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 |
|---|---|---|---|---|
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $332.59 | $604.71 | $34.61 – $233.39 | 9 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | not published | not published | $119.69 – $2,403.42 | 9 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | not published | not published | $72.53 – $326.02 | 9 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $1,387.11 – $6,734.39 | 11 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | not published | not published | $35.22 – $256.13 | 8 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | not published | not published | $1,041.00 – $3,280.89 | 2 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $7,352.49 | $13,368.16 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | not published | not published | $64.16 – $233.39 | 9 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | not published | not published | $119.69 – $233.39 | 8 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | not published | not published | $119.69 – $233.39 | 9 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | not published | not published | $59.04 – $233.39 | 9 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | not published | not published | $119.69 – $266.22 | 8 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | not published | not published | $42.75 – $259.91 | 9 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $1,961.58 | $3,566.50 | not published | 0 |
| Granisetron 1 mg tab HCPCS Q0166 | not published | not published | $1.66 – $5.08 | 2 |
| Granisetron hcl injection HCPCS J1626 | not published | not published | $0.30 – $0.62 | 4 |
| Granulocyte pheresis ea unit HCPCS P9050 | not published | not published | $1,259.19 – $1,259.19 | 1 |
| Great toe-hand transfer CPT 26551 | not published | not published | $4,386.82 – $14,934.65 | 8 |
| Great toe with reduction 28495 CPT 28495 | $366.05 | $665.55 | $230.44 – $1,496.00 | 9 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $759.20 – $8,185.00 | 10 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $774.09 – $8,185.00 | 10 |
| Grfg autol fat lipo ea addl CPT 15772 | not published | not published | $224.05 – $1,496.00 | 2 |
| Grfg autol soft tiss dir exc CPT 15769 | not published | not published | $727.76 – $8,185.00 | 10 |
| Ground mileage HCPCS A0425 | not published | not published | $9.33 – $21.71 | 8 |
| Group behave couns 2-10 HCPCS G0473 | not published | not published | $17.59 – $77.12 | 8 |
| Group mnt 2 or more 30 mins HCPCS G0271 | not published | not published | $11.89 – $25.44 | 8 |
| Growth hormone antibody CPT 86277 | not published | not published | $11.00 – $33.68 | 9 |
| Growth hormone panel CPT 80428 | not published | not published | $66.70 – $142.74 | 9 |
| Growth hormone panel CPT 80430 | not published | not published | $97.00 – $276.77 | 9 |
| Growth stimulation gene 2 CPT 83006 | not published | not published | $75.60 – $161.78 | 7 |
| Grp adapt bhv tx by phy/qhp CPT 97158 | not published | not published | $36.04 – $77.12 | 7 |
| Grp adapt bhv tx by tech CPT 97154 | not published | not published | $36.04 – $77.12 | 7 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Gstr rstcv oth/thn v-band CPT 43843 | not published | not published | $1,950.67 – $4,491.00 | 3 |
| Gstr rstcv px shrt roux-en-y CPT 43846 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Gstr rstcv px sm int rcnstj CPT 43847 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Gstr rstcv px v-banded gstp CPT 43842 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $1,067.84 – $3,949.47 | 9 |
| G-tube reposition CPT 43761 | $620.84 | $1,128.80 | $158.35 – $1,579.00 | 11 |
| Gu dilat ureter/urethra s&i CPT 74485 | not published | not published | $116.40 – $4,302.40 | 9 |
| Guided cath fluid drainage 10030 CPT 10030 | $6,352.86 | $11,550.65 | $205.07 – $1,496.00 | 9 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | not published | not published | $1,071.68 – $1,071.68 | 1 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $619.05 | $1,125.54 | not published | 0 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $10,170.53 | $18,491.88 | not published | 0 |
| Guid loc target vol rad tx CPT 77387 | not published | not published | $146.59 – $146.59 | 1 |
| Gum graft CPT 41870 | not published | not published | $464.33 – $3,193.45 | 9 |
| Gw stiffened micro access kit HCPCS C1894 | $352.58 | $641.06 | not published | 0 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $652.24 – $8,058.70 | 11 |
| Hair analysis HCPCS P2031 | not published | not published | $7.19 – $7.19 | 1 |
| Hair removal by electrolysis 17380 CPT 17380 | not published | not published | $118.95 – $1,521.15 | 8 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $384.77 – $2,891.00 | 10 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $390.97 – $2,891.00 | 10 |
| Hallus-valgus nt dyn pre ots HCPCS L3100 | not published | not published | $53.41 – $114.30 | 7 |
| Halo cervical into body jack HCPCS L0820 | not published | not published | $2,654.79 – $5,681.25 | 8 |
| Halo cervical into jckt vest HCPCS L0810 | not published | not published | $3,147.13 – $6,734.86 | 8 |
| Halo cerv into milwaukee typ HCPCS L0830 | not published | not published | $4,253.60 – $9,102.70 | 8 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | not published | not published | $5.26 – $14.42 | 4 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | not published | not published | $0.89 – $2.33 | 4 |
| Halo repl liner/interface HCPCS L0861 | not published | not published | $266.31 – $569.90 | 8 |
| Hand-held pefr meter a4614 HCPCS A4614 | not published | not published | $53.30 – $53.30 | 1 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | not published | not published | $7.00 – $7.92 | 2 |
| Hand orthosis metacarpal fracture orthosis prefa l3918 HCPCS L3918 | not published | not published | $118.75 – $254.12 | 8 |
| Hand restoration multiple fi HCPCS L6905 | not published | not published | $1,797.45 – $3,846.54 | 8 |
| Hand restoration no fingers HCPCS L6910 | not published | not published | $1,771.25 – $3,790.48 | 8 |
| Hand restoration replacmnt g HCPCS L6915 | not published | not published | $766.41 – $1,640.12 | 8 |
| Hand restorat thumb/1 finger HCPCS L6900 | not published | not published | $1,892.87 – $4,050.74 | 8 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $1,270.05 – $6,734.39 | 11 |
| Hand tendon reconstruction CPT 26500 | not published | not published | $1,034.58 – $14,934.65 | 11 |
| Hand tendon reconstruction CPT 26502 | not published | not published | $1,138.63 – $6,734.39 | 11 |
| Hand X-ray CPT 73130 | $581.35 | $1,057.00 | $41.65 – $179.11 | 9 |
| Haptoglobin quantitative CPT 83010 | $213.26 | $387.75 | $9.00 – $26.92 | 9 |
| Harness chest/shlder saddle HCPCS L6672 | not published | not published | $217.81 – $466.11 | 8 |
| Harness figure of 8 dual con HCPCS L6676 | not published | not published | $160.58 – $343.64 | 8 |
| Harness figure of 8 sing con HCPCS L6675 | not published | not published | $152.75 – $326.88 | 8 |
| Harvest allogeneic stem cell CPT 38205 | not published | not published | $127.18 – $4,386.82 | 4 |
| Harvest auto stem cells CPT 38206 | not published | not published | $125.31 – $3,205.48 | 9 |
| Harvest cultured skin graft 15040 CPT 15040 | not published | not published | $189.31 – $4,246.62 | 11 |
| Harvest eye tissue alograft CPT 68371 | not published | not published | $616.13 – $4,893.31 | 11 |
| Harvest femoropopliteal vein 35572 CPT 35572 | not published | not published | $512.59 – $1,496.00 | 2 |
| Harvest stem cell concentrte CPT 38215 | not published | not published | $72.17 – $1,579.00 | 10 |
| Harvest vein for bypass 35500 CPT 35500 | not published | not published | $475.82 – $1,496.00 | 2 |
| Hast w/i&r phys/qhp CPT 94452 | not published | not published | $52.67 – $273.84 | 8 |
| Hast w/oxygen titrate CPT 94453 | not published | not published | $70.36 – $273.84 | 8 |
| Hba1/hba2 full gene sequence CPT 81259 | $660.00 | $1,200.00 | $600.00 – $1,284.00 | 7 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $586.85 | $1,067.00 | $202.40 – $433.14 | 7 |
| Hba1/hba2 gene fam vrnt CPT 81258 | not published | not published | $375.25 – $803.04 | 7 |
| Hbb full gene sequence CPT 81364 | $3,795.00 | $6,900.00 | $324.58 – $694.60 | 8 |
| Hbb gene com variants CPT 81361 | not published | not published | $174.81 – $374.09 | 8 |
| Hbb gene dup/del variants CPT 81363 | not published | not published | $202.40 – $433.14 | 8 |
| Hbb gene known fam variant CPT 81362 | not published | not published | $375.25 – $803.04 | 8 |
| Hb glycosylated a1c home dev CPT 83037 | not published | not published | $9.71 – $20.78 | 8 |
| Hbot, full body chamber, 30m HCPCS G0277 | $1,223.45 | $2,224.45 | $132.35 – $283.23 | 8 |
| Hc ea ha check monaural CPT 92594 | not published | not published | $31.75 – $39.00 | 2 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | not published | not published | $168.70 – $442.26 | 9 |
| Hcg free betachain test CPT 84704 | not published | not published | $15.29 – $32.72 | 8 |
| Hcg qualitative CPT 84703 | $351.45 | $639.00 | $5.00 – $16.09 | 9 |
| Hcg quantitative CPT 84702 | $313.64 | $570.25 | $15.05 – $32.21 | 9 |
| Hc hearing aid chck binaurl CPT 92593 | not published | not published | $55.07 – $63.21 | 2 |
| Hc hearing aid chck monarl CPT 92592 | not published | not published | $33.26 – $63.21 | 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.