82.83 – $82.83 | 1 |
| Team conf w/pat by hc prof CPT 99366 | not published | not published | $61.63 – $61.63 | 1 |
| Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution HCPCS J9274 | not published | not published | $228.01 – $444.61 | 9 |
| Tee w or without fol w/cont,cong HCPCS C8926 | not published | not published | $753.95 – $1,613.46 | 7 |
| Tee w or without fol w/cont, mon HCPCS C8927 | not published | not published | $753.95 – $1,613.46 | 7 |
| Teflon or equal cable lining HCPCS L6665 | not published | not published | $75.17 – $160.86 | 8 |
| Telavancin injection HCPCS J3095 | not published | not published | $7.48 – $14.59 | 9 |
| Telehealth original site facility fee HCPCS Q3014 | not published | not published | $43.61 – $43.61 | 1 |
| Telethx isodose plan cplx CPT 77307 | not published | not published | $195.82 – $770.65 | 8 |
| Telethx isodose plan simple CPT 77306 | not published | not published | $108.21 – $770.65 | 8 |
| Temozolomide HCPCS J8700 | not published | not published | $0.43 – $0.61 | 4 |
| Temozolomide 100 mg intravenous solution HCPCS J9328 | not published | not published | $10.41 – $20.30 | 9 |
| Temperature gradient studies CPT 93740 | not published | not published | $2.09 – $265.98 | 8 |
| Temple bne implnt w/stimulat CPT 69715 | not published | not published | $3,181.00 – $4,386.82 | 2 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | not published | not published | $32.68 – $63.73 | 9 |
| Tendon lengthening CPT 26476 | not published | not published | $967.33 – $6,734.39 | 11 |
| Tendon lngth upr a/e ea tdn CPT 24305 | not published | not published | $887.74 – $6,734.39 | 11 |
| Tendon shortening CPT 26477 | not published | not published | $945.57 – $6,734.39 | 11 |
| Tendon transfer with graft CPT 26492 | not published | not published | $1,400.03 – $6,734.39 | 11 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | not published | not published | $185.20 – $423.97 | 9 |
| Teniposide, 50 mg HCPCS Q2017 | not published | not published | $2,620.75 – $4,099.60 | 2 |
| Tenodesis biceps tdn at elbw CPT 24340 | not published | not published | $914.79 – $14,934.65 | 11 |
| Tenolysis extensor tendon hand/finger each CPT 26445 | not published | not published | $903.38 – $6,734.39 | 11 |
| Tenolysis triceps CPT 24332 | not published | not published | $941.88 – $6,734.39 | 10 |
| Tenoplasty elbow to sho 1 CPT 24320 | not published | not published | $1,190.50 – $14,934.65 | 11 |
| Tenosynovectomy radic 26145 CPT 26145 | not published | not published | $790.98 – $3,309.55 | 11 |
| Tenotomy hip flexor open CPT 27005 | not published | not published | $1,099.13 – $6,734.39 | 8 |
| Tenotomy length/rls abductor hallucis musc 28240 CPT 28240 | not published | not published | $450.90 – $6,734.39 | 11 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | not published | not published | $370.01 – $3,309.55 | 9 |
| Tension based scoliosis orth HCPCS L1005 | not published | not published | $3,954.38 – $8,462.37 | 8 |
| Tens suppl 2 lead per month HCPCS A4595 | not published | not published | $18.77 – $19.94 | 2 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | not published | not published | $1.61 – $12.80 | 4 |
| Teriparatide injection HCPCS J3110 | not published | not published | $52.85 – $86.05 | 2 |
| Term dev auto grasp feature HCPCS L6881 | not published | not published | $5,060.90 – $10,830.33 | 8 |
| Term device, multi art digit HCPCS L6715 | not published | not published | $3,908.27 – $8,363.70 | 8 |
| Term dev mech hand vol close HCPCS L6709 | not published | not published | $1,728.38 – $3,698.73 | 8 |
| Term dev mech hand vol open HCPCS L6708 | not published | not published | $1,178.02 – $2,520.96 | 8 |
| Term dev mech hook vol close HCPCS L6707 | not published | not published | $1,752.80 – $3,750.99 | 8 |
| Term dev mech hook vol open HCPCS L6706 | not published | not published | $492.59 – $1,054.14 | 8 |
| Term dev modifier wrist unit HCPCS L6805 | not published | not published | $520.97 – $1,114.88 | 8 |
| Term dev, passive hand mitt HCPCS L6703 | not published | not published | $404.88 – $866.44 | 8 |
| Term dev precision pinch dev HCPCS L6810 | not published | not published | $304.48 – $651.59 | 8 |
| Term dev, sport/rec/work att HCPCS L6704 | not published | not published | $949.50 – $2,031.93 | 8 |
| Tert gene targeted seq alys CPT 81345 | not published | not published | $185.20 – $396.33 | 8 |
| Test for chlorohydrocarbons CPT 82441 | not published | not published | $6.01 – $12.86 | 9 |
| Test for porphobilinogen CPT 84106 | not published | not published | $5.00 – $12.45 | 9 |
| Test for urine cystines CPT 82615 | not published | not published | $6.00 – $20.44 | 9 |
| Testicular imaging w/vasc flow CPT 78761 | not published | not published | $235.12 – $822.80 | 9 |
| Testosterone pellet 75 mg HCPCS S0189 | not published | not published | $172.68 – $172.68 | 1 |
| Testosterone response panel CPT 80414 | not published | not published | $46.00 – $110.51 | 8 |
| Testosterone undecanoate 1mg HCPCS J3145 | not published | not published | $2.15 – $4.19 | 9 |
| Test pathogen(s) for platelets reference HCPCS P9100 | not published | not published | $56.74 – $121.42 | 7 |
| Test sock elbw disart/above HCPCS L6682 | not published | not published | $370.84 – $793.60 | 8 |
| Test socket above knee HCPCS L5624 | not published | not published | $593.44 – $1,269.96 | 8 |
| Test socket below knee HCPCS L5620 | not published | not published | $453.81 – $971.15 | 8 |
| Test socket hemipelvectomy HCPCS L5628 | not published | not published | $703.32 – $1,505.10 | 8 |
| Test socket hip disarticulat HCPCS L5626 | not published | not published | $651.69 – $1,394.62 | 8 |
| Test socket knee disarticula HCPCS L5622 | not published | not published | $591.76 – $1,266.37 | 8 |
| Test socket shldr disart/tho HCPCS L6684 | not published | not published | $426.74 – $913.22 | 8 |
| Test socket symes HCPCS L5618 | not published | not published | $369.85 – $791.48 | 8 |
| Test sock wrist disart/bel e HCPCS L6680 | not published | not published | $378.71 – $810.44 | 8 |
| Test stress cardiovascular tracing only CPT 93017 | $1,325.90 | $2,410.73 | $54.07 – $529.38 | 8 |
| Test urine for lactose CPT 83633 | not published | not published | $6.00 – $24.08 | 9 |
| Test urine for porphyrins CPT 84119 | not published | not published | $10.00 – $28.59 | 9 |
| Test urine urobilinogen CPT 84578 | not published | not published | $4.00 – $9.57 | 9 |
| Tetanus ig im CPT 90389 | not published | not published | $661.77 – $1,066.26 | 2 |
| Tetanus immune globulin inj HCPCS J1670 | not published | not published | $595.02 – $1,160.28 | 9 |
| Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe HCPCS J2356 | not published | not published | $17.92 – $34.94 | 9 |
| Tgfbi gene common variants CPT 81333 | not published | not published | $137.00 – $293.18 | 7 |
| Tgsap hl neo 5-50 rna alys CPT 81451 | not published | not published | $759.53 – $1,625.39 | 8 |
| Tgsap so/hl 51/< rna alys CPT 81456 | not published | not published | $2,919.60 – $6,247.94 | 8 |
| Tgsap so neo 5-50 rna alys CPT 81449 | not published | not published | $597.91 – $1,279.53 | 8 |
| Thaw cryoprsvrd reprod tiss CPT 89354 | not published | not published | $163.86 – $350.65 | 6 |
| Thawing cryopresrved embryo CPT 89352 | not published | not published | $163.86 – $350.65 | 6 |
| Thawing cryopresrved oocyte CPT 89356 | not published | not published | $163.86 – $350.65 | 6 |
| Thawing cryopresrved sperm CPT 89353 | not published | not published | $50.12 – $107.25 | 6 |
| Thaw preserved stem cells CPT 38208 | not published | not published | $43.28 – $1,579.00 | 10 |
| Theophylline therapeutic drug level CPT 80198 | $239.66 | $435.75 | $10.00 – $30.26 | 9 |
| Therapeutic procd strg endur HCPCS G0237 | not published | not published | $16.24 – $59.53 | 8 |
| Therapeutic pulpotomy HCPCS D3220 | not published | not published | $125.49 – $1,330.59 | 7 |
| Therapy activation ipnss CPT 93150 | not published | not published | $65.11 – $195.67 | 8 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $70.59 | $128.35 | $25.42 – $54.40 | 8 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $60.31 | $109.65 | $21.26 – $45.50 | 8 |
| Therapy photodnmc lght dstr lsn skn by staff rx per day CPT 96567 | not published | not published | $192.96 – $1,496.00 | 9 |
| Ther fx nasal inf turbinate CPT 30930 | not published | not published | $178.92 – $6,823.84 | 11 |
| Ther nma rdctj intus/obstrcj CPT 74283 | $477.32 | $867.85 | $123.00 – $361.01 | 9 |
| Ther/proph/diag inj ia CPT 96373 | $335.78 | $610.50 | $27.79 – $437.78 | 8 |
| Ther radiology tx plng cplx CPT 77263 | not published | not published | $257.48 – $1,111.00 | 3 |
| Ther radiology tx plng intrm CPT 77262 | not published | not published | $165.96 – $306.00 | 3 |
| Ther radiology tx plng smpl CPT 77261 | not published | not published | $108.39 – $133.00 | 3 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | not published | not published | $2.01 – $4.04 | 4 |
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.