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 |
|---|---|---|---|---|
| Pegademase bovine, 25 iu HCPCS J2504 | not published | not published | $587.26 – $587.26 | 1 |
| Pegaptanib sodium injection HCPCS J2503 | not published | not published | $1,460.59 – $1,460.59 | 1 |
| Pegaspargase injection HCPCS J9266 | not published | not published | $29,663.96 – $57,844.73 | 11 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | not published | not published | $22.78 – $279.30 | 11 |
| Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe HCPCS Q5122 | not published | not published | $102.46 – $266.98 | 11 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | not published | not published | $149.13 – $290.81 | 11 |
| Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5127 | not published | not published | $143.67 – $539.79 | 11 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | not published | not published | $67.02 – $201.27 | 11 |
| Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5130 | not published | not published | $105.11 – $331.74 | 11 |
| Peginesatide injection HCPCS J0890 | not published | not published | $21.30 – $21.30 | 1 |
| Peg interferon alfa-2a/180 HCPCS S0145 | not published | not published | $1,169.09 – $1,677.80 | 2 |
| Pegloticase 8 mg/ml intravenous solution HCPCS J2507 | not published | not published | $3,929.34 – $7,662.21 | 11 |
| Pegunigalsidase alfa-iwxj HCPCS J2508 | not published | not published | $225.66 – $440.05 | 10 |
| Pelv band/spread bar thigh c HCPCS L1640 | not published | not published | $610.60 – $1,306.68 | 10 |
| Pelvic band & belt thigh fla HCPCS L2192 | not published | not published | $453.23 – $969.91 | 10 |
| Pelvic control band & belt b HCPCS L2640 | not published | not published | $442.33 – $946.59 | 10 |
| Pelvic control band & belt u HCPCS L2630 | not published | not published | $336.48 – $720.07 | 10 |
| Pelvic control hip heavy dut HCPCS L2620 | not published | not published | $359.52 – $769.37 | 10 |
| Pelvic control pelvic sling HCPCS L2580 | not published | not published | $533.32 – $1,141.30 | 10 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $3,613.50 | $6,570.00 | $168.70 – $361.01 | 10 |
| Pelvic CT scan (with contrast) CPT 72193 | $2,862.75 | $5,205.00 | $168.70 – $445.05 | 10 |
| Pelvic CT scan (without contrast) CPT 72192 | $2,292.95 | $4,169.00 | $100.55 – $265.85 | 10 |
| Pelvic exenteration CPT 45126 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Pelvic & hip control thigh c HCPCS L1680 | not published | not published | $1,655.15 – $3,542.02 | 10 |
| Pelvic MRI (with and without contrast) CPT 72197 | $3,202.10 | $5,822.00 | $335.54 – $718.05 | 10 |
| Pelvic MRI (with contrast) CPT 72196 | $3,186.15 | $5,793.00 | $280.69 – $718.05 | 10 |
| Pelvic MRI (without contrast) CPT 72195 | $2,058.65 | $3,743.00 | $229.48 – $491.09 | 10 |
| Pelvic ring fracture uni/bil HCPCS G0413 | $15,097.50 | $27,450.00 | $1,617.90 – $14,934.65 | 11 |
| Pelvic ring fx treat int fix HCPCS G0414 | $8,171.35 | $14,857.00 | $1,363.34 – $14,934.65 | 10 |
| Pelvic Ultrasound (complete) CPT 76856 | $953.15 | $1,733.00 | $100.55 – $215.17 | 11 |
| Pelvic Ultrasound (limited) CPT 76857 | $557.15 | $1,013.00 | $37.81 – $215.17 | 11 |
| Pelv & thor control gluteal HCPCS L2650 | not published | not published | $166.13 – $355.52 | 10 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | not published | not published | $60.64 – $118.26 | 11 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | not published | not published | $4.30 – $13.56 | 11 |
| Pemivibart infusion HCPCS M0224 | not published | not published | $424.09 – $907.56 | 9 |
| Peng benzathine/procaine inj HCPCS J0558 | not published | not published | $19.52 – $38.07 | 11 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | not published | not published | $30.76 – $63.55 | 11 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | not published | not published | $0.89 – $1.26 | 4 |
| Penicillin g procaine inj HCPCS J2510 | not published | not published | $90.57 – $90.57 | 1 |
| Penile injection CPT 54235 | $458.15 | $833.00 | $112.25 – $514.23 | 10 |
| Penile rear tip xtnd 0.5cm HCPCS C2622 | $18,764.94 | $34,118.08 | not published | 0 |
| Penile vascular study CPT 93980 | not published | not published | $83.82 – $215.17 | 10 |
| Penile vascular study CPT 93981 | not published | not published | $71.84 – $215.17 | 10 |
| Penile venous occlusion CPT 37790 | not published | not published | $741.82 – $7,255.07 | 12 |
| Penis plastic surgery CPT 54360 | not published | not published | $1,101.53 – $7,255.07 | 12 |
| Penis study CPT 54240 | not published | not published | $63.17 – $560.52 | 10 |
| Pentamidine non-comp unit HCPCS J2545 | not published | not published | $85.77 – $127.20 | 4 |
| Pentastarch 10% solution HCPCS J2513 | not published | not published | $25.08 – $25.08 | 1 |
| Pentazocine injection HCPCS J3070 | not published | not published | $201.53 – $201.53 | 1 |
| Pentobarbital sodium inj HCPCS J2515 | not published | not published | $19.30 – $86.77 | 9 |
| Pentostatin 10 mg intravenous solution HCPCS J9268 | not published | not published | $2,697.99 – $5,261.07 | 11 |
| Perc cryo ablate renal tum CPT 50593 | $7,096.65 | $12,903.00 | $689.85 – $21,878.19 | 11 |
| Perc d-e cor revasc chro add HCPCS C9608 | $4,409.35 | $8,017.00 | $604.50 – $731.00 | 2 |
| Perc d-e cor revasc chro sin HCPCS C9607 | $8,720.25 | $15,855.00 | $4,386.82 – $37,729.94 | 10 |
| Perc d-e cor revasc t cabg b HCPCS C9605 | $4,409.35 | $8,017.00 | $604.50 – $731.00 | 2 |
| Perc d-e cor revasc t cabg s HCPCS C9604 | $9,765.80 | $17,756.00 | $4,386.82 – $23,760.10 | 10 |
| Perc d-e cor stent ather br HCPCS C9603 | $4,409.35 | $8,017.00 | $604.50 – $731.00 | 2 |
| Perc d-e cor stent ather s HCPCS C9602 | $9,765.80 | $17,756.00 | $4,386.82 – $37,729.94 | 10 |
| Perc drug-el cor stent bran HCPCS C9601 | $4,488.55 | $8,161.00 | $604.50 – $731.00 | 2 |
| Perc drug-el cor stent sing HCPCS C9600 | $8,789.00 | $15,980.00 | $4,386.82 – $23,760.10 | 10 |
| Perc rf ablate renal tumor CPT 50592 | $6,452.60 | $11,732.00 | $516.70 – $12,442.83 | 11 |
| Percut ablate liver rf CPT 47382 | $5,036.90 | $9,158.00 | $1,111.89 – $12,442.83 | 10 |
| Percutaneous islet celltrans HCPCS G0341 | not published | not published | $475.26 – $4,386.82 | 3 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | not published | not published | $47.74 – $69.25 | 4 |
| Pericardial drain w/cath pq w/ct guid CPT 33019 | not published | not published | $317.68 – $4,386.82 | 3 |
| Pericardiectomy/sub or com/w bypas 33031 CPT 33031 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Pericardiocentesis wwo imaging CPT 33016 | $2,715.35 | $4,937.00 | $350.94 – $6,535.00 | 11 |
| Pericardiotomy/clot/for bod remove 33020 CPT 33020 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Peri-implt capslc brst compl CPT 19371 | $6,679.20 | $12,144.00 | $1,077.63 – $8,058.70 | 12 |
| Perineoplasty rpr per nonob CPT 56810 | not published | not published | $417.98 – $6,662.61 | 12 |
| Peripheral vascular rehab CPT 93668 | not published | not published | $21.04 – $121.42 | 10 |
| Peri-proc device eval icd CPT 93287 | not published | not published | $44.53 – $44.53 | 1 |
| Peri-proc device eval pm CPT 93286 | not published | not published | $44.05 – $44.05 | 1 |
| Peritoneal cath sub q resv per CPT 49419 | not published | not published | $633.09 – $11,452.76 | 12 |
| Peritoneogram rs&i CPT 74190 | $614.35 | $1,117.00 | $46.75 – $1,124.62 | 11 |
| Perit-vens shunt pat tst CPT 78291 | $285.45 | $519.00 | $288.75 – $822.80 | 11 |
| Permanent tear duct plug HCPCS A4263 | not published | not published | $38.34 – $38.34 | 1 |
| Peroneal straps pair pre ots HCPCS L0980 | not published | not published | $26.75 – $57.24 | 10 |
| Perp bk ptb thermopls direct HCPCS L5520 | not published | not published | $2,347.37 – $5,023.37 | 10 |
| Perphenazine 4mg oral HCPCS Q0175 | not published | not published | $0.49 – $0.77 | 2 |
| Perphenazine injeciton HCPCS J3310 | not published | not published | $12.34 – $12.34 | 1 |
| Perq art m-thrombect &/nfs CPT 61645 | $17,421.80 | $31,676.00 | $1,189.00 – $4,386.82 | 3 |
| Perq clsr tcat l atr apndge CPT 33340 | $12,491.05 | $22,711.00 | $1,163.19 – $7,567.45 | 2 |
| Perq dev breast 1st mr guide CPT 19287 | not published | not published | $190.81 – $1,579.00 | 11 |
| Perq dev breast 1st strtctc CPT 19283 | $2,657.60 | $4,832.00 | $150.77 – $1,579.00 | 11 |
| Perq nl/pl lithotrp cplx>2cm CPT 50081 | not published | not published | $1,714.33 – $19,483.75 | 10 |
| Perq nl/pl lithotrp smpl<2cm CPT 50080 | not published | not published | $1,062.63 – $19,483.75 | 10 |
| Perq p-art revsc 1 abnor bi CPT 33903 | not published | not published | $1,299.10 – $23,760.10 | 10 |
| Perq p-art revsc 1 abnor uni CPT 33902 | not published | not published | $1,102.36 – $37,729.94 | 10 |
| Perq p-art revsc 1 nm nt bi CPT 33901 | not published | not published | $1,141.77 – $23,760.10 | 10 |
| Perq p-art revsc 1 nm nt uni CPT 33900 | not published | not published | $868.75 – $23,760.10 | 10 |
| Perq p-art revsc each addl CPT 33904 | not published | not published | $436.30 – $604.50 | 2 |
| Perq plmt bile duct stent CPT 47538 | $6,892.60 | $12,532.00 | $351.64 – $12,442.83 | 11 |
| Perq plmt bile duct stent CPT 47539 | $9,912.65 | $18,023.00 | $639.16 – $12,442.83 | 11 |
| Perq plmt bile duct stent CPT 47540 | $10,849.30 | $19,726.00 | $658.45 – $12,442.83 | 11 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | $613.80 | $1,116.00 | $132.20 – $1,579.00 | 11 |
| Perq skel fix rad/uln dislc CPT 25671 | $11,309.10 | $20,562.00 | $821.05 – $6,734.39 | 12 |
| Perq skel fix ulnar styld fx CPT 25651 | $10,264.10 | $18,662.00 | $753.41 – $6,734.39 | 11 |
| Perqt bx lung/mediastinum 32405 CPT 32405 | not published | not published | $991.00 – $4,386.82 | 2 |
| Perq transcath closure each CPT 93592 | $9,282.35 | $16,877.00 | $584.22 – $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.