Ascension St. John Sapulpa (St. John Sapulpa, Inc.)
1004 E Bryan Ave, Sapulpa, OK · Ascension · · NPI 1922076603
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 |
|---|---|---|---|---|
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $407.46 | $1,101.25 | $42.81 – $337.41 | 7 |
| Leishmania antibody CPT 86717 | not published | not published | $11.38 – $22.32 | 7 |
| Lengthening of hand tendon CPT 26478 | not published | not published | $655.11 – $1,122.42 | 7 |
| Lengthening of palate CPT 42227 | not published | not published | $935.02 – $1,577.51 | 7 |
| Lengthening of palate+pharyngeal flap 42226 CPT 42226 | not published | not published | $992.00 – $1,681.58 | 7 |
| Lengthening of thigh tendon CPT 27393 | not published | not published | $548.32 – $937.38 | 7 |
| Lengthening of thigh tendons CPT 27394 | not published | not published | $698.85 – $1,199.28 | 7 |
| Lengthening of thigh tendons CPT 27395 | not published | not published | $966.35 – $1,615.59 | 7 |
| Lengthening or shortening - tibia and fibula 27715 CPT 27715 | not published | not published | $1,163.92 – $1,962.53 | 7 |
| Lengthen metacarpal/finger CPT 26568 | not published | not published | $947.07 – $1,631.92 | 7 |
| Lengthen radius or ulna CPT 25391 | not published | not published | $1,099.71 – $1,832.60 | 7 |
| Lengthen radius & ulna CPT 25393 | not published | not published | $1,239.94 – $2,080.89 | 7 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $2,026.49 | $5,477.00 | $198.61 – $825.00 | 6 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $269.71 | $728.95 | $198.61 – $198.61 | 1 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $115.27 | $311.55 | $7.31 – $7.31 | 5 |
| Leukacyte transfusion CPT 86950 | not published | not published | $33.88 – $589.50 | 6 |
| Leukocyte phagocytosis CPT 86344 | not published | not published | $8.34 – $19.44 | 7 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $8,124.05 | $21,956.90 | $146.26 – $214.57 | 6 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $4,175.52 | $11,285.20 | $511.90 – $511.90 | 5 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $0.11 | $0.31 | $0.21 – $0.23 | 5 |
| Levetiracetam therapeutic drug level CPT 80177 | $70.39 | $190.25 | $20.63 – $32.02 | 6 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $34.00 | $91.90 | $15.60 – $15.60 | 5 |
| Lidocaine therapeutic drug level CPT 80176 | $59.29 | $160.25 | $15.37 – $35.73 | 7 |
| Ligate leg veins open CPT 37761 | not published | not published | $620.58 – $1,046.91 | 6 |
| Ligate leg veins radical 37760 CPT 37760 | not published | not published | $696.71 – $1,161.87 | 7 |
| Ligate oviduct(s) add-on 58611 CPT 58611 | not published | not published | $85.77 – $146.94 | 7 |
| Ligate/strip long leg vein CPT 37722 | not published | not published | $540.00 – $921.74 | 7 |
| Ligate/strip short leg vein CPT 37718 | not published | not published | $484.52 – $839.43 | 7 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | not published | not published | $398.92 – $687.06 | 7 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | $1,044.33 | $2,822.50 | $227.50 – $393.87 | 7 |
| Ligation/divis of long saph vein 37700 CPT 37700 | not published | not published | $278.76 – $479.58 | 7 |
| Ligation external carotid artery 37600 CPT 37600 | not published | not published | $803.28 – $1,342.82 | 7 |
| Ligation internal/common carotid artery 37605 CPT 37605 | not published | not published | $897.34 – $1,541.44 | 7 |
| Ligation internal jugular vein 37565 CPT 37565 | not published | not published | $817.14 – $1,442.13 | 7 |
| Ligation/major artery/extremity 37618 CPT 37618 | $1,044.42 | $2,822.75 | $430.20 – $735.35 | 7 |
| Ligation major artery neck CPT 37615 | not published | not published | $548.94 – $969.36 | 7 |
| Ligation nasal sinus artery CPT 30915 | not published | not published | $622.50 – $1,074.80 | 7 |
| Ligation of abdomen artery 37617 CPT 37617 | not published | not published | $1,518.64 – $2,531.89 | 7 |
| Ligation of femoral vein CPT 37650 | not published | not published | $527.21 – $887.73 | 7 |
| Ligation of inf vena cava CPT 37619 | not published | not published | $1,873.07 – $3,197.18 | 6 |
| Ligation of neck artery CPT 37606 | not published | not published | $585.65 – $1,080.24 | 7 |
| Ligation of salivary duct CPT 42665 | not published | not published | $226.50 – $392.50 | 7 |
| Ligation upper jaw artery CPT 30920 | not published | not published | $901.35 – $1,557.09 | 7 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | $3,071.93 | $8,302.50 | $293.67 – $499.98 | 7 |
| Lig/band angioaccess av fistula CPT 37607 | not published | not published | $424.85 – $722.43 | 7 |
| Lig&div&compl strpg saph vn CPT 37735 | not published | not published | $666.43 – $1,223.09 | 7 |
| Limb exercise test CPT 95875 | not published | not published | $40.42 – $229.92 | 7 |
| Limited visual field xm CPT 92081 | not published | not published | $17.97 – $62.58 | 7 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $64.58 | $174.54 | $32.15 – $32.15 | 5 |
| Lipase CPT 83690 | $44.68 | $120.75 | $7.30 – $16.75 | 7 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $388.09 – $666.64 | 7 |
| Lipoprotein blood high res frac & quant CPT 83701 | not published | not published | $26.06 – $60.39 | 7 |
| Lipoprotein blood quant CPT 83704 | $40.05 | $108.25 | $33.35 – $76.74 | 7 |
| Lipoprotein direct measurement hdl CPT 83718 | $36.72 | $99.25 | $8.60 – $19.93 | 7 |
| Lipoprotein direct measurement ldl CPT 83721 | $29.79 | $80.50 | $10.16 – $23.20 | 7 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $36.82 – $38.81 | 5 |
| Lip surgery procedure CPT 40799 | not published | not published | $3,050.83 – $3,050.83 | 5 |
| Listeria monocytogenes CPT 86723 | not published | not published | $13.81 – $32.09 | 7 |
| Lithium therapeutic drug level CPT 80178 | $45.51 | $123.00 | $7.04 – $16.09 | 7 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | $1,297.06 – $2,229.86 | 7 |
| Liver elastography 91200 CPT 91200 | not published | not published | $25.15 – $63.27 | 6 |
| Liver Function Test CPT 80076 | $44.31 | $119.75 | $8.60 – $19.88 | 7 |
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | $1,546.03 – $2,682.22 | 7 |
| Liver imaging CPT 78201 | not published | not published | $27.20 – $331.96 | 7 |
| Liver imag w/vasclr flow CPT 78202 | not published | not published | $31.67 – $365.30 | 7 |
| Liver/spleen imag static only CPT 78215 | not published | not published | $30.74 – $348.29 | 7 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $35.68 – $221.76 | 7 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $79.04 – $131.29 | 7 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $511.34 – $863.24 | 7 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $1.55 | $4.20 | $1.74 – $1.86 | 5 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $13.56 | $36.65 | $15.60 – $15.60 | 5 |
| Loudness balance test CPT 92562 | not published | not published | $24.29 – $83.67 | 7 |
| Low back disk surgery CPT 63030 | not published | not published | $1,045.75 – $1,775.46 | 7 |
| Low cost skin substitute app HCPCS C5273 | $2,147.57 | $5,804.25 | $3,116.95 – $3,116.95 | 5 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $715.30 | $1,933.25 | $80.04 – $557.13 | 7 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $902.80 | $2,440.00 | $77.00 – $467.32 | 7 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $843.69 | $2,280.25 | $73.00 – $373.45 | 7 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $1,396.84 | $3,775.25 | $147.87 – $980.24 | 7 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $1,054.87 | $2,851.00 | $112.11 – $840.11 | 7 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $924.82 | $2,499.50 | $92.97 – $667.32 | 7 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $148.46 | $401.25 | $13.80 – $65.31 | 7 |
| Lower jaw bone graft CPT 21215 | not published | not published | $941.97 – $1,694.51 | 7 |
| Low frequency non-thermal Ultrasound CPT 97610 | $182.78 | $494.00 | $17.85 – $592.99 | 6 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $791.97 – $1,630.56 | 7 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $914.31 – $1,851.64 | 7 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $905.34 – $1,822.39 | 7 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $997.27 – $2,006.06 | 7 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $23.19 – $53.49 | 7 |
| Lumbar diskogram s&i CPT 72295 | not published | not published | $51.04 – $186.39 | 7 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $1,758.47 – $2,936.64 | 7 |
| Lung function test (mbc/mvv) CPT 94200 | $69.75 | $188.50 | $6.65 – $45.57 | 7 |
| Lung Function Test (Spirometry) CPT 94010 | $99.16 | $268.00 | $10.26 – $65.31 | 7 |
| Lung perfusion imaging CPT 78580 | not published | not published | $46.74 – $425.16 | 7 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $1,656.82 – $2,761.14 | 7 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $36.46 – $60.54 | 7 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $783.21 – $1,297.23 | 7 |
| Lymphatics/lymph node imaging CPT 78195 | not published | not published | $75.96 – $640.11 | 7 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $59.67 – $137.37 | 7 |
| Lymphocyte transformation mitogen CPT 86353 | $95.55 | $258.25 | $51.60 – $119.28 | 7 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $55.24 – $127.23 | 7 |
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.