healthcosts.net

Ascension St. John Sapulpa (St. John Sapulpa, Inc.)

1004 E Bryan Ave, Sapulpa, OK · Ascension · · NPI 1922076603

Source: hospital's published price file ↗ · Published Jan 1, 2026 · Ingested Sep 8, 2026

Published prices by procedure

Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.

Procedure Cash price Gross charge Negotiated range Payers
Inj, abilify maintena, 1 mg HCPCS J0401 $2,488.27 $6,725.05 $3.40 – $3.40 5
Inj, bezlotoxumab, 10 mg HCPCS J0565 $46.58 $125.90 $54.26 – $58.14 5
Inj calcitriol per 0.1 mcg HCPCS J0636 $11.21 $30.30 $0.57 – $0.57 5
Inj ceftolozane tazobactam HCPCS J0695 $164.93 $445.75 $5.92 – $6.34 5
Inj, clevidipine butyrate HCPCS C9248 $17.45 $47.16 $3.40 – $6.67 6
Inj disk cerv-thor ea lev CPT 62291 not published not published $189.48 – $316.32 7
Inj dupuytren cord w/enzyme CPT 20527 not published not published $73.92 – $112.25 6
Inj dx for sinogram CPT 20501 $139.12 $376.00 $43.22 – $70.74 7
Injection arthrography hip without anesthesia (both sides) CPT 27093 $212.66 $574.75 $78.93 – $131.29 7
Injection, cangrelor HCPCS C9460 $19.75 $53.38 $21.38 – $22.91 5
Injection carpal tunnel therapeutic (both sides) CPT 20526 $424.02 $1,146.00 $64.28 – $105.44 7
Injection during cath supravalvular aortography CPT 93567 not published not published $59.79 – $91.16 6
Injection epidural blood patch or clot CPT 62273 $402.84 $1,088.75 $127.60 – $216.31 7
Injection eye drug CPT 67028 not published not published $109.39 – $189.79 7
Injection for arthrography wrist (both sides) CPT 25246 $175.29 $473.75 $85.03 – $139.46 7
Injection for bladder x-ray CPT 51600 $128.95 $348.50 $50.28 – $81.63 7
Injection for hip x-ray CPT 27095 $202.48 $547.25 $93.58 – $153.74 7
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 $141.06 $381.25 $57.68 – $95.23 7
Injection for spleen x-ray CPT 38200 not published not published $153.69 – $266.65 7
Injection for tear sac x-ray CPT 68850 not published not published $61.74 – $100.68 7
Injection for ureter x-ray CPT 50684 not published not published $56.16 – $92.52 7
Injection for ureter x-ray CPT 50690 $99.81 $269.75 $78.95 – $129.93 7
Injection, fulvestrant HCPCS J9395 $163.24 $441.20 $146.26 – $146.26 5
Injection glatiramer acetate HCPCS J1595 $272.52 $736.55 $146.26 – $146.26 5
Injection into brain canal CPT 61026 $459.45 $1,241.75 $116.83 – $239.44 7
Injection into brain canal CPT 61055 $421.43 $1,139.00 $136.82 – $253.74 7
Injection into hemorrhoid(s) CPT 46500 $193.05 $521.75 $131.02 – $242.18 7
Injection into spinal artery CPT 62294 not published not published $897.83 – $1,301.33 7
Injection into vocal cord CPT 31513 not published not published $146.85 – $248.29 7
Injection, isavuconazonium HCPCS J1833 $389.92 $1,053.85 $0.91 – $0.97 5
Injection jugular CPT 36299 not published not published $2,067.76 – $2,067.76 5
Injection of sinus tract CPT 20500 not published not published $92.47 – $159.18 7
Injection,onabotulinumtoxina HCPCS J0585 $17.91 $48.40 $5.46 – $15.60 6
Injection, peramivir HCPCS J2547 $9.71 $26.25 $2.27 – $2.43 5
Injection px peyronie ds CPT 54200 not published not published $92.00 – $1,076.07 7
Injection radioactive tracer sentinel node (both sides) CPT 38792 not published not published $43.87 – $74.83 7
Injection, renflexis HCPCS Q5104 $592.94 $1,602.55 $107.59 – $107.59 4
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 $543.53 $1,469.00 $79.37 – $367.25 6
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 $744.81 $2,013.00 $75.56 – $125.16 7
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 $1,110.37 $3,001.00 $50.36 – $84.34 7
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 $1,285.20 $3,473.50 $123.80 – $214.97 7
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 not published not published $67.80 – $115.65 6
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 $1,985.61 $5,366.50 $118.45 – $205.44 6
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 $349.28 $944.00 $58.41 – $98.64 6
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 $992.80 $2,683.25 $100.81 – $174.15 6
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 $660.73 $1,785.75 $123.44 – $212.94 6
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 $660.73 $1,785.75 $112.63 – $193.97 6
Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 $416.07 $1,124.50 $44.27 – $76.88 7
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 $263.90 $713.25 $41.98 – $71.43 7
Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 $319.77 $864.25 $46.70 – $80.27 7
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 $75.11 $203.00 $23.12 – $39.45 7
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 $75.48 $204.00 $15.56 – $135.00 6
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 $84.55 $228.50 $59.10 – $99.99 7
Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 $61.14 $165.25 $24.21 – $45.57 7
Injection torsemide 10 mg/ml HCPCS J3265 $16.02 $43.30 $15.60 – $15.60 5
Injection treatment of eye CPT 66020 not published not published $131.64 – $241.49 7
Injection treatment of eye CPT 66030 $2,911.53 $7,869.00 $109.53 – $208.16 7
Injection treatment of nerve CPT 64605 not published not published $383.97 – $631.95 7
Injection treatment of nerve CPT 64610 not published not published $536.06 – $889.77 7
Injection treatment of nerve CPT 64681 not published not published $246.44 – $376.86 7
Injection treatment of nose CPT 30200 not published not published $64.55 – $115.39 7
Inject sacroiliac joint CPT 27096 $170.57 $461.00 $81.94 – $160.54 7
Inject/treat eye socket CPT 67500 not published not published $80.29 – $112.15 7
Inject/treat eye socket CPT 67505 not published not published $82.54 – $112.15 7
Inject/treat eye socket CPT 67515 not published not published $90.04 – $172.78 7
Inj., emicizumab-kxwh 0.5 mg HCPCS J7170 $20,238.04 $54,697.40 $70.83 – $70.83 4
Inj epidural sgl cerv-thor without img CPT 62320 $516.89 $1,397.00 $114.44 – $197.47 6
Inj epidural sgl lumb-sacral without img CPT 62322 $520.31 $1,406.25 $98.47 – $170.07 6
Inj for ext venography CPT 36005 not published not published $54.98 – $91.16 7
Inj for mammo ductogram CPT 19030 $469.16 $1,268.00 $88.29 – $143.53 7
Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 not published not published $53.95 – $82.31 6
Inj hrt cath w/s&i sel hrt ang CPT 93563 not published not published $66.57 – $104.08 6
Inj hrt cath w/s&i sel hrt art CPT 93564 not published not published $69.93 – $106.13 6
Inj hrt cath w/s&i sel left vent CPT 93565 not published not published $51.68 – $80.27 6
Inj hrt cath w/s&i sel right vent CPT 93566 not published not published $52.78 – $80.27 6
Inj/inf neurolyt sbst spinal canal lesion 62282 CPT 62282 not published not published $156.09 – $271.43 7
Inj intralesional <= 7 lsn(s) CPT 11900 $159.19 $430.25 $34.89 – $58.50 7
Inj intralesional > 7 lsns CPT 11901 not published not published $54.22 – $90.48 7
Inj ivig privigen 500 mg HCPCS J1459 $520.15 $1,405.80 $38.66 – $73.06 6
Inj levocarnitine per 1 gm HCPCS J1955 $65.60 $177.30 $6.81 – $6.81 5
Inj mepivacaine hcl/10 ml HCPCS J0670 $19.37 $52.35 $15.60 – $15.60 5
Inj, moxifloxacin 100 mg HCPCS J2280 $73.08 $197.50 $15.60 – $15.60 5
Inj nephrosto/ureterogram w/img exstng access CPT 50431 $702.35 $1,898.25 $74.34 – $127.20 6
Inj peritoneal venous shunt CPT 49427 $47.55 $128.50 $52.15 – $85.03 7
Inj proc ankle arthr CPT 27648 $316.54 $855.50 $59.32 – $97.95 7
Inj proc elbow arthro CPT 24220 $302.66 $818.00 $77.53 – $127.89 7
Inj proc for lymphang CPT 38790 not published not published $92.58 – $154.41 7
Inj proc lumbr disk ea lvl CPT 62290 not published not published $191.02 – $328.56 7
Inj proc myelogram lumbar CPT 62284 $446.68 $1,207.25 $98.44 – $159.85 7
Inj proc sialogram CPT 42550 $130.24 $352.00 $71.83 – $117.00 7
Inj progesterone per 50 mg HCPCS J2675 $35.00 $94.60 $15.60 – $15.60 5
Inj retro urethrocysto CPT 51610 $111.28 $300.75 $71.95 – $118.36 7
Inj scleros sol mult veins CPT 36471 not published not published $112.34 – $190.47 7
Inj scleros sol sgl vein CPT 36470 $213.86 $578.00 $81.34 – $234.18 7
Inj secretin synthetic human HCPCS J2850 $610.89 $1,651.05 $20.31 – $73.06 6
Inj(s) sclerosant spider veins limb/trunk CPT 36468 not published not published $551.60 – $591.00 5
Inj testosterone cypionate HCPCS J1071 $32.30 $87.30 $0.06 – $0.06 5
Inj w/fluor eval cv device CPT 36598 not published not published $42.05 – $115.39 7
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln HCPCS J9229 $2,540.29 $6,865.65 $2,967.06 – $2,967.06 4
Ins cath ren art 1st bi CPT 36252 not published not published $412.52 – $686.37 6

A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.