Supplies, drugs & other prices at SSM Health St. Joseph Hospital - St. Charles
St. Charles, MO · every code in this section with a posted price and a Medicare benchmark.
122 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) | $3,660.25 | $6,655 | 4.7× |
| 2d tte w or w/o fol w/con,co (C8923) | $1,977.80 | $3,596 | 2.5× |
| 2d tte w or w/o fol w/con,fu (C8924) | $1,009.80 | $1,836 | 2.9× |
| Abltj perc cryoabltj img gdn lxtr/perph nerve (0441T) | $3,498 | $6,360 | 1.8× |
| Abltj Perc Cryoabltj Img Gdn Nrv Plex/Trncl Nrv (0442T) unusually low: confirm this is the full procedure |
$3,498 | $6,360 | 0.4× |
| Abltj perc cryoabltj img gdn uxtr/perph nerve (0440T) | $3,498 | $6,360 | 1.8× |
| Adm tocilizu covid-19 1st (M0249) | $292.60 | $532 | 0.7× |
| Admin hepatitis b vaccine (G0010) | $83.05 | $151 | 1.8× |
| Admin influenza virus vac (G0008) | $76.45 | $139 | 1.6× |
| Admin pneumococcal vaccine (G0009) | $76.45 | $139 | 1.6× |
| Bone Strength & Fracture Risk Assessment (0556T) | $439.45 | $799 | 1.8× |
| Bone strength and fracture risk using finite element analysis of functional data and bone-mineral density utilizing… (0555T) | $48.40 | $88 | 1.7× |
| Ca screen;pelvic/breast exam (G0101) | $33.55 | $61 | 0.3× |
| Catheterize for urine spec (P9612) range across 2 matching MRF lines |
$33–$38.50 | $60–$70 | varies |
| Chemo extend iv infus w/pump (G0498) | $724.35 | $1,317 | 2.2× |
| Computed tomography scan taken for the purpose of biomechanical computed tomography analysis Non-Facility Physician (0558T) | $105.05 | $191 | 1.2× |
| Depression screen annual (G0444) | $15.84 | $28.80 | 0.4× |
| Diab manage trn per indiv (G0108) | $112.20 | $204 | 2.0× |
| Diab manage trn ind/group (G0109) | $49.50 | $90 | 3.1× |
| Direct refer hospital observ (G0379) | $437.80 | $796 | 0.7× |
| Drug test def 1-7 classes (G0480) | $275.55 | $501 | 2.4× |
| Ekg tracing for initial prev (G0404) | $56.65 | $103 | 2.0× |
| Elec stim other than wound (G0283) | $97.90 | $178 | 7.7× |
| Electrophysiologic eval ccm-d leads at 1st impl (0930T) | $2,080.65 | $3,783 | 1.7× |
| Electrophysiologic eval ccm-d leads separate (0931T) | $2,080.65 | $3,783 | 1.7× |
| Electrophysiologic Eval Icds W/Ss Electrode (0577T) | $2,501.40 | $4,548 | 2.1× |
| Endovascular Venous Arterialization Tibl/Prnl Vn (0620T) likely a partial charge, not the full procedure |
$11,420.75 | $20,765 | 0.3× |
| Extraction erupted tooth/exr (D7140) | $1,966.80 | $3,576 | 3.0× |
| Group mnt 2 or more 30 mins (G0271) | $35.20 | $64 | 2.1× |
| Hbot, full body chamber, 30m (G0277) | $526.90 | $958 | 3.8× |
| Hdr electronic brachytherapy ntrstl/intrcav (0395T) | $1,340.90 | $2,438 | 1.9× |
| Home sleep test/type 3 porta (G0399) | $935 | $1,700 | 4.3× |
| Hospital outpt clinic visit (G0463) | $124.30 | $226 | 0.9× |
| Initial preventive exam (G0402) | $132.66 | $241.20 | 1.0× |
| Inj for sacroiliac jt anesth (G0260) range across 2 matching MRF lines |
$2,145–$4,290 | $3,900–$7,800 | varies |
| Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) unusually low: confirm this is the full procedure |
$14,612.40 | $26,568 | 0.5× |
| Insj/Rplc Cardiac Modulj Sys Atr Electrode Only (0410T) | $6,024.70 | $10,954 | 0.7× |
| Insj/Rplc Cardiac Modulj Sys Pls Generator Only (0409T) | $17,028 | $30,960 | 0.8× |
| Intens cardiac rehab no exer (G0423) | $111.10 | $202 | 0.9× |
| Intens cardiac rehab w/exerc (G0422) | $111.10 | $202 | 0.9× |
| Interro Device Evaluation Cardiac Modulj System (0418T) | $44 | $80 | 1.2× |
| Mnt subs tx for change dx (G0270) | $37.95 | $69 | 1.2× |
| Mra w/cont, abd (C8900) | $1,410.75 | $2,565 | 4.0× |
| Mra w/cont, chest (C8909) | $1,149.50 | $2,090 | 3.3× |
| Mra w/cont, lwr ext (C8912) | $1,619.75 | $2,945 | 4.6× |
| Mra w/cont, pelvis (C8918) | $1,280.40 | $2,328 | 3.7× |
| Mra w/o cont, abd (C8901) | $1,045 | $1,900 | 4.4× |
| Mra w/o cont, chest (C8910) | $1,045 | $1,900 | 4.4× |
| Mra w/o cont, lwr ext (C8913) | $1,410.75 | $2,565 | 5.9× |
| Mra w/o cont, pelvis (C8919) | $1,045 | $1,900 | 4.4× |
| Mra w/o fol w/cont, abd (C8902) | $1,828.75 | $3,325 | 5.2× |
| Mra w/o fol w/cont, chest (C8911) | $1,828.75 | $3,325 | 5.2× |
| Mra w/o fol w/cont, lwr ext (C8914) | $2,090 | $3,800 | 6.0× |
| Mra w/o fol w/cont, pelvis (C8920) | $1,358.50 | $2,470 | 3.9× |
| Mra, w/dye, upper extremity (C8934) | $1,619.75 | $2,945 | 4.6× |
| Mra, w/o dye, upper extr (C8935) | $1,410.75 | $2,565 | 5.9× |
| Mra, w/o&w/dye, upper extr (C8936) | $1,828.75 | $3,325 | 5.2× |
| Mri w/cont, breast, bi (C8906) | $1,619.75 | $2,945 | 4.6× |
| Mri w/cont, breast, uni (C8903) | $836 | $1,520 | 4.8× |
| Mri w/o fol w/cont, breast, (C8908) | $2,071.85 | $3,767 | 5.9× |
| Mri w/o fol w/cont, brst, un (C8905) | $888.25 | $1,615 | 2.5× |
| Neuro csf prion prtn qual (0035U) | $479.60 | $872 | 0.9× |
| Njx platelet plasma (0232T) | $320.10 | $582 | 0.7× |
| Obtaining screen pap smear (Q0091) | $28.71 | $52.20 | 1.0× |
| Oth resp proc, group (G0239) | $154 | $280 | 4.1× |
| Oth resp proc, indiv (G0238) | $87.45 | $159 | 3.0× |
| Perc d-e cor revasc chro sin (C9607) | $13,677.40 | $24,868 | 0.7× |
| Perc d-e cor revasc t cabg s (C9604) | $11,072.05 | $20,131 | 1.0× |
| Perc d-e cor stent ather s (C9602) | $12,375 | $22,500 | 0.7× |
| Perc drug-el cor stent sing (C9600) | $8,467.25 | $15,395 | 0.7× |
| Perq Sacral Augmt Bilat Inj (0201T) | $6,329.40 | $11,508 | 0.9× |
| Perq Sacral Augmt Unilat Inj (0200T) | $6,329.40 | $11,508 | 0.9× |
| Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) | $12,223.75 | $22,225 | 1.1× |
| Place device/marker, non pro (C9728) | $2,783.55 | $5,061 | 2.0× |
| Prgrmg Device Evaluation Cardiac Modulj System (0417T) | $44 | $80 | 1.2× |
| Prolonged iv inf, req pump (C8957) | $947.10 | $1,722 | 4.4× |
| Prostate biopsy, any mthd (G0416) | $911.35 | $1,657 | 2.5× |
| Psa screening (G0103) | $62.70 | $114 | 3.2× |
| Pulp cap direct (D3110) | $3,075.05 | $5,591 | 4.7× |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) | $395.45 | $719 | 0.5× |
| Reloc Skin Pocket Cardiac Modulj Pulse Generator (0416T) | $2,200 | $4,000 | 1.1× |
| Relocation skin pocket implanted ccm-d pg (0925T) | $3,135 | $5,700 | 1.5× |
| Removal perm ccm-d system pulse generator only (0919T) | $6,237.55 | $11,341 | 1.7× |
| Repos Cardiac Modulj Transvenous Electrode (0415T) | $694.65 | $1,263 | 1.1× |
| Repositioning prev impl ccm-d transvns eltrd/ld (0924T) | $1,128.60 | $2,052 | 1.8× |
| Revasc intra lithotrip-ather (C9766) | $11,860.20 | $21,564 | 0.6× |
| Revasc intra lithotrip-stent (C9765) | $11,860.20 | $21,564 | 0.6× |
| Revasc intravasc lithotripsy (C9764) | $7,417.30 | $13,486 | 0.6× |
| Revasc lith-sten-ath tib/per (C9775) | $11,860.20 | $21,564 | 0.6× |
| Revasc lithotr-ather tib/per (C9774) | $11,860.20 | $21,564 | 0.6× |
| Revasc lithotr-stent tib/per (C9773) | $12,015.30 | $21,846 | 0.7× |
| Revasc lithotrip tibi/perone (C9772) | $7,417.30 | $13,486 | 0.6× |
| Revasc lithotrip-stent-ather (C9767) | $11,860.20 | $21,564 | 0.6× |
| Rmvl Car Modulj Tranvns Elt (0413T) | $4,422.55 | $8,041 | 1.2× |
| Rmvl Cardiac Modulj Pls Gen (0412T) | $4,422.55 | $8,041 | 1.2× |
| Rmvl perm ccm-d sys 1 transvns dfb lead only (0921T) | $6,237.55 | $11,341 | 1.7× |
| Rmvl perm ccm-d sys 1 transvns pacing lead only (0920T) | $6,237.55 | $11,341 | 1.7× |
| Rmvl perm ccm-d sys dual transvns leads only (0922T) | $6,237.55 | $11,341 | 1.7× |
| Rmvl&rplcmt permanent ccm-d pulse generator only (0923T) likely a partial charge, not the full procedure |
$4,192.10 | $7,622 | 0.2× |
| Screen cerv/vag thin layer (G0123) | $70.40 | $128 | 3.5× |
| Screen pap by tech w md supv (P3000) | $41.80 | $76 | 2.3× |
| Sim ang w/prs cath rad emb (C8004) | $22,490.60 | $40,892 | 1.9× |
| Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) | $15,678.85 | $28,507 | 2.8× |
| Tee w or w/o fol w/cont,cong (C8926) | $1,995.40 | $3,628 | 2.5× |
| Therapeutic procd strg endur (G0237) | $85.80 | $156 | 3.0× |
| Therapeutic ultrafiltration (0692T) | $539 | $980 | 0.3× |
| Tooth reimplantation (D7270) | $884.40 | $1,608 | 1.4× |
| Transcatheter Renal Sympath Denervation Bilat (0339T) | $13,306.15 | $24,193 | 2.3× |
| Transcatheter renal sympath denervation unilat (0338T) | $6,652.80 | $12,096 | 1.2× |
| Trauma respons w/hosp criti (G0390) range across 4 matching MRF lines |
$5,148–$8,580 | $9,360–$15,600 | varies |
| Trim nail(s) (G0127) range across 2 matching MRF lines |
$19.01–$134.20 | $34.56–$244 | varies |
| Trluml perip athrc abd aorta (0236T) | $16,287.70 | $29,614 | 1.4× |
| Trluml Perip Athrc Brchiocph (0237T) | $17,917.35 | $32,577 | 1.5× |
| Trluml Perip Athrc Iliac Art (0238T) | $19,272 | $35,040 | 1.0× |
| Trluml Peripheral Atherectomy Renal Artery Ea (0234T) | $16,940 | $30,800 | 1.5× |
| Tte w or w/o fol w/con,stres (C8928) | $3,959.45 | $7,199 | 5.0× |
| Tte w or wo fol wcon,doppler (C8929) | $4,436.85 | $8,067 | 5.7× |
| Unsched dialysis esrd pt hos (G0257) | $1,872.75 | $3,405 | 2.7× |
| Vasc emb/occ w/prs cath (C9797) | $33,075.90 | $60,138 | 1.8× |
| Visit esketamine 56m or less (G2082) | $1,012 | $1,840 | 1.0× |
| Visit esketamine, > 56m (G2083) | $1,478.95 | $2,689 | 0.9× |
| Visit to determ ldct elig (G0296) | $42.37 | $77.04 | 0.4× |
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.