Ascension St. John Medical Center (St. John Medical Center, Inc.)
1923 S Utica Ave, Tulsa, OK · Ascension · · NPI 1154417368
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | not published | not published | $29.28 – $117.12 | 30 |
| 17-hydroxypregnenolone CPT 84143 | not published | not published | $22.81 – $91.24 | 30 |
| 17-ketosteroids CPT 83586 | not published | not published | $12.80 – $51.20 | 30 |
| 1st hosp/birthing center care per day nml nb 99460 CPT 99460 | not published | not published | $69.88 – $490.32 | 25 |
| 1st inpatient critical care pr day age 28 days/less than 99468 CPT 99468 | not published | not published | $1,079.77 – $1,099.63 | 2 |
| 24 hr ambulatory b/p monitor CPT 93786 | not published | not published | $30.19 – $490.44 | 30 |
| 2nd order venous cath CPT 36012 | $492.10 | $1,330.00 | $198.68 – $335.37 | 7 |
| 3-d radiotherapy plan CPT 77295 | $1,942.50 | $5,250.00 | $274.16 – $922.76 | 7 |
| 3d recon without postprocess indpndt CPT 76376 | $67.25 | $181.75 | $13.15 – $120.12 | 7 |
| 5' nucleotidase - sendout CPT 83915 | $38.94 | $105.25 | $11.15 – $44.60 | 30 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $36.45 | $98.50 | $19.77 – $136.50 | 7 |
| 99381 initial comp preventive med less than 1 year new CPT 99381 | not published | not published | $73.60 – $149.36 | 7 |
| 99382 initial comp preventive med 1 to 4 years new CPT 99382 | not published | not published | $83.97 – $157.90 | 7 |
| 99383 initial comp preventive med 5 to 11 years new CPT 99383 | not published | not published | $83.97 – $167.85 | 7 |
| 99391 periodic comp preventive med less than 1 year est CPT 99391 | not published | not published | $62.95 – $135.85 | 7 |
| 99392 periodic comp preventive med 1 to 4 years est CPT 99392 | not published | not published | $73.60 – $149.36 | 7 |
| 99393 periodic comp preventive med 5 to 11 years est CPT 99393 | not published | not published | $73.60 – $149.36 | 7 |
| 99394 periodic comp preventive med 12 to 17 years est CPT 99394 | not published | not published | $83.97 – $167.85 | 7 |
| 99397 periodic comp preventive med 65+ years est CPT 99397 | not published | not published | $105.85 – $198.44 | 7 |
| Aa graft w/bp/aortic root replace 33863 CPT 33863 | not published | not published | $3,580.73 – $5,967.15 | 7 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $59.44 | $160.65 | $19.78 – $19.78 | 5 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $75.85 | $205.00 | $12.01 – $48.04 | 30 |
| Abciximab injection HCPCS J0130 | $1,084.06 | $2,929.90 | $648.99 – $648.99 | 5 |
| Abd aorta w/runoff s&i CPT 75630 | $2,149.24 | $5,808.75 | $83.00 – $385.33 | 7 |
| Abd exp/postop hem/throm/infec 35840 CPT 35840 | not published | not published | $749.91 – $2,240.07 | 7 |
| Abd/low ext cath 1st CPT 36245 | $1,903.10 | $5,143.50 | $273.71 – $457.13 | 7 |
| Abd/low ext cath 2nd CPT 36246 | $1,938.43 | $5,239.00 | $292.85 – $508.14 | 7 |
| Abd/low ext cath 3rd CPT 36247 | $1,903.10 | $5,143.50 | $348.48 – $607.47 | 7 |
| Abd/low ext cath addl CPT 36248 | $502.28 | $1,357.50 | $56.31 – $96.60 | 7 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $1,093.17 | $2,954.50 | $88.13 – $677.36 | 30 |
| Abdominal CT scan (with contrast) CPT 74160 | $1,019.81 | $2,756.25 | $80.44 – $677.36 | 30 |
| Abdominal CT scan (without contrast) CPT 74150 | $954.97 | $2,581.00 | $74.80 – $404.60 | 30 |
| Abdominal MRI (with and without contrast) CPT 74183 | $1,188.35 | $3,211.75 | $141.98 – $1,358.84 | 30 |
| Abdominal MRI (with contrast) CPT 74182 | $954.14 | $2,578.75 | $108.97 – $1,358.84 | 30 |
| Abdominal MRI (without contrast) CPT 74181 | $979.02 | $2,646.00 | $91.74 – $919.72 | 30 |
| Abdominal paracentesis w/image guidance CPT 49083 | $1,165.69 | $3,150.50 | $122.92 – $3,567.32 | 29 |
| Abdominal Ultrasound (complete) CPT 76700 | $526.79 | $1,423.75 | $50.71 – $404.60 | 30 |
| Abdominal Ultrasound (limited) CPT 76705 | $362.60 | $980.00 | $37.31 – $404.60 | 30 |
| Abdominoplasty 15830 CPT 15830 | not published | not published | $1,282.24 – $2,172.72 | 7 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $881.16 | $2,381.50 | $83.32 – $3,567.32 | 29 |
| Abl1 gene CPT 81170 | $328.67 | $888.30 | $300.00 – $1,200.00 | 29 |
| Ablate arrhythmia add on CPT 93655 | $16,109.25 | $43,538.50 | $483.18 – $11,094.00 | 7 |
| Ablate atria lmtd endo 33265 CPT 33265 | not published | not published | $1,532.67 – $2,565.23 | 7 |
| Ablate atria w/bypass exten 33256 CPT 33256 | not published | not published | $2,199.49 – $3,691.71 | 7 |
| Ablate atria x10sv add-on 33258 CPT 33258 | not published | not published | $735.84 – $767.79 | 2 |
| Ablate atria x10sv endo 33266 CPT 33266 | not published | not published | $2,088.94 – $3,502.61 | 7 |
| Ablate bone tumor(s) cryo perq 20983 CPT 20983 | $7,143.04 | $19,305.50 | $417.74 – $11,709.15 | 6 |
| Ablate bone tumor(s) perq CPT 20982 | $6,487.77 | $17,534.50 | $417.29 – $705.42 | 7 |
| Ablate heart dysrhythm focus CPT 93650 | $3,877.79 | $10,480.50 | $669.25 – $11,094.00 | 8 |
| Ablate inf turbinate submuc 30802 CPT 30802 | not published | not published | $199.66 – $354.41 | 7 |
| Ablate inf turbinate superf 30801 CPT 30801 | not published | not published | $137.59 – $146.29 | 7 |
| Ablate pulm tumor perq rf CPT 32998 | $6,899.39 | $18,647.00 | $321.92 – $541.49 | 7 |
| Ablation cardiac vagal inputs atrium CPT 93799 | $5,454.73 | $14,742.50 | $148.83 – $595.32 | 29 |
| Ablation cryo abd perit om CPT 49999 | $2,576.13 | $6,962.50 | $891.83 – $3,567.32 | 29 |
| Ablation cryo adrenal tumor CPT 60699 | $2,897.47 | $7,831.00 | $3,915.50 – $6,212.94 | 6 |
| Ablation cryo pq chest wall tumor(s) w/guid CPT 23929 | not published | not published | $228.18 – $5,659.99 | 28 |
| Ablation cryo pq liver tumor(s) CPT 47383 | $5,790.50 | $15,650.00 | $516.06 – $12,901.62 | 6 |
| Ablation cryo retro lymph node CPT 38999 | not published | not published | $306.38 – $6,212.94 | 29 |
| Ablation cryo thigh/knee CPT 27599 | not published | not published | $228.18 – $5,659.99 | 28 |
| Ablation of upper extremity nerves rf CPT 64999 | not published | not published | $280.79 – $2,241.74 | 29 |
| Abortion CPT 59850 | not published | not published | $424.31 – $646.92 | 7 |
| Abortion (mpr) CPT 59866 | not published | not published | $242.86 – $1,157.40 | 30 |
| Abrasion lesions add-on CPT 15787 | not published | not published | $19.20 – $33.33 | 7 |
| Abrasion lesion single CPT 15786 | not published | not published | $150.65 – $756.04 | 30 |
| Abscess drain retroperitoneal surg code CPT 49406 | $864.04 | $2,335.25 | $226.78 – $387.06 | 6 |
| Access thoracic lymph duct CPT 38794 | not published | not published | $333.63 – $548.28 | 7 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $23.24 | $62.80 | $1.84 – $1.84 | 5 |
| Acetaminophen level CPT 80143 | not published | not published | $18.64 – $74.56 | 24 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $50.27 | $135.86 | $40.76 – $40.76 | 5 |
| Acetone qualitative CPT 82009 | $40.15 | $108.50 | $4.52 – $18.08 | 30 |
| Acetylcholine receptor modulating antibody CPT 86043 | not published | not published | $12.05 – $48.20 | 23 |
| Acetylcholinesterase assay CPT 82013 | not published | not published | $11.73 – $49.16 | 30 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $320.66 | $866.65 | $8.63 – $8.63 | 5 |
| Acid perfusion of esophagus CPT 91030 | not published | not published | $60.58 – $2,018.88 | 30 |
| Acne surgery 10040 CPT 10040 | $81.96 | $221.50 | $95.13 – $756.04 | 30 |
| Aco ccm; at least 20 min 99490aco CPT 99490 | $68.54 | $185.25 | $35.65 – $351.96 | 29 |
| Aco cmplx chron care addl 20 min 99489aco CPT 99489 | not published | not published | $29.01 – $78.24 | 6 |
| Aco cmplx chron care without pt visit, 60 min 99487aco CPT 99487 | $86.03 | $232.50 | $57.66 – $611.32 | 29 |
| Aco cont gluc mnt phys/qhp eqp 95250aco CPT 95250 | $148.56 | $401.50 | $122.58 – $490.32 | 30 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $37.00 | $100.00 | $15.55 – $62.20 | 30 |
| Acoustic immitance testing CPT 92570 | not published | not published | $33.20 – $595.32 | 29 |
| Acoustic refl threshold tst CPT 92568 | not published | not published | $17.22 – $149.36 | 30 |
| Acromp/acromionectomy prtl CPT 23130 | not published | not published | $653.02 – $1,119.02 | 7 |
| Actigraphy testing CPT 95803 | not published | not published | $56.50 – $226.00 | 29 |
| Actinotherapy uv light CPT 96900 | not published | not published | $21.20 – $149.36 | 30 |
| Acup 1/> w/estim 1st 15 min CPT 97813 | not published | not published | $23.30 – $93.20 | 30 |
| Acup 1/> wo estim 1st 15 min CPT 97810 | not published | not published | $23.30 – $93.20 | 30 |
| Acute hepatitis panel CPT 80074 | $125.62 | $339.50 | $47.63 – $190.52 | 30 |
| Acute venous thrombus image CPT 78456 | not published | not published | $66.40 – $634.68 | 7 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $11.99 | $32.40 | $1.84 – $1.84 | 5 |
| #acylcarnitineprfl CPT 82017 | $250.95 | $678.25 | $16.87 – $67.48 | 30 |
| Acylcarnitines qual CPT 82016 | not published | not published | $14.59 – $65.96 | 30 |
| Adapt behavior tx phys/qhp CPT 97155 | not published | not published | $152.83 – $611.32 | 23 |
| Adding walker to prev cast CPT 29440 | not published | not published | $32.59 – $600.36 | 30 |
| Adenovirus ag ia CPT 87301 | not published | not published | $11.98 – $47.92 | 30 |
| Adenovirus antibody,serum - quest CPT 86603 | $25.72 | $69.50 | $12.87 – $51.48 | 30 |
| Adenovirus assay w/optic CPT 87809 | not published | not published | $12.77 – $87.04 | 30 |
| Adhesiolysis tube ovary 58740 CPT 58740 | not published | not published | $978.63 – $1,654.37 | 7 |
| Adh-sendout CPT 84588 | $86.03 | $232.50 | $33.94 – $135.76 | 30 |
| Adj gastric band via subq port CPT 43999 | not published | not published | $891.83 – $3,567.32 | 28 |
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.