SSM Health St. Anthony Hospital - Oklahoma City — price list
← Hospital overviewVerified from SSM Health St. Anthony Hospital - Oklahoma City’s published price file
Includes cash prices, list prices. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
Showing the first 1,500 prices from a large file. Search a procedure or code below to narrow the list.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
21 prices shown (filtered).
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| Acetaminophen Suppos 120 MG Inpatient & outpatient | 103 CDM | $29.97 | $16.48 | — | — | |
| Formoterol Fumarate Soln Nebu 20 MCG/2ML Inpatient & outpatient | 103613 CDM | $119 | $65.64 | — | — | |
| Iohexol Inj 240 MG/ML Inpatient & outpatient | 10321 CDM | $10,485 | $5,767 | — | — | |
| Iopamidol Inj 41% Inpatient & outpatient | 10325 CDM | $8,069 | $4,438 | — | — | |
| Iopamidol Inj 51% Inpatient & outpatient | 10326 CDM | $3,646 | $2,005 | — | — | |
| Iopamidol Inj 61% Inpatient & outpatient | 10327 CDM | $7,827 | $4,305 | — | — | |
| Iopamidol IV Soln 76% Inpatient & outpatient | 10328 CDM | $4,633 | $2,548 | — | — | |
| Iothalamate Meglumine Inj 17.2% Inpatient & outpatient | 10330 CDM | $2,734 | $1,504 | — | — | |
| Isosorbide Mononitrate Tab 10 MG Inpatient & outpatient | 10356 CDM | $34.54 | $19.00 | — | — | |
| Isosulfan Blue Subcutaneous Soln 1% Inpatient & outpatient | 10358 CDM | $1,192 | $656 | — | — | |
| Itraconazole Cap 100 MG Inpatient & outpatient | 10364 CDM | $117 | $64.20 | — | — | |
| Ketoconazole Cream 2% Inpatient & outpatient | 10368 CDM | $343 | $189 | — | — | |
| Ketorolac Tromethamine Tab 10 MG Inpatient & outpatient | 10371 CDM | $56.88 | $31.28 | — | — | |
| Labetalol HCl IV Soln 5 MG/ML Inpatient & outpatient | 10372 CDM | $501 | $276 | — | — | |
| Labetalol HCl Tab 100 MG Inpatient & outpatient | 10373 CDM | $31.51 | $17.33 | — | — | |
| Labetalol HCl Tab 200 MG Inpatient & outpatient | 10374 CDM | $31.95 | $17.57 | — | — | |
| Lacosamide Oral Solution 10 MG/ML Inpatient & outpatient | 121034 CDM | $374 | $206 | — | — | |
| Lactic Acid (Ammonium Lactate) Lotion 12% Inpatient & outpatient | 10380 CDM | $424 | $233 | — | — | |
| Lchg Alpha-1-Antitrypsin Blood Inpatient & outpatient | 82103 HCPCS | $137 | $75.35 | — | — | |
| Lchg Culture Blood Fungus Quant Inpatient & outpatient | 87103 HCPCS | $682 | $375 | — | — | |
| Lchg Prostate Specific Antigen Screen Inpatient & outpatientapprox. match | G0103 HCPCS | $524 | $288 | — | — |