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 |
|---|---|---|---|---|
| X-ray sinus tract/fistula/abscess CPT 76080 | not published | not published | $50.75 – $1,124.62 | 9 |
| X-ray skull < 4 views CPT 70250 | $1,084.74 | $1,972.25 | $39.73 – $215.17 | 9 |
| X-ray skull > 4 views complete CPT 70260 | $1,098.83 | $1,997.88 | $45.00 – $215.17 | 9 |
| X-ray slg plne bdy sect without urogr CPT 76100 | not published | not published | $89.09 – $215.17 | 9 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $969.95 | $1,763.54 | $120.72 – $361.01 | 9 |
| X-ray small intestine follow-through study CPT 74248 | $284.24 | $516.80 | $71.37 – $71.37 | 1 |
| X-ray spine single view CPT 72020 | $588.84 | $1,070.61 | $23.91 – $179.11 | 9 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | not published | not published | $44.53 – $179.11 | 9 |
| X-ray sternum > 2 views CPT 71120 | $580.28 | $1,055.06 | $34.94 – $179.11 | 9 |
| X-ray surgical specimen CPT 76098 | $661.47 | $1,202.67 | $39.73 – $1,124.62 | 9 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $605.65 | $1,101.18 | $123.00 – $361.01 | 9 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $596.89 | $1,085.25 | $59.85 – $179.11 | 9 |
| X-ray thoracic spine 2 views CPT 72070 | $265.65 | $483.00 | $33.51 – $215.17 | 9 |
| X-ray thoracic spine 3 views CPT 72072 | $1,109.51 | $2,017.29 | $41.65 – $215.17 | 9 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $424.60 | $772.00 | $35.41 – $179.11 | 9 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $596.89 | $1,085.25 | $43.56 – $179.11 | 8 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $1,081.92 | $1,967.13 | $79.51 – $215.17 | 8 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $581.49 | $1,057.26 | $34.46 – $179.11 | 9 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $585.25 | $1,064.09 | $33.03 – $179.11 | 9 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $1,885.54 | $3,428.26 | $123.00 – $361.01 | 9 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $1,851.88 | $3,367.06 | $122.15 – $361.01 | 9 |
| X-ray upper gi delay w/kub CPT 74241 | not published | not published | $123.00 – $123.00 | 1 |
| X-ray upper gi&small intest CPT 74245 | not published | not published | $190.00 – $190.00 | 1 |
| X-ray wrist 2 views (both sides) CPT 73100 | $580.25 | $1,055.00 | $37.33 – $179.11 | 9 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | not published | not published | $96.76 – $361.01 | 9 |
| Xtrnl ecg rec>48hr<7d CPT 93241 | not published | not published | $374.15 – $395.30 | 2 |
| Xtrnl ecg rec up to 48 hrs CPT 93224 | not published | not published | $104.84 – $105.66 | 2 |
| Xwrap 1 sq cm HCPCS Q4204 | not published | not published | $119.69 – $4,393.53 | 8 |
| Xylose absorption test blood &/or urine CPT 84620 | not published | not published | $8.00 – $27.63 | 9 |
| Xyntha inj HCPCS J7185 | not published | not published | $1.37 – $2.67 | 9 |
| Yersinia antibody CPT 86793 | not published | not published | $9.00 – $28.23 | 9 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | not published | not published | $56,824.55 – $121,604.53 | 8 |
| Zenith amniotic membrane psc HCPCS Q4253 | not published | not published | $107.25 – $773.21 | 8 |
| Ziconotide injection HCPCS J2278 | not published | not published | $10.79 – $21.05 | 9 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | not published | not published | $1.51 – $2.95 | 9 |
| Zidovudine, oral, 100 mg HCPCS S0104 | not published | not published | $1.59 – $2.48 | 2 |
| Zika virus dna/rna amp probe CPT 87662 | $42.61 | $77.48 | $51.31 – $109.80 | 7 |
| Zika virus igm antibody CPT 86794 | not published | not published | $16.85 – $36.06 | 7 |
| Zinc paste band w >=3"<5"/yd HCPCS A6456 | not published | not published | $2.63 – $2.81 | 2 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | not published | not published | $5.91 – $16.03 | 4 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | not published | not published | $8.67 – $16.91 | 9 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | not published | not published | $10.85 – $15.24 | 4 |
| Zoster vaccine-live inj CPT 90736 | not published | not published | $359.79 – $359.79 | 1 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $193.25 – $413.56 | 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.