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 |
|---|---|---|---|---|
| Factor ix non-recombinant HCPCS J7193 | not published | not published | $1.40 – $2.74 | 9 |
| Factor ix recomb gly rebinyn HCPCS J7203 | not published | not published | $4.67 – $9.11 | 9 |
| Factor ix recombinant nos HCPCS J7195 | not published | not published | $1.86 – $3.63 | 9 |
| Factor viii CPT 85240 | $303.46 | $551.75 | $13.00 – $38.31 | 9 |
| Factor viii HCPCS J7190 | not published | not published | $1.25 – $2.43 | 9 |
| Factor viii fc fusion recomb HCPCS J7205 | not published | not published | $2.58 – $5.03 | 9 |
| Factor viii nuwiq recomb 1iu HCPCS J7209 | not published | not published | $1.22 – $2.38 | 9 |
| Factor viii pegylated recomb HCPCS J7207 | not published | not published | $2.12 – $4.13 | 9 |
| Factor viii recombinant nos HCPCS J7192 | not published | not published | $1.58 – $3.08 | 9 |
| Factor viii recomb novoeight HCPCS J7182 | not published | not published | $1.44 – $2.81 | 9 |
| Factor viii recomb obizur HCPCS J7188 | not published | not published | $3.24 – $6.31 | 9 |
| Factor xiii anti-hem factor HCPCS J7180 | not published | not published | $11.24 – $21.91 | 9 |
| Factor xiii recomb a-subunit HCPCS J7181 | not published | not published | $19.11 – $37.27 | 9 |
| Fallopian tube recnl CPT 58345 | not published | not published | $442.59 – $6,662.61 | 9 |
| Family therapy without pt 50min 90846 CPT 90846 | not published | not published | $154.35 – $365.32 | 7 |
| Family therapy with patient 50 min 90847 CPT 90847 | not published | not published | $161.23 – $365.32 | 8 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | not published | not published | $0.01 – $0.01 | 3 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | not published | not published | $32.87 – $64.10 | 9 |
| Fancc gene CPT 81242 | not published | not published | $36.62 – $78.37 | 8 |
| Fat/lipids feces qualitative CPT 82705 | $86.35 | $157.00 | $4.00 – $10.91 | 9 |
| Fatty acids nonesterified CPT 82725 | not published | not published | $9.00 – $40.17 | 9 |
| Fda ide #g240020 carry bag HCPCS Q0499 | not published | not published | $206.61 – $442.15 | 8 |
| Fecal bilirubin test CPT 82252 | not published | not published | $4.56 – $9.76 | 9 |
| Fecal microbiota, live-jslm 150 ml rectal suspension enema HCPCS J1440 | not published | not published | $65.60 – $127.93 | 9 |
| Fecal microbiota prep instil HCPCS G0455 | not published | not published | $107.39 – $1,914.03 | 8 |
| #fecal-sodium CPT 84302 | $82.36 | $149.75 | $3.00 – $10.40 | 9 |
| Feeding tube reposition CPT 74355 | not published | not published | $121.59 – $144.00 | 3 |
| Fees w/laryngeal sense test CPT 92616 | not published | not published | $77.56 – $316.60 | 8 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | not published | not published | $18.64 – $39.89 | 8 |
| Femoral endovas graft add-on 34813 CPT 34813 | not published | not published | $351.35 – $4,386.82 | 3 |
| Fem/popl revasc w/stent CPT 37226 | $19,093.17 | $34,714.85 | $773.37 – $19,278.97 | 4 |
| Feno poc CPT 95012 | not published | not published | $27.27 – $76.88 | 8 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | not published | not published | $0.96 – $1.59 | 4 |
| Fern test HCPCS Q0114 | not published | not published | $9.74 – $20.84 | 8 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | not published | not published | $1.13 – $2.21 | 9 |
| Ferritin CPT 82728 | $231.06 | $420.11 | $10.00 – $29.17 | 9 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | not published | not published | $0.37 – $0.72 | 9 |
| Ferumoxytol, esrd use HCPCS Q0139 | not published | not published | $0.37 – $0.72 | 9 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $467.50 | $850.00 | $99.55 – $215.17 | 9 |
| Fetal chrom aneuploidy gsa panel CPT 81420 | not published | not published | $759.05 – $1,624.37 | 8 |
| Fetal contract stress test 59020 - 26 CPT 59020 | not published | not published | $50.28 – $1,496.00 | 9 |
| Fetal cord puncture prenatal CPT 59012 | not published | not published | $293.08 – $1,496.00 | 9 |
| Fetal fibronectin CPT 82731 | $545.88 | $992.50 | $64.41 – $290.00 | 9 |
| Fetal fluid drainage w/us CPT 59074 | not published | not published | $293.08 – $1,579.00 | 10 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $517.96 | $941.75 | $5.00 – $16.54 | 9 |
| Fetal hemoglobin rosette CPT 85461 | $128.56 | $233.75 | $7.00 – $20.03 | 9 |
| Fetal lung maturity assess lam body dnst CPT 83664 | not published | not published | $19.32 – $41.34 | 9 |
| Fetal non stress test CPT 59025 | not published | not published | $29.19 – $1,496.00 | 9 |
| Fetal scalp blood sampling 59030 CPT 59030 | not published | not published | $170.16 – $1,496.00 | 9 |
| Fetal shunt placement w/us CPT 59076 | not published | not published | $293.08 – $1,579.00 | 10 |
| #_fet/norfentcnfrmur CPT 80354 | $169.40 | $308.00 | $35.46 – $35.46 | 1 |
| Fiasp for insulin pump use HCPCS J1811 | not published | not published | $10.00 – $11.17 | 3 |
| Fibrin degradation d dimer quantitative CPT 85379 | $319.14 | $580.25 | $7.00 – $21.79 | 9 |
| Fibrin degradation products CPT 85362 | not published | not published | $5.00 – $14.74 | 9 |
| Fibrin degrade semiquant CPT 85378 | not published | not published | $5.00 – $20.80 | 9 |
| Fibrinogen activity CPT 85384 | $565.68 | $1,028.50 | $6.00 – $20.80 | 9 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | not published | not published | $6.00 – $33.13 | 9 |
| Fibrinolytic antiplasmin CPT 85410 | not published | not published | $7.71 – $16.50 | 9 |
| Fibrinolytic plasminogen CPT 85415 | not published | not published | $12.00 – $36.79 | 9 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | not published | not published | $5.00 – $13.97 | 9 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | not published | not published | $0.32 – $0.63 | 9 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | not published | not published | $1.01 – $1.96 | 9 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | not published | not published | $0.35 – $0.69 | 9 |
| Filleted finger/toe flap CPT 14350 | not published | not published | $1,032.29 – $4,246.62 | 11 |
| Filtered speech hearing test CPT 92571 | not published | not published | $35.92 – $76.88 | 8 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $9,277.34 | $16,867.90 | not published | 0 |
| Filter vena cava fem denali HCPCS C1880 | $6,278.91 | $11,416.20 | not published | 0 |
| Fimbrioplasty 58760 CPT 58760 | not published | not published | $1,257.83 – $4,386.82 | 3 |
| Finasteride, 5 mg HCPCS S0138 | not published | not published | $0.16 – $0.26 | 2 |
| Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 CPT 10007 | not published | not published | $136.67 – $1,579.00 | 10 |
| Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008 CPT 10008 | not published | not published | $79.12 – $1,496.00 | 2 |
| Fine needle aspiration biopsy without img gdn; ea addtl 10004 CPT 10004 | not published | not published | $65.96 – $1,496.00 | 2 |
| Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 | $545.57 | $991.95 | $76.36 – $1,496.00 | 2 |
| Fine needle asp without image guide 10021 CPT 10021 | not published | not published | $83.55 – $1,496.00 | 9 |
| Finger joint sz00 swanson w/grommets HCPCS L8630 | not published | not published | $648.61 – $648.61 | 1 |
| Finger tendon transfer CPT 26497 | not published | not published | $1,366.59 – $6,734.39 | 11 |
| Finger tendon transfer CPT 26498 | not published | not published | $1,594.00 – $6,734.39 | 11 |
| Fistula repair transperine 57308 CPT 57308 | not published | not published | $1,014.88 – $4,386.82 | 3 |
| Fit aphakia spectcl monofocl CPT 92352 | not published | not published | $27.48 – $121.42 | 8 |
| Fit aphakia spectcl multifoc CPT 92353 | not published | not published | $37.30 – $121.42 | 8 |
| Fitg spect low vis 1system CPT 92354 | not published | not published | $20.09 – $76.88 | 8 |
| Fitg spect lw vis cmpnd lens CPT 92355 | not published | not published | $31.11 – $76.88 | 8 |
| Fitting of diaphragm/cap 57170 CPT 57170 | not published | not published | $72.27 – $1,496.00 | 9 |
| Fixation of ankle joint CPT 27860 | not published | not published | $249.82 – $6,734.39 | 11 |
| Fixation of knee joint CPT 27570 | not published | not published | $234.17 – $3,309.55 | 11 |
| Fixation of shoulder blade CPT 23400 | not published | not published | $1,480.12 – $14,934.65 | 11 |
| Fix g/colon tube w/device CPT 49460 | not published | not published | $76.49 – $1,872.00 | 10 |
| Fixtn pq skel dstl rad fx/epiphysl sep CPT 25606 | not published | not published | $1,023.06 – $6,734.39 | 11 |
| Flebogamma injection HCPCS J1572 | not published | not published | $63.57 – $194.18 | 8 |
| Flecainide (tambocor)-sendout CPT 80181 | not published | not published | $18.64 – $39.89 | 8 |
| Fl exam g/colon tube w contrast CPT 49465 | not published | not published | $46.04 – $1,496.00 | 9 |
| Flexible Sigmoidoscopy CPT 45330 | not published | not published | $85.41 – $1,914.03 | 10 |
| Flexor-plasty elbow CPT 24330 | not published | not published | $1,096.93 – $14,934.65 | 11 |
| Flexor-plasty elbw w/advmnt CPT 24331 | not published | not published | $1,198.12 – $14,934.65 | 11 |
| Floor of mouth biopsy 41108 CPT 41108 | not published | not published | $138.08 – $3,399.30 | 10 |
| Florbetaben f18 diagnostic HCPCS Q9983 | not published | not published | $1,452.09 – $5,242.86 | 8 |
| Flortaucipir inj 1 millicuri HCPCS A9601 | not published | not published | $371.00 – $793.94 | 7 |
| Flotufolastat f18 diag 1 mci HCPCS A9608 | not published | not published | $727.56 – $1,556.97 | 7 |
| Flow cytometry interp 16 or more CPT 88189 | not published | not published | $111.75 – $127.03 | 2 |
| Flow cytometry marker each additional CPT 88185 | $116.60 | $212.00 | $29.40 – $34.02 | 2 |
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.