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 |
|---|---|---|---|---|
| Xcellistem, 1 mg HCPCS A2004 | not published | not published | $21.99 – $21.99 | 1 |
| Xcpsl ctrc rmvl cplx insj 1+ CPT 66989 | not published | not published | $1,282.86 – $10,952.24 | 10 |
| Xe133 xenon 10mci HCPCS A9558 | not published | not published | $267.86 – $433.26 | 2 |
| Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/< CPT 14040 | not published | not published | $943.25 – $4,246.62 | 11 |
| Xfer tis s/a/l 10 sq cm/< CPT 14020 | not published | not published | $855.43 – $4,246.62 | 11 |
| X-linked intellectual dblt CPT 81470 | not published | not published | $914.00 – $1,955.96 | 8 |
| X-linked intellectual dblt CPT 81471 | not published | not published | $914.00 – $1,955.96 | 7 |
| Xm archive tissue molec anal CPT 88363 | not published | not published | $27.82 – $59.53 | 8 |
| Xpos opn axillary/sbclvn art w/cndt crtn CPT 34716 | not published | not published | $555.82 – $1,496.00 | 2 |
| Xpos opn fmrl eprst aor uni add-on CPT 34812 | not published | not published | $307.89 – $4,386.82 | 3 |
| X-ray abdomen 1 view CPT 74018 | $484.33 | $880.60 | $31.11 – $179.11 | 8 |
| X-ray abdomen 2 views CPT 74019 | $490.88 | $892.50 | $37.33 – $215.17 | 8 |
| X-ray abdomen >=3 views CPT 74021 | $537.62 | $977.50 | $43.56 – $215.17 | 8 |
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $614.76 | $1,117.75 | $50.28 – $215.17 | 9 |
| X-ray acromioclavicular joints without or w/weighted distraction bilateral CPT 73050 | $596.89 | $1,085.25 | $28.71 – $179.11 | 9 |
| X-ray ankle 2 views (both sides) CPT 73600 | $578.60 | $1,052.00 | $35.41 – $179.11 | 9 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | $3,727.61 | $6,777.48 | $151.39 – $718.05 | 9 |
| X-ray assay calculus CPT 82370 | not published | not published | $12.52 – $26.79 | 9 |
| X-ray bone age studies CPT 77072 | $275.55 | $501.00 | $24.39 – $215.17 | 8 |
| X-ray bone length studies CPT 77073 | not published | not published | $46.43 – $215.17 | 8 |
| X-ray bone survey complete CPT 77075 | $1,132.66 | $2,059.38 | $100.55 – $215.17 | 8 |
| X-ray bone survey infant CPT 77076 | not published | not published | $100.55 – $215.17 | 8 |
| X-ray cervical spine 2-3 views CPT 72040 | $582.07 | $1,058.31 | $41.65 – $179.11 | 9 |
| X-ray cervical spine 4-5 views CPT 72050 | $1,068.63 | $1,942.96 | $58.90 – $215.17 | 9 |
| X-ray cervical spine >= 6 views CPT 72052 | $1,141.11 | $2,074.75 | $69.44 – $215.17 | 9 |
| X-ray clavicle complete (both sides) CPT 73000 | $578.57 | $1,051.94 | $35.41 – $179.11 | 9 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $2,064.36 | $3,753.39 | $123.00 – $361.01 | 9 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $2,064.36 | $3,753.39 | $168.70 – $361.01 | 9 |
| X-ray consultation CPT 76140 | not published | not published | $60.00 – $60.00 | 1 |
| X-ray elbow 2 views (both sides) CPT 73070 | $275.00 | $500.00 | $30.63 – $179.11 | 9 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $302.50 | $550.00 | $35.41 – $179.11 | 9 |
| Xray endovasc thor ao repr CPT 75956 | not published | not published | $503.95 – $503.95 | 1 |
| Xray endovasc thor ao repr CPT 75957 | not published | not published | $432.75 – $432.75 | 1 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $2,064.36 | $3,753.39 | $99.63 – $361.01 | 9 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $1,127.50 | $2,050.00 | $90.04 – $215.17 | 8 |
| X-ray exam entire spi 6/> vw CPT 72084 | $1,141.25 | $2,075.00 | $100.55 – $215.17 | 8 |
| X-ray exam of arm infant CPT 73092 | $1,141.11 | $2,074.75 | $34.46 – $215.17 | 9 |
| X-ray exam of eye sockets CPT 70200 | $1,098.83 | $1,997.88 | $49.80 – $215.17 | 9 |
| X-ray exam of femur 1 CPT 73551 | $286.55 | $521.00 | $30.63 – $179.11 | 8 |
| X-ray exam of jaw joint CPT 70328 | not published | not published | $37.33 – $179.11 | 9 |
| X-ray exam of jaw joint CPT 70332 | not published | not published | $82.39 – $491.09 | 9 |
| X-ray exam of mastoids CPT 70120 | not published | not published | $42.61 – $215.17 | 9 |
| X-ray exam of middle ear CPT 70134 | not published | not published | $64.65 – $1,124.62 | 9 |
| X-ray exam of penis CPT 74445 | not published | not published | $56.78 – $222.00 | 9 |
| X-ray exam of perineum CPT 74775 | not published | not published | $73.95 – $491.09 | 9 |
| X-ray exam of salivary gland CPT 70380 | not published | not published | $42.61 – $179.11 | 9 |
| X-ray exam of sinuses CPT 70210 | $567.37 | $1,031.58 | $34.46 – $179.11 | 9 |
| X-ray exam of tear duct CPT 70170 | not published | not published | $50.11 – $491.09 | 9 |
| X-ray exam of teeth CPT 70300 | not published | not published | $11.46 – $179.11 | 9 |
| X-ray exam of teeth CPT 70310 | not published | not published | $46.93 – $491.09 | 9 |
| X-ray exam si joints CPT 72200 | $173.25 | $315.00 | $36.38 – $215.17 | 9 |
| X-ray exam thorac spine4/>vw CPT 72074 | $1,141.11 | $2,074.75 | $47.40 – $215.17 | 9 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $193.08 | $351.05 | $34.94 – $179.11 | 9 |
| X-ray facial bones complete > 3 views CPT 70150 | $1,084.74 | $1,972.25 | $50.28 – $215.17 | 9 |
| X-ray fallopian tube CPT 74742 | not published | not published | $76.34 – $266.00 | 2 |
| X-ray femur >=2 views (both sides) CPT 73552 | $583.09 | $1,060.16 | $38.78 – $179.11 | 8 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $1,230.35 | $2,237.00 | $45.48 – $179.11 | 9 |
| X-ray foot 2 views (both sides) CPT 73620 | $579.70 | $1,054.00 | $30.63 – $179.11 | 9 |
| X-ray forearm 2 views (both sides) CPT 73090 | $582.64 | $1,059.35 | $31.11 – $179.11 | 9 |
| X-ray hand 2 views (both sides) CPT 73120 | $467.50 | $850.00 | $33.98 – $215.17 | 9 |
| X-ray head for orthodontia CPT 70350 | not published | not published | $11.94 – $179.11 | 9 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $577.21 | $1,049.47 | $30.14 – $179.11 | 9 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $687.50 | $1,250.00 | $67.52 – $215.17 | 8 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $1,095.05 | $1,991.00 | $44.05 – $215.17 | 8 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $1,077.45 | $1,959.00 | $57.45 – $215.17 | 8 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $1,097.25 | $1,995.00 | $67.52 – $215.17 | 8 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $580.25 | $1,055.00 | $34.46 – $179.11 | 8 |
| X-ray humerus >= 2 views left CPT 73060 | $578.92 | $1,052.59 | $34.94 – $179.11 | 9 |
| X-ray joint survey 1 view CPT 77077 | $169.95 | $309.00 | $44.05 – $215.17 | 8 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $584.10 | $1,062.00 | $37.81 – $179.11 | 9 |
| X-ray knee 3 views (both sides) CPT 73562 | $586.30 | $1,066.00 | $45.96 – $179.11 | 9 |
| X-ray knee ap standing bilateral CPT 73565 | $213.12 | $387.50 | $45.96 – $179.11 | 9 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $552.61 | $1,004.75 | $34.46 – $179.11 | 9 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $378.95 | $689.00 | $43.08 – $215.17 | 9 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $1,056.55 | $1,921.00 | $56.98 – $215.17 | 9 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $1,058.75 | $1,925.00 | $67.52 – $215.17 | 9 |
| X-ray male genital tract CPT 74440 | not published | not published | $114.96 – $491.09 | 9 |
| X-ray mandible complete > 4 views CPT 70110 | $1,098.83 | $1,997.88 | $45.96 – $215.17 | 9 |
| X-ray mandible ltd <4 views CPT 70100 | $275.00 | $500.00 | $43.56 – $179.11 | 9 |
| X-ray measurement of pelvis CPT 74710 | not published | not published | $60.00 – $60.00 | 1 |
| X-ray nasal bones complete > 3 views CPT 70160 | $740.53 | $1,346.42 | $42.61 – $179.11 | 9 |
| X-ray neck soft tissue CPT 70360 | $490.95 | $892.64 | $32.54 – $179.11 | 9 |
| X-ray nose to rectum for foreign body child CPT 76010 | $484.78 | $881.41 | $30.14 – $179.11 | 9 |
| X-ray of mammary ducts CPT 77054 | not published | not published | $69.44 – $491.09 | 8 |
| X-ray optic foramina CPT 70190 | not published | not published | $38.78 – $179.11 | 9 |
| X-ray pelvis 1-2 views CPT 72170 | $412.50 | $750.00 | $28.23 – $215.17 | 9 |
| X-ray pelvis complete > 3 views CPT 72190 | $577.50 | $1,050.00 | $43.56 – $215.17 | 9 |
| Xray place dist ext thor ao CPT 75959 | not published | not published | $251.96 – $251.96 | 1 |
| Xray place prox ext thor ao CPT 75958 | not published | not published | $284.35 – $284.35 | 1 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $3,727.61 | $6,777.48 | $77.59 – $718.05 | 9 |
| X-ray ribs 2 views left CPT 71100 | $570.32 | $1,036.95 | $37.81 – $179.11 | 9 |
| X-ray ribs 3 views bilateral CPT 71110 | $1,098.83 | $1,997.88 | $43.56 – $215.17 | 9 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $1,119.66 | $2,035.75 | $42.61 – $215.17 | 9 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $1,121.60 | $2,039.27 | $53.63 – $215.17 | 9 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $1,098.83 | $1,997.88 | $41.18 – $215.17 | 9 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $588.59 | $1,070.16 | $34.94 – $179.11 | 9 |
| X-ray scapula complete (both sides) CPT 73010 | $1,123.66 | $2,043.02 | $21.99 – $215.17 | 9 |
| X-ray sella turcica CPT 70240 | not published | not published | $34.46 – $179.11 | 9 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $575.46 | $1,046.30 | $20.56 – $179.11 | 9 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $596.89 | $1,085.25 | $39.26 – $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.