▸ Hospital · MO · CCN 263303
Ranken Jordan Pediatric Bridge Hospital
11365 DORSETT RD, MARYLAND HEIGHTS, MO, 63043
Childrens2
Compliance grade
A
97/100
Procedures tracked
80
of 209 target codes
Payers
5
with negotiated rates
Rates published
6,915
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychiatric diagnostic evaluation | CPT | 90791 | 0 | $457.6 | $366.08 | — | — | — |
| Psychiatric eval with medical services | CPT | 90792 | 5 | $393.8 | $393.8 | $124.44 | $124.44 | $125.93 |
| Psychotherapy 30 minutes | CPT | 90832 | 0 | $139.15 | $111.32 | — | — | — |
| Psychotherapy 45 minutes | CPT | 90834 | 0 | $185.57 | $148.46 | — | — | — |
| Psychotherapy 60 minutes | CPT | 90837 | 0 | $279.14 | $223.32 | — | — | — |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 0 | $290.91 | $232.73 | — | — | — |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 0 | $1,995.4 | $1,596.32 | — | — | — |
| CT head with contrast | CPT | 70460 | 0 | $2,215.4 | $1,772.32 | — | — | — |
| CT head with and without contrast | CPT | 70470 | 0 | $2,545.4 | $2,036.32 | — | — | — |
| MRI brain without contrast | CPT | 70551 | 0 | $3,865.4 | $3,092.32 | — | — | — |
| MRI brain with contrast | CPT | 70552 | 0 | $2,765.4 | $2,212.32 | — | — | — |
| MRI brain with and without contrast | CPT | 70553 | 0 | $3,095.4 | $2,476.32 | — | — | — |
| Chest X-ray single view | CPT | 71045 | 0 | $327.8 | $262.24 | — | — | — |
| Chest X-ray 2 views | CPT | 71046 | 0 | $388.3 | $310.64 | — | — | — |
| Chest X-ray 3 views | CPT | 71047 | 0 | $388.3 | $310.64 | — | — | — |
| CT chest without contrast | CPT | 71250 | 0 | $1,640.1 | $1,312.08 | — | — | — |
| CT chest with contrast | CPT | 71260 | 0 | $1,860.1 | $1,488.08 | — | — | — |
| CT chest with and without contrast | CPT | 71270 | 0 | $2,080.1 | $1,664.08 | — | — | — |
| Lumbosacral spine X-ray | CPT | 72100 | 0 | $515.9 | $412.72 | — | — | — |
| CT cervical spine without contrast | CPT | 72125 | 0 | $2,307.47 | $1,845.98 | — | — | — |
| CT thoracic spine without contrast | CPT | 72128 | 0 | $2,307.47 | $1,845.98 | — | — | — |
| CT lumbar spine without contrast | CPT | 72131 | 0 | $1,918.62 | $1,534.9 | — | — | — |
| MRI cervical spine without contrast | CPT | 72141 | 0 | $2,856.7 | $2,285.36 | — | — | — |
| MRI thoracic spine without contrast | CPT | 72146 | 0 | $2,856.7 | $2,285.36 | — | — | — |
| MRI lumbar spine without contrast | CPT | 72148 | 0 | $2,468.4 | $1,974.72 | — | — | — |
| MRI lumbar spine with and without contrast | CPT | 72149 | 0 | $2,688.4 | $2,150.72 | — | — | — |
| MRI cervical spine with and without contrast | CPT | 72156 | 0 | $3,296.7 | $2,637.36 | — | — | — |
| MRI lumbar spine with contrast | CPT | 72158 | 0 | $2,908.4 | $2,326.72 | — | — | — |
| CT pelvis without contrast | CPT | 72192 | 0 | $2,141.7 | $1,713.36 | — | — | — |
| CT pelvis with contrast | CPT | 72193 | 0 | $2,361.7 | $1,889.36 | — | — | — |
| Shoulder X-ray | CPT | 73030 | 0 | $535.7 | $428.56 | — | — | — |
| Humerus X-ray | CPT | 73060 | 0 | $559.85 | $447.88 | — | — | — |
| Hand X-ray 3 views | CPT | 73130 | 0 | $424.71 | $339.77 | — | — | — |
| MRI upper extremity joint without contrast | CPT | 73221 | 0 | $3,412.53 | $2,730.03 | — | — | — |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 0 | $3,412.53 | $2,730.03 | — | — | — |
| Knee X-ray 1-2 views | CPT | 73560 | 0 | $390.56 | $312.45 | — | — | — |
| MRI lower extremity joint without contrast | CPT | 73721 | 0 | $1,032.55 | $826.04 | — | — | — |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 0 | $1,783.17 | $1,426.54 | — | — | — |
| CT abdomen without contrast | CPT | 74150 | 0 | $1,061.17 | $848.94 | — | — | — |
| CT abdomen with contrast | CPT | 74160 | 0 | $1,390.4 | $1,112.32 | — | — | — |
| CT abdomen with and without contrast | CPT | 74170 | 0 | $1,621.4 | $1,297.12 | — | — | — |
| Abdominal ultrasound complete | CPT | 76700 | 0 | $983.4 | $786.72 | — | — | — |
| Abdominal ultrasound limited | CPT | 76705 | 0 | $873.4 | $698.72 | — | — | — |
| Retroperitoneal ultrasound complete | CPT | 76770 | 0 | $900.9 | $720.72 | — | — | — |
| Pelvic ultrasound complete | CPT | 76856 | 0 | $1,045 | $836 | — | — | — |
| EKG complete | CPT | 93000 | 0 | $412.5 | $330 | — | — | — |
| EKG tracing only | CPT | 93005 | 0 | $220 | $176 | — | — | — |
| Transthoracic echocardiogram complete | CPT | 93306 | 0 | $3,987.5 | $3,190 | — | — | — |
| Transthoracic echocardiogram | CPT | 93307 | 0 | $4,584.8 | $3,667.84 | — | — | — |
| inpatient | ||||||||
| Initial hospital care, low complexity | CPT | 99221 | 3 | $367.4 | $367.4 | $61.76 | $61.76 | $61.76 |
| Initial hospital care, moderate complexity | CPT | 99222 | 3 | $530.2 | $530.2 | $88.82 | $88.82 | $88.82 |
| Initial hospital care, high complexity | CPT | 99223 | 3 | $653.4 | $653.4 | $121.97 | $121.97 | $121.97 |
| Hospital discharge, <30 min | CPT | 99238 | 3 | $218.9 | $218.9 | $54.59 | $54.59 | $54.59 |
| Hospital discharge, >30 min | CPT | 99239 | 3 | $314.6 | $314.6 | $77.02 | $77.02 | $77.02 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 0 | $9.05 | $7.24 | — | — | — |
| Electrolyte panel | CPT | 80051 | 0 | $7.55 | $6.04 | — | — | — |
| Comprehensive metabolic panel | CPT | 80053 | 0 | $11.31 | $9.05 | — | — | — |
| Lipid panel | CPT | 80061 | 0 | $21.45 | $17.16 | — | — | — |
| Renal function panel | CPT | 80069 | 0 | $9.81 | $7.85 | — | — | — |
| Hepatic function panel | CPT | 80076 | 0 | $8.67 | $6.94 | — | — | — |
| Urinalysis non-automated | CPT | 81002 | 0 | $28.04 | $22.44 | — | — | — |
| Glucose quantitative | CPT | 82947 | 0 | $19.25 | $15.4 | — | — | — |
| Hemoglobin A1c | CPT | 83036 | 0 | $17.3 | $13.84 | — | — | — |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 0 | $19.8 | $15.84 | — | — | — |
| Complete blood count with automated differential | CPT | 85025 | 0 | $5.5 | $4.4 | — | — | — |
| Urine culture bacterial | CPT | 87086 | 0 | $22.65 | $18.12 | — | — | — |
| Urine culture identification | CPT | 87088 | 0 | $49.83 | $39.87 | — | — | — |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 3 | $298.1 | $298.1 | $32.21 | $32.21 | $32.21 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 3 | $409.2 | $409.2 | $55.95 | $55.95 | $55.95 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 3 | $601.7 | $601.7 | $90.81 | $90.81 | $90.81 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 3 | $743 | $743 | $123.49 | $123.49 | $123.49 |
| Office visit, established patient, 5 min | CPT | 99211 | 3 | $75.9 | $75.9 | $8.44 | $8.44 | $8.44 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 3 | $136.4 | $136.4 | $24.25 | $24.25 | $24.25 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 3 | $200.2 | $200.2 | $44.67 | $44.67 | $44.67 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 3 | $301.4 | $301.4 | $65.79 | $65.79 | $65.79 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 3 | $427 | $427 | $97.69 | $97.69 | $97.69 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 0 | $1,012 | $809.6 | — | — | — |
| Upper GI endoscopy with biopsy | CPT | 43239 | 0 | $1,402.5 | $1,122 | — | — | — |
| Colonoscopy diagnostic | CPT | 45378 | 0 | $1,122 | $897.6 | — | — | — |
| Colonoscopy with biopsy | CPT | 45380 | 0 | $1,556.5 | $1,245.2 | — | — | — |
Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.
Payer mix (top 5)
| Payer | Codes covered | Median rate |
|---|---|---|
| Aetna | 15 | $65.79 |
| Blue Cross Blue Shield | 15 | $65.79 |
| meridian healthcare of illinois mc plus | 15 | $65.79 |
| healthy blue | 1 | $125.93 |
| home state | 1 | $125.93 |
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