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 |
|---|---|---|---|---|
| Liver imag w/vasclr flow CPT 78202 | not published | not published | $246.15 – $1,211.11 | 8 |
| Liver/spleen imag static only CPT 78215 | not published | not published | $229.38 – $904.12 | 8 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $146.91 – $904.12 | 8 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $110.46 – $4,458.86 | 8 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $714.34 – $6,164.76 | 9 |
| Lockingelbow forearm cntrbal HCPCS L6693 | not published | not published | $3,514.41 – $6,853.10 | 8 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | not published | not published | $1.15 – $2.25 | 3 |
| Lomustine 10 mg HCPCS S0178 | not published | not published | $118.11 – $171.08 | 2 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | not published | not published | $226.61 – $441.89 | 9 |
| Long tongue stirrup HCPCS L2265 | not published | not published | $180.44 – $351.86 | 8 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | not published | not published | $1.84 – $2.50 | 3 |
| Lo rig pos pnl l1-l5 pre ots HCPCS L0641 | not published | not published | $57.10 – $111.34 | 8 |
| Lo sag rig pnl stays pre cst HCPCS L0626 | not published | not published | $96.31 – $187.80 | 8 |
| Loudness balance test CPT 92562 | not published | not published | $69.44 – $622.80 | 8 |
| Low back disk surgery CPT 63030 | not published | not published | $1,388.55 – $13,608.67 | 8 |
| Low cost skin substitute app HCPCS C5271 | $661.10 | $1,202.00 | $731.00 – $1,163.05 | 2 |
| Low cost skin substitute app HCPCS C5273 | not published | not published | $1,411.00 – $3,475.54 | 2 |
| Low cost skin substitute app HCPCS C5275 | $661.10 | $1,202.00 | $731.00 – $1,163.05 | 2 |
| Low cost skin substitute app HCPCS C5277 | not published | not published | $731.00 – $1,163.05 | 2 |
| Low cost skin substitute app HCPCS C5272 | not published | not published | $731.00 – $731.00 | 1 |
| Low cost skin substitute app HCPCS C5274 | not published | not published | $731.00 – $731.00 | 1 |
| Low cost skin substitute app HCPCS C5276 | not published | not published | $731.00 – $731.00 | 1 |
| Low cost skin substitute app HCPCS C5278 | not published | not published | $731.00 – $731.00 | 1 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,191.75 | $3,985.00 | $168.70 – $400.55 | 8 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,133.45 | $3,879.00 | $167.16 – $803.54 | 8 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,829.30 | $3,326.00 | $100.55 – $239.27 | 8 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $2,141.70 | $3,894.00 | $317.58 – $803.54 | 8 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $1,934.35 | $3,517.00 | $279.73 – $982.11 | 8 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,629.65 | $2,963.00 | $182.50 – $664.73 | 8 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $386.86 | $703.38 | $42.13 – $239.27 | 8 |
| Lower jaw bone graft CPT 21215 | not published | not published | $1,198.98 – $11,239.75 | 9 |
| Low frequency non-thermal Ultrasound CPT 97610 | not published | not published | $27.69 – $376.28 | 8 |
| Loxapine for inhalation 1 mg HCPCS J2062 | not published | not published | $25.38 – $25.38 | 1 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $1,120.46 – $19,935.73 | 8 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $1,291.81 – $19,935.73 | 8 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $1,272.28 – $19,935.73 | 8 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $1,388.60 – $19,935.73 | 8 |
| Lso corset front HCPCS L0972 | not published | not published | $152.77 – $297.90 | 8 |
| Lso flex no ri stays pre ots HCPCS L0628 | not published | not published | $61.45 – $119.83 | 8 |
| Lso full corset HCPCS L0976 | not published | not published | $216.26 – $421.71 | 8 |
| Lso r post pnl sj-t9 pre cst HCPCS L0630 | not published | not published | $200.06 – $390.12 | 8 |
| Lso sag-coronal panel custom HCPCS L0638 | not published | not published | $1,629.51 – $3,177.54 | 8 |
| Lso sag-co shell pnl pre ots HCPCS L0651 | not published | not published | $870.15 – $1,696.79 | 8 |
| Lso sag ctr rigi pos pre ots HCPCS L0643 | not published | not published | $118.63 – $231.33 | 8 |
| Lso sagit rigid panel prefab HCPCS L0635 | not published | not published | $1,222.44 – $2,383.76 | 8 |
| Lso sagittal rigid panel cus HCPCS L0636 | not published | not published | $1,657.19 – $3,231.52 | 8 |
| Lso sc r pos/lat pnl pre cst HCPCS L0633 | not published | not published | $354.31 – $690.90 | 8 |
| Lso sc r pos/lat pnl pre ots HCPCS L0649 | not published | not published | $210.07 – $409.64 | 8 |
| Lso s/c shell/panel custom HCPCS L0640 | not published | not published | $1,292.78 – $2,520.92 | 8 |
| Lso s/c shell/panel prefab HCPCS L0639 | not published | not published | $1,501.02 – $2,926.99 | 8 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $21.99 – $32.11 | 8 |
| Lubricant per ounce HCPCS A4402 | not published | not published | $3.12 – $3.41 | 2 |
| Lumbar bolster pad HCPCS L1030 | not published | not published | $97.47 – $190.07 | 8 |
| Lumbar derotation pad HCPCS L1240 | not published | not published | $96.35 – $187.88 | 8 |
| Lumbar diskogram s&i CPT 72295 | not published | not published | $103.94 – $4,393.73 | 8 |
| Lumbar or lumbar rib pad HCPCS L1040 | not published | not published | $101.89 – $198.69 | 8 |
| Lumbar sling HCPCS L1090 | not published | not published | $117.80 – $229.71 | 8 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $2,399.76 – $34,941.10 | 8 |
| Lumizyme injection HCPCS J0221 | not published | not published | $211.13 – $411.70 | 9 |
| Lung function test (mbc/mvv) CPT 94200 | not published | not published | $17.69 – $118.80 | 8 |
| Lung Function Test (Spirometry) CPT 94010 | $309.10 | $562.00 | $27.76 – $404.95 | 8 |
| Lung perfusion imaging CPT 78580 | $934.45 | $1,699.00 | $262.44 – $904.12 | 8 |
| Lung transplant double CPT 32853 | not published | not published | $1,189.00 – $4,103.56 | 2 |
| Lung transplant single CPT 32851 | not published | not published | $1,189.00 – $4,103.56 | 2 |
| Lung transplant with bypass CPT 32852 | not published | not published | $1,189.00 – $4,103.56 | 2 |
| Lung transplant with bypass CPT 32854 | not published | not published | $1,189.00 – $4,103.56 | 2 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $1,189.00 – $4,103.56 | 2 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | not published | not published | $215.95 – $421.10 | 9 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | not published | not published | $43.51 – $84.85 | 9 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | not published | not published | $350.21 – $682.90 | 8 |
| Lutetium lu 177 vipivotide HCPCS A9607 | not published | not published | $267.32 – $521.27 | 8 |
| Lvad shower bag heartmate HCPCS Q0501 | not published | not published | $632.22 – $1,232.83 | 8 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $27.82 – $54.24 | 8 |
| Lwr ext dynamic prosth pylon HCPCS L5985 | not published | not published | $349.54 – $681.60 | 8 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $20.05 – $29.24 | 7 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $1,076.26 – $15,328.79 | 7 |
| Lymphatics/lymph node imaging CPT 78195 | $669.90 | $1,218.00 | $386.46 – $1,211.11 | 8 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $36.56 – $53.68 | 8 |
| Lymphocyte transformation mitogen CPT 86353 | $348.70 | $634.00 | $49.03 – $71.88 | 8 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $87.66 – $277.45 | 8 |
| Lymphocytotoxicity assay CPT 86806 | not published | not published | $47.59 – $69.48 | 8 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $293.42 – $1,391.09 | 8 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $279.11 – $2,952.25 | 8 |
| Lymph vessel x-ray trunk CPT 75805 | not published | not published | $308.22 – $5,980.25 | 8 |
| Lymph vessel x-ray trunk CPT 75807 | not published | not published | $295.80 – $7,081.88 | 8 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $226.32 – $1,254.00 | 9 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $236.21 – $6,071.07 | 9 |
| Lysis penil circumic lesion CPT 54162 | $210.28 | $382.32 | $306.26 – $3,920.41 | 9 |
| Lyumjev for insulin pump use HCPCS J1813 | not published | not published | $24.52 – $25.57 | 2 |
| Macro exam dissect molec study ea CPT 88387 | not published | not published | $7.74 – $52.94 | 3 |
| Macroscopic exam arthropod CPT 87168 | $84.70 | $154.00 | $4.27 – $6.23 | 8 |
| Macroscopic exam parasite CPT 87169 | $44.55 | $81.00 | $4.31 – $6.23 | 8 |
| Magnesium CPT 83735 | $67.65 | $123.00 | $6.70 – $9.59 | 8 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | not published | not published | $0.61 – $1.13 | 3 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $229.48 – $543.87 | 8 |
| Makena, 10 mg HCPCS J1726 | not published | not published | $17.14 – $33.24 | 2 |
| Malaria antibody CPT 86750 | not published | not published | $13.19 – $19.17 | 8 |
| Male sling procedure CPT 53440 | not published | not published | $1,149.68 – $24,743.68 | 9 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $1,189.00 – $4,103.56 | 2 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $543.75 – $3,040.78 | 8 |
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.