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 |
|---|---|---|---|---|
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | not published | not published | $4.00 – $7.34 | 4 |
| Leukacyte transfusion CPT 86950 | not published | not published | $39.00 – $350.65 | 9 |
| Leukocyte phagocytosis CPT 86344 | not published | not published | $9.00 – $22.23 | 9 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | not published | not published | $160.34 – $312.67 | 9 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | not published | not published | $1,841.26 – $3,590.46 | 9 |
| Leuprolide acetate implant HCPCS J9219 | not published | not published | $9,335.97 – $9,335.97 | 1 |
| Leuprolide acetate injeciton HCPCS J9218 | not published | not published | $6.98 – $22.58 | 2 |
| Leuprolide depot cipla 7.5mg HCPCS J1954 | not published | not published | $251.64 – $1,340.21 | 9 |
| Leuprolide inj, camcevi, 1mg HCPCS J1952 | not published | not published | $42.06 – $98.22 | 9 |
| Lev 1 hosp type b ed visit HCPCS G0380 | not published | not published | $71.49 – $152.99 | 7 |
| Lev 2 hosp type b ed visit HCPCS G0381 | not published | not published | $89.34 – $191.18 | 7 |
| Lev 3 hosp type b ed visit HCPCS G0382 | not published | not published | $165.32 – $353.78 | 7 |
| Lev 4 hosp type b ed visit HCPCS G0383 | not published | not published | $254.20 – $543.99 | 7 |
| Lev 5 hosp type b ed visit HCPCS G0384 | not published | not published | $395.02 – $845.35 | 7 |
| Levalbuterol comp unit HCPCS J7615 | not published | not published | $0.08 – $0.08 | 1 |
| Levalbuterol non-comp con HCPCS J7612 | not published | not published | $0.32 – $0.51 | 4 |
| Levalbuterol non-comp unit HCPCS J7614 | not published | not published | $0.08 – $0.14 | 4 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | not published | not published | $0.06 – $0.10 | 4 |
| Levetiracetam therapeutic drug level CPT 80177 | $201.85 | $367.00 | $13.25 – $28.36 | 8 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | not published | not published | $1.17 – $1.64 | 4 |
| Levonorgestrel implant sys HCPCS J7306 | not published | not published | $833.57 – $833.57 | 1 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | not published | not published | $8.28 – $11.62 | 3 |
| L hrt cath chd nm/abn nt cnj CPT 93595 | not published | not published | $395.23 – $6,672.50 | 9 |
| Lidocaine injection HCPCS J2001 | not published | not published | $0.05 – $0.05 | 1 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | not published | not published | $0.01 – $0.01 | 1 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | not published | not published | $0.02 – $0.02 | 1 |
| Lidocaine therapeutic drug level CPT 80176 | not published | not published | $10.00 – $31.44 | 9 |
| Lift assist for elbow HCPCS L6635 | not published | not published | $270.85 – $579.62 | 8 |
| Lift heel adj small gl60404sm HCPCS L3332 | not published | not published | $91.13 – $195.02 | 7 |
| Lift heel adjustable med HCPCS L3334 | not published | not published | $47.13 – $100.86 | 7 |
| Lifts elevation metal extens HCPCS L3330 | not published | not published | $699.23 – $1,496.35 | 7 |
| Ligate esophagus veins CPT 43400 | not published | not published | $2,310.42 – $5,000.00 | 3 |
| Ligate leg veins open CPT 37761 | not published | not published | $806.14 – $6,498.69 | 10 |
| Ligate leg veins radical 37760 CPT 37760 | not published | not published | $866.60 – $6,498.69 | 11 |
| Ligate oviduct(s) add-on 58611 CPT 58611 | not published | not published | $115.32 – $4,386.82 | 3 |
| Ligate/staple esophagus CPT 43405 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Ligate/strip long leg vein CPT 37722 | not published | not published | $692.48 – $6,498.69 | 11 |
| Ligate/strip short leg vein CPT 37718 | not published | not published | $590.77 – $6,498.69 | 11 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | not published | not published | $568.55 – $6,662.61 | 10 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | not published | not published | $307.99 – $3,399.30 | 11 |
| Ligation common iliac vein CPT 37660 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Ligation/divis of long saph vein 37700 CPT 37700 | not published | not published | $366.31 – $6,498.69 | 11 |
| Ligation external carotid artery 37600 CPT 37600 | not published | not published | $1,134.89 – $6,498.69 | 9 |
| Ligation internal/common carotid artery 37605 CPT 37605 | not published | not published | $1,109.13 – $6,498.69 | 9 |
| Ligation internal jugular vein 37565 CPT 37565 | not published | not published | $1,093.00 – $6,498.69 | 9 |
| Ligation major artery chest CPT 37616 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Ligation/major artery/extremity 37618 CPT 37618 | not published | not published | $591.41 – $4,386.82 | 3 |
| Ligation major artery neck CPT 37615 | not published | not published | $779.63 – $6,498.69 | 9 |
| Ligation nasal sinus artery CPT 30915 | not published | not published | $914.02 – $6,498.69 | 11 |
| Ligation of abdomen artery 37617 CPT 37617 | not published | not published | $2,000.25 – $11,452.76 | 8 |
| Ligation of femoral vein CPT 37650 | not published | not published | $690.72 – $6,498.69 | 11 |
| Ligation of inf vena cava CPT 37619 | $5,552.50 | $10,095.45 | $2,611.80 – $11,452.76 | 9 |
| Ligation of neck artery CPT 37606 | not published | not published | $1,108.70 – $6,498.69 | 9 |
| Ligation of salivary duct CPT 42665 | not published | not published | $331.01 – $6,823.84 | 11 |
| Ligation of shunt CPT 49428 | not published | not published | $654.42 – $4,386.82 | 3 |
| Ligation upper jaw artery CPT 30920 | not published | not published | $1,320.72 – $6,498.69 | 11 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | not published | not published | $382.21 – $6,498.69 | 11 |
| Lig/band angioaccess av fistula CPT 37607 | not published | not published | $560.82 – $6,498.69 | 11 |
| Lig&div&compl strpg saph vn CPT 37735 | not published | not published | $875.32 – $6,498.69 | 11 |
| Liletta, 52 mg HCPCS J7297 | not published | not published | $931.73 – $1,429.71 | 2 |
| Limb exercise test CPT 95875 | not published | not published | $92.92 – $273.81 | 8 |
| Limb nerve surgery add-on CPT 64783 | not published | not published | $324.30 – $1,496.00 | 3 |
| Limited ankle motion ea jnt HCPCS L2200 | not published | not published | $72.84 – $155.88 | 8 |
| Limited autopsy CPT 88036 | not published | not published | $109.00 – $151.91 | 2 |
| Limited autopsy CPT 88037 | not published | not published | $80.00 – $135.13 | 2 |
| Limited motion knee joint HCPCS L2184 | not published | not published | $171.28 – $366.54 | 8 |
| Limited visual field xm CPT 92081 | not published | not published | $25.36 – $121.42 | 8 |
| Lincomycin injection HCPCS J2010 | not published | not published | $7.11 – $16.16 | 4 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | not published | not published | $3.96 – $5.56 | 4 |
| Lipase CPT 83690 | $343.20 | $624.00 | $5.00 – $14.74 | 9 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $531.92 – $6,823.84 | 11 |
| Lipoprotein blood high res frac & quant CPT 83701 | not published | not published | $33.86 – $72.46 | 8 |
| Lipoprotein blood quant CPT 83704 | not published | not published | $34.19 – $73.17 | 8 |
| Lipoprotein direct measurement hdl CPT 83718 | not published | not published | $8.19 – $17.53 | 9 |
| Lipoprotein direct measurement ldl CPT 83721 | $161.70 | $294.00 | $10.50 – $22.47 | 9 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $34.19 – $73.17 | 8 |
| Lip surgery procedure CPT 40799 | not published | not published | $227.80 – $1,496.00 | 9 |
| Lisocabtagene mara car pos t HCPCS Q2054 | not published | not published | $579,570.61 – $1,130,162.70 | 9 |
| Listeria monocytogenes CPT 86723 | not published | not published | $9.00 – $28.23 | 9 |
| Lith ion batt cid, ear level HCPCS L8624 | not published | not published | $199.61 – $427.17 | 8 |
| Lith ion batt cid,non-earlvl HCPCS L8623 | not published | not published | $80.05 – $171.31 | 8 |
| Lithium ion battery charger HCPCS L7368 | not published | not published | $624.79 – $1,337.05 | 8 |
| Lithium therapeutic drug level CPT 80178 | $112.06 | $203.75 | $5.00 – $14.15 | 9 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | not published | not published | $221.46 – $221.46 | 1 |
| Litt icr 1 traj 1 smpl les CPT 61736 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Litt icr mlt trj mlt/cplx ls CPT 61737 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | not published | not published | $176.19 – $377.05 | 7 |
| Liver elastography 91200 CPT 91200 | not published | not published | $29.19 – $273.81 | 8 |
| Liver Function Test CPT 80076 | $138.46 | $251.75 | $6.00 – $17.48 | 9 |
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Liver image (3d) with flow CPT 78206 | not published | not published | $357.00 – $357.00 | 1 |
| Liver imaging CPT 78201 | $1,021.08 | $1,856.50 | $225.53 – $1,117.53 | 9 |
| Liver imaging (3d) CPT 78205 | not published | not published | $357.00 – $357.00 | 1 |
| Liver imag w/vasclr flow CPT 78202 | $1,592.25 | $2,895.00 | $246.15 – $1,117.53 | 9 |
| Liver/spleen imag static only CPT 78215 | $1,543.58 | $2,806.50 | $229.38 – $822.80 | 9 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $146.91 – $822.80 | 9 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $110.46 – $4,893.31 | 9 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $714.34 – $6,734.39 | 11 |
| Lockingelbow forearm cntrbal HCPCS L6693 | not published | not published | $3,514.41 – $7,520.84 | 8 |
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.