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 |
|---|---|---|---|---|
| Esophagus motility study CPT 91010 | not published | not published | $226.58 – $1,496.00 | 9 |
| Esoph balloon distension tst CPT 91040 | not published | not published | $358.89 – $1,496.00 | 9 |
| Esoph egd dilation <30 mm CPT 43249 | not published | not published | $231.79 – $3,949.47 | 11 |
| Esoph endoscopy dilation CPT 43226 | not published | not published | $197.07 – $3,949.47 | 11 |
| Esoph fundoplasty lap 43327 CPT 43327 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Esoph fundoplasty thor 43328 CPT 43328 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Esophgl motil w/stim/perfus CPT 91013 | not published | not published | $23.49 – $1,496.00 | 3 |
| Esoph imped function test CPT 91037 | not published | not published | $173.86 – $1,496.00 | 9 |
| Esoph imped funct test > 1hr CPT 91038 | not published | not published | $358.89 – $1,496.00 | 9 |
| Esoph optical endomicroscopy CPT 43206 | not published | not published | $200.19 – $5,316.00 | 10 |
| Esoph scope w/sclerosis inj CPT 43204 | not published | not published | $203.74 – $3,949.47 | 11 |
| Esoph scope w/submucous inj CPT 43201 | not published | not published | $156.68 – $3,949.47 | 11 |
| Esphg dstl 2/3 w/laps moblj 43287 CPT 43287 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Essure 58565 CPT 58565 | not published | not published | $699.87 – $10,295.98 | 10 |
| Establish access to aorta CPT 36160 | not published | not published | $185.34 – $1,496.00 | 2 |
| Establish access to artery CPT 36100 | not published | not published | $227.88 – $1,496.00 | 2 |
| Establish brain cavity shunt CPT 62223 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Established Patient Office Visit (level 1) CPT 99211 | $331.69 | $603.08 | $13.47 – $31.90 | 2 |
| Established Patient Office Visit (level 2) CPT 99212 | $379.26 | $689.56 | $54.17 – $78.34 | 2 |
| Established Patient Office Visit (level 3) CPT 99213 | $437.58 | $795.60 | $101.13 – $127.29 | 2 |
| Established Patient Office Visit (level 4) CPT 99214 | $525.12 | $954.76 | $149.16 – $179.41 | 2 |
| Established Patient Office Visit (level 5) CPT 99215 | $700.20 | $1,273.09 | $221.06 – $252.14 | 2 |
| Estradiol total CPT 82670 | $473.41 | $860.75 | $20.00 – $59.79 | 9 |
| Estradiol valerate 10 mg inj HCPCS J1380 | not published | not published | $8.32 – $15.18 | 4 |
| Estrogens total-sendout CPT 82672 | not published | not published | $15.00 – $46.44 | 9 |
| Etanercept injection HCPCS J1438 | not published | not published | $901.49 – $1,447.32 | 2 |
| Ethanolamine oleate 100 mg HCPCS J1430 | not published | not published | $547.27 – $1,067.18 | 9 |
| Ethmoidectomy extranasal total 31205 CPT 31205 | not published | not published | $1,415.52 – $6,823.84 | 11 |
| Ethylene glycol -sendout CPT 82693 | $126.36 | $229.75 | $11.00 – $31.89 | 9 |
| Etonogestrel implant system HCPCS J7307 | not published | not published | $1,275.36 – $1,848.22 | 2 |
| Etoposide 20 mg/ml intravenous solution HCPCS J9181 | not published | not published | $1.22 – $1.71 | 4 |
| Etoposide 50 mg cap HCPCS J8560 | not published | not published | $87.16 – $171.71 | 9 |
| Euflexxa inj per dose HCPCS J7323 | not published | not published | $98.14 – $209.09 | 9 |
| Euglobulin lysis CPT 85360 | not published | not published | $6.00 – $18.00 | 9 |
| Evacuate mole of uterus CPT 59870 | not published | not published | $812.13 – $6,662.61 | 11 |
| Eval aud rehab status/first hr 92626 CPT 92626 | $329.59 | $599.25 | $113.46 – $273.81 | 8 |
| Eval/fit voice prosthesis iii, st CPT 92607 | $477.32 | $867.85 | $115.74 – $247.68 | 7 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $673.48 | $1,224.50 | $98.11 – $209.96 | 8 |
| Evaluation heart device CPT 93640 | $4,287.36 | $7,795.20 | $367.82 – $1,496.00 | 2 |
| Evaluation of speech fluency 92521 CPT 92521 | $283.30 | $515.10 | $126.98 – $271.74 | 8 |
| Evaluation psychiatric diagnostic CPT 90791 | not published | not published | $170.71 – $365.32 | 8 |
| Evasc prlng admn rx agnt 1st CPT 61650 | not published | not published | $880.00 – $4,386.82 | 3 |
| Evasc prlng admn rx agnt add CPT 61651 | not published | not published | $375.66 – $4,386.82 | 3 |
| Evasc repair of iliac artery; endograft 34718 CPT 34718 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Evasc rpr a-ao ndgft 34701 CPT 34701 | $2,886.34 | $5,247.90 | $1,189.00 – $4,386.82 | 3 |
| Evasc rpr a-ao ndgft rpt 34702 CPT 34702 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Evasc rpr a-biiliac ndgft rptr CPT 34706 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Evasc rpr a-iliac ndgft 34717 CPT 34717 | not published | not published | $662.17 – $4,386.82 | 3 |
| Evasc rpr a-unilac ndgft 34703 CPT 34703 | $8,174.24 | $14,862.25 | $1,189.00 – $4,386.82 | 3 |
| Evasc rpr a-unilac ndgft rpt CPT 34704 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Evasc rpr ilio-iliac ndgft CPT 34707 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Evasc rpr ilio-iliac rpt CPT 34708 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Evasc st rpr thrc/aa acrs br CPT 33894 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Evasc st rpr thrc/aa x crsg CPT 33895 | not published | not published | $1,166.11 – $4,386.82 | 3 |
| Event monitor CPT 93270 | $108.93 | $198.05 | $11.94 – $76.81 | 8 |
| Evoked auditory tst complete CPT 92588 | not published | not published | $7.14 – $768.03 | 8 |
| Evoked oa emissions ltd CPT 92587 | not published | not published | $5.22 – $544.95 | 8 |
| Evoked potentials auditory screening automated analysis CPT 92650 | not published | not published | $40.19 – $72.11 | 2 |
| Evoked potentials upper limbs CPT 95925 | not published | not published | $207.67 – $544.95 | 8 |
| Evoked potential visual not glaucoma CPT 95930 | not published | not published | $70.87 – $544.95 | 8 |
| Evok oa screening qual CPT 92558 | not published | not published | $12.93 – $12.93 | 1 |
| Exam of vagina w/scope 57420 CPT 57420 | not published | not published | $137.20 – $1,579.00 | 10 |
| Exam pelvic add-on CPT 99459 | not published | not published | $28.60 – $32.59 | 2 |
| Exam plvc w/anes othr thn lcl CPT 57410 | not published | not published | $161.90 – $6,662.61 | 11 |
| Ex arm/elbow tum deep < 5 cm CPT 24076 | not published | not published | $834.32 – $5,978.45 | 11 |
| Ex arm/elbow tum deep 5 cm/> CPT 24073 | not published | not published | $1,055.36 – $8,185.00 | 10 |
| Exc abd les sc 3 cm/> CPT 22903 | not published | not published | $670.65 – $8,185.00 | 10 |
| Exc abdl tum deep < 5 cm CPT 22900 | not published | not published | $862.43 – $5,978.45 | 11 |
| Exc abdl tum deep 5 cm/> CPT 22901 | not published | not published | $1,014.75 – $8,185.00 | 10 |
| Exc abd tum 5 cm or less 49203 CPT 49203 | not published | not published | $1,817.28 – $4,386.82 | 2 |
| Exc abd tum over 10 cm 49205 CPT 49205 | not published | not published | $2,659.17 – $4,386.82 | 2 |
| Exc arm/elbo les sc >=3cm 24071 CPT 24071 | not published | not published | $618.38 – $8,185.00 | 10 |
| Exc arm/elbo les sc <3cm 24075 CPT 24075 | not published | not published | $502.67 – $3,399.30 | 11 |
| Exc aurl glomus tum trnscanl CPT 69550 | not published | not published | $1,592.96 – $12,184.12 | 11 |
| Exc aurl glomus tum trnsmstd CPT 69552 | not published | not published | $1,933.00 – $12,184.12 | 11 |
| Exc back les sbq <3 cm 21930 CPT 21930 | not published | not published | $556.35 – $3,399.30 | 11 |
| Exc back tum deep 5 cm/> CPT 21933 | not published | not published | $1,122.40 – $8,185.00 | 10 |
| Exc bartholins gland/cyst CPT 56740 | not published | not published | $481.32 – $6,662.61 | 11 |
| Exc benign feenlm 3.1-4.0cm 11444 CPT 11444 | not published | not published | $342.23 – $3,399.30 | 11 |
| Exc benign feenlm >4.0cm 11446 CPT 11446 | not published | not published | $481.96 – $5,978.45 | 11 |
| Exc benign snhfg 3.1-4.0cm 11424 CPT 11424 | not published | not published | $274.63 – $3,399.30 | 11 |
| Exc benign tal 0.5 < cm 11400 CPT 11400 | not published | not published | $126.97 – $1,579.00 | 10 |
| Exc ben+marg excep skin tag feenlm <0.5cm 11440 CPT 11440 | not published | not published | $160.95 – $1,579.00 | 10 |
| Exc ben+marg excep skin tag feenlm 1.1-2cm 11442 CPT 11442 | not published | not published | $222.13 – $1,579.00 | 10 |
| Exc ben+marg excep skin tag feenlm 2.1-3cm 11443 CPT 11443 | not published | not published | $271.14 – $3,399.30 | 10 |
| Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 CPT 11421 | not published | not published | $165.56 – $1,579.00 | 10 |
| Exc ben+marg excep skin tag snhfg 2.1-3cm 11423 CPT 11423 | $3,048.57 | $5,542.85 | $238.08 – $3,399.30 | 10 |
| Exc ben+marg excep skin tag snhfg >4cm 11426 CPT 11426 | not published | not published | $407.57 – $5,978.45 | 11 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | not published | not published | $159.70 – $1,579.00 | 10 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | not published | not published | $226.25 – $1,579.00 | 10 |
| Exc breast duct fistula 19112 CPT 19112 | not published | not published | $488.79 – $8,058.70 | 11 |
| Exc carotid body tumor without exc art 60600 CPT 60600 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Exc cervix repair bowel 57556 CPT 57556 | not published | not published | $899.78 – $10,295.98 | 11 |
| Exc cervix/repair pelvis 57545 CPT 57545 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Exc cervix/repair vagina 57555 CPT 57555 | not published | not published | $947.80 – $10,295.98 | 9 |
| Exc chest wall tumor w/ribs 21601 CPT 21601 | not published | not published | $1,736.81 – $5,978.45 | 9 |
| Exc coccygl pr ulc flap clsr CPT 15922 | not published | not published | $1,203.87 – $7,293.65 | 11 |
| Exc coccygl pr ulc prim sutr CPT 15920 | not published | not published | $953.55 – $5,978.45 | 11 |
| Exc constrict ring finger w/mlt z-plasties 26596 CPT 26596 | not published | not published | $1,237.46 – $6,734.39 | 11 |
| Exc/crtg b1 cst/b9 tum rds CPT 24120 | not published | not published | $815.90 – $6,734.39 | 11 |
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.