Fth/gft fr trnk each addl cost in Missouri

FTH/GFT FR TRNK EACH ADDL · CPT 15201

Hospital City Cash price Negotiated range Payers
SSM Health St. Joseph Hospital - Lake Saint Louis Lake Saint Louis not published $84.21 – $3,886.00 6
SSM Health St. Mary's Hospital - St. Louis Richmond Heights not published $84.21 – $3,886.00 6
SSM Health St. Joseph Hospital - St. Charles Saint Charles not published $84.21 – $3,886.00 6
SSM Health St. Joseph Hospital- Wentzville Wentzville not published $84.21 – $3,886.00 6
SSM Health Saint Louis University Hospital Saint Louis not published $96.70 – $3,886.00 5
SSM Health DePaul Hospital - St. Louis Bridgeton not published $84.21 – $3,886.00 6