Supplies, drugs & other prices at SSM Health St. Anthony Hospital - Oklahoma City
Oklahoma City, OK · every code in this section with a posted price and a Medicare benchmark.
87 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) | $2,164.80 | $3,936 | 2.9× |
| 2d tte w or w/o fol w/con,fu (C8924) | $812.35 | $1,477 | 2.4× |
| Adm tocilizu covid-19 1st (M0249) | $600.05 | $1,091 | 1.4× |
| Admin hepatitis b vaccine (G0010) | $55 | $100 | 1.2× |
| Admin influenza virus vac (G0008) range across 4 matching MRF lines |
$65.78–$66 | $119.60–$120 | varies |
| Admin pneumococcal vaccine (G0009) range across 3 matching MRF lines |
$61.60–$66 | $112–$120 | varies |
| Autolog prp not diab ulcer (G0460) | $1,278.20 | $2,324 | 0.6× |
| Ca screen;pelvic/breast exam (G0101) | $31.28 | $56.88 | 0.3× |
| Catheterize for urine spec (P9612) range across 2 matching MRF lines |
$35.20–$40.15 | $64–$73 | varies |
| Chemo extend iv infus w/pump (G0498) | $663.85 | $1,207 | 2.1× |
| Covid-19 lab test non-cdc (U0002) | $115.50 | $210 | 2.3× |
| Diab manage trn per indiv (G0108) | $103.40 | $188 | 1.9× |
| Diab manage trn ind/group (G0109) | $72.05 | $131 | 4.5× |
| Direct refer hospital observ (G0379) | $738.10 | $1,342 | 1.3× |
| Ekg tracing for initial prev (G0404) | $13.86 | $25.20 | 0.5× |
| Elec stim other than wound (G0283) | $166.10 | $302 | 13.1× |
| Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) | $15,492.95 | $28,169 | 1.4× |
| Fecal blood scrn immunoassay (G0328) range across 2 matching MRF lines |
$26.95–$45.10 | $49–$82 | varies |
| Group mnt 2 or more 30 mins (G0271) | $38.50 | $70 | 2.3× |
| Hbot, full body chamber, 30m (G0277) | $479.05 | $871 | 3.6× |
| Home sleep test/type 3 porta (G0399) | $815.65 | $1,483 | 3.9× |
| Hospital outpt clinic visit (G0463) | $68.76 | $125.01 | 0.5× |
| Inj for sacroiliac jt anesth (G0260) range across 2 matching MRF lines |
$997.70–$1,496 | $1,814–$2,720 | varies |
| Mnt subs tx for change dx (G0270) | $72.05 | $131 | 2.3× |
| Mra w/cont, abd (C8900) | $1,992.10 | $3,622 | 5.9× |
| Mra w/cont, chest (C8909) | $1,992.10 | $3,622 | 5.9× |
| Mra w/cont, lwr ext (C8912) | $1,792.45 | $3,259 | 5.3× |
| Mra w/cont, pelvis (C8918) | $1,792.45 | $3,259 | 5.3× |
| Mra w/o cont, abd (C8901) | $1,774.85 | $3,227 | 7.7× |
| Mra w/o cont, chest (C8910) | $1,731.95 | $3,149 | 7.5× |
| Mra w/o cont, lwr ext (C8913) | $1,574.65 | $2,863 | 6.9× |
| Mra w/o cont, pelvis (C8919) | $1,731.95 | $3,149 | 7.5× |
| Mra w/o fol w/cont, abd (C8902) | $2,211.55 | $4,021 | 6.6× |
| Mra w/o fol w/cont, chest (C8911) | $2,041.05 | $3,711 | 6.1× |
| Mra w/o fol w/cont, lwr ext (C8914) | $1,910.15 | $3,473 | 5.7× |
| Mra w/o fol w/cont, pelvis (C8920) | $1,870.55 | $3,401 | 5.6× |
| Mra, w/o dye, upper extr (C8935) | $1,792.45 | $3,259 | 7.8× |
| Mri w/cont, breast, bi (C8906) | $2,288.55 | $4,161 | 6.8× |
| Mri w/cont, breast, uni (C8903) | $1,422.85 | $2,587 | 8.4× |
| Mri w/o fol w/cont, breast, (C8908) | $2,461.80 | $4,476 | 7.3× |
| Mri w/o fol w/cont, brst, un (C8905) | $1,562.55 | $2,841 | 4.7× |
| Neuro csf prion prtn qual (0035U) range across 2 matching MRF lines |
$527.45–$646.25 | $959–$1,175 | varies |
| Njx bone sub matrl into subchondral bone defect (0707T) | $3,170.20 | $5,764 | 1.0× |
| Njx platelet plasma (0232T) | $969.10 | $1,762 | 2.3× |
| Obtaining screen pap smear (Q0091) | $37.22 | $67.68 | 1.3× |
| Open tx iliac spine uni/bil (G0412) | $19,150.45 | $34,819 | 2.7× |
| Oral antral fistula closure (D7260) | $1,490.50 | $2,710 | 2.4× |
| Pelvic ring fracture uni/bil (G0413) | $15,097.50 | $27,450 | 2.2× |
| Pelvic ring fx treat int fix (G0414) | $8,171.35 | $14,857 | 1.2× |
| Perc d-e cor revasc chro sin (C9607) unusually low: confirm this is the full procedure |
$8,720.25 | $15,855 | 0.5× |
| Perc d-e cor revasc t cabg s (C9604) | $9,765.80 | $17,756 | 0.9× |
| Perc d-e cor stent ather s (C9602) | $9,765.80 | $17,756 | 0.6× |
| Perc drug-el cor stent sing (C9600) | $8,789 | $15,980 | 0.8× |
| Perq Sacral Augmt Bilat Inj (0201T) | $13,971.65 | $25,403 | 2.0× |
| Perq Sacral Augmt Unilat Inj (0200T) | $6,986.10 | $12,702 | 1.0× |
| Place device/marker, non pro (C9728) | $2,590.50 | $4,710 | 1.9× |
| Prostate biopsy, any mthd (G0416) range across 2 matching MRF lines |
$578.05–$878.35 | $1,051–$1,597 | varies |
| Psa screening (G0103) range across 3 matching MRF lines |
$95.70–$288.20 | $174–$524 | varies |
| Revasc intra lithotrip-ather (C9766) | $13,230.25 | $24,055 | 0.8× |
| Revasc intra lithotrip-stent (C9765) | $21,162.35 | $38,477 | 1.2× |
| Revasc intravasc lithotripsy (C9764) | $6,529.60 | $11,872 | 0.6× |
| Revasc lith-sten-ath tib/per (C9775) | $21,162.35 | $38,477 | 1.2× |
| Revasc lithotr-ather tib/per (C9774) | $21,162.35 | $38,477 | 1.2× |
| Revasc lithotr-stent tib/per (C9773) | $21,162.35 | $38,477 | 1.2× |
| Revasc lithotrip tibi/perone (C9772) | $13,230.25 | $24,055 | 1.2× |
| Revasc lithotrip-stent-ather (C9767) | $21,162.35 | $38,477 | 1.2× |
| Scr c/v cyto,thinlayer,rescr (G0143) range across 2 matching MRF lines |
$121.55–$158.95 | $221–$289 | varies |
| Screen cerv/vag thin layer (G0123) range across 2 matching MRF lines |
$133.65–$250.25 | $243–$455 | varies |
| Screen pap by tech w md supv (P3000) range across 2 matching MRF lines |
$123.20–$139.15 | $224–$253 | varies |
| Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) | $34,586.75 | $62,885 | 1.9× |
| Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) | $34,586.75 | $62,885 | 1.9× |
| Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) | $26,939.55 | $48,981 | 1.5× |
| Tcat rmvl&rplcmt perm 1chmbr ldls pm r atrial (0825T) | $18,194 | $33,080 | 1.0× |
| Tcat rmvl&rplcmt perm 2chmbr ldls pm r atr cmpnt (0802T) | $18,818.80 | $34,216 | 1.0× |
| Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) | $6,558.75 | $11,925 | 1.2× |
| Transcatheter Renal Sympath Denervation Bilat (0339T) | $15,827.35 | $28,777 | 2.9× |
| Transcatheter renal sympath denervation unilat (0338T) | $7,913.95 | $14,389 | 1.4× |
| Trim nail(s) (G0127) | $19.01 | $34.56 | 0.3× |
| Trluml perip athrc abd aorta (0236T) | $16,379 | $29,780 | 1.5× |
| Trluml Perip Athrc Brchiocph (0237T) | $10,404.90 | $18,918 | 0.9× |
| Trluml Perip Athrc Iliac Art (0238T) | $12,802.90 | $23,278 | 0.7× |
| Trluml Peripheral Atherectomy Renal Artery Ea (0234T) unusually low: confirm this is the full procedure |
$5,523.65 | $10,043 | 0.5× |
| Tte w or w/o fol w/con,stres (C8928) | $2,435.95 | $4,429 | 3.2× |
| Tte w or wo fol wcon,doppler (C8929) | $2,424.40 | $4,408 | 3.2× |
| Unsched dialysis esrd pt hos (G0257) range across 2 matching MRF lines |
$1,345.30–$1,546.60 | $2,446–$2,812 | varies |
| Visit esketamine, > 56m (G2083) | $611.03 | $1,110.96 | 0.4× |
| Visit to determ ldct elig (G0296) | $58.21 | $105.84 | 0.6× |
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.