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 |
|---|---|---|---|---|
| Delay flap fccnaxghf 15620 CPT 15620 | not published | not published | $335.45 – $604.74 | 7 |
| Delay flap trunk 15600 CPT 15600 | not published | not published | $211.75 – $382.98 | 7 |
| Delivery of placenta 59414 CPT 59414 | $1,017.13 | $2,749.00 | $103.98 – $172.79 | 7 |
| Delivery only failed vbac 59620 CPT 59620 | not published | not published | $1,058.73 – $1,787.01 | 7 |
| Delivery only/pp care/failed vbac 59622 CPT 59622 | not published | not published | $1,354.86 – $1,448.66 | 2 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $85.56 | $231.25 | $15.92 – $773.88 | 30 |
| Denervation of hip joint CPT 27035 | not published | not published | $1,181.88 – $1,871.37 | 7 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $2,257.70 | $6,101.90 | $46.95 – $46.95 | 5 |
| Dentoalveolar/drain abs/cyst/hema 41800 CPT 41800 | $223.76 | $604.75 | $122.61 – $490.44 | 30 |
| Depo-estradiol cypionate inj HCPCS J1000 | $17.80 | $48.10 | $19.78 – $19.78 | 5 |
| Dermabrasion other than face CPT 15782 | not published | not published | $435.61 – $736.71 | 7 |
| Dermabrasion segmental face 15781 CPT 15781 | not published | not published | $455.82 – $2,677.08 | 30 |
| Dermabrasion suprfl any site CPT 15783 | not published | not published | $380.04 – $1,520.16 | 30 |
| Dermabrasion total face CPT 15780 | not published | not published | $699.20 – $1,226.49 | 7 |
| Derma-fat-fascia graft 15770 CPT 15770 | not published | not published | $710.00 – $1,255.74 | 7 |
| Dermagraft HCPCS Q4106 | $67.62 | $182.75 | $61.35 – $61.35 | 5 |
| Derm autograft face/nck/hf/g CPT 15135 | not published | not published | $811.11 – $1,426.49 | 7 |
| Derm autograft trnk/arm/leg CPT 15130 | not published | not published | $605.50 – $1,046.22 | 7 |
| Descend thora aorta rpr/lt sub art 33880 CPT 33880 | not published | not published | $2,058.03 – $3,455.00 | 7 |
| Design custom breast implant CPT 19396 | not published | not published | $149.62 – $274.14 | 7 |
| Design mlc device for imrt CPT 77338 | $1,282.33 | $3,465.75 | $291.41 – $1,392.84 | 29 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $69.11 | $186.78 | $8.63 – $8.63 | 5 |
| Desoxycorticosterone CPT 82633 | not published | not published | $30.98 – $123.92 | 30 |
| Des thora aorta/ea add prox prosth 33884 CPT 33884 | not published | not published | $473.67 – $785.69 | 7 |
| Des thora aorta rpr without left sub art 33881 CPT 33881 | not published | not published | $1,767.33 – $2,965.22 | 7 |
| Des thor aorta/prox ext prosth/ini 33883 CPT 33883 | not published | not published | $1,280.69 – $2,144.84 | 7 |
| Dest mal lesion feenlm <0.5cm 17280 CPT 17280 | not published | not published | $96.72 – $756.04 | 30 |
| Dest mal lesion feenlm 0.6-1cm 17281 CPT 17281 | not published | not published | $135.45 – $756.04 | 30 |
| Dest mal lesion feenlm 1.1 - 2.0 cm 17282 CPT 17282 | not published | not published | $157.52 – $756.04 | 30 |
| Dest mal lesion snhfg <0.5cm 17270 CPT 17270 | not published | not published | $106.54 – $756.04 | 30 |
| Dest mal lesion snhfg 0.6-1cm 17271 CPT 17271 | not published | not published | $119.99 – $756.04 | 30 |
| Dest mal lesion snhfg 1.1-2cm 17272 CPT 17272 | not published | not published | $139.39 – $756.04 | 30 |
| Dest mal lesion tal <0.5 17260 CPT 17260 | not published | not published | $73.08 – $756.04 | 30 |
| Dest mal lesion tal 0.6-1.0cm 17261 CPT 17261 | not published | not published | $98.31 – $756.04 | 30 |
| Dest mal lesion tal 1.1-2.0cm 17262 CPT 17262 | not published | not published | $126.20 – $756.04 | 30 |
| Dest mal lesion tal 2.1-3.0cm 17263 CPT 17263 | not published | not published | $139.93 – $756.04 | 30 |
| Destroy cervthor facet jnt 64633 CPT 64633 | $2,998.30 | $8,103.50 | $251.13 – $414.96 | 6 |
| Destroy cth facet jnt addl 64634 CPT 64634 | $1,616.72 | $4,369.50 | $76.84 – $125.85 | 6 |
| Destroy internal hemorrhoids destroy 46930 CPT 46930 | $693.94 | $1,875.50 | $159.51 – $274.82 | 7 |
| Destroy premlg lesns;1st lesn 17000 CPT 17000 | $79.64 | $215.25 | $57.60 – $756.04 | 30 |
| Destroy vulva lesion extensive 56515 CPT 56515 | not published | not published | $221.71 – $373.46 | 7 |
| Destroy vulva lesion simple 56501 CPT 56501 | $106.47 | $287.75 | $125.58 – $214.97 | 7 |
| Destruct ben lesion 15/> 17111 CPT 17111 | not published | not published | $89.78 – $756.04 | 30 |
| Destruct cut vasl lesions 10-50cm 17107 CPT 17107 | not published | not published | $380.63 – $2,329.08 | 30 |
| Destruct cut vasl lesions <10cm 17106 CPT 17106 | not published | not published | $303.49 – $1,520.16 | 30 |
| Destruct cut vasl lesions >50cm 17108 CPT 17108 | not published | not published | $524.17 – $975.48 | 7 |
| Destruction 2-14 lesions 17003 CPT 17003 | not published | not published | $2.71 – $8.16 | 7 |
| Destruction anal lesion(s) CPT 46910 | not published | not published | $141.56 – $251.70 | 7 |
| Destruction anal lesion(s) CPT 46924 | not published | not published | $198.57 – $345.57 | 7 |
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | not published | not published | $147.56 – $1,520.16 | 30 |
| Destruction benign lesions < 14 lesions CPT 17110 | $104.90 | $283.50 | $71.54 – $756.04 | 30 |
| Destruction by injection tx of nerve 64630 CPT 64630 | not published | not published | $212.59 – $3,387.44 | 30 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | $1,616.72 | $4,369.50 | $67.08 – $110.88 | 6 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | $2,998.30 | $8,103.50 | $247.60 – $408.83 | 6 |
| Destruction ciliary body CPT 66700 | not published | not published | $395.75 – $730.59 | 7 |
| Destruction ciliary body CPT 66720 | not published | not published | $414.45 – $792.50 | 7 |
| Destruction ciliary body CPT 66740 | not published | not published | $396.25 – $723.78 | 7 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | not published | not published | $154.35 – $756.04 | 30 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | not published | not published | $142.54 – $250.34 | 7 |
| Destruction les conjunctiva CPT 68135 | not published | not published | $152.03 – $284.34 | 7 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | $157.59 – $1,520.16 | 30 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | $193.86 – $1,520.16 | 30 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | not published | not published | $149.65 – $1,520.16 | 30 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | not published | not published | $174.67 – $1,520.16 | 30 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | not published | not published | $114.43 – $1,520.16 | 30 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | $191.03 – $321.77 | 7 |
| Destruction premal lesions 15/> 17004 CPT 17004 | not published | not published | $109.47 – $1,520.16 | 30 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $729.70 – $1,286.36 | 7 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $192.01 – $322.44 | 7 |
| Destruction vag lesions simple 57061 CPT 57061 | not published | not published | $106.97 – $182.99 | 7 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $102.05 – $170.75 | 7 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $21.11 – $120.12 | 30 |
| Detect agnt mult dna direc CPT 87800 | not published | not published | $42.21 – $174.68 | 30 |
| Developmental screen/score/document 96110 CPT 96110 | $76.59 | $207.00 | $9.70 – $12.47 | 2 |
| Devel tst phys/qhp 1st hr CPT 96112 | not published | not published | $148.83 – $595.32 | 23 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $80.11 | $216.50 | $13.40 – $335.00 | 30 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $8.88 | $24.00 | $0.60 – $0.60 | 5 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $9.25 | $25.00 | $0.18 – $0.18 | 5 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $240.74 | $650.65 | $185.43 – $185.43 | 5 |
| Dextran 40 infusion HCPCS J7100 | $34.02 | $91.95 | $19.78 – $19.78 | 5 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $31.45 | $85.00 | $19.78 – $19.78 | 5 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $48.56 | $131.25 | $19.78 – $19.78 | 5 |
| Dextrose 5 % IV bolus HCPCS J7070 | $48.58 | $131.29 | $19.78 – $19.78 | 5 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $75.48 | $204.00 | $22.23 – $88.92 | 30 |
| Diabetes (HbA1c) Test CPT 83036 | $137.09 | $370.50 | $9.71 – $38.84 | 30 |
| Diab manage trn ind/group HCPCS G0109 | $21.28 | $57.50 | $14.24 – $49.56 | 7 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $200.94 – $336.72 | 7 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $359.39 – $608.15 | 7 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $105.51 – $1,518.28 | 24 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $142.96 – $142.96 | 1 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $93.89 | $253.75 | $42.00 – $490.44 | 30 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $95.83 | $259.00 | $53.65 – $738.68 | 30 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $229.40 | $620.00 | $74.31 – $738.68 | 30 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $208.87 | $564.50 | $96.50 – $386.00 | 29 |
| Diagnostic Mammogram (one breast) CPT 77065 | $161.69 | $437.00 | $75.75 – $303.00 | 29 |
| Diagnostic radio unlisted proc CPT 76499 | $59.39 | $160.50 | $80.25 – $335.00 | 29 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $14,037.62 | $37,939.50 | $201.81 – $347.87 | 6 |
| Dialysis one evaluation CPT 90945 | $532.43 | $1,439.00 | $84.70 – $1,620.20 | 30 |
| Diathermy eg microwave CPT 97024 | not published | not published | $6.30 – $26.12 | 30 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $101.58 | $274.55 | $0.12 – $0.12 | 5 |
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.