SSM Health St. Anthony Hospital - Shawnee
1102 W Macarthur, Shawnee, OK · SSM Health · · NPI 1134123193
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 |
|---|---|---|---|---|
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $785.95 | $1,429.00 | $168.70 – $446.40 | 8 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $785.95 | $1,429.00 | $168.70 – $400.55 | 8 |
| Cta neck without &/or w/contrast CPT 70498 | $735.90 | $1,338.00 | $168.70 – $400.55 | 8 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $2,849.55 | $5,181.00 | $335.54 – $803.54 | 8 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $1,724.25 | $3,135.00 | $168.70 – $400.55 | 8 |
| CT Angiogram of the Head CPT 70496 | $735.90 | $1,338.00 | $168.70 – $400.55 | 8 |
| CT angio hrt w/3d image CPT 75574 | not published | not published | $314.19 – $803.54 | 8 |
| CT angio pelvis CPT 72191 | $897.60 | $1,632.00 | $168.70 – $400.55 | 8 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $785.95 | $1,429.00 | $168.70 – $400.55 | 8 |
| CT bone density axial CPT 77078 | not published | not published | $83.70 – $198.11 | 8 |
| CT cerebral perf w cont & prcssng CPT 70473 | not published | not published | $168.70 – $328.96 | 6 |
| CT colonography dx CPT 74261 | not published | not published | $100.55 – $450.32 | 8 |
| CT colonography dx w/dye CPT 74262 | not published | not published | $168.70 – $519.80 | 8 |
| CT colonography screening CPT 74263 | not published | not published | $229.48 – $814.99 | 8 |
| CT guidance for needle placement CPT 77012 | $1,603.80 | $2,916.00 | $101.56 – $224.62 | 2 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $1,084.05 | $1,971.00 | $81.90 – $196.66 | 2 |
| CT guid cryo ablat intramuscular CPT 20999 | not published | not published | $237.24 – $731.00 | 8 |
| CT guid parench tis ablat CPT 77013 | not published | not published | $455.63 – $618.42 | 2 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | not published | not published | $72.18 – $163.21 | 7 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | not published | not published | $277.29 – $803.54 | 8 |
| CT hrt w/3d image CPT 75572 | not published | not published | $218.86 – $803.54 | 8 |
| CT limited or localized follow-up study CPT 76380 | not published | not published | $83.70 – $198.11 | 8 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $2,007.50 | $3,650.00 | $167.63 – $400.55 | 8 |
| CT lower extremity without contrast (both sides) CPT 73700 | $1,801.25 | $3,275.00 | $100.55 – $239.27 | 8 |
| CT lwr extremity w/o&w/dye CPT 73702 | $2,011.90 | $3,658.00 | $168.70 – $400.55 | 8 |
| CT neck soft tissue w/contrast CPT 70491 | $1,207.25 | $2,195.00 | $168.70 – $400.55 | 8 |
| CT neck soft tissue without contrast CPT 70490 | $1,177.00 | $2,140.00 | $100.55 – $239.27 | 8 |
| CT neck soft tissue without & w/contrast CPT 70492 | $1,340.90 | $2,438.00 | $168.70 – $400.55 | 8 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $1,238.05 | $2,251.00 | $168.70 – $400.55 | 8 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $1,177.55 | $2,141.00 | $168.70 – $400.55 | 8 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $1,119.80 | $2,036.00 | $100.55 – $239.27 | 8 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | not published | not published | $202.45 – $991.00 | 9 |
| CT scan for therapy guide CPT 77014 | not published | not published | $108.26 – $210.18 | 2 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $2,949.65 | $5,363.00 | $335.54 – $803.54 | 8 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $2,621.85 | $4,767.00 | $325.30 – $803.54 | 8 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $2,245.10 | $4,082.00 | $152.79 – $543.87 | 8 |
| CT thoracic spine w/contrast CPT 72129 | $2,231.90 | $4,058.00 | $168.11 – $400.55 | 8 |
| CT thoracic spine without contrast CPT 72128 | $1,707.20 | $3,104.00 | $100.55 – $239.27 | 8 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $70.40 | $128.00 | $100.55 – $239.27 | 8 |
| CT t-spine w /wo contrast CPT 72130 | $2,241.25 | $4,075.00 | $168.70 – $400.55 | 8 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $1,965.70 | $3,574.00 | $217.96 – $803.54 | 8 |
| CT upper extremity without contrast (both sides) CPT 73200 | $1,342.00 | $2,440.00 | $100.55 – $239.27 | 8 |
| CT uppr extremity w/o&w/dye CPT 73202 | $2,063.60 | $3,752.00 | $168.70 – $400.55 | 8 |
| Cultr oocyte/embryo <4 days CPT 89250 | not published | not published | $62.42 – $1,583.27 | 8 |
| Cultr oocyte/embryo <4 days CPT 89251 | not published | not published | $62.42 – $1,647.02 | 8 |
| Cult skin graft fnhfg 15155 CPT 15155 | not published | not published | $1,099.18 – $6,955.84 | 9 |
| Cult skin grft t/arm/leg CPT 15150 | not published | not published | $967.40 – $3,869.58 | 9 |
| Culture aerobic additional method definitive id each CPT 87077 | $277.20 | $504.00 | $8.08 – $11.97 | 8 |
| Culture afb any source CPT 87116 | $222.20 | $404.00 | $10.80 – $15.82 | 8 |
| Culture anaerobic additional method definitive id each CPT 87076 | $25.85 | $47.00 | $8.08 – $11.97 | 8 |
| Culture anaerobic except blood CPT 87075 | $104.50 | $190.00 | $9.47 – $13.90 | 8 |
| Culture bact stool aero addl path ea CPT 87046 | $28.60 | $52.00 | $9.44 – $13.90 | 8 |
| Culture body fluid CPT 87070 | $114.95 | $209.00 | $8.62 – $12.47 | 8 |
| Culture fungi definitive id mold CPT 87107 | $63.80 | $116.00 | $10.32 – $15.34 | 8 |
| Culture fungi definitive id yeast CPT 87106 | $25.30 | $46.00 | $10.32 – $15.34 | 8 |
| Culture fungi other (except blood) CPT 87102 | $88.00 | $160.00 | $8.41 – $12.47 | 8 |
| Culture fungi skin/hair/nail CPT 87101 | $88.00 | $160.00 | $7.71 – $11.50 | 8 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $119.90 | $218.00 | $14.61 – $21.57 | 8 |
| Culture mycoplasma any source CPT 87109 | not published | not published | $15.39 – $22.52 | 8 |
| Culture quantitative aerobic other source CPT 87071 | not published | not published | $9.89 – $14.37 | 8 |
| Culture screening strep group a CPT 87081 | $101.20 | $184.00 | $6.63 – $9.59 | 8 |
| Culture typing added method CPT 87158 | not published | not published | $7.74 – $11.50 | 8 |
| Culture typing immunologic CPT 87147 | $30.25 | $55.00 | $5.18 – $7.67 | 8 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | $497.20 | $904.00 | $218.06 – $319.15 | 8 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $92.40 | $168.00 | $35.09 – $51.28 | 8 |
| Culture urine each isolate CPT 87088 | $82.50 | $150.00 | $8.09 – $11.97 | 8 |
| Culture virus isolation CPT 87250 | not published | not published | $19.56 – $28.76 | 8 |
| Curette/treat cornea CPT 65435 | not published | not published | $104.30 – $1,869.60 | 8 |
| Curette/treat cornea CPT 65436 | not published | not published | $553.79 – $4,458.86 | 8 |
| Cutter lead HCPCS C1773 | $1,922.39 | $3,495.25 | not published | 0 |
| Cv line/pic reposition CPT 36597 | not published | not published | $90.80 – $2,952.25 | 8 |
| Cv stress test i&r only 93018 CPT 93018 | not published | not published | $21.37 – $24.32 | 2 |
| Cv stress test/supervision only 93016 CPT 93016 | not published | not published | $32.31 – $35.95 | 2 |
| Cyanocobalamin unsat binding capacity CPT 82608 | $85.25 | $155.00 | $14.32 – $21.09 | 8 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | not published | not published | $0.83 – $2.37 | 3 |
| Cyclic citrullinated peptide antibody CPT 86200 | $42.90 | $78.00 | $12.95 – $19.17 | 8 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | not published | not published | $0.58 – $1.28 | 8 |
| Cyclophosphamide 25 mg capsule HCPCS J8530 | not published | not published | $1.02 – $1.82 | 3 |
| Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 | not published | not published | $64.24 – $114.24 | 3 |
| Cyclosporine 2 hour CPT 80158 | $231.55 | $421.00 | $18.05 – $26.36 | 8 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | not published | not published | $0.92 – $1.38 | 3 |
| Cyclosporine oral 100 mg HCPCS J7502 | not published | not published | $2.50 – $3.71 | 3 |
| Cyp2c19 gene com variants CPT 81225 | not published | not published | $291.36 – $426.49 | 8 |
| Cyp2c9 gene com variants CPT 81227 | not published | not published | $174.81 – $255.89 | 7 |
| Cyp2d6 gene com variants CPT 81226 | not published | not published | $450.91 – $659.86 | 8 |
| Cyp3a4 gene common variants CPT 81230 | not published | not published | $174.81 – $255.89 | 7 |
| Cyp3a5 gene common variants CPT 81231 | not published | not published | $174.81 – $255.89 | 7 |
| Cystatin c CPT 82610 | $176.00 | $320.00 | $18.52 – $27.31 | 8 |
| Cystic fibrosis cftr CPT 81223 | not published | not published | $499.00 – $730.30 | 8 |
| Cystine urine quantitative CPT 82131 | $129.25 | $235.00 | $22.98 – $33.54 | 8 |
| Cysto cgen post urtl valves CPT 52400 | not published | not published | $728.32 – $6,610.93 | 9 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $514.25 | $935.00 | $37.81 – $803.54 | 8 |
| Cysto impl 4 or more HCPCS C9740 | not published | not published | $4,103.56 – $17,753.89 | 8 |
| Cysto insj dev ischmc rmdlg CPT 53865 | not published | not published | $4,103.56 – $17,753.89 | 6 |
| Cysto, litho, vacuum kidney HCPCS C9761 | not published | not published | $3,066.00 – $17,753.89 | 8 |
| Cystometrogram w/up 51727 CPT 51727 | not published | not published | $376.08 – $1,307.75 | 8 |
| Cystorrhaphy wound comp 51865 CPT 51865 | not published | not published | $1,365.38 – $4,103.56 | 2 |
| Cystorrhaphy wound simple 51860 CPT 51860 | not published | not published | $1,136.35 – $17,753.89 | 8 |
| Cysto rx balo cath urtl strx CPT 52284 | not published | not published | $249.46 – $10,055.79 | 7 |
| Cystoscopy and biopsy CPT 52007 | not published | not published | $251.83 – $6,610.93 | 9 |
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.