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 |
|---|---|---|---|---|
| Destroy vulva lesion extensive 56515 CPT 56515 | not published | not published | $324.08 – $4,246.62 | 11 |
| Destroy vulva lesion simple 56501 CPT 56501 | not published | not published | $202.34 – $4,246.62 | 9 |
| Destruct ben lesion 15/> 17111 CPT 17111 | not published | not published | $125.55 – $1,496.00 | 9 |
| Destruct cut vasl lesions 10-50cm 17107 CPT 17107 | not published | not published | $543.88 – $1,579.00 | 10 |
| Destruct cut vasl lesions <10cm 17106 CPT 17106 | not published | not published | $390.97 – $1,579.00 | 10 |
| Destruct cut vasl lesions >50cm 17108 CPT 17108 | not published | not published | $799.60 – $4,246.62 | 10 |
| Destruction 2-14 lesions 17003 CPT 17003 | not published | not published | $3.10 – $1,496.00 | 2 |
| Destruction anal lesion(s) CPT 46910 | not published | not published | $205.85 – $4,246.62 | 9 |
| Destruction anal lesion(s) CPT 46924 | not published | not published | $276.32 – $5,712.83 | 11 |
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | not published | not published | $208.98 – $1,579.00 | 10 |
| Destruction benign lesions < 14 lesions CPT 17110 | not published | not published | $103.00 – $1,496.00 | 9 |
| Destruction by injection tx of nerve 64630 CPT 64630 | not published | not published | $290.84 – $2,100.00 | 11 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | not published | not published | $89.71 – $1,496.00 | 2 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | $2,729.10 | $4,962.00 | $293.66 – $5,316.00 | 10 |
| Destruction ciliary body CPT 66700 | not published | not published | $586.72 – $4,749.93 | 11 |
| Destruction ciliary body CPT 66720 | not published | not published | $614.23 – $4,893.31 | 11 |
| Destruction ciliary body CPT 66740 | not published | not published | $586.72 – $4,893.31 | 11 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | not published | not published | $192.96 – $1,496.00 | 9 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | not published | not published | $196.82 – $5,712.83 | 11 |
| Destruction les conjunctiva CPT 68135 | not published | not published | $223.69 – $4,893.31 | 10 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | $207.86 – $1,496.00 | 9 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | $253.95 – $1,579.00 | 10 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | not published | not published | $198.15 – $1,496.00 | 9 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | not published | not published | $232.43 – $1,579.00 | 10 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | not published | not published | $161.72 – $1,496.00 | 9 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | $261.14 – $4,246.62 | 11 |
| Destruction premal lesions 15/> 17004 CPT 17004 | not published | not published | $148.76 – $1,579.00 | 10 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $1,059.35 – $8,185.00 | 11 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $283.58 – $6,662.61 | 11 |
| Destruction vag lesions simple 57061 CPT 57061 | not published | not published | $174.42 – $6,662.61 | 9 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $145.67 – $4,246.62 | 9 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $14.00 – $64.26 | 9 |
| Detect agnt mult dna direc CPT 87800 | not published | not published | $43.67 – $93.45 | 9 |
| Developmental screen/score/document 96110 CPT 96110 | not published | not published | $16.74 – $16.74 | 1 |
| Devel tst phys/qhp 1st hr CPT 96112 | not published | not published | $123.75 – $273.81 | 8 |
| Device intraute mirena HCPCS J7298 | not published | not published | $1,275.36 – $1,809.54 | 2 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | not published | not published | $77.86 – $87.50 | 2 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $519.75 | $945.00 | $32.06 – $179.11 | 8 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | not published | not published | $90.02 – $234.73 | 9 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | not published | not published | $1.21 – $1.94 | 2 |
| Dexamethasone 4 mg tablet HCPCS J8540 | not published | not published | $0.07 – $0.13 | 4 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | not published | not published | $0.10 – $0.20 | 4 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $203.66 – $397.13 | 9 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | not published | not published | $41.44 – $177.41 | 9 |
| Dextran 40 infusion HCPCS J7100 | not published | not published | $40.99 – $58.29 | 2 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | not published | not published | $1.43 – $2.61 | 4 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | not published | not published | $8.38 – $12.70 | 2 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | not published | not published | $2.07 – $3.17 | 4 |
| Dextrose 5 % IV bolus HCPCS J7070 | not published | not published | $4.15 – $6.34 | 4 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $376.89 | $685.25 | $16.00 – $47.57 | 9 |
| Diabetes (HbA1c) Test CPT 83036 | $266.34 | $484.25 | $7.00 – $20.78 | 9 |
| Diabetes training group per 30 min g0109 HCPCS G0136 | not published | not published | $13.94 – $77.12 | 7 |
| Diab manage trn ind/group HCPCS G0109 | not published | not published | $15.17 – $32.46 | 8 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $257.02 – $3,663.36 | 11 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $501.34 – $12,442.83 | 11 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $142.63 – $1,579.00 | 10 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $189.82 – $3,359.00 | 10 |
| Diagnostic anoscopy spx 46600 CPT 46600 | not published | not published | $62.27 – $1,496.00 | 9 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $94.98 | $172.69 | $160.93 – $358.72 | 2 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $47.49 | $86.35 | $125.50 – $301.70 | 2 |
| Diagnostic laryngoscopy 31505 CPT 31505 | not published | not published | $74.64 – $1,496.00 | 9 |
| Diagnostic laryngoscopy 31575 CPT 31575 | not published | not published | $103.64 – $1,496.00 | 9 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $837.38 | $1,522.51 | $98.65 – $250.45 | 8 |
| Diagnostic Mammogram (one breast) CPT 77065 | $418.69 | $761.25 | $76.91 – $198.79 | 8 |
| Diagnostic radio unlisted proc CPT 76499 | $211.31 | $384.20 | $60.00 – $179.11 | 8 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $3,629.20 | $6,598.55 | $301.68 – $1,496.00 | 2 |
| Dialysis one evaluation CPT 90945 | $1,826.52 | $3,320.95 | $130.45 – $858.80 | 8 |
| Diathermy eg microwave CPT 97024 | not published | not published | $6.74 – $14.42 | 8 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | not published | not published | $0.09 – $0.13 | 4 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | not published | not published | $6.60 – $9.26 | 4 |
| Dicyclomine injection HCPCS J0500 | not published | not published | $14.66 – $41.01 | 4 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.39 – $0.39 | 1 |
| Diffusing capacity CPT 94729 | $1,333.20 | $2,424.00 | $68.97 – $75.67 | 2 |
| Digital analysis of eeg CPT 95957 | not published | not published | $278.26 – $396.01 | 2 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | not published | not published | $5.56 – $15.46 | 4 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | not published | not published | $5,383.32 – $10,497.48 | 9 |
| Digoxin total therapeutic drug level CPT 80162 | $224.95 | $409.00 | $9.00 – $28.42 | 9 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | not published | not published | $69.54 – $137.20 | 4 |
| Dilate biliary duct/ampulla CPT 47542 | not published | not published | $203.77 – $1,496.00 | 2 |
| Dilate esophagus CPT 43453 | not published | not published | $131.10 – $3,949.47 | 11 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $120.40 – $1,872.00 | 11 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | not published | not published | $517.35 – $4,386.82 | 4 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | not published | not published | $258.68 – $4,386.82 | 4 |
| Dilate ic vasospasm init CPT 61640 | not published | not published | $736.50 – $4,386.82 | 4 |
| Dilate tear duct opening CPT 68801 | not published | not published | $118.65 – $1,496.00 | 9 |
| Dilate urethra stricture CPT 53600 | not published | not published | $96.55 – $1,579.00 | 10 |
| Dilate urethra stricture CPT 53601 | not published | not published | $80.96 – $1,579.00 | 10 |
| Dilate urethra stricture CPT 53605 | not published | not published | $97.40 – $7,255.07 | 11 |
| Dilate urethra stricture CPT 53621 | not published | not published | $109.28 – $1,579.00 | 10 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $63.20 – $1,496.00 | 9 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $258.32 – $2,462.91 | 11 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $73.45 – $6,662.61 | 10 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $293.60 – $2,462.91 | 11 |
| Dilation of salivary duct CPT 42660 | not published | not published | $130.09 – $1,496.00 | 9 |
| Dilation of urethra CPT 53661 | not published | not published | $61.35 – $1,496.00 | 9 |
| Dilation of urethra CPT 53665 | not published | not published | $57.75 – $4,302.40 | 11 |
| Dilation of vagina CPT 57400 | not published | not published | $199.04 – $6,662.61 | 11 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $89.35 – $3,193.45 | 10 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $132.29 – $1,496.00 | 9 |
| Dilat xst trc ndurlgc px CPT 50436 | not published | not published | $224.97 – $8,185.00 | 10 |
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.