SSM Health St. Mary's Hospital - St. Louis — price list
← Hospital overviewVerified from SSM Health St. Mary's Hospital - St. Louis’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 325 MG Inpatient & outpatient | 104 CDM | $3.30 | $1.82 | — | — | |
| Acetaminophen Susp 160 MG/5ML Inpatient & outpatient | 104963 CDM | $3.47 | $1.91 | — | — | |
| Bethanechol Chloride Tab 10 MG Inpatient & outpatient | 1043 CDM | $6.60 | $3.63 | — | — | |
| Bethanechol Chloride Tab 25 MG Inpatient & outpatient | 1044 CDM | $5.89 | $3.24 | — | — | |
| Brimonidine Tartrate-Timolol Maleate Ophth Soln 0.2-0.5% Inpatient & outpatient | 104643 CDM | $808 | $445 | — | — | |
| Leuprolide Acetate (3 Month) For Inj Kit 22.5 MG Inpatient & outpatient | 21045 CDM | $25,498 | $14,024 | — | — | |
| Levothyroxine Sodium Tab 112 MCG Inpatient & outpatient | 10404 CDM | $3.30 | $1.82 | — | — | |
| Levothyroxine Sodium Tab 88 MCG Inpatient & outpatient | 10403 CDM | $3.30 | $1.82 | — | — | |
| Lidocaine Inj 0.5% w/ Epinephrine-1:200000 Inpatient & outpatient | 10426 CDM | $16.50 | $9.08 | — | — | |
| Lidocaine Inj 1.5% w/ Epinephrine-1:200000 (PF) Inpatient & outpatient | 10429 CDM | $70.59 | $38.82 | — | — | |
| Lidocaine Inj 1% w/ Epinephrine-1:100000 Inpatient & outpatient | 10427 CDM | $44.95 | $24.72 | — | — | |
| Lidocaine Inj 1% w/ Epinephrine-1:200000 (PF) Inpatient & outpatient | 10428 CDM | $60.89 | $33.49 | — | — | |
| Lidocaine Inj 2% w/ Epinephrine-1:100000 Inpatient & outpatient | 10430 CDM | $22.51 | $12.38 | — | — | |
| Lidocaine Inj 2% w/ Epinephrine-1:200000 (PF) Inpatient & outpatient | 10431 CDM | $20.00 | $11.00 | — | — | |
| Lidocaine-Prilocaine Cream 2.5-2.5% Inpatient & outpatient | 10434 CDM | $32.72 | $18.00 | — | — | |
| Liothyronine Sodium Tab 5 MCG Inpatient & outpatient | 10443 CDM | $3.30 | $1.82 | — | — | |
| Lisinopril Tab 10 MG Inpatient & outpatient | 10449 CDM | $3.30 | $1.82 | — | — | |
| Lisinopril Tab 40 MG Inpatient & outpatient | 10450 CDM | $3.30 | $1.82 | — | — | |
| Lithium Carbonate Tab ER 450 MG Inpatient & outpatient | 10455 CDM | $3.30 | $1.82 | — | — | |
| Loratadine Tab 10 MG Inpatient & outpatient | 10466 CDM | $3.30 | $1.82 | — | — | |
| Lorazepam Inj 2 MG/ML Inpatient & outpatient | 10467 CDM | $16.50 | $9.08 | — | — |