Supplies, drugs & other prices at SSM Health St. Mary's Hospital - Jefferson City
Jefferson City, MO · every code in this section with a posted price and a Medicare benchmark.
60 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2d tte w or w/o fol w/con,fu (C8924) | $1,315.55 | $2,391.91 | 3.8× |
| Admin hepatitis b vaccine (G0010) | $60.50 | $110 | 1.3× |
| Admin influenza virus vac (G0008) | $38.50 | $70 | 0.8× |
| Admin pneumococcal vaccine (G0009) | $33 | $60 | 0.7× |
| Diab manage trn per indiv (G0108) | $104.50 | $190 | 1.9× |
| Diab manage trn ind/group (G0109) | $71.50 | $130 | 4.5× |
| Direct refer hospital observ (G0379) | $160.93 | $292.60 | 0.3× |
| Drug test def 1-7 classes (G0480) | $319.55 | $581 | 2.8× |
| Ekg tracing for initial prev (G0404) | $9.90 | $18 | 0.3× |
| Elec stim other than wound (G0283) | $53.46 | $97.20 | 4.2× |
| Extraction erupted tooth/exr (D7140) | $1,365.65 | $2,483 | 2.1× |
| Fecal blood scrn immunoassay (G0328) | $17.98 | $32.70 | 1.0× |
| Hbot, full body chamber, 30m (G0277) | $522.50 | $950 | 3.8× |
| Hdr electronic brachytherapy ntrstl/intrcav (0395T) | $2,106.72 | $3,830.40 | 3.0× |
| Home sleep test/type 3 porta (G0399) | $1,160.59 | $2,110.17 | 5.4× |
| Hospital outpt clinic visit (G0463) | $61.74 | $112.26 | 0.5× |
| Initial preventive exam (G0402) | $127.51 | $231.84 | 1.0× |
| Inj for sacroiliac jt anesth (G0260) | $2,622.84 | $4,768.80 | 3.7× |
| Mra w/cont, abd (C8900) | $1,164.24 | $2,116.80 | 3.3× |
| Mra w/cont, chest (C8909) | $1,180.08 | $2,145.60 | 3.4× |
| Mra w/cont, lwr ext (C8912) | $1,164.24 | $2,116.80 | 3.3× |
| Mra w/cont, pelvis (C8918) | $1,164.24 | $2,116.80 | 3.3× |
| Mra w/o cont, abd (C8901) | $453.42 | $824.40 | 1.9× |
| Mra w/o cont, chest (C8910) | $1,133.22 | $2,060.40 | 4.7× |
| Mra w/o cont, lwr ext (C8913) | $1,133.22 | $2,060.40 | 4.7× |
| Mra w/o cont, pelvis (C8919) | $453.42 | $824.40 | 1.9× |
| Mra w/o fol w/cont, abd (C8902) | $1,552.32 | $2,822.40 | 4.4× |
| Mra w/o fol w/cont, chest (C8911) | $1,521.96 | $2,767.20 | 4.4× |
| Mra w/o fol w/cont, lwr ext (C8914) | $1,521.96 | $2,767.20 | 4.4× |
| Mra w/o fol w/cont, pelvis (C8920) | $1,552.32 | $2,822.40 | 4.4× |
| Mra, w/dye, spinal canal (C8931) | $1,164.24 | $2,116.80 | 3.3× |
| Mra, w/o dye, spinal canal (C8932) | $453.42 | $824.40 | 1.9× |
| Mra, w/o&w/dye, spinal canal (C8933) | $1,521.96 | $2,767.20 | 4.4× |
| Mra, w/o&w/dye, upper extr (C8936) | $1,521.96 | $2,767.20 | 4.4× |
| Mri w/cont, breast, bi (C8906) | $1,280.40 | $2,328 | 3.7× |
| Mri w/cont, breast, uni (C8903) | $745.14 | $1,354.80 | 4.2× |
| Mri w/o fol w/cont, breast, (C8908) | $1,707.20 | $3,104 | 4.9× |
| Mri w/o fol w/cont, brst, un (C8905) | $993.30 | $1,806 | 2.8× |
| Neuro csf detcj prion prtn quakg conf conv qual (0035U) | $85.80 | $156 | 0.2× |
| Obtaining screen pap smear (Q0091) | $32.87 | $59.76 | 1.1× |
| Oth resp proc, group (G0239) | $154.55 | $281 | 4.1× |
| Oth resp proc, indiv (G0238) | $70.95 | $129 | 2.4× |
| Perc d-e cor revasc chro sin (C9607) | $9,804.19 | $17,825.80 | 0.5× |
| Perc d-e cor revasc t cabg s (C9604) | $8,772.25 | $15,949.55 | 0.8× |
| Perc d-e cor stent ather s (C9602) | $9,287.96 | $16,887.20 | 0.5× |
| Perc drug-el cor stent sing (C9600) | $7,223.56 | $13,133.75 | 0.6× |
| Perq Sacral Augmt Bilat Inj (0201T) | $13,685.76 | $24,883.20 | 1.9× |
| Perq Sacral Augmt Unilat Inj (0200T) | $6,842.88 | $12,441.60 | 0.9× |
| Prostate biopsy, any mthd (G0416) | $620.95 | $1,129 | 1.7× |
| Psa screening (G0103) | $78.10 | $142 | 4.0× |
| Pulp cap direct (D3110) | $2,074.05 | $3,771 | 3.2× |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) | $541.75 | $985 | 0.8× |
| Screen cerv/vag thin layer (G0123) | $161.70 | $294 | 8.0× |
| Screen pap by tech w md supv (P3000) | $131.45 | $239 | 7.1× |
| Therapeutic procd strg endur (G0237) | $133.32 | $242.40 | 4.6× |
| Tooth reimplantation (D7270) | $557.70 | $1,014 | 0.9× |
| Tte w or w/o fol w/con,stres (C8928) | $1,869.47 | $3,399.03 | 2.4× |
| Tte w or wo fol wcon,doppler (C8929) | $2,631.10 | $4,783.82 | 3.4× |
| Unsched dialysis esrd pt hos (G0257) | $1,653.96 | $3,007.20 | 2.4× |
| Visit to determ ldct elig (G0296) | $24.16 | $43.92 | 0.2× |