How many shoppable procedure prices are published for SSM Health St. Mary's Hospital - Jefferson City?

SSM Health St. Mary's Hospital - Jefferson City in Jefferson City, MO currently has 123 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do SSM Health St. Mary's Hospital - Jefferson City's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, SSM Health St. Mary's Hospital - Jefferson City's median negotiated commercial rate is 1.4× the regionally adjusted fair BaseRate benchmark.

What is SSM Health St. Mary's Hospital - Jefferson City's CMS Care Compare overall star rating?

CMS Care Compare assigns SSM Health St. Mary's Hospital - Jefferson City an overall hospital quality rating of 3 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Proprietary 140 Beds · urban Updated: 2026-04-01

SSM Health St. Mary's Hospital - Jefferson City

2505 Mission Drive, Jefferson City, MO 65109 · 123 Priced Procedures · 75% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

Above Fair Market · Negotiate

1.35×vs. Fair Market Price

Typical commercial prices here are +35% above the fair benchmark (1.35×) even after accounting for local nurse/doctor wages and patient complexity.

77/100 · Corroborated

77/100Self-Pay Cash Beats Insurance 22% of the Time

File Completeness56

Price Logic70

Peer Alignment73

Clean Billing93

Real Cash Discount100

Regional Value Leader

4-Star CMS clinical quality rating paired with 1.35× fair market pricing.

Behavioral Pricing FingerprintHigh-HHI Market Leverage

Consolidated System Premium Pricer

Operating in a concentrated regional market (CBSA HHI 9,962), SSM Health St. Mary's Hospital - Jefferson City commands a 1.35× BaseRate commercial premium across insurers. Self-pay cash quotes, in-state peer hospitals, and freestanding outpatient facilities offer critical leverage against consolidated system pricing.

#62 of 79 in MO · 77th State Percentile#2,358 of 3,385 in U.S. · 69th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.92× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 22% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (73/100 safety score) with 75% patient recommendation
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.35× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
Captive ER (2.2×) & laboratory (2.4×) services average 1.20× higher multiples than routine shoppable care (1.5×)
Upper-quartile procedures (Q75 1.63×) jump +23% above the median procedure ratio (Q50 1.32×)
Consolidated metro market (HHI 9,962) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.5× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER1.20× Divergence

1.8× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+23% Upper Tail

Q25 0.92× · Q50 1.32× · Q75 1.63×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

1.5× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.5× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.9× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

2.2× MedicareFair

Inpatient Lab & PathologyBack-Door Captive

2.4× MedicareFair

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

0.5× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

22% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 73/100Fair

Procedure Prices at SSM Health St. Mary's Hospital - Jefferson City

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 123 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	—	$25,615	$30,775	0.8×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$16,289	$19,087	0.9×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$15,872	$19,432	0.8×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$15,017	$17,936	0.8×
Total hip replacement CPT Code: `27130`	—	$13,065	$13,413	1.0×
Total knee replacement CPT Code: `27447`	—	$13,065	$13,523	1.0×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$7,275	$8,223	0.9×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$6,358	$6,109	unverified
Breast lump removal CPT Code: `19120`	$3,913	$3,981	$3,875	1.0×
Inguinal hernia repair CPT Code: `49505`	—	$3,647	$3,629	1.0×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$3,441	$3,372	1.0×
Bunion correction surgery CPT Code: `28296`	—	$3,333	$3,446	1.0×
Cataract surgery with lens implant CPT Code: `66984`	—	$2,427	$2,540	1.0×
Vaginal delivery (full package) CPT Code: `59400`	—	$2,277	$2,680	0.8×
C-section delivery (full package) CPT Code: `59510`	—	$2,277	$2,975	0.8×
Colonoscopy with biopsy CPT Code: `45380`	—	$1,647	$1,256	1.3×
Sleep study (overnight, in lab) CPT Code: `95810`	$1,925	$1,369	$1,021	1.3×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$1,304	$981	1.3×
Upper endoscopy with biopsy CPT Code: `43239`	—	$1,272	$987	1.3×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,552	$826	$511	unverified
Injection procedure for pain management HCPCS Code: `G0260`	$2,623	$742	$855	0.9×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,117	$641	$448	1.4×
Blood transfusion CPT Code: `36430`	$832	$619	$498	1.2×
MRI, brain (no contrast) CPT Code: `70551`	$1,033	$590	$343	unverified
MRI, lower back (no contrast) CPT Code: `72148`	$958	$540	$338	1.6×
MRI, knee or other leg joint CPT Code: `73721`	$1,180	$474	$369	1.3×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,077	$432	$583	0.7×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$973	$402	$272	1.5×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,873	$394	$303	1.3×
CT scan, head (with contrast) CPT Code: `70460`	$1,043	$359	$242	1.5×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,192	$358	$258	1.4×
CT scan, sinuses CPT Code: `70486`	$820	$303	$166	1.8×
Psychiatric evaluation (first visit) CPT Code: `90791`	$229	$320	$185	unverified
CT scan, neck (cervical spine) CPT Code: `72125`	$820	$290	$169	1.7×
CT scan, chest (no contrast) CPT Code: `71250`	$547	$286	$167	1.7×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$896	$287	$168	1.7×
Family therapy session CPT Code: `90847`	$196	$275	$173	1.6×
Rabies immune globulin HCPCS Code: `90375`	—	$289	$322	0.9×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$330	$242	$148	1.6×
Neurobehavioral status check CPT Code: `96116`	$405	$257	$231	1.1×
Ultrasound, thyroid and neck CPT Code: `76536`	$567	$216	$132	1.6×
Ultrasound, abdomen (complete) CPT Code: `76700`	$712	$217	$134	1.6×
CT scan, head (no contrast) CPT Code: `70450`	$820	$237	$160	1.5×
CT scan, pelvis CPT Code: `72192`	$746	$234	$163	1.4×
Psychotherapy session (45 minutes) CPT Code: `90834`	$210	$231	$166	1.4×
Care planning with family CPT Code: `90887`	—	$236	$107	unverified
Review of medical records for care CPT Code: `90889`	—	$203	$114	1.8×
Ultrasound, abdomen (limited) CPT Code: `76705`	$574	$196	$126	1.6×
Ultrasound, pelvis CPT Code: `76856`	$548	$211	$130	unverified
Speech therapy (language evaluation) CPT Code: `92507`	$186	$143	$86	1.7×
New patient office visit (30-44 min) CPT Code: `99203`	$161	$161	$110	1.5×
Office visit, established patient (20-29 min) CPT Code: `99213`	$131	$131	$87	1.5×
Office visit, established patient (30-39 min) CPT Code: `99214`	$156	$156	$123	1.3×
Hepatitis B immune globulin HCPCS Code: `90371`	—	$147	$151	1.0×
Psychological testing by technician CPT Code: `96138`	—	$134	$395	0.3×
X-ray, hip CPT Code: `73502`	$309	$89	$93	1.0×
Group therapy session CPT Code: `90853`	$194	$95	$100	0.9×
X-ray, lower back CPT Code: `72110`	$456	$106	$112	0.9×
X-ray, ankle CPT Code: `73610`	$245	$87	$93	0.9×
X-ray, neck (cervical spine) CPT Code: `72040`	$238	$86	$93	0.9×
X-ray, hand CPT Code: `73130`	$248	$86	$93	0.9×
X-ray, foot CPT Code: `73630`	$272	$85	$92	0.9×
Psychological testing evaluation CPT Code: `96136`	—	$98	$128	0.8×
Psychotherapy session (60 minutes) CPT Code: `90837`	$118	$118	$181	unverified
Screening mammogram (both breasts) CPT Code: `77067`	$86	$86	$123	unverified
Typhoid vaccine HCPCS Code: `90675`	—	$331	$347	1.0×
Drug screening test HCPCS Code: `G0480`	$320	$320	$116	unverified
Pneumococcal vaccine HCPCS Code: `90732`	$225	$141	$140	1.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$97	$97	$14	6.9×
Blood test, lipase CPT Code: `83690`	$64	$64	$7	9.1×
Blood test, amylase CPT Code: `82150`	$60	$60	$7	8.6×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$83	$83	$11	7.5×
Culture, blood CPT Code: `87040`	$72	$72	$11	6.5×
Blood test, vitamin B12 CPT Code: `82607`	$78	$78	$16	4.9×
Blood test, PSA (prostate screen) CPT Code: `84153`	$82	$82	$19	4.3×
Blood test, vitamin D CPT Code: `82306`	$101	$101	$31	3.3×
Blood test, magnesium CPT Code: `83735`	$54	$54	$7	7.7×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$78	$78	$20	3.9×
Culture, bacterial CPT Code: `87070`	$51	$51	$9	5.7×
Blood test, liver function panel CPT Code: `80076`	$45	$45	$9	5.0×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$69	$69	$14	4.9×
X-ray, shoulder CPT Code: `73030`	$257	$79	$92	0.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$53	$53	$18	2.9×
Occupational therapy (self-care training) CPT Code: `97535`	$64	$67	$38	1.8×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$63	$63	$56	1.1×
X-ray, chest (two views) CPT Code: `71046`	$279	$71	$93	0.8×
X-ray, pelvis CPT Code: `72170`	$254	$74	$110	0.7×
Blood test, calcium CPT Code: `82310`	$31	$31	$5	6.2×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$24	$24	$4	6.0×
Blood test, potassium CPT Code: `84132`	$26	$26	$5	5.2×
Blood test, complete blood count (CBC) CPT Code: `85025`	$39	$39	$8	4.9×
Blood test, sodium CPT Code: `84295`	$24	$24	$5	4.8×
Blood test, creatinine (kidney) CPT Code: `82565`	$22	$22	$5	4.4×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$39	$39	$10	3.9×
Hepatitis C antibody test CPT Code: `86803`	$47	$47	$15	3.1×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$55	$25	2.2×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$75	$63	$35	1.8×
Physical therapy (manual therapy) CPT Code: `97140`	$65	$59	$34	1.7×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$69	$65	$38	1.7×
Physical therapy (functional capacity test) CPT Code: `97750`	$77	$65	$38	1.7×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$65	$68	$40	1.7×
Physical therapy (gait training) CPT Code: `97116`	$59	$55	$33	1.7×
Orthotic fitting and training CPT Code: `97760`	$83	$76	$51	1.5×
Prosthetic fitting and training CPT Code: `97761`	$73	$67	$45	1.5×
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$52	$35	1.5×
Flu vaccine injection HCPCS Code: `G0008`	$39	$70	$48	1.5×
Colorectal cancer screening HCPCS Code: `G0010`	$61	$70	$49	1.4×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$20	$20	$5	4.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$32	$17	$6	2.8×
Blood test, basic metabolic panel CPT Code: `80048`	$68	$24	$9	2.7×
Speech therapy (group session) CPT Code: `92508`	—	$42	$27	1.6×
Breathing treatment (nebulizer) CPT Code: `94640`	$108	$66	$201	0.3×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$184	$35	$64	0.5×
Blood test, hemoglobin CPT Code: `85018`	$17	$7	$3	2.3×
Electrical stimulation therapy HCPCS Code: `G0283`	$53	$27	$14	1.9×
Flu vaccine (high dose) HCPCS Code: `90656`	$25	$24	$25	1.0×
Hepatitis B vaccine HCPCS Code: `90744`	—	$33	$37	0.9×
Pneumonia vaccine injection HCPCS Code: `G0009`	$33	$33	$49	0.7×
Blood antibody screen CPT Code: `86850`	$45	$20	$46	0.4×
X-ray, chest (single view) CPT Code: `71045`	$264	$39	$92	0.4×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$39	$9	$3	3.0×
Hospital observation (per hour) HCPCS Code: `G0378`	$2	$2	$86	0.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$27	$27	$4	unverified

Showing top 25 high-impact procedures of 123 total

Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at SSM Health St. Mary's Hospital - Jefferson City (Zero PHI Required)

CMS CCN: 260011

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $25,615

1. Amount on Your Bill or Quote ($) Pre-filled with SSM Health St. Mary's Hospital - Jefferson City’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 274% of 2026 FPL

Above Standard 400% FPL Financial-Assistance Ceiling

At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask SSM Health St. Mary's Hospital - Jefferson City's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$30,701 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($61,476) is $30,701 above the denoised Fair BaseRate ($30,775) and 2.6× the $23,504 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) For-Profit / Non-501(c)(3)

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Public IRS & CMS ownership records classify SSM Health St. Mary's Hospital - Jefferson City as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall4/5 Stars (4/5)

Safety Composite73/100

Would Recommend75%

Rated 9 or 10 (HCAHPS)77%

Median ER Wait170 min

Left ER Before Seen2%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate3.1%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionsame

C. diff Hospital-Onset Infectionbetter

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at SSM Health St. Mary's Hospital - Jefferson City. Prior administrative notices do not necessarily reflect current compliance status.

2025-07-30·administrative_or_closure
Met Requirements
Recorded
2023-05-30·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (565 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Value & Quality Leader Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for SSM Health St. Mary's Hospital - Jefferson City.

Price Index: 1.00× regional baseline

Quality: 72/100 CMS composite

Median Household Income$73,273U.S. Census ACS

Local Uninsured Share6.7%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 77/100 · Corroborated CMS CCN 260011

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 260011) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-04-01

Validated Rate Rows1,631 (CMS v3.0.0)

File Integrity DigestVerified · CCN 260011

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy