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.
18 prices shown (filtered).
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| Acetylcysteine Inhal Soln 10% Inpatient & outpatient | 122 CDM | $28.83 | $15.86 | — | — | |
| Bupivacaine HCl Inj 0.25% Inpatient & outpatient | 1222 CDM | $16.50 | $9.08 | — | — | |
| Bupivacaine HCl Inj 0.5% Inpatient & outpatient | 1223 CDM | $16.50 | $9.08 | — | — | |
| Bupivacaine HCl Preservative Free (PF) Inj 0.25% Inpatient & outpatient | 122215 CDM | $16.50 | $9.08 | — | — | |
| Bupivacaine HCl Preservative Free (PF) Inj 0.5% Inpatient & outpatient | 122216 CDM | $16.50 | $9.08 | — | — | |
| Bupivacaine Inj 0.25% w/ Epinephrine 1:200000 (PF) Inpatient & outpatient | 122218 CDM | $21.58 | $11.87 | — | — | |
| Bupivacaine Inj 0.5% w/ Epinephrine 1:200000 (PF) Inpatient & outpatient | 122219 CDM | $51.58 | $28.37 | — | — | |
| Buprenorphine HCl-Naloxone HCl SL Film 2-0.5 MG (Base Equiv) Inpatient & outpatient | 122209 CDM | $16.19 | $8.90 | — | — | |
| Buprenorphine HCl-Naloxone HCl SL Film 8-2 MG (Base Equiv) Inpatient & outpatient | 122276 CDM | $29.01 | $15.96 | — | — | |
| Dabigatran Etexilate Mesylate Cap 75 MG (Etexilate Base Eq) Inpatient & outpatient | 122963 CDM | $13.09 | $7.20 | — | — | |
| Dornase Alfa Inhal Soln 2.5 MG/2.5ML Inpatient & outpatient | 12211 CDM | $530 | $291 | — | — | |
| Enoxaparin Sodium Inj Soln Pref Syr 150 MG/ML Inpatient & outpatient | 122222 CDM | $55.28 | $30.40 | — | — | |
| Lacosamide IV Inj 200 MG/20ML (10 MG/ML) Inpatient & outpatient | 112243 CDM | $77.83 | $42.81 | — | — | |
| Lacosamide Tab 50 MG Inpatient & outpatient | 112239 CDM | $37.51 | $20.63 | — | — | |
| Lchg Cftr Gene Cystic Fibrosis Inpatient & outpatient | 81220 HCPCS | $3,583 | $1,971 | — | — | |
| Lchg Cftr Gene Full Sequence Inpatient & outpatient | 81223 HCPCS | $1,777 | $977 | — | — | |
| Lchg Cyp2C19 Gene Cytochrom P450 Inpatient & outpatient | 81225 HCPCS | $1,751 | $963 | — | — | |
| Lchg Cytogen Micrarray Copy Nmbr+Snp Gene Inpatient & outpatient | 81229 HCPCS | $2,121 | $1,167 | — | — |