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 |
|---|---|---|---|---|
| Injection estrone per 1 mg HCPCS J1435 | not published | not published | $0.08 – $0.08 | 1 |
| Injection eye drug CPT 67028 | not published | not published | $137.84 – $1,579.00 | 10 |
| Injection, famotidine, 20 mg HCPCS S0028 | not published | not published | $0.93 – $1.46 | 2 |
| Injection for arthrography wrist (both sides) CPT 25246 | $116.64 | $212.08 | $111.38 – $1,496.00 | 2 |
| Injection for bladder x-ray CPT 51600 | $302.24 | $549.52 | $66.13 – $1,496.00 | 2 |
| Injection for hip x-ray CPT 27095 | not published | not published | $124.32 – $1,496.00 | 2 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $116.64 | $212.08 | $75.88 – $1,496.00 | 2 |
| Injection for spleen x-ray CPT 38200 | not published | not published | $197.53 – $1,496.00 | 2 |
| Injection for tear sac x-ray CPT 68850 | not published | not published | $77.71 – $1,496.00 | 2 |
| Injection for ureter x-ray CPT 50684 | not published | not published | $76.92 – $1,496.00 | 2 |
| Injection for ureter x-ray CPT 50690 | not published | not published | $105.50 – $1,496.00 | 2 |
| Injection, fosphenytoin sodi HCPCS S0078 | not published | not published | $41.74 – $61.59 | 2 |
| Injection, fulvestrant HCPCS J9395 | not published | not published | $7.87 – $13.88 | 4 |
| Injection glatiramer acetate HCPCS J1595 | not published | not published | $94.44 – $184.89 | 2 |
| Injection, glucarpidase HCPCS C9293 | not published | not published | $432.33 – $961.08 | 7 |
| Injection, inclisiran, 1 mg HCPCS J1306 | not published | not published | $12.90 – $25.16 | 9 |
| Injection into brain canal CPT 61026 | not published | not published | $166.60 – $1,579.00 | 11 |
| Injection into brain canal CPT 61055 | $788.67 | $1,433.95 | $178.08 – $1,579.00 | 11 |
| Injection into hemorrhoid(s) CPT 46500 | not published | not published | $274.59 – $1,914.03 | 9 |
| Injection into spinal artery CPT 62294 | not published | not published | $850.66 – $2,891.00 | 11 |
| Injection into vocal cord CPT 31513 | not published | not published | $199.33 – $2,100.00 | 11 |
| Injection intraop add-on CPT 48400 | not published | not published | $160.80 – $4,386.82 | 3 |
| Injection, isavuconazonium HCPCS J1833 | not published | not published | $1.03 – $2.20 | 8 |
| Injection jaw joint x-ray CPT 21116 | not published | not published | $67.67 – $1,496.00 | 2 |
| Injection jugular CPT 36299 | $997.18 | $1,813.05 | $731.00 – $1,496.00 | 2 |
| Injection, khapzory, 0.5 mg HCPCS J0642 | not published | not published | $1.35 – $2.51 | 4 |
| Injection, necitumumab, 1 mg HCPCS J9295 | not published | not published | $5.73 – $11.18 | 9 |
| Injection of HIV prep drug HCPCS G0012 | not published | not published | $21.57 – $148.19 | 8 |
| Injection of sinus tract CPT 20500 | not published | not published | $135.79 – $3,193.45 | 9 |
| Injection,onabotulinumtoxina HCPCS J0585 | not published | not published | $6.51 – $12.69 | 9 |
| Injection, pentamidine iseth HCPCS S0080 | not published | not published | $102.59 – $160.47 | 2 |
| Injection, peramivir HCPCS J2547 | not published | not published | $1.68 – $3.59 | 8 |
| Injection, piperacillin sodi HCPCS S0081 | not published | not published | $3.43 – $3.43 | 1 |
| Injection px peyronie ds CPT 54200 | not published | not published | $132.43 – $1,579.00 | 10 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $1,484.78 | $2,699.60 | $49.00 – $1,579.00 | 10 |
| Injection, renflexis HCPCS Q5104 | not published | not published | $26.62 – $51.90 | 9 |
| Injection, ruconest HCPCS J0596 | not published | not published | $37.83 – $73.77 | 9 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | not published | not published | $678.90 – $1,579.00 | 11 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | not published | not published | $97.01 – $1,579.00 | 10 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $1,431.48 | $2,602.70 | $63.93 – $1,579.00 | 10 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | not published | not published | $169.47 – $1,820.41 | 11 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | not published | not published | $90.63 – $1,496.00 | 2 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | not published | not published | $160.39 – $1,820.41 | 10 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | not published | not published | $77.81 – $1,496.00 | 2 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $2,505.80 | $4,556.00 | $137.66 – $1,820.41 | 10 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | not published | not published | $163.97 – $1,579.00 | 10 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | not published | not published | $151.64 – $1,579.00 | 10 |
| Injection, siltuximab HCPCS J2860 | not published | not published | $174.07 – $339.43 | 9 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $48.31 | $87.84 | $59.56 – $1,579.00 | 10 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $769.97 | $1,399.95 | $56.24 – $1,579.00 | 10 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | not published | not published | $63.93 – $1,579.00 | 10 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $231.55 | $421.00 | $22.58 – $96.38 | 8 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $277.20 | $504.00 | $14.39 – $33.36 | 2 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $292.05 | $531.00 | $53.68 – $437.78 | 8 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $327.25 | $595.00 | $21.57 – $148.19 | 8 |
| Injection, ticarcillin disod HCPCS S0040 | not published | not published | $26.28 – $26.28 | 1 |
| Injection torsemide 10 mg/ml HCPCS J3265 | not published | not published | $5.86 – $5.86 | 1 |
| Injection treatment of eye CPT 66020 | not published | not published | $196.44 – $4,749.93 | 11 |
| Injection treatment of eye CPT 66030 | not published | not published | $166.30 – $4,749.93 | 11 |
| Injection treatment of nerve CPT 64605 | not published | not published | $642.43 – $4,019.07 | 11 |
| Injection treatment of nerve CPT 64610 | not published | not published | $729.19 – $4,019.07 | 11 |
| Injection treatment of nerve CPT 64681 | not published | not published | $333.13 – $2,100.00 | 11 |
| Injection treatment of nose CPT 30200 | not published | not published | $90.37 – $1,579.00 | 10 |
| Inject sacroiliac joint CPT 27096 | not published | not published | $126.46 – $1,496.00 | 3 |
| Inject/treat eye socket CPT 67500 | not published | not published | $98.02 – $1,496.00 | 9 |
| Inject/treat eye socket CPT 67505 | not published | not published | $108.60 – $1,579.00 | 10 |
| Inject/treat eye socket CPT 67515 | not published | not published | $70.76 – $1,579.00 | 10 |
| Inj efgart-alfa 2mg hya-qvfc HCPCS J9334 | not published | not published | $34.26 – $66.80 | 8 |
| Inj eflapegrastim-xnst 0.1mg HCPCS J1449 | not published | not published | $25.78 – $75.20 | 9 |
| Inj., emapalumab-lzsg, 1 mg HCPCS J9210 | not published | not published | $392.78 – $765.92 | 9 |
| Inj., emicizumab-kxwh 0.5 mg HCPCS J7170 | not published | not published | $58.03 – $113.16 | 8 |
| Inj epidural sgl cerv-thor without img CPT 62320 | not published | not published | $152.31 – $1,579.00 | 10 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | not published | not published | $121.46 – $1,820.41 | 10 |
| Inj, epinephrine (belcher) HCPCS J0173 | not published | not published | $2.57 – $3.60 | 4 |
| Inj., eravacycline, 1 mg HCPCS J0122 | not published | not published | $1.38 – $2.69 | 8 |
| Inj, erzofri, 1 mg HCPCS J2428 | not published | not published | $15.87 – $33.97 | 7 |
| Inj, etelcalcetide, 0.1 mg HCPCS J0606 | not published | not published | $2.47 – $6.34 | 8 |
| Inj, eteplirsen, 10 mg HCPCS J1428 | not published | not published | $167.42 – $358.29 | 8 |
| Inj, evinacumab-dgnb, 5mg HCPCS J1305 | not published | not published | $197.63 – $385.38 | 8 |
| Inj., evomela, 1 mg HCPCS J9246 | not published | not published | $18.04 – $35.19 | 9 |
| Inj, exagamglogene autotem HCPCS J3392 | not published | not published | $2,300,906.67 – $4,923,940.27 | 7 |
| Inj, factor x, (human), 1iu HCPCS J7175 | not published | not published | $9.95 – $19.41 | 9 |
| Inj, faricimab-svoa, 0.1mg HCPCS J2777 | not published | not published | $32.38 – $63.14 | 9 |
| Inj fe-based mr contrast,1ml HCPCS Q9953 | not published | not published | $101.92 – $101.92 | 1 |
| Inj. fe derisomaltose 10 mg HCPCS J1437 | not published | not published | $21.08 – $41.10 | 9 |
| Inj fensolvi 0.25 mg HCPCS J1951 | not published | not published | $145.31 – $283.36 | 8 |
| Inj ferric pyrophosphate cit HCPCS J1443 | not published | not published | $0.03 – $0.05 | 2 |
| Inj., fibryga, 1 mg HCPCS J7177 | not published | not published | $1.23 – $2.40 | 9 |
| Inj fluphenazine hcl 1.25 mg HCPCS J2679 | not published | not published | $10.72 – $12.40 | 3 |
| Inj, focinvez, 1mg HCPCS J1434 | not published | not published | $2.46 – $4.83 | 8 |
| Inj follitropin alfa 75 iu HCPCS S0126 | not published | not published | $253.59 – $396.68 | 2 |
| Inj follitropin beta 75 iu HCPCS S0128 | not published | not published | $228.38 – $357.24 | 2 |
| Inj for ext venography CPT 36005 | $512.85 | $932.45 | $71.51 – $1,496.00 | 2 |
| Inj for mammo ductogram CPT 19030 | not published | not published | $115.20 – $1,496.00 | 2 |
| Inj, fosaprepitant (teva) HCPCS J1456 | not published | not published | $0.04 – $1.82 | 9 |
| Inj fosnetupitant, palonoset HCPCS J1454 | not published | not published | $503.85 – $1,140.19 | 9 |
| Inj., fremanezumab-vfrm 1 mg HCPCS J3031 | not published | not published | $5.24 – $5.24 | 1 |
| Inj, fulvestrant (fresenius) HCPCS J9394 | not published | not published | $3.78 – $87.05 | 9 |
| Inj, fulvestrant (teva) HCPCS J9393 | not published | not published | $33.84 – $89.17 | 7 |
| Inj, gadopiclenol, 1 ml HCPCS A9573 | not published | not published | $5.21 – $18.68 | 3 |
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.