Visits & medical services 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.

218 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
Ablation av node (93650) $6,913.20 $12,569.45 0.9×
Administration of prolonged chemotherapy into artery (96425) $49.50 $90 0.1×
Airway inhalation treatment (94640) $108.24 $196.80 0.5×
Appl on-body injector for timed subq injection (96377) $159.50 $290 3.4×
Behav assmt w/score & docd/stand instrument (96127) $7.26 $13.20 0.2×
Behavioral and qualitative analysis of voice and resonance (92524) $180.65 $328.45 1.6×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $588.03 $1,069.15 1.6×
Caloric vestibular test w/rec bi bithermal (92537) $380.66 $692.10 3.0×
Caloric vestibular test w/rec bi monothermal (92538) $291.02 $529.13 1.3×
Car seat/bed test 60 min (94780) $88 $160 2.4×
Cardiac Stress Tst,Tracing Only (93017) $825 $1,500 3.8×
Cardiopulmonary resuscitation (92950) $721.05 $1,311 3.3×
Cardioversion (92960) $1,593.90 $2,898 2.4×
Cath Cath Place/Coronary Angio, Img Super/Interp, Bypass Angio (93455) $4,390.57 $7,982.85 1.4×
Cath Cath Place/Coronary Angio, Img Super/Interp,W Right Heart Cath (93456) $4,390.57 $7,982.85 1.4×
Cath Place/Coron Angio, Img Super/Interp, Bypass Angio,W L Hrt Ventric (93459) $9,804.19 $17,825.80 3.0×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $8,772.25 $15,949.55 2.7×
Cbt 1st hour (94644) $175.38 $318.87 1.3×
Chemo Hormon Antineopl Sq/Im (96402) $236.94 $430.80 3.3×
Chemo inj subarach/intravent (96542) $77.88 $141.60 0.2×
Chemo IV push addl drug (96411) $244.20 $444 3.4×
Chemo Iv Push Sngl Drug (96409) $260.70 $474 0.8×
Chemo prolong 8+ hrs infuse w/pump (96416) $436.92 $794.40 1.3×
Chemother, IV infusion, 1 hr (96413) $533.50 $970 1.6×
Chemother, IV infusion, ea add hr (96415) $184.80 $336 2.6×
Chemother,ia infusn tech,<1 hr (96422) $373.56 $679.20 1.1×
Chemother,Ia Push Technique (96420) $135.30 $246 0.4×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $236.94 $430.80 3.3×
Chemotherapy admn intraarterial infusion ea hr (96423) $184.14 $334.80 3.9×
Chemotherapy, unspecified procedure (96549) $67.98 $123.60 1.4×
Chemotx Admn Cns Req Spinal Puncture (96450) $837.54 $1,522.80 2.5×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $414.48 $753.60 5.7×
Chemotx Admn Pleural Cavity Req&W/Thoracnts (96440) $90.42 $164.40 0.3×
Color/duplex Doppler, complete (93975) $914.10 $1,662 3.8×
Color/duplex Doppler, limited (93976) $841.60 $1,530.19 8.0×
Coronary artery angio s&i (93454) $3,822.61 $6,950.20 1.2×
Cpap initiation and management (94660) $328.65 $597.55 1.5×
Cpt initial (94667) $87.12 $158.40 0.7×
Critical care (99291) $1,478.41 $2,688.02 1.8×
Debridement Open Wound 20 Sq Cm< (97597) $369.60 $672 1.8×
Demo &/or eval,pt use,aerosol device (94664) $99 $180 0.5×
Dialysis other/than hemodialysis 1 phys/qhp eval (90945) $768.24 $1,396.80 1.8×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $660.24 $1,200.43 2.8×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $231.06 $420.10 2.2×
Dup-scan artl infl&ven o/f pen vsl compl (93980) $539.92 $981.67 5.2×
Dup-scan artl infl&ven o/f pen vsl f-up/lmtd std (93981) $438.16 $796.66 4.2×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $1,188 $2,160 5.0×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $520.17 $945.76 5.0×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $1,040.94 $1,892.61 4.4×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $505.20 $918.55 4.8×
Dup-scan xtr veins unilateral/limited study (93971) $529.14 $962.08 5.1×
Duplex scan extracranial art compl bi study (93880) $980.89 $1,783.44 4.1×
Echo Heart Xthoracic,Limited (93308) $835.49 $1,519.07 3.5×
Echo transesophageal (93312) $1,823.88 $3,316.15 3.3×
Echo Transthoracic - Congenital Tte Complete (93303) $1,007.44 $1,831.70 1.8×
EEG awake asleep (95819) $605 $1,100 2.8×
EEG awake drowsy (95816) $698.91 $1,270.75 3.2×
EEG cerebral death evaluation (95824) $882.38 $1,604.33 2.4×
EKG (93005) $184.25 $335 3.1×
Electroconvulsive Therapy (90870) $668.28 $1,215.05 0.8×
EMG four extremities (95864) $313.50 $570 2.4×
EMG one extremity (95860) $313.50 $570 2.4×
EMG three extremities (95863) $272.58 $495.60 2.1×
EMG two extremities (95861) $252.12 $458.40 1.9×
Er level 1 (99281) $114.76 $208.65 1.4×
Er level ii (99282) $222.88 $405.24 1.4×
Er level iii (99283) $424.38 $771.60 1.6×
Er level IV (99284) $700.99 $1,274.53 1.7×
Er level v (99285) $998.72 $1,815.86 1.7×
Eval&/Fitg Voice Prostc Dev Suplmnt Oral Speec (92597) $175.06 $318.29 2.5×
Evaluation of speech fluency (92521) $273.14 $496.62 2.0×
Evaluation of speech sound production (92522) $291.46 $529.92 2.6×
Evaluation of swallowing function (92610) $330.25 $600.46 3.9×
Flexible Endoscopic Eval Swallow C/V Rec (92612) $414.06 $752.84 2.1×
Group Therapeutic Procedures (97150) $155.55 $282.82 8.6×
Hemodialysis (90935) $896.28 $1,629.60 1.3×
Holter Monitor Recording (93225) $382.66 $695.74 2.9×
Img retina detcj/mntr ds poc auto a/r uni/bi (92229) $39.76 $72.29 0.7×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $49.50 $90 1.2×
Immuniz admin,intranasal/oral,1 vac/tox (90473) $23.10 $42 0.3×
Immunization Admin (90471) $22 $40 0.3×
Injection intra arterial (96373) $224.68 $408.50 1.1×
Ins swan ganz bedside (93503) $2,586.90 $4,703.45 1.6×
Intralesional Chemo Admin,8+ Lesn (96406) $90.42 $164.40 0.4×
Intralesional Chemo Admin,<8 Lesn (96405) $77.88 $141.60 1.1×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $214.83 $390.60 3.6×
IV infusion hydration each additional hour (96361) $181.50 $330 3.9×
IV infusion hydration initial 31 min-1 hour (96360) $275 $500 1.3×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $198 $360 2.7×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $280.50 $510 1.3×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $181.50 $330 3.9×
IV push initial (96374) $247.50 $450 1.2×
Low frequency non-thermal us (97610) $508.73 $924.96 2.5×
Maintenance of spinal canal or brain drug infusion pump (95990) $450.78 $819.60 1.4×
Manual therapy 15 min (97140) $65.49 $119.08 2.4×
Massage 15 min (97124) $104.46 $189.92 3.5×
Mechanical chest wall oscillation (94669) $335.28 $609.60 1.5×
Mechanical traction (97012) $41.78 $75.97 2.9×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $114.18 $207.60 3.6×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $59.40 $108 1.6×
Methacholine challenge (94070) $912.36 $1,658.83 2.4×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $247.69 $450.34 2.7×
Multiple sleep latency test (95805) $1,650 $3,000 1.9×
Nasopharyngoscopy (92511) $302.53 $550.05 1.5×
Neg press wnd tx </=50 sq cm (97607) $513.48 $933.60 1.3×
Neg press wound tx >50 cm (97608) $842.16 $1,531.20 2.1×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $237.60 $432 1.2×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $1,346.68 $2,448.50 3.3×
Nerve conduction studies 13/> studies (95913) $156.04 $283.70 0.4×
Nerve Conduction Studies 3-4 Studies (95908) $140.56 $255.57 0.6×
Nerve Conduction Studies 9-10 Studies (95911) $156.04 $283.70 0.4×
Nerve conduction studies; 1-2 studies (95907) $156.04 $283.70 0.7×
Nerve conduction studies; 11-12 studies (95912) $156.04 $283.70 0.4×
Nerve conduction studies; 5-6 studies (95909) $156.04 $283.70 0.7×
Nerve conduction studies; 7-8 studies (95910) $156.04 $283.70 0.4×
Neurobehavioral Status Exam (96116) $404.92 $736.22 1.9×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $280.98 $510.88 2.1×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $874.96 $1,590.83 4.0×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $248.88 $452.51 1.9×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $83 $150.91 1.8×
Oscillating Tracking Test (92545) $196.66 $357.56 0.9×
Osteopathic manipulative tx 1-2 body regions (98925) $91.08 $165.60 4.2×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $56.46 $102.66 1.8×
Ot Contrast Bath Ea 15 Min (97034) $45.17 $82.13 3.2×
Ot eval high complex 60 min (97167) $194.24 $353.15 1.9×
Ot eval low complex 30 min (97165) $154.14 $280.26 1.5×
Ot eval mod complex 45 min (97166) $189.71 $344.93 1.9×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $86.39 $157.07 1.7×
Ot Prosthetic Training, Each 15 Min (97761) $72.84 $132.43 1.8×
Ot re-eval est plan care (97168) $138.60 $252 2.0×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $187.55 $341 1.5×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $121.31 $220.56 0.9×
Paraffin bath (97018) $57.31 $104.20 9.5×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $99 $180 0.5×
Phy/qhp op pulm rhb w/mntr (94626) $307.56 $559.20 5.2×
Phy/qhp op pulm rhb w/o mntr (94625) $307.56 $559.20 5.2×
Plethysmography (94726) $898.17 $1,633.04 2.4×
Pm device eval in person (93288) $55.45 $100.82 1.5×
Pm device progr eval dual (93280) $20.97 $38.12 0.6×
Pm device progr eval sngl (93279) $28.54 $51.89 0.8×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $2,200 $4,000 2.6×
Polysom <6 yrs 4/> paramtrs (95782) $2,295.15 $4,173 2.7×
Polysom <6 Yrs Sleep W/Cpap/Bilvl Vent 4/> Param (95783) $2,272.60 $4,132 2.6×
Positional Nystagmus Test (92542) $171.51 $311.84 1.3×
Prq card revasc chronic 1vsl (92943) $6,609.10 $12,016.55 0.6×
Prq Card Stent W/Angio 1 Vsl (92928) $9,287.96 $16,887.20 0.8×
Prq Card Stent/Ath/Angio (92933)
unusually low: confirm this is the full procedure
$6,707.86 $12,196.10 0.4×
Prq revasc byp graft 1 vsl (92937) $7,223.56 $13,133.75 0.6×
Prq trluml coronary angio/atherect one art/brnch (92924) $10,319.90 $18,763.45 0.9×
Prq trluml coronary angioplasty one art/branch (92920) $6,191.62 $11,257.50 1.1×
Psych diag eval w/med srvcs (90792) $151.04 $274.62 0.8×
Psychiatric diagnostic evaluation (90791) $229.47 $417.22 1.3×
Pt Aquatic Therapy/Exercises (97113) $80.18 $145.78 2.2×
Pt Electric Current Therapy (97033) $77.35 $140.64 4.1×
Pt Electrical Stimulation (97032) $65.49 $119.08 4.5×
Pt eval high complex 45 min (97163) $179.30 $326 1.8×
Pt eval low complex 20 min (97161) $167.75 $305 1.7×
Pt Gait Training Therapy (97116) $59.28 $107.79 2.0×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $69.30 $126 2.1×
Pt Physical Performance Test (97750) $77.35 $140.64 2.3×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $173.25 $315 1.8×
Pt re-evaluation (97164) $120.45 $219 1.8×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $64.29 $116.90 2.0×
Pt Ultrasound Therapy (97035) $47.43 $86.23 3.3×
Pt Whirlpool Therapy (97022) $91.19 $165.80 5.8×
Pulm function test by gas (94727) $671.21 $1,220.38 3.1×
Pulmonary stress testing (94618) $746.65 $1,357.54 5.6×
R & L Hrt Cath Winjx Hrt Art& L Ventr Img (93460) $7,223.56 $13,133.75 2.2×
R hrt art/grft angio (93457) $4,390.57 $7,982.85 1.4×
R& L Hrt Cath W/Injec Hrt Art/Grft& L Vent I (93461) $6,191.62 $11,257.50 1.9×
Refill/Maint Pump/Resvr Syst (96522) $302.94 $550.80 1.4×
Refill/maint, portable pump (96521) $233.64 $424.80 1.1×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $215.50 $391.82 5.8×
Right heart cath (93451) $6,707.86 $12,196.10 2.1×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $529.32 $962.40 2.6×
Rt Chest Wall Manipulation,Subsequent (94668) $31.02 $56.40 0.2×
Sensory Integration Ea 15 Min (97533) $60.98 $110.87 1.0×
Sinusoidal Rotational Test (92546) $266.29 $484.17 2.1×
Sleep study attended (95807) $685.85 $1,247 1.8×
Sleep study unattended (95806) $825 $1,500 3.8×
Smoking cessation > 10 min (99407) $47.79 $86.90 1.3×
Speech sound lang comprehen (92523) $389.54 $708.26 1.7×
Spirometry (94010) $530.65 $964.82 2.5×
Spontaneous Nystagmus Test (92541) $163.77 $297.77 1.2×
Stress echo (93350) $1,443.65 $2,624.81 2.6×
Subcut infusion, therap/proph/diagnost,ea add hour (96370) $81.95 $149 1.7×
Subcut infusion, therap/proph/diagnost,initial,1st hour (96369) $215.05 $391 1.0×
Temp transcutaneous pacing (92953) $1,176.78 $2,139.60 1.8×
Tensilon test (95857) $85.45 $155.37 0.4×
Test for abnormal eye movement using a moving target with recording (92544) $196.66 $357.56 1.5×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $77.35 $140.64 3.5×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $65.49 $119.08 3.1×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $202.99 $369.08 2.0×
Ther/Proph/Diag Inj Sc/Im (96372) $209 $380 2.9×
Therapeutic Activities (97530) $65.49 $119.08 1.9×
Therapeutic phlebotomy (99195) $303.60 $552 2.3×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $36.79 $66.90 1.0×
Trans Care Mgmt 14 Day Disch (99495) $150.48 $273.60 1.1×
Trans Care Mgmt 7 Day Disch (99496) $203.54 $370.08 1.5×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $2,077.18 $3,776.70 3.8×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $872.99 $1,587.26 3.7×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $186.42 $338.94 2.4×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $226.33 $411.51 2.7×
Tx/Pro/Dx Inj New Drug Addon (96375) $189.75 $345 4.0×
Tympanometry (92567) $368.16 $669.39 9.8×
Tympanometry And Reflex Threshold Measurements (92550) $414.59 $753.80 1.9×
Unlisted Cardiovascular Service/Procedure (93799) $2,409.51 $4,380.92 18.7×
Unlisted pulmonary service/procedure (94799) $437.95 $796.28 3.4×
Vasc Duplex Extrem Venous,Bilat (93970) $972.95 $1,769 4.1×
Vasc Duplex Scan Extracranial,Limited (93882) $432.17 $785.76 4.1×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $1,406.90 $2,558 6.5×
Vasopneumatic device (97016) $62.11 $112.92 5.2×
Veeg by tech 2-12 hr continuous r-t monitoring (95713) $913.83 $1,661.51 2.4×
Veeg by tech 2-12 hr intermittent monitoring (95712) $499.14 $907.53 1.3×
Ventilation assist & mgmt inpatient 1st day (94002) $851.68 $1,548.50 1.4×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $474.43 $862.60 0.8×
Vital capacity total (94150) $355.27 $645.95 2.8×
Wheelchair Mgmt Ea 15 Min (97542) $75.10 $136.54 2.4×