Epidrm a-grft f/n/hf/g addl cost in Missouri

Epidrm a-grft f/n/hf/g addl · CPT 15116

Hospital City Cash price Negotiated range Payers
SSM Health St. Mary's Hospital - Jefferson City Jefferson City not published $1,351.00 – $2,277.00 2
SSM Health Cardinal Glennon Children's Hospital Saint Louis not published $158.90 – $3,886.00 5
SSM Health St. Clare Hospital - Fenton Fenton not published $162.67 – $3,886.00 6
SSM Health St. Mary's Hospital - St. Louis Richmond Heights not published $162.67 – $3,886.00 6
SSM Health St. Joseph Hospital - St. Charles Saint Charles not published $162.67 – $3,886.00 6
SSM Health St. Joseph Hospital- Wentzville Wentzville not published $162.67 – $3,886.00 6
SSM Health Saint Louis University Hospital Saint Louis not published $186.78 – $3,886.00 5
SSM Health DePaul Hospital - St. Louis Bridgeton not published $162.67 – $3,886.00 6
SSM Health St. Joseph Hospital - Lake Saint Louis Lake Saint Louis not published $162.67 – $3,886.00 6