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 |
|---|---|---|---|---|
| Fluorodopa f-18 diag per mci HCPCS A9602 | not published | not published | $568.43 – $1,830.88 | 8 |
| Fluoroestradiol f 18 HCPCS A9591 | not published | not published | $460.42 – $1,309.88 | 8 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $141.65 | $257.55 | $110.66 – $162.18 | 2 |
| Fluoroguide needle placement CPT 77002 | $223.58 | $406.51 | $128.87 – $179.05 | 2 |
| Fluoro polarize fetal lung CPT 83663 | not published | not published | $18.91 – $40.47 | 9 |
| Fluoroscopy up to 1 hour CPT 76000 | $898.07 | $1,632.85 | $40.21 – $491.09 | 9 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | not published | not published | $2.52 – $5.29 | 4 |
| Fluphenazine decanoate 25 mg/ml injection solution HCPCS J2680 | not published | not published | $10.07 – $15.03 | 4 |
| Flutamide 125 mg HCPCS S0175 | not published | not published | $35.94 – $59.03 | 2 |
| Flutemetamol f18 diagnostic HCPCS Q9982 | not published | not published | $1,944.01 – $6,179.09 | 8 |
| Fluvirin vacc, 3 yrs & >, im HCPCS Q2037 | not published | not published | $30.58 – $30.58 | 1 |
| Fluzone vacc, 3 yrs & >, im HCPCS Q2038 | not published | not published | $126.90 – $126.90 | 1 |
| Fmri brain by phys/psych CPT 70555 | not published | not published | $229.48 – $815.39 | 8 |
| Fmri brain by tech CPT 70554 | not published | not published | $229.48 – $491.09 | 8 |
| Fna bx w/ct gdn 1st les CPT 10009 | not published | not published | $165.66 – $1,579.00 | 10 |
| Fna bx w/ct gdn ea addl CPT 10010 | not published | not published | $110.87 – $1,496.00 | 2 |
| Fna bx w/mr gdn 1st les CPT 10011 | not published | not published | $489.91 – $1,579.00 | 10 |
| Fna bx w/mr gdn ea addl CPT 10012 | not published | not published | $278.08 – $1,496.00 | 2 |
| Foam drg >16<=48 sq in w/bdr HCPCS A6213 | not published | not published | $20.61 – $20.61 | 1 |
| Foam drg >16<=48 sq in without b HCPCS A6210 | not published | not published | $41.76 – $44.66 | 2 |
| Foam drg <=16 sq in w/border HCPCS A6212 | not published | not published | $20.36 – $21.76 | 2 |
| Foam drg > 48 sq in w/border HCPCS A6214 | not published | not published | $21.59 – $23.08 | 2 |
| Foam drg > 48 sq in without brdr HCPCS A6211 | not published | not published | $61.56 – $65.83 | 2 |
| Foam drsg <=16 sq in without bdr HCPCS A6209 | not published | not published | $15.66 – $16.75 | 2 |
| Foam/fabric leg strap HCPCS A5114 | not published | not published | $18.75 – $20.05 | 2 |
| Foam stability fetal lung CPT 83662 | not published | not published | $18.91 – $40.47 | 9 |
| Folic acid CPT 82746 | $124.58 | $226.50 | $10.00 – $31.46 | 9 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | not published | not published | $0.07 – $0.10 | 3 |
| Follow-up angiography CPT 75898 | $3,701.20 | $6,729.45 | $62.96 – $6,498.69 | 9 |
| Followup eval of foot pt lop HCPCS G0246 | not published | not published | $30.83 – $274.02 | 8 |
| Follow-up surgery of eye CPT 66250 | not published | not published | $832.35 – $4,893.31 | 11 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | not published | not published | $6.18 – $24.64 | 8 |
| Fondaparinux sodium HCPCS J1652 | not published | not published | $0.98 – $1.79 | 4 |
| Fo nontorsion joint cf HCPCS L3935 | not published | not published | $248.46 – $531.70 | 8 |
| Foot arch support remov prem HCPCS L3030 | not published | not published | $94.30 – $201.80 | 8 |
| Foot arch supp premold metat HCPCS L3050 | not published | not published | $58.14 – $124.42 | 7 |
| Foot drp splt w/exp heel lg HCPCS L4398 | not published | not published | $95.45 – $204.26 | 8 |
| Foot external keel sach foot HCPCS L5970 | not published | not published | $278.64 – $596.29 | 8 |
| Foot insert plastazote or eq HCPCS L3002 | not published | not published | $199.51 – $426.95 | 8 |
| Foot insert remov molded spe HCPCS L3001 | not published | not published | $163.39 – $349.65 | 7 |
| Foot insert silicone gel eac HCPCS L3003 | not published | not published | $215.28 – $460.70 | 8 |
| Foot lamin/prepreg composite HCPCS L3031 | not published | not published | $151.31 – $323.80 | 7 |
| Foot longitudinal arch suppo HCPCS L3010 | not published | not published | $215.28 – $460.70 | 7 |
| Foot longitud/metatarsal sup HCPCS L3020 | not published | not published | $245.12 – $524.56 | 7 |
| Foot plas heel stabi pre ots HCPCS L3170 | not published | not published | $62.84 – $134.48 | 7 |
| Foot plate molded stirrup at HCPCS L2250 | not published | not published | $408.31 – $873.78 | 8 |
| Foot single axis ankle/foot HCPCS L5974 | not published | not published | $324.52 – $694.47 | 8 |
| Foot X-ray CPT 73630 | $1,137.95 | $2,069.00 | $37.81 – $179.11 | 9 |
| Forearm/arm cuffs ext/flex a HCPCS L3730 | not published | not published | $1,247.88 – $2,670.46 | 8 |
| Forearm/arm cuffs free motio HCPCS L3720 | not published | not published | $853.15 – $1,825.74 | 8 |
| Forehead flap w/vasc pedicle 15731 CPT 15731 | not published | not published | $1,459.00 – $7,293.65 | 11 |
| Forensic autopsy (necropsy) CPT 88040 | not published | not published | $436.00 – $843.39 | 2 |
| Forensic cytopathology CPT 88125 | not published | not published | $5.00 – $107.25 | 8 |
| Foreskn manip w/lss preputial ads+stretching 54450 CPT 54450 | not published | not published | $86.97 – $1,579.00 | 11 |
| Formoterol comp unit HCPCS J7640 | not published | not published | $1.71 – $2.50 | 2 |
| Formoterol fumarate, inh HCPCS J7606 | not published | not published | $1.94 – $6.73 | 4 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | not published | not published | $0.14 – $0.23 | 4 |
| Foscarnet sodium injection HCPCS J1455 | not published | not published | $24.66 – $129.43 | 4 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | not published | not published | $0.66 – $4.11 | 8 |
| Fractionation ketosteroids CPT 83593 | not published | not published | $19.00 – $60.99 | 9 |
| Fracture assessment via dxa CPT 77086 | $289.97 | $527.21 | $36.86 – $179.11 | 8 |
| _fragile x methylation-sendout CPT 81244 | not published | not published | $44.89 – $96.06 | 8 |
| Fragmenting of kidney stone CPT 50590 | $8,932.06 | $16,240.10 | $874.02 – $8,185.00 | 10 |
| Frame typ sock above elb/dis HCPCS L6688 | not published | not published | $834.62 – $1,786.09 | 8 |
| Frame typ socket bel elbow/w HCPCS L6687 | not published | not published | $706.16 – $1,511.18 | 8 |
| Frame typ socket shoulder di HCPCS L6689 | not published | not published | $873.35 – $1,868.97 | 8 |
| Frame typ sock interscap-tho HCPCS L6690 | not published | not published | $947.61 – $2,027.89 | 8 |
| Free fascial flap microvasc CPT 15758 | not published | not published | $2,074.00 – $4,386.82 | 3 |
| Freeing of bowel adhesion 44005 CPT 44005 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Free jejunum flap microvasc CPT 43496 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Free myo/skin flap microvasc CPT 15756 | not published | not published | $2,074.00 – $4,386.82 | 3 |
| Free omental flap microvasc CPT 49906 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Free/remove chest lining 32320 CPT 32320 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Free skin flap microvasc CPT 15757 | not published | not published | $2,074.00 – $4,386.82 | 3 |
| Frenectomy 41115 CPT 41115 | not published | not published | $221.24 – $3,193.45 | 10 |
| Frenotomy 40806 CPT 40806 | not published | not published | $44.25 – $1,496.00 | 9 |
| Frenulotomy of penis CPT 54164 | not published | not published | $296.36 – $4,302.40 | 11 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $364.10 | $662.00 | $73.77 – $157.87 | 7 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | not published | not published | $85.98 – $184.00 | 7 |
| Fresh frozen plasma thawing ea un CPT 86927 | not published | not published | $8.00 – $350.65 | 9 |
| Fr frz plasma donor retested HCPCS P9060 | not published | not published | $53.25 – $113.96 | 7 |
| Frozen blood freeze/thaw CPT 86932 | not published | not published | $35.92 – $137.05 | 9 |
| Frozen blood prep CPT 86930 | not published | not published | $71.00 – $350.65 | 9 |
| Frozen blood thaw CPT 86931 | not published | not published | $78.00 – $350.65 | 9 |
| Frozen cell preparation CPT 88241 | not published | not published | $11.00 – $25.87 | 8 |
| Frozen plasma, pooled, sd HCPCS P9023 | not published | not published | $55.96 – $119.75 | 7 |
| Fructosamine glycated protein CPT 82985 | $18.70 | $34.00 | $11.00 – $35.87 | 9 |
| Ft arch suprt premold longit HCPCS L3040 | not published | not published | $58.14 – $124.42 | 7 |
| Fth/gft fr n/e/e/l each addl CPT 15261 | not published | not published | $204.33 – $1,496.00 | 3 |
| Fth/gft fr trnk each addl CPT 15201 | not published | not published | $115.47 – $1,496.00 | 3 |
| Ft insert ucb berkeley shell HCPCS L3000 | not published | not published | $388.12 – $830.58 | 8 |
| Ftl cgen abnor 3 proteins CPT 81509 | not published | not published | $1,487.37 – $3,182.97 | 8 |
| Ftl cgen abnor five anal CPT 81512 | not published | not published | $69.52 – $148.77 | 8 |
| Ftl cgen abnor four anal CPT 81511 | $438.35 | $797.00 | $153.50 – $328.49 | 8 |
| Ftl cgen abnor three anal CPT 81510 | not published | not published | $55.54 – $118.86 | 8 |
| Ftl cgen abnor two proteins CPT 81508 | not published | not published | $54.30 – $116.20 | 8 |
| Ft prosth multiaxial ankl/ft HCPCS L5978 | not published | not published | $416.66 – $891.65 | 8 |
| Full field erg w/i&r CPT 92273 | not published | not published | $130.27 – $529.38 | 8 |
| Full mouth x-ray of teeth CPT 70320 | not published | not published | $61.30 – $491.09 | 9 |
| Full sole/heel wedge btween HCPCS L3420 | not published | not published | $67.55 – $144.56 | 7 |
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.