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.

28 prices shown (filtered).

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
Acetazolamide Tab 250 MG Inpatient & outpatient	113 CDM	$94.09	$51.75	—	—
Albuterol Sulfate Soln Nebu 0.083% (2.5 MG/3ML) Inpatient & outpatient	250 CDM	$33.70	$18.54	—	—
Amikacin Sulfate Inj 1 GM/4ML (250 MG/ML) Inpatient & outpatient	124714 CDM	$1,303	$717	—	—
Aminocaproic Acid Inj 250 MG/ML Inpatient & outpatient	403 CDM	$749	$412	—	—
Amoxicillin (Trihydrate) Cap 250 MG Inpatient & outpatient	450 CDM	$24.28	$13.35	—	—
Ampicillin Sodium For Inj 250 MG Inpatient & outpatient	473 CDM	$318	$175	—	—
Argatroban Inj 250 MG/2.5ML (Concentrate For IV Infusion) Inpatient & outpatient	28947 CDM	$2,667	$1,467	—	—
Ascorbic Acid IV Soln 25000 MG/50ML (500 MG/ML) Inpatient & outpatient	160625 CDM	$247	$136	—	—
Azithromycin Tab 250 MG Inpatient & outpatient	20943 CDM	$153	$84.21	—	—
Bivalirudin Trifluoroacetate For IV Soln 250 MG (Base Equiv) Inpatient & outpatient	159897 CDM	$9,303	$5,117	—	—
Calcium Carbonate (Antacid) Susp 1250 MG/5ML Inpatient & outpatient	157704 CDM	$72.58	$39.92	—	—
Ciprofloxacin HCl Tab 250 MG (Base Equiv) Inpatient & outpatient	25118 CDM	$98.56	$54.21	—	—
Diphenhydramine HCl Cap 25 MG Inpatient & outpatient	2509 CDM	$20.36	$11.20	—	—
Diphenhydramine HCl Inj 50 MG/ML Inpatient & outpatient	2508 CDM	$87.50	$48.12	—	—
Divalproex Sodium Tab Delayed Release 250 MG Inpatient & outpatient	2552 CDM	$49.81	$27.40	—	—
Divalproex Sodium Tab ER 24 HR 250 MG Inpatient & outpatient	34418 CDM	$53.26	$29.29	—	—
Erythromycin Tab 250 MG Inpatient & outpatient	2889 CDM	$147	$80.76	—	—
Fentanyl Citrate 2 MCG/ML-Bupivacaine 0.125%-NaCl 0.9% Inj,Fentanyl 0.2 MG/100ML-Bupiv 0.125%-NaCl 0.9% Epidural Inj,Fentanyl 0.5 MG/250ML-Bupiv 0.125%-NaCl 0.9% Epidural Inj Inpatient & outpatient	30862 CDM	$2,051	$1,128	—	—
Fentanyl Citrate Preservative Free (PF) Inj 250 MCG/5ML Inpatient & outpatient	150548 CDM	$87.50	$48.12	—	—
Fentanyl Citrate Preservative Free (PF) Inj 2500 MCG/50ML Inpatient & outpatient	150580 CDM	$2,279	$1,253	—	—
Fulvestrant Inj Soln Pref Syr 250 MG/5ML Inpatient & outpatient	124678 CDM	$4,908	$2,699	—	—
Gabapentin Oral Soln 250 MG/5ML Inpatient & outpatient	29169 CDM	$69.32	$38.13	—	—
Hydrocortisone Sodium Succinate PF For Inj 250 MG Inpatient & outpatient	141876 CDM	$437	$240	—	—
Lchg Citric Acid Urine Timed Inpatient & outpatient	82507 HCPCS	$333	$183	—	—
Lchg Factor Ix Assay Inpatient & outpatient	85250 HCPCS	$500	$275	—	—
Levetiracetam Tab 250 MG Inpatient & outpatient	26816 CDM	$23.80	$13.09	—	—
Levofloxacin in D5W IV Soln 250 MG/50ML Inpatient & outpatient	124699 CDM	$547	$301	—	—
Levofloxacin Tab 250 MG Inpatient & outpatient	18918 CDM	$163	$89.90	—	—