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 |
|---|---|---|---|---|
| Full thick gft/nose/ear/lid/lip/20sqcm or< 15260 CPT 15260 | not published | not published | $1,254.00 – $4,246.62 | 11 |
| Full thick gft/scalp/arm/leg/20sqcm or< 15220 CPT 15220 | not published | not published | $921.29 – $4,246.62 | 11 |
| Full thick gft/scalp/arm/leg/add 20sqcm 15221 CPT 15221 | not published | not published | $104.33 – $1,496.00 | 3 |
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | not published | not published | $1,201.23 – $4,246.62 | 11 |
| Functional brain mapping CPT 96020 | not published | not published | $231.43 – $240.91 | 2 |
| Fundus photography with i&r 92250 CPT 92250 | not published | not published | $23.91 – $273.84 | 8 |
| Furnsh initial orthosis only HCPCS L1200 | not published | not published | $2,070.70 – $4,431.30 | 8 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | not published | not published | $0.02 – $0.03 | 3 |
| Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr HCPCS J1940 | not published | not published | $0.66 – $0.94 | 2 |
| Fuse bile ducts and bowel 47785 CPT 47785 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Fuse esophagus & intestine CPT 43340 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Fuse esophagus & intestine CPT 43341 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Fuse esophagus & stomach CPT 43320 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Fuse gallbladder & bowel CPT 47740 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Fuse gallbladder & bowel CPT 47741 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Fuse/graft added joint CPT 26863 | not published | not published | $343.64 – $1,496.00 | 3 |
| Fuse liver duct & intestine CPT 47802 | not published | not published | $1,189.00 – $4,386.82 | 2 |
| Fuse liver ducts & bowel CPT 47765 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Fuse pancreas and bowel CPT 48548 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Fuse pancreas cyst and bowel CPT 48540 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Fuse pancreas cyst and bowel 48520 CPT 48520 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Fuse upper gi structures CPT 47721 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Fusion/graft of finger joint CPT 26862 | not published | not published | $1,156.78 – $6,734.39 | 11 |
| Fusion/graft of hand joint CPT 26844 | not published | not published | $1,298.03 – $14,934.65 | 11 |
| Fusion of ankle joint open CPT 27870 | not published | not published | $1,537.30 – $26,424.41 | 11 |
| Fusion of big toe joint CPT 28750 | not published | not published | $880.63 – $14,934.65 | 11 |
| Fusion of big toe joint CPT 28755 | not published | not published | $512.61 – $14,934.65 | 11 |
| Fusion of facial/other nerve CPT 64866 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Fusion of finger jnt add-on CPT 26861 | not published | not published | $154.02 – $1,496.00 | 3 |
| Fusion of finger joint CPT 26860 | not published | not published | $919.37 – $6,734.39 | 11 |
| Fusion of finger tendons CPT 26471 | not published | not published | $993.04 – $6,734.39 | 11 |
| Fusion of finger tendons CPT 26474 | not published | not published | $979.54 – $3,309.55 | 11 |
| Fusion of foot bones CPT 28730 | not published | not published | $1,106.90 – $26,424.41 | 11 |
| Fusion of foot bones CPT 28735 | not published | not published | $1,187.12 – $26,424.41 | 11 |
| Fusion of foot bones CPT 28740 | not published | not published | $942.84 – $14,934.65 | 11 |
| Fusion of hand joint CPT 26843 | not published | not published | $1,179.40 – $14,934.65 | 11 |
| Fusion of knee CPT 27580 | not published | not published | $2,237.84 – $26,424.41 | 8 |
| Fusion of knuckle CPT 26850 | not published | not published | $1,106.77 – $14,934.65 | 11 |
| Fusion of knuckle joint CPT 26516 | not published | not published | $991.00 – $6,734.39 | 11 |
| Fusion of knuckle joints CPT 26517 | not published | not published | $1,306.69 – $6,734.39 | 11 |
| Fusion of knuckle joints CPT 26518 | not published | not published | $1,323.44 – $14,934.65 | 11 |
| Fusion of knuckle with graft CPT 26852 | not published | not published | $1,258.96 – $14,934.65 | 11 |
| Fusion of skull arteries CPT 61711 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Fusion of spermatic ducts CPT 54900 | not published | not published | $1,221.79 – $4,302.40 | 11 |
| Fusion of spermatic ducts CPT 54901 | not published | not published | $1,594.00 – $7,255.07 | 11 |
| Fusion of tendons at wrist CPT 25300 | not published | not published | $1,054.80 – $6,734.39 | 11 |
| Fusion of tendons at wrist CPT 25301 | not published | not published | $985.16 – $6,734.39 | 11 |
| Fusion of thumb CPT 26841 | not published | not published | $1,167.49 – $14,934.65 | 11 |
| Fusion of tibiofibular joint CPT 27871 | not published | not published | $1,053.61 – $26,424.41 | 11 |
| Fusion of toes CPT 28280 | not published | not published | $529.23 – $6,734.39 | 11 |
| Fusion of ureter & bowel CPT 50810 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Fusion of ureter & kidney CPT 50740 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Fusion of ureter & kidney CPT 50750 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Fxn gene charac alleles CPT 81285 | not published | not published | $274.83 – $588.14 | 7 |
| Fxn gene detc abnor alleles CPT 81284 | not published | not published | $137.00 – $293.18 | 7 |
| Fxn gene full gene sequence CPT 81286 | not published | not published | $274.83 – $588.14 | 7 |
| Fxn gene known famil variant CPT 81289 | not published | not published | $185.20 – $396.33 | 7 |
| G0180 home health certification HCPCS G0180 | not published | not published | $80.88 – $80.88 | 1 |
| G6pc gene CPT 81250 | not published | not published | $58.49 – $125.17 | 8 |
| G6pd full gene sequence CPT 81249 | $1,320.00 | $2,400.00 | $600.00 – $1,284.00 | 7 |
| G6pd gene alys cmn variant CPT 81247 | not published | not published | $174.81 – $374.09 | 7 |
| G6pd known familial variant CPT 81248 | not published | not published | $375.25 – $803.04 | 7 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | $923.05 | $1,678.27 | $252.81 – $252.81 | 1 |
| Ga-68 gallium 68 dotatate HCPCS A9587 | not published | not published | $49.63 – $106.21 | 8 |
| Gabapentin non-blood CPT 80355 | $144.10 | $262.00 | $35.46 – $35.46 | 1 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | not published | not published | $0.30 – $0.56 | 4 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | not published | not published | $1.70 – $2.50 | 4 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | not published | not published | $0.14 – $0.21 | 4 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | not published | not published | $16.77 – $24.21 | 4 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | not published | not published | $15.00 – $45.09 | 9 |
| Galactokinase - sendout CPT 82759 | not published | not published | $15.00 – $45.97 | 9 |
| Galactose transferase test CPT 82776 | not published | not published | $6.00 – $25.12 | 9 |
| Galectin-3 CPT 82777 | $78.79 | $143.25 | $44.25 – $94.70 | 8 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $1,004.87 – $12,442.83 | 10 |
| Gallium ga-68 psma-11, ucla HCPCS A9594 | not published | not published | $363.50 – $1,296.43 | 8 |
| Gallium ga-68 psma-11 ucsf HCPCS A9593 | not published | not published | $550.13 – $1,324.08 | 8 |
| Gallium illuccix 1 millicure HCPCS A9596 | not published | not published | $478.52 – $1,760.10 | 8 |
| Gallium locametz 1 millicuri HCPCS A9800 | not published | not published | $362.50 – $1,542.90 | 8 |
| Gallium nitrate injection HCPCS J1457 | not published | not published | $3.94 – $3.94 | 1 |
| Galsulfase injection HCPCS J1458 | not published | not published | $525.97 – $1,025.64 | 9 |
| Gamma globulin > 10 cc inj HCPCS J1560 | not published | not published | $162.52 – $833.17 | 9 |
| Gamma globulin 1 cc inj HCPCS J1460 | not published | not published | $48.87 – $95.30 | 9 |
| Gammaglobulin iga CPT 82784 | $78.79 | $143.25 | $9.30 – $19.90 | 9 |
| Gammaglobulin ige CPT 82785 | $139.42 | $253.50 | $16.46 – $35.22 | 9 |
| Gamma glutamyltransferase CPT 82977 | $61.05 | $111.00 | $5.00 – $15.41 | 9 |
| Gammagraft HCPCS Q4111 | not published | not published | $8.66 – $233.39 | 9 |
| Gammaplex injection HCPCS J1557 | not published | not published | $65.53 – $129.23 | 9 |
| Gamunex-c/gammaked HCPCS J1561 | not published | not published | $49.01 – $95.58 | 9 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | not published | not published | $36.58 – $73.78 | 4 |
| Ganciclovir long act implant HCPCS J7310 | not published | not published | $31,536.00 – $31,536.00 | 1 |
| Gardner vag dna amp probe CPT 87511 | not published | not published | $35.09 – $75.09 | 8 |
| Gardner vag dna quant CPT 87512 | not published | not published | $41.76 – $89.37 | 8 |
| Gastric analy w/ph ea spec CPT 82930 | not published | not published | $6.71 – $14.36 | 8 |
| Gastric emptying imag study CPT 78265 | not published | not published | $384.49 – $822.80 | 8 |
| Gastric emptying imag study CPT 78266 | not published | not published | $517.72 – $1,117.53 | 8 |
| Gastric motility studies CPT 91020 | not published | not published | $295.06 – $1,496.00 | 9 |
| Gastric mucosa imaging CPT 78261 | not published | not published | $226.93 – $822.80 | 9 |
| Gastrin test CPT 82938 | not published | not published | $17.69 – $37.86 | 9 |
| Gastroduodenostomy CPT 43810 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Gastroesophageal reflux study CPT 78262 | not published | not published | $279.64 – $822.80 | 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.