Visits & medical services prices at SSM Health St. Anthony Hospital - Midwest
Midwest City, OK · every code in this section with a posted price and a Medicare benchmark.
197 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Ablate Heart Dysrhythm Focus (93650) | $11,161.56 | $20,293.75 | 1.5× |
| Admn Sarscov2 Vacc 1 Dose (90480) | $49.50 | $90 | 1.3× |
| Airway Inhalation Treatment (94640) range across 3 matching MRF lines |
$299.20–$344.08 | $544–$625.60 | varies |
| Analyze Pacemaker System (93724) | $764.01 | $1,389.11 | 2.6× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $86.49 | $157.25 | 6.0× |
| Application on-body injector (96377) | $202.40 | $368 | 4.5× |
| Arrhythmia Induction (93618) | $1,909.74 | $3,472.25 | 1.6× |
| Behavral qualit analys voice (92524) range across 7 matching MRF lines |
$230.01–$376.80 | $418.20–$685.10 | varies |
| Bundle of his recording (93600) | $7,075.14 | $12,863.90 | 0.9× |
| Cardiac Stress Tst,Tracing Only (93017) | $1,325.90 | $2,410.73 | 6.4× |
| Cardiopulmonary resuscitation (92950) range across 2 matching MRF lines |
$852.25–$979.88 | $1,549.55–$1,781.60 | varies |
| Cardioversion (92960) range across 2 matching MRF lines |
$1,136.96–$1,307.60 | $2,067.20–$2,377.45 | varies |
| Cardioversion elective internal (92961) | $654.03 | $1,189.15 | 1.0× |
| Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) | $18,878.12 | $34,323.85 | 6.1× |
| Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) | $6,166.32 | $11,211.50 | 2.0× |
| Cbt 1st hour (94644) range across 2 matching MRF lines |
$287.76–$330.66 | $523.20–$601.20 | varies |
| Chemo Anti-Neopl Sq/Im (96401) | $72 | $130.90 | 1.0× |
| Chemo Hormon Antineopl Sq/Im (96402) | $72 | $130.90 | 1.0× |
| Chemo IV infusion addl hr (96415) | $190.27 | $345.95 | 2.7× |
| Chemo IV push addl drug (96411) | $115.47 | $209.95 | 1.7× |
| Chemother Prolong Infuse W/Pump (96416) | $781.66 | $1,421.20 | 2.5× |
| Chemotherapy Into Cns (96450) | $378.68 | $688.50 | 1.2× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $208.97 | $379.95 | 3.0× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $362.31 | $658.75 | 1.1× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $305.74 | $555.90 | 1.0× |
| Chemotx Njx Subarachnd/Intraventr Rsvr 1/Mult (96542) | $243.57 | $442.85 | 0.8× |
| Chest Wall Manipulation (94668) | $232.82 | $423.30 | 1.8× |
| Color/duplex Doppler, complete (93975) | $2,356.61 | $4,284.75 | 10.3× |
| Color/duplex Doppler, limited (93976) | $1,141.11 | $2,074.75 | 11.3× |
| Continuous Pulse Ox (94762) | $741.18 | $1,347.60 | 6.0× |
| Coronary Art/Grft Angio S&I (93455) | $7,386.97 | $13,430.85 | 2.4× |
| Coronary Artery Angio S&I (93454) | $7,386.97 | $13,430.85 | 2.4× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) range across 2 matching MRF lines |
$259.46–$604.01 | $471.75–$1,098.20 | varies |
| Cpt initial (94667) | $232.82 | $423.30 | 1.8× |
| Critical care first hour (99291) | $3,226.16 | $5,865.75 | 4.1× |
| Debridement Open Wound 20 Sq Cm< (97597) | $554.46 | $1,008.10 | 2.9× |
| Dialysis One Evaluation (90945) | $1,826.52 | $3,320.95 | 4.6× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $2,356.61 | $4,284.75 | 10.3× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $1,141.11 | $2,074.75 | 11.3× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $2,495.90 | $4,538 | 10.9× |
| Dup-scan xtr veins unilateral/limited study (93971) | $1,247.95 | $2,269 | 12.4× |
| Duplex Scan Artl Infl&Ven O/F Hemo Compl Bi Std (93985) | $695.17 | $1,263.95 | 3.0× |
| Duplex Scan Artl Infl&Ven O/F Hemo Compl Uni Std (93986) | $382.88 | $696.15 | 3.8× |
| Duplex up extrem art bilat (93930) | $1,141.11 | $2,074.75 | 5.0× |
| Duplex up extrem art unilat/ltd (93931) | $1,141.11 | $2,074.75 | 11.3× |
| Echo Heart Xthoracic,Limited (93308) | $583.44 | $1,060.80 | 2.5× |
| Echo transesophageal (93312) | $1,961.63 | $3,566.60 | 3.7× |
| Echo Transesophageal - Congenital Tee Complete (93315) | $655.44 | $1,191.70 | 1.2× |
| Eeg 41-60 Minutes (95812) | $1,070.81 | $1,946.92 | 5.2× |
| EEG awake and asleep (95819) | $725.91 | $1,319.84 | 3.5× |
| EEG awake drowsy (95816) | $725.91 | $1,319.84 | 3.5× |
| EEG cerebral death evaluation (95824) | $1,296.38 | $2,357.05 | 3.6× |
| EEG cont rec w/video by tech min 8 channels (95700) | $342.21 | $622.20 | 1.6× |
| EEG extended monitoring 61-119 minutes (95813) | $805.04 | $1,463.70 | 3.9× |
| Eeg Sleep Only (95822) | $725.91 | $1,319.84 | 3.5× |
| Eeg W/O Vid 2-12 Hr Unmntr (95705) | $787.15 | $1,431.19 | 3.8× |
| EEG w/o vid 2-12hr cont mntr (95707) | $342.21 | $622.20 | 1.6× |
| EEG w/o vid ea 12-26hr intmt (95709) | $631.12 | $1,147.50 | 1.8× |
| Eeg W/O Vid Tech Ea Incr 12-26 Hr Cont R-T Mntr (95710) | $631.12 | $1,147.50 | 1.8× |
| EEG w/o video by tech 2-12 hr intermittent mntr (95706) | $342.21 | $622.20 | 1.6× |
| EEG wo vid ea 12-26hr unmntr (95708) | $631.12 | $1,147.50 | 1.8× |
| Electrical Stimulation Ea 15 Min (97032) | $61.71 | $112.20 | 4.2× |
| Electrocardiogram Tracing (93005) | $422.70 | $768.54 | 7.4× |
| Electroconvulsive Therapy (90870) | $1,512.50 | $2,750 | 1.8× |
| Electrophysiologic Follow-Up W/Pac/Rec W/Arrhyt (93624) | $11,613.64 | $21,115.70 | 1.5× |
| Electrophysiology Evaluation (93642) | $2,121.98 | $3,858.15 | 1.8× |
| Emergency Dept Visit Level 2 (99282) | $892.38 | $1,622.50 | 6.0× |
| Emergency Dept Visit Level 3 (99283) | $1,304.19 | $2,371.25 | 5.0× |
| Emergency Dept Visit Level 4 (99284) | $2,173.19 | $3,951.25 | 5.4× |
| Emg 3 Extremities (95863) | $976.14 | $1,774.80 | 7.9× |
| Endomyocardial Biopsy (93505) | $2,177.62 | $3,959.30 | 0.7× |
| Ep & ablate supravent arrhyt (93653) | $25,508.67 | $46,379.40 | 1.0× |
| Ep & ablate ventric tachy (93654) | $17,877.67 | $32,504.85 | 0.7× |
| Ep Compre Electrophysiologic Arrhythmia Induction (93620) | $12,401.96 | $22,549.01 | 1.7× |
| Er level 1 (99281) | $686.40 | $1,248 | 8.5× |
| Er level v (99285) | $2,402.54 | $4,368.25 | 4.2× |
| Eval aud funcj cand/po surg implt dev 1st hr (92626) | $329.59 | $599.25 | 2.7× |
| Evaluate pt use of inhaler (94664) | $361.38 | $657.05 | 1.7× |
| Evaluate Speech Production (92522) range across 5 matching MRF lines |
$230.01–$393.17 | $418.20–$714.85 | varies |
| Evaluate Swallowing Function (92610) range across 5 matching MRF lines |
$217.39–$311.36 | $395.25–$566.10 | varies |
| Evaluation of speech fluency (92521) | $283.30 | $515.10 | 2.1× |
| External ECG rec>48hr<7d recording (93242) | $46.28 | $84.15 | 1.3× |
| External ECG rec>7d<15d recording (93246) | $72.46 | $131.75 | 2.0× |
| External Ecg Scanning Analysis Report (93226) | $796.62 | $1,448.40 | 14.0× |
| Extracranial Bilat Study (93880) | $1,454.86 | $2,645.20 | 6.3× |
| Extracranial Uni/Ltd Study (93882) | $298.26 | $542.30 | 3.0× |
| Fluorescein angiography (92235) | $623.64 | $1,133.90 | 3.0× |
| Group Therapeutic Procedures (97150) | $72.93 | $132.60 | 4.0× |
| Heart catheterization, both sides, with coronary and bypass graft angiography (93461) | $20,039.86 | $36,436.10 | 6.4× |
| Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935) | $1,570.33 | $2,855.15 | 2.4× |
| Holter monitor recording (93225) | $796.62 | $1,448.40 | 6.2× |
| Im Adm Intransl/Oral 1 Vaccine (90473) | $95.70 | $174 | 1.4× |
| Img retina detcj/mntr ds poc auton a/r uni/bi (92229) | $52.80 | $96 | 0.9× |
| Immunization administration (90471) | $123.75 | $225 | 1.8× |
| Insert/Place Heart Catheter (93503) | $2,362.74 | $4,295.90 | 1.6× |
| Intra-atrial pacing (93610) | $7,075.14 | $12,863.90 | 0.9× |
| Intra-atrial recording (93602) | $7,075.14 | $12,863.90 | 0.9× |
| Intraventricular pacing (93612) likely a partial charge, not the full procedure |
$2,220.16 | $4,036.65 | 0.3× |
| Iontophoresis 15 min (97033) | $82.75 | $150.45 | 4.3× |
| Irrig Drug Delivery Device (96523) | $83.68 | $152.15 | 1.5× |
| IV infusion hydration each additional hour (96361) range across 2 matching MRF lines |
$242–$278.30 | $440–$506 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) range across 2 matching MRF lines |
$919.60–$1,057.65 | $1,672–$1,923 | varies |
| IV infusion ther proph addl sequential to 1 hr (96367) range across 2 matching MRF lines |
$275–$316.25 | $500–$575 | varies |
| IV infusion therapy prophylaxis/dx ea hour (96366) range across 2 matching MRF lines |
$211.75–$243.65 | $385–$443 | varies |
| IV push initial (96374) range across 2 matching MRF lines |
$254.10–$292.05 | $462–$531 | varies |
| L Hrt Art/Grft Angio (93459) | $19,317.57 | $35,122.85 | 6.2× |
| Mechanical chest wall oscillation per session (94669) | $230.48 | $419.05 | 1.1× |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) | $60.31 | $109.65 | 1.9× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $70.59 | $128.35 | 1.9× |
| Medical nutrition therapy grp2/ indiv ea 30 mi (97804) | $40.20 | $73.10 | 2.4× |
| Motion Fluoroscopy/Swallow (92611) range across 2 matching MRF lines |
$188.87–$374.94 | $343.40–$681.70 | varies |
| Muscle Test 2 Limbs (95861) | $1,052.81 | $1,914.20 | 8.2× |
| Muscle Test One Limb (95860) | $232.82 | $423.30 | 1.8× |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) | $857.40 | $1,558.90 | 2.2× |
| Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) | $520.80 | $946.90 | 1.3× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) | $468.44 | $851.70 | 2.4× |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $520.80 | $946.90 | 1.3× |
| Nerve conduction studies 13 or more studies (95913) | $151.14 | $274.80 | 0.4× |
| Neuromuscular Reeducation (97112) range across 2 matching MRF lines |
$138.85–$156.14 | $252.45–$283.90 | varies |
| Newborn resuscitation (99465) | $1,196.45 | $2,175.36 | 1.9× |
| Oral Function Therapy (92526) range across 5 matching MRF lines |
$153.81–$262.74 | $279.65–$477.70 | varies |
| Oral Speech Device Eval (92597) | $200.09 | $363.80 | 2.8× |
| Ot eval high complexity (97167) | $388.96 | $707.20 | 3.9× |
| Ot Eval Low Complex (97165) | $291.72 | $530.40 | 2.9× |
| Ot Eval Moderate Complexity (97166) | $340.34 | $618.80 | 3.4× |
| Ot manual therapy 15 min (97140) | $223.46 | $406.30 | 8.1× |
| Ot Re-Eval Est Plan Care (97168) | $275.82 | $501.50 | 4.0× |
| Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) | $213.65 | $388.45 | 1.0× |
| Perq Transcath Cls Aortic (93591) | $18,697.66 | $33,995.75 | 1.1× |
| Perq Transcath Cls Mitral (93590) | $18,697.66 | $33,995.75 | 1.1× |
| Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) | $5,892.37 | $10,713.40 | 1.1× |
| Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) | $21,004.78 | $38,190.50 | 1.9× |
| Phlebotomy therapeutic (99195) | $137.44 | $249.90 | 1.1× |
| Prq Card Angio/Athrect 1 Art (92924) | $21,004.78 | $38,190.50 | 1.9× |
| Prq Card Stent W/Angio 1 Vsl (92928) | $22,075.35 | $40,137 | 2.0× |
| Prq Card Stent/Ath/Angio (92933) | $20,358.69 | $37,015.80 | 1.2× |
| Prq Revasc Byp Graft 1 Vsl (92937) | $16,888.90 | $30,707.10 | 1.5× |
| Prq Tcat Clsr Cgen Ventr Septal Dfct W/Implt (93581) | $16,369.51 | $29,762.75 | 0.9× |
| Psych diag eval w/med srvcs (90792) | $191.21 | $347.65 | 1.1× |
| Pt Eval High Complex (97163) | $316.03 | $574.60 | 3.2× |
| Pt eval low complex 20 min (97161) | $291.72 | $530.40 | 3.0× |
| Pt Eval Mod Complex (97162) | $303.88 | $552.50 | 3.1× |
| Pt gait training 15 min (97116) | $174.84 | $317.90 | 6.0× |
| Pt mechanical traction (97012) | $95.84 | $174.25 | 6.7× |
| Pt Re-Eval Est Plan Care (97164) | $225.34 | $409.70 | 3.3× |
| Pulm function test by gas (94727) | $741.18 | $1,347.60 | 3.6× |
| Pulmonary service/procedure (94799) range across 3 matching MRF lines |
$138.60–$370.26 | $252–$673.20 | varies |
| Pulmonary Stress Testing (94618) | $231 | $420 | 1.8× |
| R Hrt Art/Grft Angio (93457) | $11,034.87 | $20,063.40 | 3.5× |
| R hrt coronary artery angio (93456) | $7,386.97 | $13,430.85 | 2.4× |
| R&L Hrt Cath W/Ventriclgrphy (93453) | $16,037.12 | $29,158.40 | 5.1× |
| Refill/Maint Portable Pump (96521) | $243.57 | $442.85 | 1.2× |
| Refill/Maint Pump/Resvr Syst (96522) | $243.57 | $442.85 | 1.2× |
| Remote 30 Day Ecg Rev/Report (93270) | $108.93 | $198.05 | 3.0× |
| Right Heart Cath (93451) | $7,386.97 | $13,430.85 | 2.4× |
| Right ventricular recording (93603) | $2,220.16 | $4,036.65 | 1.9× |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) | $477.32 | $867.85 | 3.9× |
| Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) | $217.86 | $396.10 | 4.6× |
| Self Care Mngment Training (97535) range across 2 matching MRF lines |
$215.52–$215.98 | $391.85–$392.70 | varies |
| Short-Latency Somatosens Ep Std Trnk/Head (95927) | $494.34 | $898.80 | 2.4× |
| Speech sound lang comprehen (92523) range across 7 matching MRF lines |
$281.44–$846.64 | $511.70–$1,539.35 | varies |
| Ssep lower limbs (95926) | $749.76 | $1,363.20 | 3.6× |
| Standardized Cognitive Performance Testing (96125) | $90.29 | $164.16 | 0.9× |
| Stress Tte Only (93350) | $1,367.44 | $2,486.25 | 2.6× |
| Temp transcutaneous pacing (92953) range across 2 matching MRF lines |
$2,273.92–$2,615.20 | $4,134.40–$4,754.90 | varies |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) | $96.30 | $175.10 | 4.3× |
| Ther Ivntj Ea Addl 15 Min (97130) | $96.30 | $175.10 | 4.6× |
| Ther/Prop/Diag Inj/Inf Proc (96379) | $145.75 | $265 | 3.2× |
| Ther/Proph/Diag Inj Ia (96373) | $335.78 | $610.50 | 1.6× |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 2 matching MRF lines |
$284.35–$327.25 | $517–$595 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) range across 2 matching MRF lines |
$828.85–$953.15 | $1,507–$1,733 | varies |
| Therapeutic Activities (97530) range across 2 matching MRF lines |
$180.92–$181.39 | $328.95–$329.80 | varies |
| Tilt table test with heart rhythm and blood pressure monitoring (93660) | $3,370.44 | $6,128.08 | 9.4× |
| Tobacco Use Cessation Intensive >10 Minutes (99407) | $70.94 | $128.99 | 2.0× |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) | $68.84 | $125.16 | 1.9× |
| Transcath Closure of Asd (93580) | $16,369.51 | $29,762.75 | 0.9× |
| Tte w/doppler, complete (93306) | $1,974.25 | $3,589.55 | 3.8× |
| Tte W/O Doppler Complete (93307) | $1,704.97 | $3,099.95 | 7.4× |
| Tx atrial fib pulm vein isol (93656) | $13,763.67 | $25,024.85 | 0.5× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $184.20 | $334.90 | 2.4× |
| Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) | $64.98 | $118.15 | 2.7× |
| Tx/Pro/Dx Inj New Drug Addon (96375) range across 2 matching MRF lines |
$201.30–$231.55 | $366–$421 | varies |
| Unlisted cardiovascular service/procedure (93799) range across 3 matching MRF lines |
$1,278.61–$3,876.51 | $2,324.75–$7,048.20 | varies |
| Upr/L Xtremity Art 2 Levels (93922) | $1,332.54 | $2,422.80 | 10.4× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $493.02 | $896.40 | 2.4× |
| Valvuloplasty aortic valve (92986) | $5,920.89 | $10,765.25 | 1.1× |
| Vasopneumatic device (97016) | $120.62 | $219.30 | 10.0× |
| Veeg 2-12 Hr Cont Mntr (95713) | $631.12 | $1,147.50 | 1.8× |
| Veeg 2-12 hr intmt mntr (95712) | $342.21 | $622.20 | 1.0× |
| Veeg 2-12 hr unmonitored (95711) | $342.21 | $622.20 | 1.6× |
| Veeg by tech ea incr 12-26 hr intermittent mntr (95715) | $631.12 | $1,147.50 | 1.8× |
| Veeg Ea 12-26 Hr Unmntr (95714) | $631.12 | $1,147.50 | 1.8× |
| Veeg ea 12-26hr cont mntr (95716) | $1,189.32 | $2,162.40 | 1.4× |
| Vent Mgmt Inpat Init Day (94002) | $3,413.22 | $6,205.85 | 5.7× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $3,334.68 | $6,063.05 | 5.6× |
| Vital capacity, total (94150) | $291.72 | $530.40 | 2.4× |
| Wheelchair Mgmt Ea 15 Min (97542) | $133.24 | $242.25 | 4.3× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.