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 |
|---|---|---|---|---|
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | not published | not published | $9.00 – $25.64 | 11 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $1,612.05 | $2,931.00 | $25.00 – $75.09 | 11 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $321.20 | $584.00 | $35.09 – $75.09 | 11 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $293.15 | $533.00 | $37.27 – $79.76 | 10 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $1,086.25 | $1,975.00 | $416.78 – $891.91 | 10 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $394.90 | $718.00 | $25.00 – $75.09 | 11 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $61.05 | $111.00 | $35.09 – $75.09 | 10 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $294.25 | $535.00 | $25.00 – $89.20 | 11 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $321.20 | $584.00 | $35.09 – $75.09 | 11 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $124.85 | $227.00 | $46.18 – $109.80 | 10 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $582.45 | $1,059.00 | $128.44 – $305.23 | 10 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $582.45 | $1,059.00 | $128.44 – $305.23 | 10 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $63.36 | $115.20 | $35.09 – $75.09 | 11 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $107.80 | $196.00 | $35.09 – $75.09 | 10 |
| Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae CPT 87494 | not published | not published | $70.18 – $150.19 | 8 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $200.20 | $364.00 | $69.09 – $164.29 | 9 |
| Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets CPT 87627 | not published | not published | $679.77 – $1,454.71 | 8 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $1,086.25 | $1,975.00 | $416.78 – $891.91 | 9 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | not published | not published | $128.29 – $274.54 | 9 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | not published | not published | $261.41 – $562.80 | 10 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $1,608.20 | $2,924.00 | $30.00 – $91.68 | 11 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $725.45 | $1,319.00 | $42.84 – $91.68 | 11 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $1,557.05 | $2,831.00 | $42.84 – $91.68 | 11 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $1,056.00 | $1,920.00 | $85.10 – $182.11 | 11 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | not published | not published | $142.63 – $305.23 | 10 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | not published | not published | $31.48 – $61.38 | 11 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | not published | not published | $22.52 – $60.12 | 11 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | not published | not published | $18.14 – $54.03 | 11 |
| Influenza dna amp prob addl CPT 87503 | not published | not published | $26.30 – $62.53 | 10 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | not published | not published | $70.22 – $133.59 | 4 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $32.91 – $46.19 | 4 |
| Inf lwr xtr fscl pln blk uni w/wo image CPT 64474 | not published | not published | $358.20 – $604.50 | 2 |
| Infratemporal approach/skull CPT 61591 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Infratemporal approach/skull CPT 61590 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Inf thrc fascial pln blk bi w/wo image CPT 64469 | not published | not published | $550.31 – $604.50 | 2 |
| Inf thrc fascial pln blk uni w/wo image CPT 64467 | not published | not published | $362.65 – $604.50 | 2 |
| Infuse radioactive materials CPT 77750 | not published | not published | $119.00 – $793.83 | 11 |
| Ingest challenge ea addl 60 min CPT 95079 | not published | not published | $104.15 – $120.17 | 2 |
| Ingest challenge ini 120 min CPT 95076 | not published | not published | $113.00 – $928.55 | 10 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $271.70 | $494.00 | $63.96 – $450.70 | 10 |
| Init ak ischal plstr direct HCPCS L5505 | not published | not published | $2,839.14 – $6,075.76 | 10 |
| Init bk ptb plaster direct HCPCS L5500 | not published | not published | $1,756.84 – $3,759.64 | 10 |
| Initial custom socket insert HCPCS L5683 | not published | not published | $1,628.34 – $3,484.65 | 10 |
| Initial foot exam pt lops HCPCS G0245 | not published | not published | $61.54 – $274.02 | 10 |
| Initial hosp neonate 28 d/less than not critically ill 99477 CPT 99477 | not published | not published | $519.70 – $519.70 | 1 |
| Initial nursing facility care/day 35 minutes CPT 99305 | not published | not published | $186.00 – $204.18 | 2 |
| Initial nursing facility care/day 45 minutes CPT 99306 | not published | not published | $254.25 – $279.27 | 2 |
| Initial nursing facility care/day low severity 99304 CPT 99304 | not published | not published | $112.31 – $122.86 | 2 |
| Initiation & management bipap/cpap initial day CPT 94660 | $864.60 | $1,572.00 | $56.91 – $450.70 | 10 |
| Init nb em per day non-fac CPT 99461 | not published | not published | $93.74 – $126.76 | 2 |
| Init pm e/m new pat 65+ yrs CPT 99387 | $486.20 | $884.00 | $187.49 – $187.49 | 1 |
| Init/sub psych care m 1st 30 HCPCS G2214 | not published | not published | $58.93 – $209.09 | 10 |
| Inj, abilify asimtufii, 1 mg HCPCS J0402 | not published | not published | $6.18 – $12.06 | 10 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | not published | not published | $7.46 – $14.55 | 11 |
| Inj acetaminoph 10mg/ibu 3mg HCPCS J0138 | not published | not published | $0.09 – $0.33 | 10 |
| Inj, acetaminophen (b braun) HCPCS J0136 | not published | not published | $0.06 – $0.10 | 4 |
| Inj acetaminophen -fresenius HCPCS J0134 | not published | not published | $0.06 – $0.08 | 4 |
| Inj, acetaminophen (hikma) HCPCS J0137 | not published | not published | $0.03 – $0.08 | 4 |
| Inj. acthar gel to 40 units HCPCS J0801 | not published | not published | $4,133.45 – $8,060.23 | 11 |
| Inj, adstiladrin, per tx dos HCPCS J9029 | not published | not published | $64,331.61 – $125,446.65 | 11 |
| Inj, aducanumab-avwa, 2 mg HCPCS J0172 | not published | not published | $8.97 – $9.82 | 3 |
| Inj, adzynma, 10 iu HCPCS J7171 | not published | not published | $36.21 – $70.62 | 10 |
| Inj, aflibercept-ayyh, 1 mg HCPCS Q5147 | not published | not published | $803.26 – $1,566.35 | 10 |
| Inj, aflibercept hd, 1 mg HCPCS J0177 | not published | not published | $298.68 – $582.43 | 10 |
| Inj, afstyla, 1 i.u HCPCS J7210 | not published | not published | $1.62 – $3.16 | 11 |
| Inj, alfentanil hcl, 500mcg HCPCS J0216 | not published | not published | $2.90 – $7.42 | 2 |
| Inj allopurinol sodium 1 mg HCPCS J0206 | not published | not published | $4.07 – $9.12 | 11 |
| Inj, alyglo, 500 mg HCPCS J1552 | not published | not published | $121.54 – $237.01 | 10 |
| Inj alymsys 10 mg HCPCS Q5126 | not published | not published | $52.50 – $155.89 | 11 |
| Inj andexxa, 10 mg HCPCS J7169 | not published | not published | $131.16 – $280.69 | 9 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | not published | not published | $18.51 – $36.09 | 11 |
| Inj. (ani), up to 40 units HCPCS J0802 | not published | not published | $3,674.68 – $7,165.62 | 11 |
| Inj, aponvie, 1 mg HCPCS C9145 | not published | not published | $2.12 – $2.12 | 1 |
| Inj., aristada initio, 1 mg HCPCS J1943 | not published | not published | $3.46 – $6.75 | 11 |
| Inj, artesunate, 1mg HCPCS J0391 | not published | not published | $51.83 – $110.91 | 9 |
| Inj. asceniv HCPCS J1554 | not published | not published | $509.14 – $992.82 | 11 |
| Inj, aspara, rylaze, 0.1 mg HCPCS J9021 | not published | not published | $58.70 – $114.46 | 11 |
| Inj atezolizumb 5mg hya-tqjs HCPCS J9024 | not published | not published | $32.55 – $63.48 | 10 |
| Inj avacincaptad pegol 0.1mg HCPCS J2782 | not published | not published | $103.20 – $201.25 | 10 |
| Inj aval alfa-nqpt 4mg HCPCS J0219 | not published | not published | $83.94 – $163.69 | 11 |
| Inj belantamab mafodot blmf HCPCS J9037 | not published | not published | $74.65 – $74.65 | 1 |
| Inj., benralizumab, 1 mg HCPCS J0517 | not published | not published | $165.56 – $322.85 | 11 |
| Inj beta interferon sq 1 mcg HCPCS Q3028 | not published | not published | $43.70 – $61.73 | 2 |
| Inj, betibeglogene autotemce HCPCS J3393 | not published | not published | $2,930,260.34 – $6,270,757.14 | 9 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | not published | not published | $39.82 – $77.66 | 11 |
| Inj bimatoprost itc imp1mcg HCPCS J7351 | not published | not published | $213.76 – $416.82 | 11 |
| Inj, biorphen, 20 micrograms HCPCS J2372 | not published | not published | $0.21 – $0.30 | 4 |
| Inj bortezomib boruzu 0.1 mg HCPCS J9054 | not published | not published | $24.75 – $52.96 | 9 |
| Inj, bortezomib, dr. reddy's HCPCS J9046 | not published | not published | $3.46 – $77.48 | 10 |
| Inj, bortezomib freseniuskab HCPCS J9048 | not published | not published | $6.97 – $77.48 | 10 |
| Inj, bortezomib, hospira HCPCS J9049 | not published | not published | $1.63 – $2.50 | 4 |
| Inj., brexanolone, 1 mg HCPCS J1632 | not published | not published | $78.23 – $126.05 | 2 |
| Inj, brixadi, 7 days or less HCPCS J0577 | not published | not published | $430.58 – $839.62 | 10 |
| Inj brixadi, more than 7 day HCPCS J0578 | not published | not published | $1,722.30 – $3,358.49 | 10 |
| Inj, brolucizumab-dbll, 1 mg HCPCS J0179 | not published | not published | $359.71 – $701.44 | 11 |
| Inj bulking agent anal canal HCPCS L8605 | not published | not published | $1,394.25 – $1,394.25 | 1 |
| Inj, bupivacaine liposome HCPCS J0666 | not published | not published | $1.45 – $2.84 | 9 |
| Inj. byooviz, 0.1 mg HCPCS Q5124 | not published | not published | $128.35 – $469.90 | 10 |
| Inj calcitriol per 0.1 mcg HCPCS J0636 | not published | not published | $0.96 – $1.76 | 2 |
| Inj, carmustine (accord) HCPCS J9052 | not published | not published | $30.22 – $296.06 | 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.