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 |
|---|---|---|---|---|
| Hysteroscopy remove fb CPT 58562 | not published | not published | $338.31 – $6,662.61 | 11 |
| Hysteroscopy remove myoma CPT 58561 | not published | not published | $546.69 – $10,295.98 | 11 |
| Hysteroscopy resect septum CPT 58560 | not published | not published | $477.66 – $10,295.98 | 11 |
| Hysterotomy abdominal 59100 CPT 59100 | not published | not published | $1,304.70 – $10,295.98 | 10 |
| Hzv zoster vacc recombinant adjuvanted im inj CPT 90750 | not published | not published | $207.80 – $310.28 | 2 |
| I-123 iobenguane diag HCPCS A9582 | $24,446.40 | $44,448.00 | $2,317.50 – $8,434.94 | 8 |
| I-123 ioflupane diag HCPCS A9584 | not published | not published | $1,387.74 – $4,621.21 | 8 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | $417.27 | $758.67 | $100.63 – $167.27 | 2 |
| I125 iothalamate, dx HCPCS A9554 | not published | not published | $39.38 – $1,390.23 | 8 |
| I125 serum albumin, dx HCPCS A9532 | not published | not published | $303.81 – $1,003.79 | 7 |
| I-131 iobenguane sulf diag mibg HCPCS A9508 | not published | not published | $953.01 – $2,039.44 | 7 |
| I131 iodide cap, rx HCPCS A9517 | $1,059.27 | $1,925.94 | $24.07 – $70.36 | 8 |
| I131 iodide sol, rx HCPCS A9530 | not published | not published | $16.29 – $44.45 | 8 |
| I131 max 100uci HCPCS A9531 | not published | not published | $6.23 – $6.23 | 1 |
| I131 serum albumin, dx HCPCS A9524 | not published | not published | $95.00 – $148.24 | 2 |
| Iaadi respiratory synctial virus CPT 87280 | $81.40 | $148.00 | $9.00 – $28.72 | 9 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | $356.95 | $649.00 | $35.09 – $75.09 | 8 |
| Ia infect ag ab qual/semiquant sgl step CPT 86318 | not published | not published | $9.00 – $38.71 | 9 |
| Ia nfct ab sarscov2 covid19 CPT 86328 | not published | not published | $45.28 – $96.90 | 8 |
| Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 | not published | not published | $33.33 – $42.05 | 3 |
| Ibmfs seq alys pnl 30 genes CPT 81441 | not published | not published | $2,448.56 – $5,239.92 | 8 |
| Ibuprofen injection HCPCS J1741 | not published | not published | $3.25 – $6.34 | 9 |
| Ibutilide fumarate 0.1 mg/ml intravenous solution HCPCS J1742 | not published | not published | $175.89 – $489.96 | 8 |
| Icatibant injection HCPCS J1744 | not published | not published | $142.86 – $229.33 | 4 |
| Icd cobalt xt dr MRI is1 df1 HCPCS C1721 | $59,009.89 | $107,290.71 | not published | 0 |
| Icd crtd cobalt hf MRI is1 df1 HCPCS C1882 | $71,785.11 | $130,518.39 | not published | 0 |
| Icd crtp serena MRI HCPCS C2621 | $34,525.69 | $62,773.98 | not published | 0 |
| Icd reliance df4 ib 64cm HCPCS C1895 | $14,220.44 | $25,855.35 | not published | 0 |
| Icg angiography i&r uni/bi CPT 92240 | not published | not published | $204.10 – $544.95 | 8 |
| Icut allergy test-delayed CPT 95028 | not published | not published | $18.17 – $76.88 | 8 |
| Icut allergy test drug/bug CPT 95024 | not published | not published | $1.46 – $121.42 | 8 |
| Icut allergy titrate-airborn CPT 95027 | not published | not published | $7.21 – $59.53 | 8 |
| I&d abscess posterior spine l/s/ls-22015 CPT 22015 | not published | not published | $1,440.62 – $14,934.65 | 8 |
| I&d abscss rtrphryngl/paraphryngl intraorl apprch CPT 42720 | not published | not published | $589.05 – $6,823.84 | 11 |
| Idarubicin hcl injection HCPCS J9211 | not published | not published | $49.60 – $70.51 | 4 |
| I&d/bursa/foot 28001 CPT 28001 | not published | not published | $148.05 – $3,399.30 | 9 |
| Idecabtagene vicleucel car HCPCS Q2055 | not published | not published | $567,977.78 – $1,107,556.67 | 9 |
| Identify sperm tissue CPT 89264 | not published | not published | $50.12 – $107.25 | 7 |
| Idet 1 or more levels CPT 22527 | not published | not published | $233.05 – $8,185.00 | 4 |
| Idet single level CPT 22526 | not published | not published | $500.47 – $8,185.00 | 4 |
| I&d frarm&/wrst deep absc/hematoma CPT 25028 | not published | not published | $991.00 – $6,734.39 | 11 |
| Idh1 common variants CPT 81120 | not published | not published | $193.25 – $413.56 | 8 |
| Idh2 common variants CPT 81121 | not published | not published | $295.79 – $632.99 | 8 |
| I&d intramural/intramuscular/submuc abscess transanal anes CPT 46045 | not published | not published | $667.20 – $5,712.83 | 11 |
| I&d lacrimal gland CPT 68400 | not published | not published | $196.99 – $2,051.76 | 10 |
| I&d lacrimal sac CPT 68420 | not published | not published | $250.14 – $5,316.00 | 10 |
| Iduc valve sply repl HCPCS A4342 | not published | not published | $1,291.26 – $1,380.78 | 2 |
| I&d upper arm/elbow deep abscess/hematoma CPT 23930 | $2,936.37 | $5,338.85 | $327.81 – $5,978.45 | 11 |
| Idursulfase injection HCPCS J1743 | not published | not published | $570.04 – $1,111.58 | 9 |
| I & d vag hematoma non-ob 57023 CPT 57023 | not published | not published | $490.06 – $5,978.45 | 11 |
| I&d vag hemtma obst/postpart CPT 57022 | not published | not published | $276.71 – $5,978.45 | 9 |
| Ifnl3 gene CPT 81283 | not published | not published | $73.37 – $157.01 | 7 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | not published | not published | $28.07 – $43.94 | 4 |
| Igh@/bcl2 translocation alys CPT 81278 | not published | not published | $207.31 – $443.64 | 8 |
| Igh gene rearrang dir probe CPT 81262 | not published | not published | $68.55 – $146.70 | 7 |
| Igh gene rearrange amp meth CPT 81261 | not published | not published | $197.99 – $423.70 | 8 |
| Igh@ var region somatic mutation analy CPT 81263 | $544.50 | $990.00 | $294.52 – $630.27 | 7 |
| Igk rearrangeabn clonal pop CPT 81264 | not published | not published | $172.73 – $369.64 | 8 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $277.34 | $504.25 | $91.52 – $126.92 | 2 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $348.15 | $633.00 | $195.47 – $737.75 | 8 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $1,201.20 | $2,184.00 | $92.00 – $350.65 | 9 |
| Iiv3 vacc no prsv 0.25 ml im CPT 90655 | not published | not published | $24.37 – $24.37 | 1 |
| Ikbkap gene CPT 81260 | not published | not published | $39.31 – $84.12 | 8 |
| Ileostomy/jejunostomy non-tube 44310 CPT 44310 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Iliac bone graft microvasc CPT 20956 | not published | not published | $3,992.84 – $14,934.65 | 8 |
| Iliac/fem angio cath insert HCPCS G0278 | $1,509.56 | $2,744.65 | $14.64 – $20.38 | 2 |
| Iliac revasc add-on 37222 CPT 37222 | $3,564.69 | $6,481.25 | $276.28 – $5,000.00 | 2 |
| Iloprost non-comp unit dose HCPCS Q4074 | not published | not published | $169.59 – $240.91 | 4 |
| Imatinib 100 mg tab HCPCS S0088 | not published | not published | $3.12 – $5.39 | 2 |
| Imbrication/diaphragm/transthor/transabd 39545 CPT 39545 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Imetelstat 188 mg intravenous solution HCPCS J0870 | not published | not published | $59.53 – $116.09 | 8 |
| Img rta detcj/mntr ds staff CPT 92227 | not published | not published | $25.36 – $121.42 | 8 |
| Img rta detc/mntr ds phy/qhp CPT 92228 | not published | not published | $19.12 – $76.88 | 8 |
| Img rta detc/mntr ds poc aly CPT 92229 | $52.80 | $96.00 | $56.74 – $121.42 | 8 |
| Immntx 1 sting insect CPT 95130 | not published | not published | $31.75 – $31.75 | 1 |
| Immntx 4 sting insects CPT 95133 | not published | not published | $59.03 – $59.03 | 1 |
| Immntx 5 sting insects CPT 95134 | not published | not published | $70.96 – $70.96 | 1 |
| Immob elbow child sm HCPCS L3762 | not published | not published | $120.93 – $258.79 | 8 |
| Immobilizer shldr cntor adlt HCPCS L3670 | not published | not published | $132.02 – $282.52 | 8 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | $103.56 | $188.30 | $63.18 – $135.21 | 8 |
| Immobilizer shldr sling med HCPCS L3660 | not published | not published | $115.57 – $247.32 | 8 |
| Immt breast prosthesis 19340 CPT 19340 | not published | not published | $1,148.73 – $16,822.37 | 11 |
| Immune complex assay CPT 86332 | $35.20 | $64.00 | $17.00 – $52.15 | 9 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | not published | not published | $49.30 – $96.14 | 9 |
| Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution HCPCS J1566 | not published | not published | $80.96 – $157.87 | 9 |
| Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution HCPCS J1568 | not published | not published | $47.06 – $91.76 | 9 |
| Immune globulin ig human im use 90281 CPT 90281 | not published | not published | $99.83 – $160.85 | 2 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $352.82 | $641.50 | $15.00 – $44.53 | 9 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $176.41 | $320.75 | $15.00 – $44.53 | 9 |
| Immunoassay tumor qual CPT 86294 | not published | not published | $14.00 – $54.72 | 9 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | not published | not published | $9.00 – $25.64 | 9 |
| Immunodiffusion nes CPT 86329 | not published | not published | $10.00 – $30.07 | 9 |
| Immunoelectrophoresis assay CPT 86327 | not published | not published | $28.00 – $43.61 | 2 |
| Immunofixation electrophoresis serum CPT 86334 | $210.10 | $382.00 | $22.34 – $75.00 | 9 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $252.45 | $459.00 | $123.60 – $145.14 | 2 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $665.50 | $1,210.00 | $163.86 – $350.65 | 9 |
| Immunoglobulin assay CPT 86023 | $154.00 | $280.00 | $9.00 – $26.66 | 9 |
| Immunology procedure CPT 86849 | not published | not published | $80.00 – $80.00 | 1 |
| Immunotherapy 2/> injections CPT 95125 | not published | not published | $22.78 – $22.78 | 1 |
| Impact tooth remov part bony HCPCS D7230 | not published | not published | $277.06 – $1,330.59 | 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.