SSM HEALTH DEPAUL HOSPITAL ST LOUIS

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
C9769	Cysto w/temp pros implant	—	—	$2,224	$8,775	4
C9772	Revasc lithotrip tibi/perone	—	—	$2,666	$13,875	15
C9773	Revasc lithotr-stent tib/per	—	—	$2,666	$22,033	15
C9774	Revasc lithotr-ather tib/per	—	—	$2,666	$22,033	15
C9775	Revasc lith-sten-ath tib/per	—	—	$2,666	$22,033	15
C9777	Esophag mucosal integ add-on	—	—	$1,444	$8,775	14
C9778	Colpopexy, min/inv, ex-perit	—	—	$2,727	$6,013	13
C9779	ESD endoscopy or colonoscopy	—	—	$2,224	$8,775	14
C9780	Insert cv cath inf & sup app	—	—	$2,224	$9,706	13
C9781	Arthro/shoul surg; w/spacer	—	—	$3,112	$15,431	13
C9783	Blind cor sinus reducer impl	—	—	$4,223	$13,875	13
C9784	Endo sleeve gastro w/tube	—	—	$2,224	$6,144	6
C9785	Endo outlet restrict w/tube	—	—	$2,224	$12,776	13
C9789	Instill pharm renal pelvis	—	—	$1,226	$3,532	13
C9790	Kidney histotripsy w/image	—	—	$2,666	$4,498	3
C9792	Blind/nonblind trans atrial	—	—	$4,223	$11,471	13
C9796	Rpr intst excl anrect fist	—	—	$1,944	$3,532	13
C9797	Vasc emb/occ w/prs cath	—	—	$2,224	$22,033	13
C9901	Endo defect closure GI tract	—	—	$2,224	$12,776	13
G0104	CA screen;flexi sigmoidscope	—	—	$67.6	$2,414	37
G0105	Colorectal scrn; hi risk ind	—	—	$217	$3,213	41
G0121	Colon ca scrn not hi rsk ind	—	—	$217	$3,213	41
G0186	Dstry eye lesn,fdr vssl tech	—	—	$551	$4,808	38
G0259	Inject for sacroiliac joint	—	—	$541	$2,414	6
G0260	Inj for sacroiliac jt anesth	—	—	$707	$3,886	17
G0412	Open tx iliac spine uni/bil	—	—	$776	$8,722	37
G0413	Pelvic ring fracture uni/bil	—	—	$1,140	$8,775	38
G0414	Pelvic ring fx treat int fix	—	—	$1,029	$8,722	37
G0415	Open tx post pelvic fxcture	—	—	$1,466	$8,081	37
G0448	Place perm pacing cardiovert	—	—	$2,275	$8,050	8
G0455	Fecal microbiota prep instil	—	—	$79.43	$2,414	36
G0516	Insert drug del implant, >4	—	—	$115	$2,414	38
G0517	Remove drug implant	—	—	$131	$2,414	38
G0518	Remove w insert drug implant	—	—	$212	$2,414	38
G0561	Temp tube delivery, unil	—	—	$541	$3,102	8
P9612	Catheterize for urine spec	—	—	$3	$2,414	40
P9615	Urine specimen collect mult	—	—	$3	$2,414	33
S2083	gastric band adjustment, percutaneous	—	—	$1,444	$2,414	3
S2095	percut occlusion tumor dest, yttrium-90	—	—	$2,224	$3,697	3
S2225	Myringotomy, laser-assisted	—	—	$2,224	$3,697	3
0191T	Insert ant segment drain int	—	—	$2,444	$5,982	5
0195T	Prescrl fuse w/o instr l5/s1	—	—	$2,444	$4,261	3
0312T	Laps impltj nstim vagus	—	—	$2,444	$4,261	3
0313T	Laps rmvl nstim array vagus	—	—	$2,444	$4,261	3
0314T	Laps rmvl vgl arry&pls gen	—	—	$2,444	$4,261	3
0315T	Rmvl vagus nerve pls gen	—	—	$2,444	$4,261	3
0316T	Replc vagus nerve pls gen	—	—	$2,444	$4,261	3
0375T	Total disc arthrp ant appr	—	—	$2,444	$8,861	5
0376T	Insert ant segment drain int	—	—	$2,302	$4,261	5
0377T	Anoscpy inj agent for incont	—	—	$1,628	$4,261	5

Showing top 50 of 14,888 priced procedures, sorted by gross charge.

Data straight from this hospital's federally-mandated machine-readable file (45 CFR § 180). The compliance grade reflects how completely the hospital published the six required data elements, not the quality of care.