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 |
|---|---|---|---|---|
| Desoxycorticosterone CPT 82633 | $68.75 | $125.00 | $22.00 – $66.30 | 11 |
| Des thora aorta/ea add prox prosth 33884 CPT 33884 | not published | not published | $591.55 – $4,386.82 | 3 |
| Des thora aorta rpr without left sub art 33881 CPT 33881 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Des thor aorta/prox ext prosth/ini 33883 CPT 33883 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Dest mal lesion feenlm <0.5cm 17280 CPT 17280 | not published | not published | $131.68 – $412.94 | 10 |
| Dest mal lesion feenlm 0.6-1cm 17281 CPT 17281 | not published | not published | $179.21 – $412.94 | 10 |
| Dest mal lesion feenlm 1.1 - 2.0 cm 17282 CPT 17282 | not published | not published | $192.96 – $412.94 | 10 |
| Dest mal lesion snhfg <0.5cm 17270 CPT 17270 | not published | not published | $144.93 – $412.94 | 10 |
| Dest mal lesion snhfg 0.6-1cm 17271 CPT 17271 | not published | not published | $159.31 – $412.94 | 10 |
| Dest mal lesion snhfg 1.1-2cm 17272 CPT 17272 | not published | not published | $183.83 – $412.94 | 10 |
| Dest mal lesion tal <0.5 17260 CPT 17260 | not published | not published | $106.80 – $412.94 | 10 |
| Dest mal lesion tal 0.6-1.0cm 17261 CPT 17261 | not published | not published | $132.16 – $412.94 | 10 |
| Dest mal lesion tal 1.1-2.0cm 17262 CPT 17262 | not published | not published | $167.45 – $412.94 | 10 |
| Dest mal lesion tal 2.1-3.0cm 17263 CPT 17263 | not published | not published | $185.37 – $412.94 | 10 |
| Destroy cervthor facet jnt 64633 CPT 64633 | $1,705.00 | $3,100.00 | $293.19 – $4,019.07 | 11 |
| Destroy cth facet jnt addl 64634 CPT 64634 | $242.00 | $440.00 | $102.56 – $604.50 | 2 |
| Destroy internal hemorrhoids destroy 46930 CPT 46930 | $2,417.80 | $4,396.00 | $227.95 – $5,316.00 | 11 |
| Destroy premlg lesns;1st lesn 17000 CPT 17000 | $217.25 | $395.00 | $82.86 – $412.94 | 10 |
| Destroy vulva lesion extensive 56515 CPT 56515 | not published | not published | $324.08 – $4,246.62 | 12 |
| Destroy vulva lesion simple 56501 CPT 56501 | not published | not published | $202.34 – $4,246.62 | 10 |
| Destruct ben lesion 15/> 17111 CPT 17111 | $228.25 | $415.00 | $125.55 – $412.94 | 10 |
| Destruct cut vasl lesions 10-50cm 17107 CPT 17107 | not published | not published | $543.88 – $1,579.00 | 11 |
| Destruct cut vasl lesions <10cm 17106 CPT 17106 | $508.75 | $925.00 | $390.97 – $1,579.00 | 11 |
| Destruct cut vasl lesions >50cm 17108 CPT 17108 | not published | not published | $799.60 – $4,246.62 | 11 |
| Destruction 2-14 lesions 17003 CPT 17003 | $16.50 | $30.00 | $3.10 – $604.50 | 2 |
| Destruction anal lesion(s) CPT 46910 | not published | not published | $205.85 – $4,246.62 | 10 |
| Destruction anal lesion(s) CPT 46924 | not published | not published | $276.32 – $5,712.83 | 12 |
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | not published | not published | $208.98 – $1,579.00 | 11 |
| Destruction benign lesions < 14 lesions CPT 17110 | $206.25 | $375.00 | $103.00 – $412.94 | 10 |
| Destruction by injection tx of nerve 64630 CPT 64630 | not published | not published | $290.84 – $2,100.00 | 12 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | $692.45 | $1,259.00 | $89.71 – $604.50 | 2 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | $1,705.00 | $3,100.00 | $293.66 – $5,316.00 | 11 |
| Destruction ciliary body CPT 66700 | not published | not published | $586.72 – $4,749.93 | 12 |
| Destruction ciliary body CPT 66720 | not published | not published | $614.23 – $4,893.31 | 12 |
| Destruction ciliary body CPT 66740 | not published | not published | $586.72 – $4,893.31 | 12 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | not published | not published | $192.96 – $412.94 | 10 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | not published | not published | $196.82 – $5,712.83 | 12 |
| Destruction les conjunctiva CPT 68135 | not published | not published | $223.69 – $4,893.31 | 11 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | $207.86 – $836.68 | 10 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | $253.95 – $1,579.00 | 11 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | not published | not published | $198.15 – $836.68 | 10 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | not published | not published | $232.43 – $1,579.00 | 11 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | not published | not published | $161.72 – $836.68 | 10 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | $261.14 – $4,246.62 | 12 |
| Destruction premal lesions 15/> 17004 CPT 17004 | not published | not published | $148.76 – $1,579.00 | 11 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $1,059.35 – $7,185.00 | 12 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $283.58 – $6,662.61 | 12 |
| Destruction vag lesions simple 57061 CPT 57061 | not published | not published | $174.42 – $6,662.61 | 10 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $145.67 – $4,246.62 | 10 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $14.00 – $64.26 | 11 |
| Detect agnt mult dna direc CPT 87800 | not published | not published | $43.67 – $93.45 | 11 |
| Developmental screen/score/document 96110 CPT 96110 | $15.84 | $28.80 | $16.74 – $16.74 | 1 |
| Devel tst phys/qhp 1st hr CPT 96112 | not published | not published | $123.75 – $273.81 | 10 |
| Device ablt adv novasure HCPCS C1886 | $2,743.59 | $4,988.35 | not published | 0 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $2,712.06 | $4,931.02 | not published | 0 |
| Device intraute mirena HCPCS J7298 | not published | not published | $1,275.36 – $1,809.54 | 2 |
| Device tiss remov myosure reach HCPCS C1782 | $1,204.42 | $2,189.86 | not published | 0 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | not published | not published | $77.86 – $87.50 | 2 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $519.75 | $945.00 | $32.06 – $179.11 | 10 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | not published | not published | $90.02 – $234.73 | 11 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | not published | not published | $1.21 – $1.94 | 2 |
| Dexamethasone 4 mg tablet HCPCS J8540 | not published | not published | $0.07 – $0.13 | 4 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | not published | not published | $0.10 – $0.20 | 4 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $203.66 – $397.13 | 11 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | not published | not published | $41.44 – $177.41 | 11 |
| Dextran 40 infusion HCPCS J7100 | not published | not published | $40.99 – $58.29 | 2 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | not published | not published | $1.43 – $2.61 | 4 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | not published | not published | $8.38 – $12.70 | 2 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | not published | not published | $2.07 – $3.17 | 4 |
| Dextrose 5 % IV bolus HCPCS J7070 | not published | not published | $4.15 – $6.34 | 4 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $136.40 | $248.00 | $16.00 – $47.57 | 11 |
| Diabetes (HbA1c) Test CPT 83036 | $121.55 | $221.00 | $7.00 – $20.78 | 11 |
| Diabetes training group per 30 min g0109 HCPCS G0136 | not published | not published | $13.94 – $77.12 | 9 |
| Diab manage trn ind/group HCPCS G0109 | $72.05 | $131.00 | $15.17 – $32.46 | 10 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $257.02 – $3,663.36 | 12 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $501.34 – $12,442.83 | 12 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $142.63 – $1,579.00 | 11 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $189.82 – $3,359.00 | 11 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $88.70 | $161.28 | $62.27 – $273.84 | 10 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $154.00 | $280.00 | $160.93 – $358.72 | 2 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $77.00 | $140.00 | $125.50 – $301.70 | 2 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $164.45 | $299.00 | $74.64 – $410.83 | 10 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $872.30 | $1,586.00 | $103.64 – $410.83 | 10 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $440.00 | $800.00 | $98.65 – $250.45 | 10 |
| Diagnostic Mammogram (one breast) CPT 77065 | $220.00 | $400.00 | $76.91 – $198.79 | 10 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $60.00 – $179.11 | 10 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $4,889.50 | $8,890.00 | $301.68 – $604.50 | 2 |
| Dialysis one evaluation CPT 90945 | $689.15 | $1,253.00 | $130.45 – $858.80 | 10 |
| Diathermy eg microwave CPT 97024 | not published | not published | $6.74 – $14.42 | 10 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | not published | not published | $0.09 – $0.13 | 4 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | not published | not published | $6.60 – $9.26 | 4 |
| Dicyclomine injection HCPCS J0500 | not published | not published | $14.66 – $41.01 | 4 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.39 – $0.39 | 1 |
| Diffusing capacity CPT 94729 | $573.65 | $1,043.00 | $68.97 – $75.67 | 2 |
| Digital analysis of eeg CPT 95957 | $201.30 | $366.00 | $278.26 – $396.01 | 2 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | not published | not published | $5.56 – $15.46 | 4 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | not published | not published | $5,383.32 – $10,497.48 | 11 |
| Digoxin total therapeutic drug level CPT 80162 | $238.70 | $434.00 | $9.00 – $28.42 | 11 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | not published | not published | $69.54 – $137.20 | 4 |
| Dilate biliary duct/ampulla CPT 47542 | $2,610.85 | $4,747.00 | $203.77 – $604.50 | 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.