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 |
|---|---|---|---|---|
| Cta abdomen without & /or w/contrast CPT 74175 | $3,915.45 | $7,119.00 | $168.70 – $361.01 | 8 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $4,221.80 | $7,676.00 | $168.70 – $446.40 | 8 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $3,469.54 | $6,308.25 | $168.70 – $361.01 | 8 |
| Cta neck without &/or w/contrast CPT 70498 | $2,949.11 | $5,362.01 | $168.70 – $361.01 | 8 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $5,462.60 | $9,932.00 | $335.54 – $718.05 | 8 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $3,469.54 | $6,308.25 | $168.70 – $361.01 | 8 |
| CT Angiogram of the Head CPT 70496 | $2,949.11 | $5,362.01 | $168.70 – $361.01 | 8 |
| CT angio hrt w/3d image CPT 75574 | not published | not published | $314.19 – $718.05 | 8 |
| CT angio pelvis CPT 72191 | $1,323.30 | $2,406.00 | $168.70 – $361.01 | 8 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $2,814.35 | $5,117.00 | $168.70 – $361.01 | 8 |
| CT bone density axial CPT 77078 | not published | not published | $83.70 – $179.11 | 8 |
| CT cerebral perf w cont & prcssng CPT 70473 | not published | not published | $168.70 – $361.01 | 6 |
| CT colonography dx CPT 74261 | not published | not published | $100.55 – $450.32 | 8 |
| CT colonography dx w/dye CPT 74262 | not published | not published | $168.70 – $519.80 | 8 |
| CT colonography screening CPT 74263 | not published | not published | $229.48 – $814.99 | 8 |
| CT guidance for needle placement CPT 77012 | $4,002.49 | $7,277.25 | $101.56 – $202.16 | 2 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $1,330.74 | $2,419.52 | $81.90 – $176.99 | 2 |
| CT guid cryo ablat intramuscular CPT 20999 | not published | not published | $237.24 – $1,496.00 | 9 |
| CT guid parench tis ablat CPT 77013 | not published | not published | $455.63 – $530.07 | 2 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | not published | not published | $83.70 – $179.11 | 7 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | not published | not published | $277.29 – $718.05 | 8 |
| CT hrt w/3d image CPT 75572 | not published | not published | $218.86 – $718.05 | 8 |
| CT limited or localized follow-up study CPT 76380 | not published | not published | $83.70 – $179.11 | 8 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $4,143.15 | $7,533.00 | $167.63 – $361.01 | 8 |
| CT lower extremity without contrast (both sides) CPT 73700 | $4,117.85 | $7,487.00 | $100.55 – $215.17 | 8 |
| CT lwr extremity w/o&w/dye CPT 73702 | $4,459.95 | $8,109.00 | $168.70 – $361.01 | 8 |
| CT neck soft tissue w/contrast CPT 70491 | $2,949.11 | $5,362.01 | $168.70 – $361.01 | 8 |
| CT neck soft tissue without contrast CPT 70490 | $2,949.11 | $5,362.01 | $100.55 – $215.17 | 8 |
| CT neck soft tissue without & w/contrast CPT 70492 | $2,949.11 | $5,362.01 | $168.70 – $361.01 | 8 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $2,949.11 | $5,362.01 | $168.70 – $361.01 | 8 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $2,949.11 | $5,362.01 | $168.70 – $361.01 | 8 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $2,424.81 | $4,408.74 | $100.55 – $215.17 | 8 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | not published | not published | $202.45 – $1,579.00 | 11 |
| CT scan for therapy guide CPT 77014 | not published | not published | $108.26 – $189.16 | 2 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $9,006.80 | $16,376.00 | $335.54 – $718.05 | 8 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $7,625.20 | $13,864.00 | $325.30 – $718.05 | 8 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $6,299.70 | $11,454.00 | $152.79 – $491.09 | 8 |
| CT thoracic spine w/contrast CPT 72129 | $3,816.45 | $6,939.00 | $168.11 – $361.01 | 8 |
| CT thoracic spine without contrast CPT 72128 | $3,768.05 | $6,851.00 | $100.55 – $215.17 | 8 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $1,421.20 | $2,584.00 | $100.55 – $215.17 | 8 |
| CT t-spine w /wo contrast CPT 72130 | $4,461.05 | $8,111.00 | $168.70 – $361.01 | 8 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $4,263.05 | $7,751.00 | $217.96 – $718.05 | 8 |
| CT upper extremity without contrast (both sides) CPT 73200 | $4,054.05 | $7,371.00 | $100.55 – $215.17 | 8 |
| CT uppr extremity w/o&w/dye CPT 73202 | $4,855.40 | $8,828.00 | $168.70 – $361.01 | 8 |
| Cultr oocyte/embryo <4 days CPT 89250 | not published | not published | $163.86 – $1,583.27 | 9 |
| Cultr oocyte/embryo <4 days CPT 89251 | not published | not published | $163.86 – $1,647.02 | 8 |
| Cult skin graft fnhfg 15155 CPT 15155 | not published | not published | $1,099.18 – $7,293.65 | 11 |
| Cult skin grft t/arm/leg CPT 15150 | not published | not published | $967.40 – $4,246.62 | 11 |
| Culture aerobic additional method definitive id each CPT 87077 | $319.13 | $580.23 | $6.00 – $17.29 | 9 |
| Culture afb any source CPT 87116 | $183.15 | $333.00 | $8.00 – $23.11 | 9 |
| Culture anaerobic additional method definitive id each CPT 87076 | $147.95 | $269.00 | $6.00 – $17.29 | 9 |
| Culture anaerobic except blood CPT 87075 | $362.54 | $659.16 | $7.00 – $20.27 | 9 |
| Culture bact stool aero addl path ea CPT 87046 | $90.20 | $164.00 | $7.00 – $20.20 | 9 |
| Culture body fluid CPT 87070 | $463.43 | $842.60 | $6.00 – $18.45 | 9 |
| Culture fungi definitive id mold CPT 87107 | $117.70 | $214.00 | $7.00 – $22.08 | 9 |
| Culture fungi definitive id yeast CPT 87106 | $132.00 | $240.00 | $7.00 – $22.08 | 9 |
| Culture fungi other (except blood) CPT 87102 | $142.45 | $259.00 | $6.00 – $18.00 | 9 |
| Culture fungi skin/hair/nail CPT 87101 | $65.31 | $118.75 | $5.00 – $16.50 | 9 |
| Culture mycobacteria definitive id each isolate CPT 87118 | not published | not published | $8.00 – $31.27 | 9 |
| Culture mycoplasma any source CPT 87109 | not published | not published | $11.00 – $32.93 | 9 |
| Culture quantitative aerobic other source CPT 87071 | not published | not published | $9.89 – $21.16 | 9 |
| Culture screening strep group a CPT 87081 | $182.57 | $331.95 | $5.00 – $14.19 | 9 |
| Culture typing added method CPT 87158 | not published | not published | $4.00 – $16.56 | 9 |
| Culture typing immunologic CPT 87147 | $87.72 | $159.50 | $4.00 – $11.09 | 9 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | $599.50 | $1,090.00 | $218.06 – $466.65 | 8 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $184.25 | $335.00 | $35.09 – $75.09 | 8 |
| Culture urine each isolate CPT 87088 | $159.50 | $290.00 | $6.00 – $17.31 | 9 |
| Culture virus isolation CPT 87250 | not published | not published | $19.56 – $41.86 | 9 |
| Curette/treat cornea CPT 65435 | not published | not published | $104.30 – $2,051.76 | 10 |
| Curette/treat cornea CPT 65436 | not published | not published | $553.79 – $4,893.31 | 9 |
| Cutter lead HCPCS C1773 | $2,903.86 | $5,279.74 | not published | 0 |
| Cv line/pic reposition CPT 36597 | $1,727.41 | $3,140.75 | $90.80 – $3,239.91 | 10 |
| Cv stress test i&r only 93018 CPT 93018 | not published | not published | $21.37 – $21.76 | 2 |
| Cv stress test/supervision only 93016 CPT 93016 | not published | not published | $32.16 – $32.31 | 2 |
| Cyanocobalamin unsat binding capacity CPT 82608 | $60.64 | $110.25 | $10.00 – $30.64 | 9 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | not published | not published | $0.76 – $2.37 | 4 |
| Cyclic citrullinated peptide antibody CPT 86200 | $109.72 | $199.50 | $12.95 – $27.71 | 8 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | not published | not published | $0.58 – $1.23 | 8 |
| Cyclophosphamide 25 mg capsule HCPCS J8530 | not published | not published | $1.02 – $1.82 | 4 |
| Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 | not published | not published | $64.24 – $114.24 | 4 |
| Cyclosporine 2 hour CPT 80158 | $275.00 | $500.00 | $13.00 – $38.63 | 9 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | not published | not published | $0.84 – $1.38 | 4 |
| Cyclosporine oral 100 mg HCPCS J7502 | not published | not published | $2.30 – $3.71 | 4 |
| Cyp2c19 gene com variants CPT 81225 | not published | not published | $291.36 – $623.51 | 8 |
| Cyp2c9 gene com variants CPT 81227 | not published | not published | $174.81 – $374.09 | 7 |
| Cyp2d6 gene com variants CPT 81226 | not published | not published | $450.91 – $964.95 | 8 |
| Cyp3a4 gene common variants CPT 81230 | not published | not published | $174.81 – $374.09 | 7 |
| Cyp3a5 gene common variants CPT 81231 | not published | not published | $174.81 – $374.09 | 7 |
| Cystatin c CPT 82610 | $159.64 | $290.25 | $18.52 – $39.63 | 8 |
| Cystic fibrosis cftr CPT 81223 | not published | not published | $499.00 – $1,067.86 | 8 |
| Cystine urine quantitative CPT 82131 | $25.30 | $46.00 | $12.00 – $49.18 | 9 |
| Cysto cgen post urtl valves CPT 52400 | not published | not published | $728.32 – $7,255.07 | 11 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $2,064.36 | $3,753.39 | $37.81 – $718.05 | 9 |
| Cysto impl 4 or more HCPCS C9740 | not published | not published | $4,386.82 – $19,483.75 | 9 |
| Cysto insj dev ischmc rmdlg CPT 53865 | not published | not published | $2,074.00 – $19,483.75 | 7 |
| Cysto, litho, vacuum kidney HCPCS C9761 | not published | not published | $2,074.00 – $19,483.75 | 10 |
| Cystometrogram w/up 51727 CPT 51727 | not published | not published | $376.08 – $1,496.00 | 9 |
| Cystorrhaphy wound comp 51865 CPT 51865 | not published | not published | $1,365.38 – $4,386.82 | 3 |
| Cystorrhaphy wound simple 51860 CPT 51860 | not published | not published | $1,136.35 – $19,483.75 | 9 |
| Cysto rx balo cath urtl strx CPT 52284 | not published | not published | $249.46 – $11,035.58 | 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.