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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ProcedurePosted cashPosted gross× Medicare
Ablate Heart Dysrhythm Focus (93650) $6,913.20 $12,569.45 0.9×
Admn Sarscov2 Vacc 1 Dose (90480) $49.50 $90 1.2×
Airway Inhalation Treatment (94640)
range across 4 matching MRF lines
$21.45–$528 $39–$960 varies
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $47.43 $86.23 3.3×
Application on-body injector (96377) $159.50 $290 3.4×
Behavral qualit analys voice (92524)
range across 4 matching MRF lines
$152.71–$266.94 $277.66–$485.34 varies
Brief Emotional/Behav Assmt (96127) $7.26 $13.20 0.2×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $588.03 $1,069.15 1.6×
Caloric vestibular test w/rec bi monothermal (92538) $291.02 $529.13 1.3×
Caloric Vstblr Test W/Rec (92537) $380.66 $692.10 3.0×
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)
range across 2 matching MRF lines
$670.89–$771.21 $1,219.80–$1,402.20 varies
Cardioversion (92960)
range across 2 matching MRF lines
$1,482.36–$1,705.44 $2,695.20–$3,100.80 varies
Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) $7,223.56 $13,133.75 2.2×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $8,772.25 $15,949.55 2.7×
Cbt 1st hour (94644)
range across 2 matching MRF lines
$130.25–$220.51 $236.81–$400.93 varies
Chemo Anti-Neopl Sq/Im (96401) $236.94 $430.80 3.3×
Chemo Hormon Antineopl Sq/Im (96402) $236.94 $430.80 3.3×
Chemo Ia Push (96420) $135.30 $246 0.4×
Chemo Intralesional Over 7 (96406) $90.42 $164.40 0.4×
Chemo intralesional up to 7 (96405) $77.88 $141.60 1.1×
Chemo IV infusion addl hr (96415) $184.80 $336 2.6×
Chemo IV push addl drug (96411) $244.20 $444 3.4×
Chemother Prolong Infuse W/Pump (96416) $436.92 $794.40 1.3×
Chemotherapy Admin Intra-Arterial Infus </1 Hr (96422) $373.56 $679.20 1.1×
Chemotherapy Admn Intraarterial Infusion Ea Hr (96423) $184.14 $334.80 3.9×
Chemotherapy Into Cns (96450) $837.54 $1,522.80 2.5×
Chemotherapy Intracavitary (96440) $90.42 $164.40 0.3×
Chemotherapy Unspecified (96549) $67.98 $123.60 1.4×
Chemotx Admn Ia Nfs >8 Hr Prtble Impltbl Pmp (96425) $49.50 $90 0.1×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $414.48 $753.60 5.7×
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) $533.50 $970 1.6×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $260.70 $474 0.8×
Chemotx Njx Subarachnd/Intraventr Rsvr 1/Mult (96542) $77.88 $141.60 0.2×
Chest Wall Manipulation (94668) $31.02 $56.40 0.2×
Color/duplex Doppler, complete (93975) $914.10 $1,662 3.8×
Color/duplex Doppler, limited (93976) $841.60 $1,530.19 8.0×
Community/Work Reintegration Trainj Ea 15 Min (97537) $56.46 $102.66 1.8×
Continuous Pulse Ox (94762) $248.88 $452.51 1.9×
Coronary Art/Grft Angio S&I (93455) $4,390.57 $7,982.85 1.4×
Coronary Artery Angio S&I (93454) $3,822.61 $6,950.20 1.2×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $328.65 $597.55 1.5×
Cpt initial (94667) $87.12 $158.40 0.7×
Critical care first hour (99291)
range across 2 matching MRF lines
$396–$2,560.82 $720–$4,656.04 varies
Debridement Open Wound 20 Sq Cm< (97597)
range across 3 matching MRF lines
$37.95–$425.15 $69–$773 varies
Dialysis One Evaluation (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 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 Xtr Veins Complete Bilateral Study (93970) $972.95 $1,769 4.1×
Dup-scan xtr veins unilateral/limited study (93971) $529.14 $962.08 5.1×
Duplex up extrem art bilat (93930) $1,040.94 $1,892.61 4.4×
Duplex up extrem art unilat/ltd (93931) $505.20 $918.55 4.8×
Echo Congenital Complete (93303) $1,007.44 $1,831.70 1.8×
Echo Heart Xthoracic,Limited (93308) $835.49 $1,519.07 3.5×
Echo transesophageal (93312) $1,823.88 $3,316.15 3.3×
EEG awake and 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×
Electrical Stimulation Ea 15 Min (97032) $65.49 $119.08 4.5×
Electrocardiogram Tracing (93005) $184.25 $335 3.1×
Electroconvulsive Therapy (90870) $668.28 $1,215.05 0.8×
Emergency Dept Visit Level 2 (99282)
range across 2 matching MRF lines
$66–$379.77 $120–$690.49 varies
Emergency Dept Visit Level 3 (99283)
range across 2 matching MRF lines
$97.35–$751.41 $177–$1,366.20 varies
Emergency Dept Visit Level 4 (99284)
range across 2 matching MRF lines
$162.80–$1,239.18 $296–$2,253.06 varies
Emg 3 Extremities (95863) $272.58 $495.60 2.1×
Emg 4 Extremities (95864) $313.50 $570 2.4×
Er level 1 (99281)
range across 2 matching MRF lines
$39.05–$190.46 $71–$346.30 varies
Er level v (99285)
range across 2 matching MRF lines
$262.35–$1,735.09 $477–$3,154.71 varies
Evaluate pt use of inhaler (94664) $99 $180 0.5×
Evaluate Speech Production (92522)
range across 4 matching MRF lines
$210.45–$422.13 $382.63–$767.51 varies
Evaluate Swallowing Function (92610)
range across 5 matching MRF lines
$196.78–$391.71 $357.79–$712.20 varies
Evaluation of speech fluency (92521)
range across 4 matching MRF lines
$152.71–$463.72 $277.66–$843.13 varies
Extracranial Bilat Study (93880) $980.89 $1,783.44 4.1×
Extracranial Uni/Ltd Study (93882) $432.17 $785.76 4.1×
Flexible endoscopic eval swallow c/v rec (92612) $414.06 $752.84 2.1×
Group Therapeutic Procedures (97150)
range across 4 matching MRF lines
$107.84–$203.26 $196.08–$369.57 varies
Heart catheterization, both sides, with coronary and bypass graft angiography (93461) $6,191.62 $11,257.50 1.9×
Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935) $896.28 $1,629.60 1.3×
Holter monitor recording (93225) $382.66 $695.74 2.9×
Im Adm Intransl/Oral 1 Vaccine (90473) $23.10 $42 0.3×
Img retina detcj/mntr ds poc auton a/r uni/bi (92229) $39.76 $72.29 0.7×
Immunization administration (90471)
range across 2 matching MRF lines
$18.15–$25.85 $33–$47 varies
Insert/Place Heart Catheter (93503) $2,586.90 $4,703.45 1.6×
Iontophoresis 15 min (97033) $77.35 $140.64 4.1×
Irrig Drug Delivery Device (96523)
range across 2 matching MRF lines
$199.98–$229.68 $363.60–$417.60 varies
IV infusion hydration each additional hour (96361)
range across 3 matching MRF lines
$17.05–$209 $31–$380 varies
IV infusion hydration initial 31 min-1 hour (96360)
range across 3 matching MRF lines
$42.35–$316.25 $77–$575 varies
IV infusion ther proph addl sequential to 1 hr (96367)
range across 3 matching MRF lines
$38.50–$227.70 $70–$414 varies
IV infusion therapy prophylaxis/dx ea hour (96366)
range across 3 matching MRF lines
$27.50–$209 $50–$380 varies
IV push initial (96374)
range across 3 matching MRF lines
$39.05–$284.90 $71–$518 varies
L Hrt Art/Grft Angio (93459) $9,804.19 $17,825.80 3.0×
Low frequency non-thermal us (97610) $508.73 $924.96 2.5×
Lwr Xtr Vasc Stdy Bilat (93924) $1,406.90 $2,558 6.5×
Mechanical chest wall oscillation per session (94669) $335.28 $609.60 1.5×
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 Fluoroscopy/Swallow (92611)
range across 6 matching MRF lines
$161.40–$270.66 $293.46–$492.11 varies
Multiple Sleep Latency Test (95805) $1,650 $3,000 1.9×
Muscle Test 2 Limbs (95861) $252.12 $458.40 1.9×
Muscle Test One Limb (95860) $313.50 $570 2.4×
Nasopharyngoscopy (92511)
range across 2 matching MRF lines
$281.63–$323.43 $512.05–$588.05 varies
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $513.48 $933.60 1.3×
Neg Pressure Wound Therapy Non Dme >50 Sq 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)
range across 2 matching MRF lines
$475.20–$2,218.15 $864–$4,033 varies
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 13 or more studies (95913) $156.04 $283.70 0.4×
Nerve Conduction Studies 3-4 Studies (95908) $140.56 $255.57 0.6×
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×
Nerve Conduction Studies 9-10 Studies (95911) $156.04 $283.70 0.4×
Neurobehavioral Status Exam (96116) $404.92 $736.22 1.9×
Neuromuscular Reeducation (97112) $69.30 $126 2.1×
Optokinetic Nystagmus Test (92544) $196.66 $357.56 1.5×
Oral Function Therapy (92526)
range across 4 matching MRF lines
$155.82–$348.15 $283.30–$633 varies
Oral Speech Device Eval (92597) $175.06 $318.29 2.5×
Orthc/Prostc Mgmt Sbsq Enc (97763)
range across 2 matching MRF lines
$83.57–$89.21 $151.94–$162.20 varies
Orthotics Mgmt & Trainj 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 Contrast Bath Ea 15 Min (97034) $45.17 $82.13 3.2×
Ot eval high complexity (97167)
range across 4 matching MRF lines
$192.54–$197.62 $350.07–$359.31 varies
Ot Eval Low Complex (97165)
range across 4 matching MRF lines
$153.02–$154.14 $278.21–$280.26 varies
Ot Eval Moderate Complexity (97166)
range across 4 matching MRF lines
$186.89–$189.71 $339.80–$344.93 varies
Ot manual therapy 15 min (97140) $65.49 $119.08 2.4×
Ot paraffin bath (97018)
range across 2 matching MRF lines
$55.34–$59.28 $100.61–$107.79 varies
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×
Penile Vascular Study,Ltd or F/U (93981) $438.16 $796.66 4.2×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $99 $180 0.5×
Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) $6,191.62 $11,257.50 1.1×
Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) $6,609.10 $12,016.55 0.6×
Phlebotomy therapeutic (99195) $303.60 $552 2.3×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $307.56 $559.20 5.2×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $307.56 $559.20 5.2×
Physical Performance Test (97750) $77.35 $140.64 2.3×
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 Angio/Athrect 1 Art (92924) $10,319.90 $18,763.45 0.9×
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×
Psych diag eval w/med srvcs (90792) $151.04 $274.62 0.8×
Psychiatric diagnostic evaluation (90791) $229.47 $417.22 1.3×
Pt Eval High Complex (97163)
range across 4 matching MRF lines
$173.25–$198 $315–$360 varies
Pt eval low complex 20 min (97161) $167.75 $305 1.7×
Pt Eval Mod Complex (97162)
range across 5 matching MRF lines
$173.25–$202.40 $315–$368 varies
Pt gait training 15 min (97116) $59.28 $107.79 2.0×
Pt mechanical traction (97012) $41.78 $75.97 2.9×
Pt Re-Eval Est Plan Care (97164)
range across 3 matching MRF lines
$120.45–$144.65 $219–$263 varies
Pulm function test by gas (94727) $671.21 $1,220.38 3.1×
Pulmonary service/procedure (94799)
range across 5 matching MRF lines
$244.37–$551.28 $444.31–$1,002.33 varies
Pulmonary Stress Testing (94618) $746.65 $1,357.54 5.6×
R Hrt Art/Grft Angio (93457) $4,390.57 $7,982.85 1.4×
R hrt coronary artery angio (93456) $4,390.57 $7,982.85 1.4×
Refill&Maintenance Pump Drug Dlvr Spinal/Brain (95990) $450.78 $819.60 1.4×
Refill/Maint Portable Pump (96521) $233.64 $424.80 1.1×
Refill/Maint Pump/Resvr Syst (96522) $302.94 $550.80 1.4×
Remote 30 Day Ecg Rev/Report (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)
range across 2 matching MRF lines
$492.36–$566.28 $895.20–$1,029.60 varies
Self Care Mngment Training (97535)
range across 2 matching MRF lines
$59.28–$69.30 $107.79–$126 varies
Sensory Integration Ea 15 Min (97533)
range across 2 matching MRF lines
$59.28–$62.67 $107.79–$113.95 varies
Sinusoidal Vertical Axis Rotational Testing (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×
Speech sound lang comprehen (92523)
range across 4 matching MRF lines
$323.43–$456.90 $588.05–$830.72 varies
Spirometry (94010) $530.65 $964.82 2.5×
Spontaneous Nystagmus Test (92541) $163.77 $297.77 1.2×
Stress Tte Only (93350) $1,443.65 $2,624.81 2.6×
Subcutaneous Infusion Each Additional Hour (96370) $81.95 $149 1.7×
Subcutaneous infusion initial 1 hr w/pump set-up (96369) $215.05 $391 1.0×
Temp transcutaneous pacing (92953)
range across 2 matching MRF lines
$1,094.28–$1,259.28 $1,989.60–$2,289.60 varies
Tensilon Test (95857) $85.45 $155.37 0.4×
Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129)
range across 3 matching MRF lines
$73.96–$77.35 $134.48–$140.64 varies
Ther Ivntj Ea Addl 15 Min (97130)
range across 3 matching MRF lines
$50.25–$65.49 $91.37–$119.08 varies
Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) $80.18 $145.78 2.2×
Ther Px 1/> Areas Each 15 Minutes Massage (97124)
range across 2 matching MRF lines
$102.20–$106.72 $185.81–$194.03 varies
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $202.99 $369.08 2.0×
Ther/Proph/Diag Inj Ia (96373)
range across 2 matching MRF lines
$209–$240.35 $380–$437 varies
Ther/Proph/Diag Inj Sc/Im (96372)
range across 3 matching MRF lines
$18.15–$240.35 $33–$437 varies
Ther/Proph/Diag Iv Inf Init (96365)
range across 3 matching MRF lines
$86.90–$322.85 $158–$587 varies
Therapeutic Activities (97530) $65.49 $119.08 1.9×
Tobacco Use Cessation Intensive >10 Minutes (99407)
range across 2 matching MRF lines
$41.80–$53.78 $76–$97.79 varies
Tobacco Use Cessation Intermediate 3-10 Minutes (99406)
range across 2 matching MRF lines
$19.80–$53.78 $36–$97.79 varies
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 (93306) $2,077.18 $3,776.70 3.8×
Tte W/O Doppler Complete (93307) $872.99 $1,587.26 3.7×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507)
range across 4 matching MRF lines
$149.61–$270.60 $272.01–$492 varies
Tx/Pro/Dx Inj New Drug Addon (96375)
range across 3 matching MRF lines
$20.35–$218.35 $37–$397 varies
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×
Upr/L Xtremity Art 2 Levels (93922)
range across 2 matching MRF lines
$20.35–$541.61 $37–$984.75 varies
Upr/Lxtr Art Stdy 3+ Lvls (93923) $874.96 $1,590.83 4.0×
Vasopneumatic device (97016) $62.11 $112.92 5.2×
Veeg 2-12 Hr Cont Mntr (95713) $913.83 $1,661.51 2.4×
Veeg 2-12 hr intmt mntr (95712) $499.14 $907.53 1.3×
Vent Mgmt Inpat Init 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)
range across 2 matching MRF lines
$56.46–$93.73 $102.66–$170.41 varies
Whirlpool Therapy (97022)
range across 2 matching MRF lines
$63.24–$119.14 $114.98–$216.61 varies

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.