SSM Health St. Anthony Hospital - Oklahoma City
1000 North Lee Avenue, Oklahoma City, OK · SSM Health · · NPI 1366545311
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 |
|---|---|---|---|---|
| Upper ext fx orthosis rad/ul HCPCS L3982 | not published | not published | $467.12 – $999.64 | 10 |
| Upper ext harvest for cabg1 seg 35600 CPT 35600 | not published | not published | $278.12 – $4,386.82 | 3 |
| Uppr gi scope w/submuc inj CPT 43236 | not published | not published | $209.22 – $2,100.00 | 12 |
| Urachal cyst/sinus excision 51500 CPT 51500 | not published | not published | $973.95 – $12,442.83 | 12 |
| Urea nitrogen CPT 84520 | $54.45 | $99.00 | $3.00 – $8.45 | 11 |
| Urea nitrogen 24 hour urine CPT 84540 | $40.70 | $74.00 | $3.00 – $11.90 | 11 |
| Urea nitrogen clearance CPT 84545 | not published | not published | $5.00 – $15.41 | 11 |
| Urea nitrogen semi-quant CPT 84525 | not published | not published | $4.00 – $10.98 | 11 |
| Ureteral embolization/occl CPT 50705 | $2,082.30 | $3,786.00 | $269.32 – $604.50 | 2 |
| Ureteral reflux study CPT 78740 | not published | not published | $264.84 – $822.80 | 11 |
| Ureter endoscopy CPT 50970 | not published | not published | $560.96 – $7,255.07 | 12 |
| Ureter endoscopy & biopsy CPT 50955 | not published | not published | $533.48 – $11,035.58 | 12 |
| Ureter endoscopy & biopsy CPT 50974 | not published | not published | $716.00 – $11,035.58 | 12 |
| Ureter endoscopy & catheter CPT 50972 | not published | not published | $541.45 – $7,255.07 | 12 |
| Ureter endoscopy & treatment CPT 50957 | not published | not published | $536.11 – $11,035.58 | 12 |
| Ureter endoscopy & treatment CPT 50961 | not published | not published | $480.35 – $11,035.58 | 12 |
| Ureter endoscopy & treatment CPT 50976 | not published | not published | $706.18 – $11,035.58 | 12 |
| Ureter endoscopy & treatment CPT 50980 | not published | not published | $538.82 – $11,035.58 | 12 |
| Ureteroneocystostomy 50780 CPT 50780 | not published | not published | $1,694.60 – $4,386.82 | 3 |
| Ureteroureterostomy 50760 CPT 50760 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $803.00 | $1,460.00 | $73.47 – $491.09 | 11 |
| Urethrlys transvag with scope CPT 53500 | not published | not published | $1,142.65 – $7,255.07 | 10 |
| Urethrocystography void s&i CPT 74455 | $933.90 | $1,698.00 | $127.43 – $491.09 | 11 |
| Uric acid blood CPT 84550 | $64.90 | $118.00 | $3.00 – $9.67 | 11 |
| Uric acid urine CPT 84560 | $64.35 | $117.00 | $3.00 – $10.87 | 11 |
| Urinalysis glass test CPT 81020 | not published | not published | $4.00 – $10.06 | 11 |
| Urinalysis microscopic only CPT 81015 | not published | not published | $3.00 – $6.53 | 11 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | not published | not published | $2.17 – $4.64 | 11 |
| Urinalysis (with microscopy) CPT 81001 | $141.90 | $258.00 | $3.00 – $6.78 | 11 |
| Urinalysis (without microscopy) CPT 81003 | $127.05 | $231.00 | $2.25 – $4.82 | 11 |
| Urinary bldr retent nuc study CPT 78730 | not published | not published | $49.00 – $103.32 | 3 |
| Urinary pouch on barr w/flng HCPCS A5073 | not published | not published | $6.63 – $7.10 | 2 |
| Urinary pouch w/barrier HCPCS A5071 | not published | not published | $12.60 – $13.47 | 2 |
| Urinary reflex study CPT 51792 | not published | not published | $56.74 – $315.20 | 10 |
| Urinary suspensory HCPCS A5105 | not published | not published | $80.15 – $85.71 | 2 |
| Urine Culture Test CPT 87086 | $198.55 | $361.00 | $6.00 – $17.27 | 11 |
| Urine flow measurement 51736 CPT 51736 | not published | not published | $8.10 – $273.84 | 10 |
| Urine ost pouch w faucet/tap HCPCS A4428 | not published | not published | $13.67 – $14.62 | 2 |
| Urine pregnancy test CPT 81025 | $419.65 | $763.00 | $5.00 – $18.43 | 11 |
| Urine screen for bacteria CPT 81007 | not published | not published | $3.00 – $64.16 | 11 |
| Urine shunt to intestine CPT 50815 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Urine specimen collect mult HCPCS P9615 | not published | not published | $2.70 – $12.47 | 3 |
| Urofollitropin, 75 iu HCPCS J3355 | not published | not published | $71.81 – $205.56 | 2 |
| Urography, antegrade CPT 74425 | $1,669.80 | $3,036.00 | $161.44 – $718.05 | 11 |
| Urography inf drip &/or bolus CPT 74410 | not published | not published | $168.70 – $361.01 | 11 |
| Urokinase 250,000 iu inj HCPCS J3365 | not published | not published | $851.11 – $851.11 | 1 |
| Urokinase 5000 iu injection HCPCS J3364 | not published | not published | $17.02 – $17.02 | 1 |
| Use 1st target lesion CPT 76982 | not published | not published | $93.89 – $215.17 | 10 |
| User adjustable heel height HCPCS L5990 | not published | not published | $2,245.81 – $4,806.03 | 10 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | not published | not published | $11.36 – $22.14 | 11 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | not published | not published | $252.88 – $252.88 | 1 |
| U/s trtmt, not leiomyomata HCPCS C9734 | not published | not published | $3,066.00 – $26,424.41 | 10 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | not published | not published | $184.28 – $258.64 | 4 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | not published | not published | $167.65 – $239.67 | 4 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | not published | not published | $177.73 – $249.43 | 4 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | not published | not published | $100.07 – $144.18 | 4 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | not published | not published | $74.73 – $107.67 | 4 |
| Vaccine dtap < 7 years im CPT 90700 | not published | not published | $31.07 – $46.02 | 2 |
| Vaccine dtap-hep b-ipv im CPT 90723 | not published | not published | $102.87 – $152.16 | 2 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | not published | not published | $65.96 – $100.47 | 2 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | not published | not published | $163.40 – $248.00 | 2 |
| Vaccine dtap-ipv/hib im CPT 90698 | not published | not published | $126.06 – $188.30 | 2 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | not published | not published | $32.11 – $48.80 | 2 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | not published | not published | $13.83 – $20.45 | 2 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | not published | not published | $82.26 – $115.45 | 4 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | not published | not published | $132.51 – $199.40 | 2 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | not published | not published | $39.91 – $60.64 | 2 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | not published | not published | $39.88 – $39.88 | 1 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $85.67 – $123.43 | 4 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | not published | not published | $80.23 – $115.60 | 4 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | not published | not published | $202.42 – $284.09 | 4 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | not published | not published | $36.10 – $50.67 | 4 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | not published | not published | $322.99 – $486.46 | 2 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | not published | not published | $270.98 – $270.98 | 1 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | not published | not published | $95.18 – $133.59 | 4 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | not published | not published | $95.18 – $133.58 | 4 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | not published | not published | $24.92 – $34.97 | 4 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | not published | not published | $25.48 – $35.76 | 4 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | not published | not published | $34.30 – $34.30 | 1 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | not published | not published | $127.06 – $127.06 | 1 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | not published | not published | $20.07 – $37.42 | 2 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | not published | not published | $36.71 – $36.71 | 1 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | not published | not published | $17.15 – $17.15 | 1 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | not published | not published | $45.65 – $45.65 | 1 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | not published | not published | $120.56 – $120.56 | 1 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | not published | not published | $38.53 – $58.96 | 4 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | not published | not published | $10.41 – $17.49 | 4 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | not published | not published | $234.94 – $357.51 | 2 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | not published | not published | $199.77 – $304.01 | 2 |
| Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 | not published | not published | $180.57 – $264.10 | 2 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | not published | not published | $165.22 – $251.20 | 2 |
| Vaccine mmr live subcutaneous CPT 90707 | not published | not published | $97.11 – $151.91 | 2 |
| Vaccine mmrv live subcutaneous CPT 90710 | not published | not published | $292.07 – $457.03 | 2 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | not published | not published | $152.16 – $219.22 | 4 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | not published | not published | $294.11 – $423.75 | 4 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | not published | not published | $297.71 – $417.83 | 4 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | not published | not published | $356.71 – $500.64 | 4 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | not published | not published | $46.97 – $66.75 | 2 |
| Vaccine rabies im CPT 90675 | not published | not published | $331.98 – $647.36 | 11 |
| Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 | not published | not published | $309.75 – $499.07 | 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.