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 |
|---|---|---|---|---|
| Unlisted px small intestine CPT 44799 | not published | not published | $872.31 – $1,872.00 | 9 |
| Unlisted px temporal bone CPT 69979 | not published | not published | $227.80 – $1,496.00 | 9 |
| Unlisted px ther rad tx plng CPT 77299 | not published | not published | $129.27 – $276.64 | 8 |
| Unlisted px tongue flr mouth CPT 41599 | not published | not published | $227.80 – $1,496.00 | 9 |
| Unlisted px vestibule mouth CPT 40899 | not published | not published | $227.80 – $1,496.00 | 9 |
| Unlisted reprod med lab proc CPT 89398 | not published | not published | $50.12 – $107.25 | 7 |
| Unlisted resp px dx nuc med CPT 78599 | not published | not published | $261.00 – $822.80 | 8 |
| Unlisted spec derm svc/px CPT 96999 | not published | not published | $192.96 – $412.94 | 7 |
| Unlisted surgical path px CPT 88399 | not published | not published | $50.12 – $109.00 | 8 |
| Unlisted transfusion med px CPT 86999 | not published | not published | $27.82 – $167.00 | 8 |
| Unlisted ultrasound procedure CPT 76999 | $596.89 | $1,085.25 | $82.00 – $179.11 | 8 |
| Unlisted urinalysis px CPT 81099 | not published | not published | $29.00 – $29.00 | 1 |
| Unlisted vasc endoscopy px CPT 37501 | not published | not published | $603.32 – $1,496.00 | 9 |
| Unlstd hematop ret/endo lymp CPT 78199 | not published | not published | $326.00 – $822.80 | 8 |
| Unlstd laps px mat care&dlvr CPT 59898 | not published | not published | $4,386.82 – $12,442.83 | 9 |
| Unlstd laps px sprmatic cord CPT 55559 | not published | not published | $4,386.82 – $12,442.83 | 9 |
| Unsched dialysis esrd pt hos HCPCS G0257 | $1,906.93 | $3,467.15 | $660.08 – $1,412.56 | 7 |
| Upgrade pm system CPT 33214 | $5,986.80 | $10,885.10 | $714.47 – $21,512.16 | 9 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $3,833.97 | $6,970.85 | $319.50 – $718.05 | 8 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $2,060.27 | $3,745.95 | $283.56 – $718.05 | 8 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $2,060.27 | $3,745.95 | $181.53 – $491.09 | 8 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | not published | not published | $185.11 – $1,872.00 | 11 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | not published | not published | $209.22 – $2,100.00 | 11 |
| Upper ext fx orthosis rad/ul HCPCS L3982 | not published | not published | $467.12 – $999.64 | 8 |
| Upper ext harvest for cabg1 seg 35600 CPT 35600 | not published | not published | $278.12 – $4,386.82 | 3 |
| Uppr gi scope w/submuc inj CPT 43236 | not published | not published | $209.22 – $2,100.00 | 11 |
| Urachal cyst/sinus excision 51500 CPT 51500 | not published | not published | $973.95 – $12,442.83 | 11 |
| Urea nitrogen CPT 84520 | $66.96 | $121.75 | $3.00 – $8.45 | 9 |
| Urea nitrogen 24 hour urine CPT 84540 | $80.44 | $146.25 | $3.00 – $11.90 | 9 |
| Urea nitrogen clearance CPT 84545 | not published | not published | $5.00 – $15.41 | 9 |
| Urea nitrogen semi-quant CPT 84525 | not published | not published | $4.00 – $10.98 | 9 |
| Ureteral embolization/occl CPT 50705 | not published | not published | $269.32 – $1,496.00 | 2 |
| Ureteral reflux study CPT 78740 | not published | not published | $264.84 – $822.80 | 9 |
| Ureter endoscopy CPT 50970 | not published | not published | $560.96 – $7,255.07 | 11 |
| Ureter endoscopy & biopsy CPT 50955 | not published | not published | $533.48 – $11,035.58 | 11 |
| Ureter endoscopy & biopsy CPT 50974 | not published | not published | $716.00 – $11,035.58 | 11 |
| Ureter endoscopy & catheter CPT 50972 | not published | not published | $541.45 – $7,255.07 | 11 |
| Ureter endoscopy & treatment CPT 50957 | not published | not published | $536.11 – $11,035.58 | 11 |
| Ureter endoscopy & treatment CPT 50961 | not published | not published | $480.35 – $11,035.58 | 11 |
| Ureter endoscopy & treatment CPT 50976 | not published | not published | $706.18 – $11,035.58 | 11 |
| Ureter endoscopy & treatment CPT 50980 | not published | not published | $538.82 – $11,035.58 | 11 |
| Ureteroneocystostomy 50780 CPT 50780 | not published | not published | $1,694.60 – $4,386.82 | 3 |
| Ureteroureterostomy 50760 CPT 50760 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $2,003.12 | $3,642.04 | $73.47 – $491.09 | 9 |
| Urethrlys transvag with scope CPT 53500 | not published | not published | $1,142.65 – $7,255.07 | 9 |
| Urethrocystography void s&i CPT 74455 | $624.11 | $1,134.75 | $127.43 – $491.09 | 9 |
| Uric acid blood CPT 84550 | $184.66 | $335.75 | $3.00 – $9.67 | 9 |
| Uric acid urine CPT 84560 | $80.44 | $146.25 | $3.00 – $10.87 | 9 |
| Urinalysis glass test CPT 81020 | not published | not published | $4.00 – $10.06 | 9 |
| Urinalysis microscopic only CPT 81015 | not published | not published | $3.00 – $6.53 | 9 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | not published | not published | $2.17 – $4.64 | 9 |
| Urinalysis (with microscopy) CPT 81001 | $218.34 | $396.99 | $3.00 – $6.78 | 9 |
| Urinalysis (without microscopy) CPT 81003 | $199.77 | $363.21 | $2.25 – $4.82 | 9 |
| Urinary bldr retent nuc study CPT 78730 | not published | not published | $49.00 – $103.32 | 3 |
| Urinary pouch on barr w/flng HCPCS A5073 | not published | not published | $6.63 – $7.10 | 2 |
| Urinary pouch w/barrier HCPCS A5071 | not published | not published | $12.60 – $13.47 | 2 |
| Urinary reflex study CPT 51792 | not published | not published | $56.74 – $1,496.00 | 9 |
| Urinary suspensory HCPCS A5105 | not published | not published | $80.15 – $85.71 | 2 |
| Urine Culture Test CPT 87086 | $332.20 | $604.00 | $6.00 – $17.27 | 9 |
| Urine flow measurement 51736 CPT 51736 | not published | not published | $8.10 – $1,496.00 | 9 |
| Urine ost pouch w faucet/tap HCPCS A4428 | not published | not published | $13.67 – $14.62 | 2 |
| Urine pregnancy test CPT 81025 | $415.94 | $756.25 | $5.00 – $18.43 | 9 |
| Urine screen for bacteria CPT 81007 | not published | not published | $3.00 – $64.16 | 9 |
| Urine shunt to intestine CPT 50815 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Urine specimen collect mult HCPCS P9615 | not published | not published | $11.36 – $12.47 | 2 |
| Urofollitropin, 75 iu HCPCS J3355 | not published | not published | $71.81 – $205.56 | 2 |
| Urography, antegrade CPT 74425 | not published | not published | $161.44 – $718.05 | 9 |
| Urography inf drip &/or bolus CPT 74410 | not published | not published | $168.70 – $361.01 | 9 |
| Urokinase 250,000 iu inj HCPCS J3365 | not published | not published | $851.11 – $851.11 | 1 |
| Urokinase 5000 iu injection HCPCS J3364 | not published | not published | $17.02 – $17.02 | 1 |
| Use 1st target lesion CPT 76982 | not published | not published | $93.89 – $215.17 | 8 |
| User adjustable heel height HCPCS L5990 | not published | not published | $2,245.81 – $4,806.03 | 8 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | not published | not published | $11.36 – $22.14 | 9 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | not published | not published | $252.88 – $252.88 | 1 |
| U/s trtmt, not leiomyomata HCPCS C9734 | not published | not published | $3,066.00 – $26,424.41 | 8 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | not published | not published | $184.28 – $258.64 | 4 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | not published | not published | $167.65 – $239.67 | 4 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | not published | not published | $177.73 – $249.43 | 4 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | not published | not published | $100.07 – $144.18 | 4 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | not published | not published | $74.73 – $107.67 | 4 |
| Vaccine dtap < 7 years im CPT 90700 | not published | not published | $31.07 – $46.02 | 2 |
| Vaccine dtap-hep b-ipv im CPT 90723 | not published | not published | $102.87 – $152.16 | 2 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | not published | not published | $65.96 – $100.47 | 2 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | not published | not published | $163.40 – $248.00 | 2 |
| Vaccine dtap-ipv/hib im CPT 90698 | not published | not published | $126.06 – $188.30 | 2 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | not published | not published | $32.11 – $48.80 | 2 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | not published | not published | $13.83 – $20.45 | 2 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | not published | not published | $82.26 – $115.45 | 4 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | not published | not published | $132.51 – $199.40 | 2 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | not published | not published | $39.91 – $60.64 | 2 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | not published | not published | $39.88 – $39.88 | 1 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $85.67 – $123.43 | 4 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | not published | not published | $80.23 – $115.60 | 4 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | not published | not published | $202.42 – $284.09 | 4 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | not published | not published | $36.10 – $50.67 | 4 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | not published | not published | $322.99 – $486.46 | 2 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | not published | not published | $270.98 – $270.98 | 1 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | not published | not published | $95.18 – $133.59 | 4 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | not published | not published | $95.18 – $133.58 | 4 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | not published | not published | $24.92 – $34.97 | 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.