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.
19 prices shown (filtered).
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| Acetaminophen Suppos 325 MG Inpatient & outpatient | 104 CDM | $40.86 | $22.47 | — | — | |
| Bethanechol Chloride Tab 10 MG Inpatient & outpatient | 1043 CDM | $54.23 | $29.83 | — | — | |
| Bethanechol Chloride Tab 25 MG Inpatient & outpatient | 1044 CDM | $65.66 | $36.11 | — | — | |
| Lanreotide Acetate Extended Release Inj 120 MG/0.5ML Inpatient & outpatient | 104949 CDM | $87,290 | $48,010 | — | — | |
| Lchg Alpha-1-Antitrypsin Blood Phenotype Inpatient & outpatient | 82104 HCPCS | $85.00 | $46.75 | — | — | |
| Leuprolide Acetate (3 Month) For Inj Kit 22.5 MG Inpatient & outpatient | 21045 CDM | $63,204 | $34,762 | — | — | |
| Levothyroxine Sodium Tab 112 MCG Inpatient & outpatient | 10404 CDM | $33.92 | $18.66 | — | — | |
| Levothyroxine Sodium Tab 137 MCG Inpatient & outpatient | 10405 CDM | $32.48 | $17.86 | — | — | |
| Levothyroxine Sodium Tab 88 MCG Inpatient & outpatient | 10403 CDM | $53.98 | $29.69 | — | — | |
| Lidocaine Inj 0.5% w/ Epinephrine-1:200000 Inpatient & outpatient | 10426 CDM | $353 | $194 | — | — | |
| Lidocaine Inj 1% w/ Epinephrine-1:100000 Inpatient & outpatient | 10427 CDM | $1,185 | $652 | — | — | |
| Lidocaine Inj 1% w/ Epinephrine-1:200000 (PF) Inpatient & outpatient | 10428 CDM | $1,401 | $771 | — | — | |
| Lidocaine Inj 2% w/ Epinephrine-1:100000 Inpatient & outpatient | 10430 CDM | $816 | $449 | — | — | |
| Lidocaine Inj 2% w/ Epinephrine-1:200000 (PF) Inpatient & outpatient | 10431 CDM | $2,142 | $1,178 | — | — | |
| Lidocaine-Prilocaine Cream 2.5-2.5% Inpatient & outpatient | 10434 CDM | $171 | $94.28 | — | — | |
| Liothyronine Sodium Tab 5 MCG Inpatient & outpatient | 10443 CDM | $33.54 | $18.45 | — | — | |
| Lisinopril Tab 10 MG Inpatient & outpatient | 10449 CDM | $21.09 | $11.60 | — | — | |
| Lisinopril Tab 40 MG Inpatient & outpatient | 10450 CDM | $22.86 | $12.57 | — | — | |
| Lithium Carbonate Tab ER 300 MG Inpatient & outpatient | 10454 CDM | $28.55 | $15.70 | — | — |