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 |
|---|---|---|---|---|
| Tib/per revasc stent & ather 37231 CPT 37231 | $13,154.52 | $23,917.30 | $1,098.32 – $30,526.42 | 4 |
| Tib/per revasc stnt & ather CPT 37235 | $6,961.54 | $12,657.35 | $553.37 – $5,000.00 | 2 |
| Tib/per revasc w/ather add-on 37233 CPT 37233 | $4,586.64 | $8,339.35 | $481.40 – $9,166.00 | 2 |
| Tic-brn enceph vac 0.25ml im CPT 90626 | not published | not published | $475.39 – $475.39 | 1 |
| Tic-brn enceph vac 0.5ml im CPT 90627 | not published | not published | $475.39 – $475.39 | 1 |
| Tigecycline injection HCPCS J3243 | not published | not published | $0.34 – $1.22 | 4 |
| Tilt table locking hip sing HCPCS L5270 | not published | not published | $6,563.13 – $14,045.10 | 8 |
| Tilt table study CPT 93660 | $3,370.44 | $6,128.08 | $104.82 – $1,496.00 | 9 |
| Tinzaparin sodium injection HCPCS J1655 | not published | not published | $8.62 – $8.62 | 1 |
| Tirofiban 12.5 mg/50 ml HCPCS J3246 | not published | not published | $4.05 – $7.10 | 4 |
| Tisagenlecleucel car-pos t HCPCS Q2042 | not published | not published | $611,693.17 – $1,192,801.68 | 8 |
| Tis cgen car anomal 1st shnt CPT 33745 | not published | not published | $1,189.00 – $1,872.00 | 2 |
| Tis cgen car anomal ea addl CPT 33746 | not published | not published | $641.05 – $1,872.00 | 2 |
| Tis clt agrft f/s/n/h/f/g ad CPT 15156 | not published | not published | $227.34 – $1,496.00 | 3 |
| Tis clt agrft f/s/n/h/f/g ea CPT 15157 | not published | not published | $247.72 – $1,496.00 | 3 |
| Tis cltr skn agrft t/a/l add CPT 15151 | not published | not published | $164.84 – $1,496.00 | 3 |
| Tis cltr skn agrft t/a/l ea CPT 15152 | not published | not published | $210.39 – $1,496.00 | 3 |
| Tisotumab vedotin-tftv 40 mg intravenous solution HCPCS J9273 | not published | not published | $196.12 – $382.44 | 9 |
| Tiss ex molecul study add-on CPT 88388 | not published | not published | $19.12 – $19.12 | 1 |
| Tissue amnio epifix inj 100mg HCPCS Q4145 | not published | not published | $22.06 – $35.31 | 2 |
| Tissue culture placenta CPT 88235 | not published | not published | $150.30 – $321.64 | 9 |
| Tissue culture skin/biopsy CPT 88233 | not published | not published | $140.73 – $301.16 | 8 |
| Tissue culture tumor CPT 88239 | not published | not published | $147.52 – $315.69 | 8 |
| Tissue exam koh skin/hair/nails CPT 87220 | $108.90 | $198.00 | $3.00 – $9.14 | 9 |
| Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm HCPCS Q4122 | not published | not published | $115.50 – $256.13 | 8 |
| Tissue transglutaminase iga CPT 86364 | $83.05 | $151.00 | $11.53 – $24.67 | 8 |
| Tixagev and cilgav inj HCPCS M0220 | not published | not published | $220.44 – $220.44 | 1 |
| Tl-201 thallium diag per mci HCPCS A9505 | $100.10 | $182.00 | $34.29 – $61.15 | 2 |
| Tlh uterus 250 g or less CPT 58570 | not published | not published | $1,236.26 – $21,878.19 | 10 |
| Tlh uterus over 250 g CPT 58572 | not published | not published | $1,555.76 – $21,878.19 | 10 |
| Tlh w/t/o 250 g or less CPT 58571 | not published | not published | $1,391.72 – $21,878.19 | 10 |
| Tlh w/t/o uterus over 250 g CPT 58573 | not published | not published | $1,866.70 – $21,878.19 | 10 |
| Tlso 2mod symphis-xipho pre HCPCS L0458 | not published | not published | $1,101.88 – $2,358.02 | 8 |
| Tlso 2 piece rigid shell HCPCS L0491 | not published | not published | $948.87 – $2,030.58 | 8 |
| Tlso 2 shl symphys-stern cst HCPCS L0460 | not published | not published | $1,240.27 – $2,654.18 | 8 |
| Tlso 3mod sacro-scap pre HCPCS L0462 | not published | not published | $1,542.64 – $3,301.25 | 8 |
| Tlso 3 piece rigid shell HCPCS L0492 | not published | not published | $614.96 – $1,316.01 | 8 |
| Tlso corset front HCPCS L0970 | not published | not published | $167.07 – $357.53 | 8 |
| Tlso flex trnk sj-t9 pre ots HCPCS L0455 | not published | not published | $254.02 – $543.60 | 8 |
| Tlso full corset HCPCS L0974 | not published | not published | $230.94 – $494.21 | 8 |
| Tlso r fram soft ant pre cst HCPCS L0466 | not published | not published | $491.93 – $1,052.73 | 8 |
| Tlso r fram soft pre ots HCPCS L0467 | not published | not published | $284.88 – $609.64 | 8 |
| Tlso rig fram pelvic pre cst HCPCS L0468 | not published | not published | $569.51 – $1,218.75 | 8 |
| Tlso rig fram pelvic pre ots HCPCS L0469 | not published | not published | $362.99 – $776.80 | 8 |
| Tlso rigid frame pre subclav HCPCS L0470 | not published | not published | $732.62 – $1,567.81 | 8 |
| Tlso rigid lined custom fab HCPCS L0482 | not published | not published | $1,781.97 – $3,813.42 | 8 |
| Tlso rigid lined pre one pie HCPCS L0488 | not published | not published | $1,240.27 – $2,654.18 | 8 |
| Tlso rigid plastic cust fab HCPCS L0484 | not published | not published | $2,042.14 – $4,370.18 | 8 |
| Tlso rigid plastic custom fa HCPCS L0480 | not published | not published | $1,762.06 – $3,770.81 | 8 |
| Tlso rigid plastic pre one HCPCS L0490 | not published | not published | $349.48 – $747.89 | 8 |
| Tlso trnk sj-t9 pre cst HCPCS L0454 | not published | not published | $428.50 – $916.99 | 8 |
| Tmvr w/prosthetic ring 33426 CPT 33426 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Tmvr w/rad reconst w or without ring 33427 CPT 33427 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Tnot opn elbw to sho ea tdn CPT 24310 | not published | not published | $727.17 – $6,734.39 | 11 |
| Tobramycin comp unit HCPCS J7685 | not published | not published | $39.55 – $39.55 | 1 |
| Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 | not published | not published | $1.82 – $4.37 | 4 |
| Tobramycin non-comp unit HCPCS J7682 | not published | not published | $16.87 – $35.79 | 4 |
| Tobramycin peak therapeutic drug level CPT 80200 | $480.56 | $873.75 | $11.00 – $34.52 | 9 |
| Tocilizumab 162 mg/0.9 ml subcutaneous pen injector HCPCS J3262 | not published | not published | $5.41 – $10.55 | 9 |
| Tocilizumab for covid-19 HCPCS Q0249 | not published | not published | $8.63 – $12.11 | 4 |
| Toe joint transfer CPT 26556 | not published | not published | $4,386.82 – $14,934.65 | 8 |
| Tomosynthesis breast diagnostic left HCPCS G0279 | not published | not published | $11.33 – $59.10 | 8 |
| Tomosynthesis breast screen bilateral CPT 77063 | $67.84 | $123.35 | $20.88 – $83.90 | 8 |
| Tone decay hearing test CPT 92563 | not published | not published | $35.92 – $76.88 | 8 |
| Tongue and neck surgery CPT 41135 | not published | not published | $2,074.00 – $4,386.82 | 3 |
| Tongue base vol reduction CPT 41530 | not published | not published | $561.92 – $6,823.84 | 10 |
| Tongue biopsy; posterior one-third 41105 CPT 41105 | not published | not published | $167.39 – $6,823.84 | 10 |
| Tongue jaw & neck surgery CPT 41155 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Tongue mouth jaw surgery CPT 41150 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Tongue mouth neck surgery CPT 41153 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Tongue removal neck surgery CPT 41145 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Tongue suspension CPT 41512 | not published | not published | $995.29 – $12,184.12 | 10 |
| Tongue to lip surgery CPT 41510 | not published | not published | $674.03 – $6,823.84 | 11 |
| Tonsillectomy (age 12+) CPT 42826 | not published | not published | $390.95 – $6,823.84 | 11 |
| Tonsillectomy (child under 12) CPT 42825 | not published | not published | $409.98 – $12,184.12 | 11 |
| Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution HCPCS J9351 | not published | not published | $1.28 – $2.04 | 4 |
| Topotecan oral HCPCS J8705 | not published | not published | $125.33 – $244.40 | 9 |
| Toripalimab-tpzi 240 mg/6 ml (40 mg/ml) intravenous solution HCPCS J3263 | not published | not published | $40.89 – $79.74 | 8 |
| Torsion ank & half solid sti HCPCS L2375 | not published | not published | $173.12 – $370.48 | 8 |
| Torsion straight knee joint HCPCS L2380 | not published | not published | $188.63 – $403.67 | 8 |
| Tot abd hyst/par vag/pelv node sam 58200 CPT 58200 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Total hip arthroplasty CPT 27132 | not published | not published | $2,532.13 – $26,424.41 | 8 |
| Total Hip Replacement CPT 27130 | not published | not published | $1,949.15 – $26,424.41 | 9 |
| Total hysterectomy CPT 58150 | not published | not published | $1,556.58 – $4,386.82 | 3 |
| Total Knee Replacement CPT 27447 | not published | not published | $1,946.36 – $26,424.41 | 9 |
| Total lung lavage CPT 32997 | not published | not published | $513.91 – $4,386.82 | 3 |
| Total ob care failed vbac 59618 CPT 59618 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Total tau CPT 84394 | $137.50 | $250.00 | $128.92 – $275.89 | 6 |
| Tot contact ak/knee disart s HCPCS L5650 | not published | not published | $701.34 – $1,500.87 | 8 |
| Tot disc arthrp 1ntrspc crv CPT 22856 | not published | not published | $2,463.27 – $36,087.88 | 9 |
| Tot disc arthrp 1ntrspc lmbr CPT 22857 | not published | not published | $2,647.48 – $36,087.88 | 8 |
| Tot disc arthrp 2ntrspc lmbr CPT 22860 | not published | not published | $528.54 – $4,386.82 | 4 |
| Tot disc arthrp ant appr disc 2nd level cervi 22858 CPT 22858 | not published | not published | $731.00 – $1,496.00 | 2 |
| Tot esophagectomy without thoracotomy 43107 CPT 43107 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Tot estradiol response panel CPT 80415 | not published | not published | $46.00 – $119.60 | 9 |
| Toxoplasma antibody igg CPT 86777 | $121.96 | $221.75 | $14.39 – $30.79 | 9 |
| Toxoplasma antibody igm CPT 86778 | $244.06 | $443.75 | $14.41 – $30.84 | 9 |
| Tp53 gene full gene sequence CPT 81351 | not published | not published | $641.85 – $1,373.56 | 8 |
| Tp53 gene known famil vrnt CPT 81353 | not published | not published | $308.00 – $659.12 | 8 |
| Tp53 gene trgt sequence alys CPT 81352 | $1,082.40 | $1,968.00 | $329.51 – $705.15 | 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.