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 |
|---|---|---|---|---|
| Triptorelin pamoate HCPCS J3315 | not published | not published | $466.36 – $909.41 | 9 |
| Trluml dil aq o/f can without st CPT 66174 | not published | not published | $932.07 – $8,507.36 | 10 |
| Trluml dil aq o/f can w/st CPT 66175 | not published | not published | $1,084.81 – $10,952.24 | 10 |
| Trml dstrj ios bvn 1st 2 l/s CPT 64628 | not published | not published | $630.92 – $26,424.41 | 8 |
| Trml dstrj ios bvn ea addl CPT 64629 | not published | not published | $300.33 – $1,496.00 | 2 |
| Trmt of fracture (femoral shaft) 27500 CPT 27500 | not published | not published | $237.24 – $1,579.00 | 11 |
| Trnscath plc stent crv crtd without prtct CPT 37216 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Trnscath plc stent crv crtd w/prtct CPT 37215 | $5,104.00 | $9,280.00 | $1,189.00 – $4,386.82 | 3 |
| Trnscath plc stnt ante carotid art CPT 37218 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Trnscath plc vas stent w/s&i ea addl artery CPT 37237 | $7,320.58 | $13,310.15 | $315.59 – $5,000.00 | 2 |
| Trnscath plc vas stent w/s&i ea addl vein CPT 37239 | $6,560.90 | $11,928.90 | $224.83 – $5,000.00 | 2 |
| Trnscath plc vas stent w/s&i ini vein CPT 37238 | $11,027.39 | $20,049.80 | $458.78 – $23,760.10 | 9 |
| Trnscath retrv pq vasc fb w/guide CPT 37197 | $4,354.35 | $7,917.00 | $450.95 – $8,185.00 | 10 |
| Trnscath tx thromblytc artery non-intracrn ini day CPT 37211 | $7,258.35 | $13,197.00 | $579.80 – $11,452.76 | 10 |
| Trnscath tx thromblytc art/ven sbsq day CPT 37213 | $4,354.35 | $7,917.00 | $346.47 – $8,185.00 | 10 |
| Trnscath tx thromblytc cath rmv sbsq day CPT 37214 | $4,354.35 | $7,917.00 | $182.83 – $8,185.00 | 10 |
| Trnscath tx thromblytc vein ini day CPT 37212 | $4,354.35 | $7,917.00 | $506.02 – $6,498.69 | 10 |
| Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm CPT 14301 | not published | not published | $1,313.87 – $8,185.00 | 10 |
| Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/< CPT 14302 | not published | not published | $325.71 – $1,496.00 | 2 |
| Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/< CPT 14060 | not published | not published | $1,005.32 – $4,246.62 | 11 |
| Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm CPT 14061 | not published | not published | $1,236.74 – $4,246.62 | 11 |
| Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm CPT 14021 | not published | not published | $1,070.53 – $4,246.62 | 11 |
| Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm CPT 14001 | not published | not published | $986.65 – $4,246.62 | 11 |
| Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/< CPT 14000 | not published | not published | $760.94 – $4,246.62 | 11 |
| Trnsplj pd lvr&bwl cd154+cll CPT 81560 | not published | not published | $640.73 – $1,371.16 | 8 |
| Trnspl rej kdn mrna qpcr 139 CPT 81558 | not published | not published | $3,240.00 – $6,933.60 | 7 |
| Trnsxj/repos abrrnt rnl vsls CPT 50100 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Troponin quantitative CPT 84484 | $377.57 | $686.49 | $7.00 – $26.69 | 9 |
| Tr retinal les preterm inf CPT 67229 | not published | not published | $528.97 – $1,496.00 | 9 |
| Trurl dstrj prst8 tiss rf wv CPT 53854 | not published | not published | $581.82 – $8,185.00 | 10 |
| Truskin, per sq centimeter HCPCS Q4167 | not published | not published | $105.82 – $256.13 | 8 |
| Truss addition to std pad wa HCPCS L8320 | not published | not published | $75.29 – $161.12 | 8 |
| Truss add to std pad scrotal HCPCS L8330 | not published | not published | $80.58 – $172.44 | 8 |
| Truss double with standard pad HCPCS L8310 | not published | not published | $163.05 – $348.93 | 8 |
| Truss single with standard pad HCPCS L8300 | not published | not published | $103.28 – $221.02 | 8 |
| Tte w or without contr, cont ecg HCPCS C8930 | not published | not published | $753.95 – $1,613.46 | 7 |
| Tte w or without fol w/con,stres HCPCS C8928 | $1,887.76 | $3,432.30 | $753.95 – $1,613.46 | 7 |
| Tte w or without fol w/cont, com HCPCS C8921 | not published | not published | $753.95 – $1,613.46 | 7 |
| Tte w or without fol w/cont, f/u HCPCS C8922 | not published | not published | $753.95 – $1,613.46 | 7 |
| Tubal Ligation (Laparoscopic) CPT 58670 | not published | not published | $569.50 – $12,442.83 | 11 |
| Tube drain vert dev st 5-40f HCPCS A5200 | not published | not published | $23.70 – $25.34 | 2 |
| Tube trach disp innr can 5 xlt HCPCS A7521 | $309.95 | $563.54 | $98.60 – $105.43 | 2 |
| Tube trach disp innr can 6 xlt HCPCS A4623 | not published | not published | $11.69 – $12.50 | 2 |
| Tube trach fen sz 6 uncuffed HCPCS A7520 | not published | not published | $99.50 – $106.40 | 2 |
| Tubing (oxygen) per foot HCPCS A4616 | not published | not published | $0.13 – $0.13 | 1 |
| Tubular dressing HCPCS A6457 | not published | not published | $2.39 – $2.55 | 2 |
| Tumor cell deplete of harvst CPT 38211 | not published | not published | $109.29 – $1,579.00 | 10 |
| Tvh >250 gms 58290 CPT 58290 | not published | not published | $1,764.34 – $15,262.36 | 9 |
| Tvh w/mmk 58267 CPT 58267 | not published | not published | $1,639.05 – $4,386.82 | 3 |
| Twelve volt battery utah/equ HCPCS L7364 | not published | not published | $645.85 – $1,382.12 | 8 |
| Tx atrial fib pulm vein isol CPT 93656 | $13,763.67 | $25,024.85 | $1,410.33 – $53,796.61 | 9 |
| Tx closed distal humerus fx CPT 24999 | not published | not published | $237.24 – $1,496.00 | 9 |
| Tx closed hip disl traumatic without anes CPT 27250 | $667.12 | $1,212.95 | $237.24 – $1,579.00 | 11 |
| Tx closed tib fx proximal w/w/o manip w/skel trac CPT 27532 | not published | not published | $889.78 – $6,734.39 | 11 |
| Tx closed tib shaft fx without manip CPT 27750 | not published | not published | $237.24 – $1,579.00 | 11 |
| Tx contour defects >10.0 cc CPT 11954 | not published | not published | $169.00 – $1,521.15 | 8 |
| Tx contour defects 1.1-5.0cc 11951 CPT 11951 | not published | not published | $110.05 – $1,521.15 | 8 |
| Tx ectopic pregnancy abdl pregnancy 59130 CPT 59130 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Tx ectopic pregnancy ntrstl prtl rescj uter 59136 CPT 59136 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Tx l/r atrial fib addl CPT 93657 | $5,583.35 | $10,151.55 | $456.37 – $1,496.00 | 2 |
| Tx open art fx mcp/iphlngl jnt incl int fixtn ea CPT 26746 | not published | not published | $1,132.24 – $6,734.39 | 11 |
| Tx open dstl phlngl fx f/t internal fixation ea CPT 26765 | not published | not published | $771.42 – $6,734.39 | 11 |
| Tx open iphlngl jt disl internal fixation sngl CPT 26785 | not published | not published | $837.99 – $6,734.39 | 11 |
| Tx open nsl fx uncomp CPT 21325 | not published | not published | $666.51 – $6,823.84 | 11 |
| Tx open nsl sptl fx CPT 21336 | not published | not published | $957.04 – $6,734.39 | 11 |
| Tx phalangeal shaft fx open prox/middle ea CPT 26735 | not published | not published | $910.60 – $6,734.39 | 11 |
| Tx septic abortion surgical 59830 CPT 59830 | not published | not published | $706.31 – $4,386.82 | 3 |
| Tx tarsal bone fx without manip 28450 CPT 28450 | not published | not published | $237.24 – $1,496.00 | 9 |
| Tympanic membrane repair CPT 69610 | not published | not published | $438.91 – $3,193.45 | 9 |
| Tympanolysis transcanal 69450 CPT 69450 | not published | not published | $824.78 – $6,823.84 | 11 |
| Tympanometry & reflex thresh CPT 92550 | not published | not published | $33.16 – $444.41 | 8 |
| Tympanostomy/ven tube/loc/top anes 69433 CPT 69433 | not published | not published | $200.88 – $1,579.00 | 10 |
| Tympp antrt/mastoidotomy prosthesis torp 69637 CPT 69637 | not published | not published | $1,933.00 – $12,184.12 | 11 |
| Tympp antrt/mastoid without ossic chain recnst 69635 CPT 69635 | not published | not published | $1,917.19 – $12,184.12 | 11 |
| Tyms gene com variants CPT 81346 | not published | not published | $174.81 – $374.09 | 7 |
| Typhoid vaccine oral CPT 90690 | not published | not published | $112.00 – $175.21 | 2 |
| U2af1 gene common variants CPT 81357 | not published | not published | $193.25 – $413.56 | 8 |
| Ua w/micro/comp poc CPT 81000 | not published | not published | $3.00 – $8.60 | 9 |
| Ublituximab-xiiy 25 mg/ml intravenous solution HCPCS J2329 | not published | not published | $72.24 – $140.87 | 9 |
| Ue triple control harness HCPCS L6677 | not published | not published | $367.25 – $785.92 | 8 |
| Ugt1a1 gene analy common variants CPT 81350 | not published | not published | $234.00 – $500.76 | 7 |
| Ultrasound abdomen aorta screening study aaa CPT 76706 | $1,002.51 | $1,822.75 | $100.55 – $215.17 | 8 |
| Ultrasound bone density measure CPT 76977 | not published | not published | $6.67 – $215.17 | 9 |
| Ultrasound breast complete CPT 76641 | $1,716.00 | $3,120.00 | $98.19 – $215.17 | 8 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $2,213.75 | $4,025.00 | $76.15 – $179.11 | 8 |
| Ultrasound chest CPT 76604 | $1,141.11 | $2,074.75 | $43.56 – $215.17 | 9 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | not published | not published | $30.63 – $215.17 | 9 |
| Ultrasound dx ophth b-scan CPT 76512 | not published | not published | $25.84 – $215.17 | 9 |
| Ultrasound elastography ea l target les CPT 76983 | not published | not published | $53.15 – $53.15 | 1 |
| Ultrasound elastography parenchyma CPT 76981 | not published | not published | $100.55 – $215.17 | 8 |
| Ultrasound encephalogram CPT 76506 | $1,141.11 | $2,074.75 | $100.55 – $215.17 | 9 |
| Ultrasound exam follow-up CPT 76970 | not published | not published | $82.00 – $82.00 | 1 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $1,141.11 | $2,074.75 | $100.55 – $215.17 | 8 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $412.50 | $750.00 | $71.32 – $215.17 | 9 |
| Ultrasound guidance for vascular access CPT 76937 | $568.70 | $1,034.00 | $35.41 – $60.82 | 2 |
| Ultrasound guided needle placement supervision & interpretation CPT 76942 | $2,252.11 | $4,094.75 | $40.68 – $94.54 | 3 |
| Ultrasound guide intraoperative CPT 76998 | not published | not published | $70.79 – $245.87 | 2 |
| Ultrasound guide tissue ablation CPT 76940 | not published | not published | $86.36 – $203.33 | 3 |
| Ultrasound hips infant dynamic CPT 76885 | not published | not published | $83.70 – $179.11 | 9 |
| Ultrasound infant hips ltd without stress CPT 76886 | not published | not published | $83.70 – $179.11 | 9 |
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.