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 |
|---|---|---|---|---|
| Pressure velocity wire add ves CPT 93572 | $557.70 | $1,014.00 | $82.52 – $604.50 | 2 |
| Pre-tibial shell molded to p HCPCS L2340 | not published | not published | $636.87 – $1,362.90 | 10 |
| Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 | $249.15 | $453.00 | $7.00 – $350.65 | 11 |
| Pretreat rbc absorption reference CPT 86978 | $353.65 | $643.00 | $12.38 – $121.42 | 11 |
| Pretreat rbc density gradient separation reference CPT 86972 | not published | not published | $11.00 – $350.65 | 11 |
| Pretreat rbc w chem/drugs reference CPT 86970 | not published | not published | $11.00 – $121.42 | 11 |
| Pretreat rbc w enzyme reference CPT 86971 | $277.20 | $504.00 | $11.00 – $350.65 | 11 |
| Pr evaluation psychiatric diagnostic w/medical services CPT 90792 | not published | not published | $170.71 – $365.32 | 10 |
| Preventive counseling group CPT 99411 | not published | not published | $11.38 – $11.38 | 1 |
| Preventive counseling group CPT 99412 | not published | not published | $19.12 – $19.12 | 1 |
| Prev med cnsl indiv apprx 15 CPT 99401 | $71.50 | $130.00 | $36.23 – $36.23 | 1 |
| Prev med cnsl indiv apprx 30 CPT 99402 | $142.45 | $259.00 | $73.53 – $73.53 | 1 |
| Prev med cnsl indiv apprx 45 CPT 99403 | $213.40 | $388.00 | $109.77 – $109.77 | 1 |
| Prev med cnsl indiv apprx 60 CPT 99404 | $284.90 | $518.00 | $146.54 – $146.54 | 1 |
| Pr exam init preventive phys new visit during 1st 12 mo of mcare enrollment HCPCS G0402 | not published | not published | $128.05 – $274.02 | 10 |
| Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm CPT 11420 | $2,820.40 | $5,128.00 | $124.45 – $3,399.30 | 11 |
| Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 | $3,194.40 | $5,808.00 | $249.07 – $3,399.30 | 12 |
| Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 | $1,247.40 | $2,268.00 | $155.35 – $1,579.00 | 11 |
| Pr gastrorrhaphy suture perforated duodenal or gastric ulcer/wound/ injury CPT 43840 | not published | not published | $2,065.18 – $7,935.28 | 9 |
| Prgrmg dev eval impltbl sys CPT 93260 | not published | not published | $35.89 – $76.81 | 10 |
| Prgrmg dev eval pm/ldls pm CPT 93279 | not published | not published | $35.89 – $76.81 | 10 |
| Prgrmg dev eval scrms ip CPT 93285 | not published | not published | $35.89 – $76.81 | 10 |
| Prgrmg eval implantable dfb CPT 93282 | not published | not published | $35.89 – $76.81 | 10 |
| Prgrmg eval implantable dfb CPT 93283 | not published | not published | $35.89 – $76.81 | 10 |
| Prgrmg eval implantable dfb CPT 93284 | not published | not published | $35.89 – $76.81 | 10 |
| Prgr stim/pace a/iv drug CPT 93623 | $4,188.25 | $7,615.00 | $31.50 – $7,119.13 | 2 |
| Pr hospital ip/obs care initial high level per day CPT 99223 | not published | not published | $242.84 – $265.74 | 2 |
| Pr hospital ip/obs care initial moderate level per day CPT 99222 | not published | not published | $182.11 – $200.20 | 2 |
| Pr hospital ip/obs care initial straightforward or low level per day CPT 99221 | not published | not published | $115.27 – $126.69 | 2 |
| Pr hospital ip/obs care subsequent high level per day CPT 99233 | not published | not published | $165.48 – $181.99 | 2 |
| Pr hospital ip/obs care subsequent moderate level per day CPT 99232 | not published | not published | $110.81 – $120.95 | 2 |
| Pr hospital ip/obs care subsequent straightforward or low level per day CPT 99231 | not published | not published | $68.62 – $75.93 | 2 |
| Prim art mech thrmbc non-intracranial CPT 37184 | $9,753.70 | $17,734.00 | $644.11 – $37,729.94 | 11 |
| Prim art mech thrmbc non-intracranial add-on CPT 37185 | $3,482.60 | $6,332.00 | $243.73 – $604.50 | 2 |
| Prin care mgmt staff 1st 30 CPT 99426 | not published | not published | $75.97 – $209.09 | 10 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $1,317.80 | $2,396.00 | $279.45 – $1,579.00 | 11 |
| Pr incision & drainage abscess simple/single CPT 10060 | $855.80 | $1,556.00 | $160.92 – $412.94 | 10 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $802.45 | $1,459.00 | $192.17 – $2,100.00 | 11 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $1,015.85 | $1,847.00 | $159.39 – $836.68 | 10 |
| Pr management transitional care high w/in 7 days of discharge CPT 99496 | not published | not published | $128.05 – $291.95 | 10 |
| Pr management transitional care moderate w/in 14 days of discharge CPT 99495 | not published | not published | $128.05 – $274.02 | 10 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $273.35 | $497.00 | $18.59 – $67.81 | 2 |
| Pr neuroplasty and/or transposition ulnar nerve at elbow CPT 64718 | $7,565.25 | $13,755.00 | $918.57 – $4,019.07 | 12 |
| Probe cryo 1150mm endo flex ster disp HCPCS C2618 | $3,001.20 | $5,456.73 | not published | 0 |
| Probe nasolacrimal duct CPT 68810 | not published | not published | $191.10 – $1,579.00 | 12 |
| Probe nasolacrimal duct CPT 68811 | $2,685.65 | $4,883.00 | $202.21 – $4,893.31 | 12 |
| Probe nasolacrimal duct CPT 68815 | $2,685.65 | $4,883.00 | $332.13 – $4,893.31 | 12 |
| Probe nl duct w/balloon CPT 68816 | $2,685.65 | $4,883.00 | $235.39 – $5,316.00 | 11 |
| Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 | not published | not published | $240.33 – $575.95 | 11 |
| Procalcitonin CPT 84145 | $424.60 | $772.00 | $24.98 – $58.25 | 10 |
| Procarbazine 50 mg caps 100 each bottle HCPCS S0182 | not published | not published | $135.73 – $212.33 | 2 |
| Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 | not published | not published | $3.33 – $5.63 | 4 |
| Prochlorperazine maleate 5 mg tablet HCPCS Q0164 | not published | not published | $0.50 – $0.57 | 2 |
| Proctectomy combined abd pull-thru px 45112 CPT 45112 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Proctectomy complete abd w/clst 45110 CPT 45110 | not published | not published | $1,189.00 – $4,386.82 | 3 |
| Proctosigmoidoscopy ablate CPT 45320 | not published | not published | $158.55 – $5,712.83 | 12 |
| Proctosigmoidoscopy control bleed 45317 CPT 45317 | not published | not published | $168.49 – $2,462.91 | 12 |
| Proctosigmoidoscopy dilate 45303 CPT 45303 | not published | not published | $129.87 – $2,462.91 | 11 |
| Proctosigmoidoscopy dx 45300 CPT 45300 | not published | not published | $73.16 – $1,914.03 | 11 |
| Proctosigmoidoscopy removal CPT 45308 | not published | not published | $127.92 – $5,712.83 | 12 |
| Proctosigmoidoscopy removal CPT 45309 | not published | not published | $135.60 – $2,462.91 | 12 |
| Proctosigmoidoscopy tumor removal 45315 CPT 45315 | not published | not published | $160.06 – $2,462.91 | 12 |
| Proctosigmoidoscopy volvul CPT 45321 | not published | not published | $156.46 – $5,712.83 | 12 |
| Proctosigmoidoscopy w/bx 45305 CPT 45305 | not published | not published | $110.38 – $2,462.91 | 12 |
| Proctosigmoidoscopy w/fb remove 45307 CPT 45307 | not published | not published | $151.95 – $5,712.83 | 12 |
| Proctosigmoidoscopy w/stent CPT 45327 | not published | not published | $176.85 – $12,495.04 | 12 |
| Progenamatrix, per sq cm HCPCS Q4222 | not published | not published | $119.69 – $233.39 | 10 |
| Progesterone CPT 84144 | $117.70 | $214.00 | $15.00 – $44.64 | 11 |
| Prolactin CPT 84146 | $264.00 | $480.00 | $14.00 – $41.47 | 11 |
| Prolng clin staff svc 1st hr CPT 99415 | not published | not published | $29.63 – $29.63 | 1 |
| Prolng clin staff svc ea add CPT 99416 | not published | not published | $13.86 – $13.86 | 1 |
| Prolng ip/obs e/m ea 15 min CPT 99418 | not published | not published | $16.96 – $60.61 | 2 |
| Prolng off/op e/m ea 15 min 99417 CPT 99417 | not published | not published | $16.96 – $46.06 | 2 |
| Prolonged IV inf, req pump HCPCS C8957 | not published | not published | $204.57 – $597.04 | 9 |
| Prolong home eval add 15m HCPCS G0318 | not published | not published | $46.02 – $46.02 | 1 |
| Prolong service without contact CPT 99358 | not published | not published | $135.16 – $135.16 | 1 |
| Prolong serv without contact add CPT 99359 | not published | not published | $56.42 – $56.42 | 1 |
| Promethazine 25 mg tablet HCPCS Q0169 | not published | not published | $0.05 – $0.13 | 2 |
| Promethazine hcl injection HCPCS J2550 | not published | not published | $3.77 – $5.90 | 4 |
| Proph rta dtchmnt crtx dthrm CPT 67141 | not published | not published | $305.27 – $2,100.00 | 12 |
| Proph rta dtchmnt pc CPT 67145 | not published | not published | $323.08 – $1,579.00 | 11 |
| Proph tx w/wo mthylmthcrylt CPT 24498 | not published | not published | $1,321.28 – $26,424.41 | 12 |
| Prophylactic tx radius CPT 25490 | not published | not published | $1,098.54 – $14,934.65 | 12 |
| Prophylactic tx radius&ulna CPT 25492 | not published | not published | $1,381.51 – $6,734.39 | 12 |
| Prophylactic tx ulna CPT 25491 | not published | not published | $1,129.37 – $26,424.41 | 12 |
| Propofol infusion 10 mg/ml HCPCS J2704 | not published | not published | $0.10 – $0.21 | 4 |
| _propoxygc/msur CPT 80367 | $114.95 | $209.00 | $22.23 – $35.46 | 2 |
| Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 | not published | not published | $3.76 – $13.14 | 2 |
| Pros sheath/sock w gel cushn HCPCS L8417 | not published | not published | $93.09 – $199.21 | 10 |
| Pros soc insert gasket/seal HCPCS L7700 | not published | not published | $138.17 – $295.68 | 10 |
| Pros sock multi ply upper lm HCPCS L8435 | not published | not published | $29.52 – $63.17 | 10 |
| Pros sock single ply ak HCPCS L8480 | not published | not published | $12.87 – $27.54 | 10 |
| Pros sock single ply upper l HCPCS L8485 | not published | not published | $13.62 – $29.15 | 10 |
| Prostate biopsy, any mthd HCPCS G0416 | $878.35 | $1,597.00 | $275.33 – $737.75 | 10 |
| Prostate ca screening; dre HCPCS G0102 | not published | not published | $13.47 – $30.87 | 2 |
| Prostatectomy (turp) CPT 52601 | not published | not published | $1,111.69 – $11,035.58 | 12 |
| Prostate laser enucleation CPT 52649 | not published | not published | $1,258.68 – $11,035.58 | 11 |
| Prostatic microwave thermotx CPT 53850 | not published | not published | $542.71 – $7,255.07 | 11 |
| Prostatic rf thermotx CPT 53852 | not published | not published | $581.82 – $7,255.07 | 10 |
| Prosthesis voc advantage 20f 14mm HCPCS L8509 | not published | not published | $135.20 – $289.33 | 10 |
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.