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 |
|---|---|---|---|---|
| Actigraphy testing CPT 95803 | not published | not published | $56.74 – $135.57 | 8 |
| Actinotherapy uv light CPT 96900 | not published | not published | $35.91 – $76.88 | 8 |
| Acup 1/> w/estim 1st 15 min CPT 97813 | not published | not published | $27.82 – $59.53 | 7 |
| Acup 1/> wo estim 1st 15 min CPT 97810 | not published | not published | $27.82 – $59.53 | 7 |
| Acute hepatitis panel CPT 80074 | $1,028.91 | $1,870.75 | $38.00 – $101.93 | 9 |
| Acute venous thrombus image CPT 78456 | not published | not published | $199.00 – $2,664.63 | 9 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | not published | not published | $0.05 – $0.10 | 4 |
| #acylcarnitineprfl CPT 82017 | not published | not published | $12.00 – $36.10 | 9 |
| Acylcarnitines qual CPT 82016 | not published | not published | $16.00 – $35.29 | 9 |
| Adapt behavior tx phys/qhp CPT 97155 | not published | not published | $170.71 – $365.32 | 7 |
| Adding walker to prev cast CPT 29440 | not published | not published | $43.38 – $1,496.00 | 9 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | not published | not published | $0.44 – $0.99 | 4 |
| Adenovirus ag ia CPT 87301 | not published | not published | $9.00 – $25.64 | 9 |
| Adenovirus antibody,serum - quest CPT 86603 | $86.90 | $158.00 | $9.00 – $27.54 | 9 |
| Adenovirus assay w/optic CPT 87809 | not published | not published | $21.76 – $46.57 | 8 |
| Adhesiolysis tube ovary 58740 CPT 58740 | not published | not published | $1,379.24 – $4,386.82 | 3 |
| Adh-sendout CPT 84588 | $267.85 | $487.00 | $24.00 – $72.63 | 9 |
| Adj gastric band via subq port CPT 43999 | not published | not published | $872.31 – $1,872.00 | 9 |
| Adjmt/revj ext fixj sys anes CPT 20693 | not published | not published | $682.00 – $14,934.65 | 11 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | not published | not published | $1,152.36 – $4,246.62 | 11 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | not published | not published | $0.51 – $1.02 | 2 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $190.27 | $345.95 | $40.80 – $148.19 | 8 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $208.97 | $379.95 | $69.25 – $148.19 | 8 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $362.31 | $658.75 | $187.28 – $679.83 | 8 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $305.74 | $555.90 | $144.92 – $679.83 | 8 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $72.00 | $130.90 | $51.82 – $148.19 | 8 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $72.00 | $130.90 | $69.25 – $148.19 | 8 |
| Administration immunization 1 vaccine CPT 90471 | $123.75 | $225.00 | $30.67 – $148.19 | 8 |
| Administration immunization each additional component CPT 90461 | not published | not published | $12.25 – $13.47 | 2 |
| Administration immunization each additional vaccine CPT 90472 | $58.30 | $106.00 | $20.17 – $21.93 | 2 |
| Administration immunization first component each vaccine CPT 90460 | not published | not published | $31.64 – $34.39 | 2 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $95.70 | $174.00 | $24.92 – $148.19 | 8 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | not published | not published | $16.60 – $18.08 | 2 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | $17.05 | $31.00 | $31.68 – $33.95 | 2 |
| Administration vaccine hepatitis b HCPCS G0010 | $177.92 | $323.50 | $45.04 – $96.38 | 8 |
| Administration vaccine influenza virus HCPCS G0008 | $203.36 | $369.75 | $45.04 – $96.38 | 8 |
| Administration vaccine pneumococcal HCPCS G0009 | $123.75 | $225.00 | $45.04 – $96.38 | 8 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | $9.35 | $17.00 | $26.95 – $29.22 | 2 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | not published | not published | $43.63 – $85.07 | 9 |
| Adrenal cortex & medulla img CPT 78075 | not published | not published | $257.00 – $2,664.63 | 9 |
| Adrenalectomy expl w/exc retro tumor 60545 CPT 60545 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Advance care planning each additional 30 min 99498 CPT 99498 | not published | not published | $99.96 – $108.90 | 2 |
| Aep hearing status deter i&r CPT 92651 | not published | not published | $124.50 – $544.95 | 8 |
| Aep neurodiagnostic i&r CPT 92653 | not published | not published | $125.22 – $544.95 | 8 |
| Aep thrshld est mlt freq i&r CPT 92652 | not published | not published | $169.47 – $544.95 | 8 |
| Afamelanotide implant, 1 mg HCPCS J7352 | not published | not published | $2,943.42 – $6,298.92 | 8 |
| _afb id by dna probe rflx ast CPT 87149 | not published | not published | $14.00 – $42.91 | 9 |
| #afb mycobacteria suscep. #1 CPT 87190 | not published | not published | $4.00 – $15.64 | 9 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $253.82 | $461.50 | $115.36 – $246.87 | 8 |
| Aflibercept injection HCPCS J0178 | not published | not published | $743.60 – $1,450.03 | 9 |
| Afo tib fx semi-rigid l2114 HCPCS L2114 | not published | not published | $753.46 – $1,612.40 | 8 |
| After cataract laser surgery CPT 66821 | not published | not published | $464.17 – $2,100.00 | 11 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | not published | not published | $232.72 – $453.80 | 9 |
| Air conduction bilat CPT 92552 | not published | not published | $54.58 – $273.84 | 8 |
| Air injection into abdomen 49400 CPT 49400 | not published | not published | $136.66 – $1,496.00 | 3 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | not published | not published | $46.43 – $273.81 | 8 |
| Albumin body fluid quantitative each specimen CPT 82042 | $106.84 | $194.25 | $4.00 – $16.65 | 9 |
| Albumin (human), 25%, 50ml HCPCS P9047 | not published | not published | $53.32 – $103.98 | 9 |
| Albumin, human 25 % intravenous solution HCPCS P9046 | not published | not published | $21.33 – $41.59 | 9 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | not published | not published | $53.08 – $103.50 | 9 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | not published | not published | $10.62 – $20.70 | 9 |
| Albumin ischemia modified CPT 82045 | not published | not published | $33.94 – $72.63 | 8 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $48.95 | $89.00 | $4.00 – $12.37 | 9 |
| Albumin serum plasma or whole blood CPT 82040 | $83.88 | $152.50 | $4.00 – $10.59 | 9 |
| Albuterol ipratrop non-comp HCPCS J7620 | not published | not published | $0.22 – $0.31 | 4 |
| Albuterol non-comp con HCPCS J7611 | not published | not published | $0.21 – $0.28 | 4 |
| Albuterol non-comp unit HCPCS J7613 | not published | not published | $0.07 – $0.12 | 4 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | not published | not published | $17.27 – $36.96 | 8 |
| Alcohol/sub misuse assess HCPCS G2011 | not published | not published | $25.77 – $59.53 | 8 |
| Alcohol/subs interv >30 min HCPCS G0397 | not published | not published | $98.65 – $365.32 | 8 |
| Aldesleukin injection HCPCS J9015 | not published | not published | $3,338.87 – $9,118.29 | 8 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | not published | not published | $2,544.94 – $4,962.63 | 9 |
| Alkaline phosphatase CPT 84075 | $87.72 | $159.50 | $4.00 – $11.09 | 9 |
| Allergen alpha lactalbumin ige CPT 86008 | $64.90 | $118.00 | $17.93 – $38.37 | 7 |
| Allergen egg white ige CPT 86003 | $88.41 | $160.75 | $5.22 – $15.00 | 9 |
| Allergen specific ige qual multi scrn ea CPT 86005 | $33.82 | $61.50 | $6.00 – $17.06 | 9 |
| Allergy injections; 2 or more 95117 CPT 95117 | not published | not published | $17.69 – $96.38 | 8 |
| Allergy injection; single 95115 CPT 95115 | not published | not published | $14.82 – $96.38 | 8 |
| Allergy Skin Testing CPT 95004 | not published | not published | $5.29 – $1,780.43 | 8 |
| Allg patch or app # of tests 95044 CPT 95044 | not published | not published | $7.14 – $1,780.43 | 8 |
| Allgrft implnt knee w/scope CPT 29867 | not published | not published | $1,942.58 – $26,424.41 | 9 |
| Allograft 160mg placental salera mini membrane HCPCS Q4168 | not published | not published | $19.31 – $28.35 | 2 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | not published | not published | $94.35 – $233.39 | 9 |
| Allograft amnioexcel plus 17mm disk HCPCS Q4137 | not published | not published | $116.49 – $233.39 | 9 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $20,503.48 | $37,279.06 | $119.69 – $256.13 | 7 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | not published | not published | $27.90 – $233.39 | 9 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | not published | not published | $119.69 – $253.33 | 9 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | not published | not published | $104.82 – $256.13 | 8 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | not published | not published | $119.69 – $380.65 | 9 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | not published | not published | $119.69 – $403.68 | 9 |
| Alloskin HCPCS Q4115 | not published | not published | $14.11 – $233.39 | 9 |
| All tstg perq&iq drugs/biol CPT 95018 | not published | not published | $10.84 – $76.88 | 8 |
| All tstg perq&iq w/venoms CPT 95017 | not published | not published | $5.63 – $59.53 | 8 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | not published | not published | $5.13 – $10.01 | 9 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | not published | not published | $64.41 – $137.84 | 8 |
| Alpha-fetoprotein amniotic CPT 82106 | not published | not published | $17.00 – $36.38 | 9 |
| Alpha-fetoprotein tumor marker CPT 82105 | $142.18 | $258.50 | $16.77 – $35.89 | 9 |
| Alprostadil for injection HCPCS J0270 | not published | not published | $10.78 – $16.51 | 2 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | not published | not published | $98.59 – $192.24 | 9 |
| Alt/sgpt CPT 84460 | $89.79 | $163.25 | $4.00 – $11.34 | 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.