SSM Health St. Mary's Hospital - Jefferson City — price list
← Hospital overviewVerified from SSM Health St. Mary's Hospital - Jefferson 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 | $3.30 | $1.82 | — | — | |
| Diazepam Rectal Gel Delivery System 10 MG Inpatient & outpatient | 103895 CDM | $1,201 | $661 | — | — | |
| Diazepam Rectal Gel Delivery System 2.5 MG Inpatient & outpatient | 103893 CDM | $585 | $322 | — | — | |
| Formoterol Fumarate Soln Nebu 20 MCG/2ML Inpatient & outpatient | 103613 CDM | $81.15 | $44.63 | — | — | |
| Iopamidol Inj 41% Inpatient & outpatient | 10325 CDM | $256 | $141 | — | — | |
| Iopamidol Inj 61% Inpatient & outpatient | 10327 CDM | $340 | $187 | — | — | |
| Iopamidol IV Soln 76% Inpatient & outpatient | 10328 CDM | $805 | $443 | — | — | |
| Iothalamate Meglumine Inj 17.2% Inpatient & outpatient | 10330 CDM | $119 | $65.34 | — | — | |
| Iothalamate Meglumine Inj 43% Inpatient & outpatient | 10332 CDM | $128 | $70.42 | — | — | |
| Isosulfan Blue Subcutaneous Soln 1% Inpatient & outpatient | 10358 CDM | $481 | $264 | — | — | |
| Itraconazole Cap 100 MG Inpatient & outpatient | 10364 CDM | $30.61 | $16.84 | — | — | |
| Ketoconazole Cream 2% Inpatient & outpatient | 10368 CDM | $688 | $378 | — | — | |
| Labetalol HCl IV Soln 5 MG/ML Inpatient & outpatient | 10372 CDM | $35.97 | $19.78 | — | — | |
| Labetalol HCl Tab 100 MG Inpatient & outpatient | 10373 CDM | $3.30 | $1.82 | — | — | |
| Labetalol HCl Tab 200 MG Inpatient & outpatient | 10374 CDM | $3.30 | $1.82 | — | — | |
| Lacosamide Oral Solution 10 MG/ML Inpatient & outpatient | 121034 CDM | $111 | $61.12 | — | — | |
| Lactic Acid (Ammonium Lactate) Lotion 12% Inpatient & outpatient | 10380 CDM | $126 | $69.32 | — | — | |
| Lchg Alpha-1-Antitrypsin Blood Inpatient & outpatient | 82103 HCPCS | $186 | $102 | — | — | |
| Lchg Culture Blood Fungus Quant Inpatient & outpatient | 87103 HCPCS | $116 | $63.80 | — | — | |
| Lchg Prostate Specific Antigen Screen Inpatient & outpatientapprox. match | G0103 HCPCS | $142 | $78.10 | — | — | |
| Leuprolide Acetate For Inj Kit 7.5 MG Inpatient & outpatient | 10392 CDM | $8,499 | $4,675 | — | — |