| 1 | Bjc Health System Saint Louis | E | $11.8B | $11.3B | $8.0B |
| 2 | Washington University St. Louis | B | $9.2B | $5.2B | $20.5B |
| 3 | Bjc Health System St. Louis | E | $6.5B | $2.0B | $7.8B |
| 4 | Government Employees Health Association INC Lees Summit | Z | $6.2B | $6.1B | $2.5B |
| 5 | Ascension Seton Saint Louis | Z | $3.3B | $3.3B | $3.2B |
| 6 | Ascension Health Alliance Saint Louis | Z | $2.4B | $2.4B | $24.0B |
| 7 | Ssm Health Care St. Louis Saint Louis | E | $2.2B | $2.2B | $1.1B |
| 8 | Childrens Mercy Hospital Kansas City | E | $2.1B | $2.1B | $3.3B |
| 9 | Greater Horizons Kansas City | T | $2.0B | $754.1M | $2.8B |
| 10 | Lester E Cox Medical Center Springfield | E | $2.0B | $1.8B | $2.1B |
| 11 | Mercy Hospitals East Communities Chesterfield | E | $1.9B | $1.9B | $916.1M |
| 12 | Sacred Heart Health System INC Saint Louis | E | $1.7B | $1.7B | $981.7M |
| 13 | Greater Kansas City Community Foundation Kansas City | T | $1.5B | $781.8M | $3.4B |
| 14 | Mhm Support Services Chesterfield | Z | $1.5B | $1.5B | $848.9M |
| 15 | St. Vincent Hospital & Health Care Saint Louis | E | $1.5B | $1.5B | $1.1B |
| 16 | Marvin M Schwan Charitable Foundation Earth City | X | $1.5B | $49.2M | $459.5M |
| 17 | Ssm Health Care Corporation Saint Louis | E | $1.4B | $1.4B | $7.0B |
| 18 | Mercy Hospital Springfield Springfield | E | $1.3B | $1.3B | $555.3M |
| 19 | St. Louis University Saint Louis | B | $1.3B | $864.3M | $3.0B |
| 20 | Patterson Family Foundation Kansas City | T | $1.3B | $0 | $1.5B |
| 21 | Ascension Health-is INC Saint Louis | Z | $1.3B | $1.3B | $695.3M |
| 22 | Saint Thomas West Hospital Saint Louis | E | $1.3B | $1.3B | $815.7M |
| 23 | Presence Chicago Hospitals Network Saint Louis | P | $1.2B | $1.2B | $1.0B |
| 24 | Stifel Charitable INC Saint Louis | T | $1.1B | $340.5M | $508.8M |
| 25 | Ssm Health Care of Oklahoma INC Saint Louis | E | $1.1B | $1.1B | $453.7M |
| 26 | Ssm-sluh INC Saint Louis | Z | $948.3M | $947.9M | $708.1M |
| 27 | Ascension Welfare Benefits Trust Saint Louis | Y | $915.1M | $191.4M | $172.4M |
| 28 | Truman Medical Center Incorporated Kansas City | E | $835.9M | $835.9M | $517.0M |
| 29 | Presence St. Marys Hospital Presence Central and Suburban Hospitals Net Saint Louis | E | $807.3M | $807.2M | $530.0M |
| 30 | Delta Dental of Missouri St. Louis | Z | $805.5M | $805.5M | $229.1M |
| 31 | Freeman Health System Joplin | E | $795.1M | $709.6M | $734.7M |
| 32 | Heartland Regional Medical Center Saint Joseph | E | $782.7M | $782.2M | $495.4M |
| 33 | The Foundation for Barnes-jewish Hospital Saint Louis | E | $776.2M | $106.3M | $927.6M |
| 34 | Ssm Health Care of Wisconsin INC Saint Louis | E | $770.4M | $770.2M | $499.4M |
| 35 | Ascension via Christi Hospitals Wichita INC Saint Louis | E | $759.3M | $759.1M | $380.0M |
| 36 | Mercy Clinic East Communities Chesterfield | Z | $739.7M | $739.7M | $136.1M |
| 37 | St. Lukes Episcopal-presbyterian Hospital Chesterfield | E | $737.2M | $664.6M | $859.5M |
| 38 | Saint Francis Medical Center Cpe Girardeau | E | $695.1M | $695.1M | $1.7B |
| 39 | St. Marys Health INC DBA Ascension Saint Louis | E | $689.6M | $689.6M | $394.1M |
| 40 | Mercy Hospital South Saint Louis | E | $664.0M | $661.3M | $515.8M |
| 41 | Columbia St. Marys Hospital Milwaukee INC Saint Louis | E | $662.7M | $662.4M | $501.6M |
| 42 | St. John Medical Center INC Saint Louis | E | $600.4M | $600.4M | $328.2M |
| 43 | Ewing Marion Kauffman Foundation Kansas City | B | $599.1M | $0 | $2.5B |
| 44 | Agnesian Healthcare INC Saint Louis | E | $584.7M | $584.4M | $743.4M |
| 45 | Mercy Clinic Springfield Communities Chesterfield | E | $562.9M | $562.9M | $39.8M |
| 46 | Compass Health INC Clinton | F | $557.6M | $557.2M | $432.9M |
| 47 | The Hagan Scholarship Foundation Columbia | B | $540.9M | $0 | $293.5M |
| 48 | Ascension Health Saint Louis | E | $525.8M | $233.0M | $292.9M |
| 49 | Saint Thomas Rutherford Hospital Saint Louis | E | $513.4M | $512.9M | $446.3M |
| 50 | St. Agnes Healthcare INC Saint Louis | E | $494.2M | $494.2M | $404.0M |