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.

26 prices shown (filtered).

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
Acetazolamide Tab 250 MG Inpatient & outpatient	113 CDM	$3.30	$1.82	—	—
Albuterol Sulfate Soln Nebu 0.083% (2.5 MG/3ML) Inpatient & outpatient	250 CDM	$4.40	$2.42	—	—
Aminocaproic Acid Inj 250 MG/ML Inpatient & outpatient	403 CDM	$23.07	$12.69	—	—
Amoxicillin (Trihydrate) Cap 250 MG Inpatient & outpatient	450 CDM	$3.30	$1.82	—	—
Ascorbic Acid IV Soln 25000 MG/50ML (500 MG/ML) Inpatient & outpatient	160625 CDM	$1,072	$589	—	—
Azithromycin Tab 250 MG Inpatient & outpatient	20943 CDM	$4.89	$2.69	—	—
Bivalirudin Trifluoroacetate For IV Soln 250 MG (Base Equiv) Inpatient & outpatient	159897 CDM	$3,753	$2,064	—	—
Calcium Carbonate (Antacid) Susp 1250 MG/5ML Inpatient & outpatient	157704 CDM	$10.15	$5.58	—	—
Cefdinir For Susp 250 MG/5ML Inpatient & outpatient	39522 CDM	$328	$181	—	—
Ciprofloxacin HCl Tab 250 MG (Base Equiv) Inpatient & outpatient	25118 CDM	$14.64	$8.05	—	—
Clarithromycin For Susp 250 MG/5ML Inpatient & outpatient	12886 CDM	$389	$214	—	—
Diphenhydramine HCl Cap 25 MG Inpatient & outpatient	2509 CDM	$3.30	$1.82	—	—
Diphenhydramine HCl Inj 50 MG/ML Inpatient & outpatient	2508 CDM	$16.50	$9.08	—	—
Disulfiram Tab 250 MG Inpatient & outpatient	2540 CDM	$13.33	$7.33	—	—
Divalproex Sodium Tab Delayed Release 250 MG Inpatient & outpatient	2552 CDM	$3.30	$1.82	—	—
Divalproex Sodium Tab ER 24 HR 250 MG Inpatient & outpatient	34418 CDM	$6.42	$3.53	—	—
Erythromycin Tab 250 MG Inpatient & outpatient	2889 CDM	$41.13	$22.62	—	—
Fentanyl Citrate 2 MCG/ML-Ropivacaine 0.2%-NaCl 0.9% Inj,Fentanyl 0.5 mg/250ml-ropiv 0.2%-NaCl 0.9% epidural inj,Fentanyl Cit 0.2 MG/100ML-Ropiv 0.2%-NaCl 0.9% Epidural Inj Inpatient & outpatient	34272 CDM	$186	$102	—	—
Fentanyl Citrate Preservative Free (PF) Inj 250 MCG/5ML Inpatient & outpatient	150548 CDM	$16.50	$9.08	—	—
Fentanyl Citrate Preservative Free (PF) Inj 2500 MCG/50ML Inpatient & outpatient	150580 CDM	$129	$70.97	—	—
Fulvestrant Inj Soln Pref Syr 250 MG/5ML Inpatient & outpatient	124678 CDM	$3,839	$2,112	—	—
Gabapentin Oral Soln 250 MG/5ML Inpatient & outpatient	29169 CDM	$5.49	$3.02	—	—
Heparin Sod (Porcine) in NaCl IV Soln 25000 Unit/250ML-0.45% Inpatient & outpatient	152617 CDM	$56.10	$30.86	—	—
Hydrocortisone Sodium Succinate PF For Inj 250 MG Inpatient & outpatient	141876 CDM	$176	$96.99	—	—
Lchg Citric Acid Urine Timed Inpatient & outpatient	82507 HCPCS	$762	$419	—	—
Lchg Factor Ix Assay Inpatient & outpatient	85250 HCPCS	$509	$280	—	—