Missouri Baptist Sullivan Hospital
751 Sappington Bridge Rd, Sullivan, MO 63080 · Critical access hospital · Emergency room
These are Missouri Baptist Sullivan Hospital's own posted figures from its standard-charges file dated December 15, 2025. They are not a quote. Source: the hospital's file · its price transparency page.
161 of the services we track have a posted price here. Tap a service to compare it with nearby hospitals. How to read these numbers.
Emergency room
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Critical care, first 30 to 74 minutes CPT 99291 | $2,323.80 | $3,873.00 | $827.36 – $6,853.00 |
| Emergency room visit, level 1 (minor) CPT 99281 | $258.00 | $430.00 | $84.46 – $1,898.00 |
| Emergency room visit, level 2 CPT 99282 | $550.20 | $917.00 | $175.49 – $1,898.00 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $907.80 | $1,513.00 | $273.42 – $2,674.00 |
| Emergency room visit, level 4 CPT 99284 | $1,279.20 | $2,132.00 | $469.04 – $3,275.55 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $1,792.20 | $2,987.00 | $596.49 – $5,551.00 |
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $30.00 | $50.00 | $11.00 – $210.00 |
| Abdominal X-ray, 1 view CPT 74018 | $306.60 | $511.00 | $39.90 – $449.00 |
| Ankle X-ray, 3 or more views CPT 73610 | $388.20 | $647.00 | $53.00 – $562.89 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $369.00 | $615.00 | $51.13 – $535.05 |
| Breast ultrasound, one breast, complete CPT 76641 | $1,447.20 | $2,412.00 | $126.43 – $2,098.44 |
| Breast ultrasound, one breast, limited CPT 76642 | $1,076.40 | $1,794.00 | $98.57 – $1,560.78 |
| Chest X-ray, 1 view CPT 71045 | $141.60 | $236.00 | $30.49 – $449.00 |
| Chest X-ray, 2 views CPT 71046 | $330.60 | $551.00 | $43.02 – $479.37 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $1,473.60 | $2,456.00 | $175.68 – $2,136.72 |
| CT angiogram of the head CPT 70496 | $1,529.40 | $2,549.00 | $175.68 – $2,235.00 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $3,217.20 | $5,362.00 | $349.44 – $4,732.00 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $3,631.20 | $6,052.00 | $349.44 – $5,265.24 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $1,948.20 | $3,247.00 | $225.02 – $2,907.00 |
| CT scan of the abdomen, without contrast CPT 74150 | $903.00 | $1,505.00 | $104.71 – $1,725.00 |
| CT scan of the chest, with contrast CPT 71260 | $1,272.00 | $2,120.00 | $175.68 – $1,844.40 |
| CT scan of the chest, without contrast CPT 71250 | $895.20 | $1,492.00 | $104.71 – $1,725.00 |
| CT scan of the head, without contrast CPT 70450 | $879.60 | $1,466.00 | $104.71 – $1,725.00 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $1,010.40 | $1,684.00 | $104.71 – $1,725.00 |
| CT scan of the pelvis, with contrast CPT 72193 | $1,341.00 | $2,235.00 | $175.68 – $1,944.45 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $1,017.60 | $1,696.00 | $104.71 – $1,725.00 |
| Diagnostic mammogram, both breasts CPT 77066 | $399.00 | $665.00 | $102.44 – $578.55 |
| Diagnostic mammogram, one breast CPT 77065 | $260.40 | $434.00 | $79.65 – $368.90 |
| Foot X-ray, 3 or more views CPT 73630 | $357.00 | $595.00 | $48.21 – $517.65 |
| Hand X-ray, 3 or more views CPT 73130 | $339.60 | $566.00 | $52.37 – $492.42 |
| Knee X-ray, 3 views CPT 73562 | $400.20 | $667.00 | $59.25 – $580.29 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $1,958.40 | $3,264.00 | $238.99 – $2,839.68 |
| Leg or arm vein ultrasound, one side CPT 93971 | $997.20 | $1,662.00 | $104.71 – $1,701.00 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $403.80 | $673.00 | $54.24 – $585.51 |
| MRI of the abdomen, without and with contrast CPT 74183 | $2,789.40 | $4,649.00 | $349.44 – $4,044.63 |
| MRI of the brain, without and with contrast CPT 70553 | $2,822.40 | $4,704.00 | $349.44 – $4,092.48 |
| MRI of the brain, without contrast CPT 70551 | $1,418.40 | $2,364.00 | $238.99 – $2,303.00 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $1,891.20 | $3,152.00 | $267.88 – $2,742.24 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $2,638.80 | $4,398.00 | $238.99 – $3,826.26 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $1,305.60 | $2,176.00 | $238.99 – $2,250.00 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $2,549.40 | $4,249.00 | $238.99 – $3,696.63 |
| MRI of the pelvis, without and with contrast CPT 72197 | $1,912.80 | $3,188.00 | $349.44 – $3,214.00 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $2,478.60 | $4,131.00 | $267.88 – $3,593.97 |
| Neck X-ray, 2 or 3 views CPT 72040 | $373.80 | $623.00 | $53.63 – $542.01 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $859.20 | $1,432.00 | $104.71 – $1,245.84 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $900.60 | $1,501.00 | $104.71 – $1,305.87 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $703.20 | $1,172.00 | $104.71 – $1,019.64 |
| Screening mammogram, both breasts CPT 77067 | $274.20 | $457.00 | $84.26 – $397.59 |
| Shoulder X-ray, 2 or more views CPT 73030 | $372.00 | $620.00 | $47.38 – $539.40 |
| Transvaginal pregnancy ultrasound CPT 76817 | $633.60 | $1,056.00 | $104.71 – $918.72 |
| Transvaginal ultrasound CPT 76830 | $695.40 | $1,159.00 | $104.71 – $1,008.33 |
| Ultrasound of the abdomen, complete CPT 76700 | $1,020.00 | $1,700.00 | $104.71 – $1,479.00 |
| Ultrasound of the neck or thyroid CPT 76536 | $733.20 | $1,222.00 | $104.71 – $1,063.14 |
| Wrist X-ray, 3 or more views CPT 73110 | $326.40 | $544.00 | $60.49 – $473.28 |
| X-ray of the lower back, 4 or more views CPT 72110 | $552.60 | $921.00 | $72.35 – $801.27 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $111.00 | $185.00 | $8.46 – $261.00 |
| Blood culture CPT 87040 | $64.80 | $108.00 | $10.32 – $323.00 |
| Blood draw (venipuncture) CPT 36415 | $24.00 | $40.00 | $4.23 – $34.80 |
| BNP test (heart failure) CPT 83880 | $88.20 | $147.00 | $32.34 – $194.00 |
| C-reactive protein (CRP) test CPT 86140 | $78.60 | $131.00 | $5.18 – $113.97 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $163.20 | $272.00 | $31.00 – $236.64 |
| Complete blood count (CBC) with differential CPT 85025 | $84.60 | $141.00 | $7.77 – $154.00 |
| Complete blood count (CBC), automated CPT 85027 | $87.00 | $145.00 | $6.47 – $126.15 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $214.80 | $358.00 | $10.56 – $359.00 |
| COVID-19 PCR test CPT 87635 | $77.40 | $129.00 | $28.38 – $129.00 |
| D-dimer test (blood clots) CPT 85379 | $127.80 | $213.00 | $10.18 – $185.31 |
| Drug screen, instrument chemistry CPT 80307 | $123.60 | $206.00 | $45.32 – $197.00 |
| Ferritin (iron stores) test CPT 82728 | $139.20 | $232.00 | $13.63 – $201.84 |
| Free T4 (thyroid) test CPT 84439 | $133.20 | $222.00 | $9.02 – $193.14 |
| General health panel (blood tests) CPT 80050 | $240.60 | $401.00 | $27.49 – $463.00 |
| Glucose (blood sugar) test CPT 82947 | $70.20 | $117.00 | $3.93 – $101.79 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $129.00 | $215.00 | $31.00 – $187.05 |
| Hemoglobin A1c test CPT 83036 | $91.80 | $153.00 | $22.96 – $101.13 |
| Iron test CPT 83540 | $78.60 | $131.00 | $6.47 – $113.97 |
| Kidney function panel CPT 80069 | $53.40 | $89.00 | $8.68 – $313.00 |
| Lipase test (pancreas) CPT 83690 | $119.40 | $199.00 | $6.89 – $173.13 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $125.40 | $209.00 | $13.39 – $181.83 |
| Liver function panel CPT 80076 | $167.40 | $279.00 | $8.17 – $242.73 |
| Magnesium test CPT 83735 | $46.80 | $78.00 | $6.70 – $156.00 |
| Obstetric blood test panel CPT 80055 | $235.20 | $392.00 | $47.81 – $341.04 |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $37.20 | $62.00 | $6.01 – $132.00 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $137.40 | $229.00 | $15.05 – $199.23 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $22.80 | $38.00 | $4.29 – $33.06 |
| PSA (prostate specific antigen), free CPT 84154 | $116.40 | $194.00 | $18.39 – $168.78 |
| PSA (prostate specific antigen), total CPT 84153 | $139.20 | $232.00 | $18.39 – $201.84 |
| Rapid strep test CPT 87880 | $25.20 | $42.00 | $9.24 – $51.00 |
| Sed rate (ESR) test CPT 85652 | $44.40 | $74.00 | $2.70 – $64.38 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $146.40 | $244.00 | $16.80 – $212.28 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $402.00 | $670.00 | $64.12 – $442.87 |
| Troponin test (heart damage) CPT 84484 | $92.40 | $154.00 | $12.47 – $143.00 |
| Urinalysis, automated, with microscope CPT 81001 | $31.80 | $53.00 | $3.17 – $46.11 |
| Urinalysis, automated, without microscope CPT 81003 | $24.00 | $40.00 | $2.25 – $34.80 |
| Urine culture, colony count CPT 87086 | $112.20 | $187.00 | $8.07 – $162.69 |
| Urine pregnancy test CPT 81025 | $79.20 | $132.00 | $8.61 – $126.00 |
| Vitamin B12 test CPT 82607 | $126.00 | $210.00 | $15.08 – $182.70 |
| Vitamin D test CPT 82306 | $202.80 | $338.00 | $29.60 – $294.06 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $1,725.00 | $2,875.00 | $238.99 – $4,135.00 |
| ECG tracing only (no interpretation) CPT 93005 | $183.60 | $306.00 | $59.09 – $530.00 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $3,993.00 | $6,655.00 | $547.30 – $8,910.00 |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $4,739.40 | $7,899.00 | $696.75 – $6,872.13 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Breast biopsy with ultrasound guidance CPT 19083 | $4,030.20 | $6,717.00 | $503.00 – $5,843.79 |
| Carpal tunnel release CPT 64721 | $6,645.42 | $11,075.70 | $1,955.88 – $23,928.36 |
| Colonoscopy with biopsy CPT 45380 | $10,817.52 | $18,029.20 | $1,198.57 – $15,685.40 |
| Colonoscopy with polyp removal (snare) CPT 45385 | $15,047.56 | $25,079.26 | $1,198.57 – $21,818.96 |
| Colonoscopy, diagnostic CPT 45378 | $5,946.37 | $9,910.61 | $258.00 – $8,622.23 |
| Colposcopy with biopsy CPT 57454 | $6,036.84 | $10,061.40 | $305.22 – $9,632.98 |
| Cystoscopy (bladder scope) CPT 52000 | $27,480.71 | $45,801.18 | $739.70 – $112,585.19 |
| Flexible sigmoidoscopy, diagnostic CPT 45330 | $5,433.58 | $9,055.96 | $258.00 – $8,870.40 |
| Hysteroscopy with biopsy or polyp removal CPT 58558 | $9,970.48 | $16,617.47 | $3,242.35 – $18,906.28 |
| Inguinal (groin) hernia repair, open, age 5 or older CPT 49505 | $24,985.25 | $41,642.09 | $3,911.00 – $36,228.62 |
| Upper endoscopy (EGD) with biopsy CPT 43239 | $6,849.37 | $11,415.61 | $908.45 – $9,931.58 |
| Upper endoscopy (EGD), diagnostic CPT 43235 | $3,362.85 | $5,604.75 | $526.34 – $4,876.13 |
Pregnancy and birth
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Fetal non-stress test CPT 59025 | $541.80 | $903.00 | $198.66 – $1,509.45 |
| IUD insertion CPT 58300 | $10,614.00 | $17,690.00 | $216.78 – $16,689.25 |
Hospital stays
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897 | $5,748.66 | $9,581.10 | $1,011.00 – $24,467.10 |
| C-section, without complications MS-DRG 788 | $16,220.25 | $27,033.75 | $6,872.52 – $27,033.75 |
| Chest pain MS-DRG 313 | $11,029.56 | $18,382.60 | $1,011.00 – $29,934.15 |
| COPD flare-up, with major complications MS-DRG 190 | $11,043.57 | $18,405.95 | $1,011.00 – $35,000.23 |
| Fainting (syncope) MS-DRG 312 | $10,545.66 | $17,576.10 | $1,011.00 – $34,363.55 |
| Gastrointestinal bleeding, with complications MS-DRG 378 | $15,929.98 | $26,549.96 | $1,011.00 – $36,845.30 |
| Heart failure, with major complications MS-DRG 291 | $11,888.85 | $19,814.75 | $1,011.00 – $40,278.75 |
| Irregular heartbeat, without complications MS-DRG 310 | $5,538.90 | $9,231.50 | $1,011.00 – $31,003.00 |
| Kidney failure, with complications MS-DRG 683 | $9,120.78 | $15,201.30 | $1,011.00 – $29,105.00 |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | $5,821.11 | $9,701.85 | $1,011.00 – $24,087.30 |
| Normal newborn care MS-DRG 795 | $3,717.93 | $6,196.55 | $653.00 – $6,337.65 |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | $6,862.65 | $11,437.75 | $1,011.00 – $28,427.90 |
| Pneumonia, with complications MS-DRG 194 | $9,719.82 | $16,199.70 | $1,011.00 – $26,038.15 |
| Pneumonia, with major complications MS-DRG 193 | $12,747.78 | $21,246.30 | $1,011.00 – $36,045.75 |
| Pneumonia, without complications MS-DRG 195 | $11,133.48 | $18,555.80 | $1,011.00 – $22,075.20 |
| Psychoses (inpatient psychiatric stay) MS-DRG 885 | $15,983.94 | $26,639.90 | $660.00 – $31,105.60 |
| Sepsis, with major complications MS-DRG 871 | $15,204.36 | $25,340.60 | $1,011.00 – $56,648.22 |
| Sepsis, without major complications MS-DRG 872 | $10,558.32 | $17,597.20 | $1,011.00 – $34,275.35 |
| Skin infection (cellulitis), without major complications MS-DRG 603 | $6,565.47 | $10,942.45 | $1,011.00 – $23,480.47 |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | $9,477.13 | $15,795.21 | $1,011.00 – $24,573.30 |
| Stroke, with complications or clot-busting drug MS-DRG 65 | $12,227.25 | $20,378.75 | $250.00 – $43,995.73 |
| Vaginal delivery, without complications MS-DRG 807 | $6,186.21 | $10,310.35 | $4,701.52 – $10,508.08 |
| Weight loss surgery, without complications MS-DRG 621 | $24,887.78 | $41,479.64 | $12,057.04 – $47,487.12 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | $4,673.43 | $7,789.05 | $1,713.59 – $38,621.44 |
Eye
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 | $1,281.09 | $2,135.15 | $469.73 – $6,771.00 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Home sleep apnea test CPT 95806 | $870.00 | $1,450.00 | $216.27 – $3,034.00 |
| Sleep study with CPAP titration CPT 95811 | $5,253.00 | $8,755.00 | $860.13 – $8,605.00 |
| Sleep study, overnight in a sleep lab CPT 95810 | $4,716.00 | $7,860.00 | $860.13 – $7,722.00 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $346.20 | $577.00 | $126.94 – $552.00 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $118.80 | $198.00 | $26.36 – $332.00 |
| Physical therapy evaluation, low complexity CPT 97161 | $153.60 | $256.00 | $56.32 – $332.00 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $181.80 | $303.00 | $66.66 – $332.00 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $130.80 | $218.00 | $27.90 – $332.00 |
| Therapeutic activities, 15 minutes CPT 97530 | $99.60 | $166.00 | $33.22 – $332.00 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $193.20 | $322.00 | $70.84 – $618.00 |
| IV hydration, each additional hour CPT 96361 | $194.40 | $324.00 | $46.90 – $369.00 |
| IV hydration, first hour CPT 96360 | $454.20 | $757.00 | $166.54 – $792.00 |
| IV push injection of a drug, first CPT 96374 | $432.00 | $720.00 | $103.00 – $626.40 |
| IV push injection, each additional drug CPT 96375 | $241.80 | $403.00 | $46.90 – $618.00 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $76.77 | $127.95 | $6.04 – $111.32 |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $5.43 | $9.05 | ? – $8.30 |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $88.20 | $147.00 | $1.43 – $164.49 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $2.28 | $3.80 | ? – $10.60 |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $35.64 | $59.40 | $7.62 – $55.24 |
| Morphine injection, up to 10 mg HCPCS J2270 | $57.00 | $95.00 | $20.90 – $1,680.82 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $26.37 | $43.95 | $1.35 – $62.80 |
| Propofol injection, per 10 mg HCPCS J2704 | $28.29 | $47.15 | $5.80 – $49.76 |
Cash price: the hospital's posted discounted price for people paying themselves. Gross charge: its list price before any discount. Insurer rates: the lowest and highest rates it says it negotiated with any insurer. When the file lists a service on several rows, this page shows one (the facility row for the usual setting); the service's own page lists every row.