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 |
|---|---|---|---|---|
| Fusion of spermatic ducts CPT 54901 | not published | not published | $1,189.12 – $1,923.06 | 7 |
| Fusion of tendons at wrist CPT 25300 | not published | not published | $741.14 – $1,264.59 | 7 |
| Fusion of tendons at wrist CPT 25301 | not published | not published | $704.94 – $1,180.92 | 7 |
| Fusion of thumb CPT 26841 | not published | not published | $767.29 – $1,318.32 | 7 |
| Fusion of tibiofibular joint CPT 27871 | not published | not published | $753.82 – $1,272.08 | 7 |
| Fusion of toes CPT 28280 | not published | not published | $387.44 – $659.16 | 7 |
| G6pc gene CPT 81250 | $314.78 | $850.75 | $58.49 – $233.96 | 29 |
| G6pd full gene sequence CPT 81249 | not published | not published | $600.00 – $2,400.00 | 29 |
| G6pd gene alys cmn variant CPT 81247 | not published | not published | $174.81 – $699.24 | 29 |
| G6pd known familial variant CPT 81248 | not published | not published | $375.25 – $1,501.00 | 29 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | $45.33 | $122.50 | $69.92 – $69.92 | 5 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $0.74 | $2.00 | $0.57 – $0.57 | 5 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $9.25 | $25.00 | $2.72 – $2.72 | 5 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $2.16 | $5.85 | $0.59 – $0.59 | 5 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $31.52 | $85.20 | $18.70 – $18.70 | 5 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | $96.94 | $262.00 | $21.07 – $84.28 | 30 |
| Galactokinase - sendout CPT 82759 | not published | not published | $21.48 – $85.92 | 30 |
| Galactose transferase test CPT 82776 | not published | not published | $8.86 – $46.96 | 30 |
| Galectin-3 CPT 82777 | not published | not published | $34.24 – $177.00 | 29 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $735.82 – $1,219.01 | 7 |
| Gamma globulin 1 cc inj HCPCS J1460 | $29.56 | $79.90 | $19.78 – $19.78 | 5 |
| Gammaglobulin iga CPT 82784 | $72.15 | $195.00 | $9.30 – $37.20 | 30 |
| Gammaglobulin ige CPT 82785 | $58.18 | $157.25 | $16.46 – $65.84 | 30 |
| Gamma glutamyltransferase CPT 82977 | $49.03 | $132.50 | $7.20 – $28.80 | 30 |
| Gamunex-c/gammaked HCPCS J1561 | $140.60 | $380.00 | $185.43 – $185.43 | 5 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $131.15 | $354.45 | $92.63 – $92.63 | 5 |
| Gardner vag dna quant CPT 87512 | $63.27 | $171.00 | $19.90 – $167.04 | 30 |
| Gastric analy w/ph ea spec CPT 82930 | not published | not published | $6.71 – $26.84 | 29 |
| Gastric emptying imag study CPT 78265 | $585.53 | $1,582.50 | $333.80 – $1,528.92 | 29 |
| Gastric emptying imag study CPT 78266 | not published | not published | $429.72 – $2,048.04 | 29 |
| Gastric motility studies CPT 91020 | not published | not published | $93.89 – $2,018.88 | 30 |
| Gastric mucosa imaging CPT 78261 | not published | not published | $43.60 – $1,528.92 | 30 |
| Gastrin test CPT 82938 | not published | not published | $17.69 – $70.76 | 30 |
| Gastroesophageal reflux study CPT 78262 | $395.62 | $1,069.25 | $42.33 – $1,528.92 | 30 |
| Gastroesophageal reflux test CPT 91034 | not published | not published | $63.58 – $2,018.88 | 30 |
| Gastrojejunostomy;w/o vagotomy 43820 CPT 43820 | not published | not published | $1,427.07 – $2,485.64 | 7 |
| Gastrostomy open neonatal CPT 43831 | not published | not published | $622.06 – $3,567.32 | 30 |
| Gated heart multiple CPT 78473 | not published | not published | $96.59 – $1,528.92 | 30 |
| Gba gene CPT 81251 | not published | not published | $47.25 – $508.71 | 29 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $184.50 | $498.65 | $19.78 – $19.78 | 5 |
| Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 | $10,030.70 | $27,110.00 | $260.22 – $278.81 | 5 |
| General health panel CPT 80050 | $161.14 | $435.50 | $29.19 – $114.83 | 6 |
| Genetic tstg severe inh cond CPT 81443 | $1,358.64 | $3,672.00 | $2,779.12 – $2,779.12 | 1 |
| Genioplasty augmentation CPT 21120 | not published | not published | $518.75 – $920.39 | 7 |
| Geniop sldg augmentation CPT 21123 | not published | not published | $933.88 – $1,623.08 | 7 |
| Geniop sldg osteot 1 CPT 21121 | not published | not published | $702.73 – $1,183.64 | 7 |
| Geniop sldg osteot 2/> CPT 21122 | not published | not published | $725.34 – $1,299.29 | 7 |
| Genome sequence analysis CPT 81425 | not published | not published | $5,710.41 – $5,710.41 | 1 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $10.93 | $29.55 | $19.78 – $19.78 | 5 |
| Gentamicin peak therapeutic drug level CPT 80170 | $88.43 | $239.00 | $16.38 – $65.52 | 30 |
| G-esoph reflx tst w/electrod CPT 91035 | not published | not published | $103.81 – $2,018.88 | 30 |
| Ghs abscess perianal iandd CPT 46050 | $1,410.90 | $3,813.25 | $98.31 – $3,468.96 | 30 |
| Ghs abscess postoperative iandd complex CPT 10180 | $1,244.68 | $3,364.00 | $190.85 – $329.93 | 7 |
| Ghs acetylcholinesterase, rbc CPT 82482 | $44.12 | $119.25 | $8.08 – $39.24 | 30 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $103.14 | $278.75 | $16.94 – $68.44 | 30 |
| Ghs alpha thalasemia, 7 deletions CPT 81257 | $213.03 | $575.75 | $102.26 – $422.60 | 29 |
| Ghs analysis neurostim without reprogramming CPT 95970 | $62.72 | $169.50 | $26.98 – $490.44 | 30 |
| Ghs antibodies (torch) igm CPT 86694 | $49.03 | $132.50 | $14.39 – $57.56 | 30 |
| Ghs aspiration bladder - needle CPT 51100 | not published | not published | $44.41 – $925.40 | 30 |
| Ghs bladder cath - complex-foley CPT 51703 | $190.55 | $515.00 | $86.94 – $595.32 | 30 |
| Ghs bleeding time (ivy) CPT 85002 | not published | not published | $4.69 – $19.28 | 30 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | $1,147.19 | $3,100.50 | $104.82 – $2,634.96 | 30 |
| Ghs central line insert < age 5, failed CPT 36555 | $1,030.45 | $2,785.00 | $122.11 – $225.84 | 7 |
| Ghs change cysto/gastrost CPT 43762 | $413.29 | $1,117.00 | $231.35 – $925.40 | 27 |
| Ghs chemo >8 hrs CPT 96416 | $187.13 | $505.75 | $142.25 – $1,262.04 | 30 |
| Ghs chemo infusion >8 hrs CPT 96425 | $156.60 | $423.25 | $186.65 – $1,262.04 | 30 |
| Ghs chemo IV push, ea addtl CPT 96411 | $76.87 | $207.75 | $64.22 – $270.80 | 30 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $164.84 | $445.50 | $35.09 – $140.36 | 30 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $223.76 | $604.75 | $228.18 – $912.72 | 30 |
| Ghs closed reduction ankle dislocation CPT 27840 | $541.96 | $1,464.75 | $228.18 – $912.72 | 30 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | $2,628.48 | $7,104.00 | $456.82 – $790.46 | 7 |
| Ghs closed tx radiocarpal disloc w manip CPT 25660 | not published | not published | $228.18 – $912.72 | 30 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | $2,856.96 | $7,721.50 | $529.67 – $914.25 | 7 |
| Ghs closure surg wound/dehiscence-13160 CPT 13160 | $2,433.40 | $6,576.75 | $886.96 – $1,501.31 | 7 |
| Ghs clsd red med malleolus fx without manip CPT 27760 | $404.41 | $1,093.00 | $228.18 – $912.72 | 30 |
| Ghs clsd red med malleolus fx w manip CPT 27762 | $3,066.01 | $8,286.50 | $466.35 – $803.37 | 7 |
| Ghs clsd tx frac distal tibia w/manipulation CPT 27825 | $3,347.95 | $9,048.50 | $539.50 – $909.50 | 7 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | $603.19 | $1,630.25 | $228.18 – $912.72 | 30 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | $393.40 | $1,063.25 | $228.18 – $912.72 | 30 |
| Ghs community re-entry 15 minutes CPT 97537 | $42.55 | $115.00 | $29.91 – $119.64 | 30 |
| Ghs conjunctiva foreign body-embed bil CPT 65210 | $696.71 | $1,883.00 | $56.50 – $1,518.28 | 30 |
| Ghs conjunctiva foreign body-superf bil CPT 65205 | $187.41 | $506.50 | $46.92 – $490.44 | 30 |
| Ghs corneal fb without slit lamp bilat CPT 65220 | $265.66 | $718.00 | $46.32 – $1,518.28 | 30 |
| Ghs corneal fb with slit lamp bilat CPT 65222 | $221.82 | $599.50 | $57.25 – $490.44 | 30 |
| Ghs cricothyroidotomy CPT 31605 | $1,183.26 | $3,198.00 | $208.76 – $883.56 | 30 |
| Ghs cutdown placement age 1 and over CPT 36425 | not published | not published | $45.40 – $1,518.28 | 30 |
| Ghs cutdown placement under 1 yr CPT 36420 | $189.07 | $511.00 | $59.38 – $490.44 | 30 |
| Ghs diphtheria toxoid ab igg CPT 86648 | not published | not published | $15.21 – $60.84 | 30 |
| Ghs dislocation elbow closed treatment CPT 24600 | $444.09 | $1,200.25 | $228.18 – $912.72 | 30 |
| Ghs ed peritoneal lavage w guidance if performed CPT 49084 | $965.15 | $2,608.50 | $123.10 – $3,567.32 | 29 |
| Ghs ed rmvl or bivalving cast CPT 29700 | $120.07 | $324.50 | $37.66 – $1,010.52 | 30 |
| Ghs ed therapeutic lp, drain csf w fluoro CPT 62329 | not published | not published | $658.74 – $2,634.96 | 23 |
| Ghs eeg cont rec w/video by tec min 8 chnls CPT 95700 | not published | not published | $148.83 – $595.32 | 23 |
| Ghs electrostagmgraphy CPT 92537 | not published | not published | $8.63 – $595.32 | 29 |
| Ghs elect torsion swing CPT 92546 | not published | not published | $17.88 – $595.32 | 30 |
| Ghs elect vertical elct CPT 92547 | not published | not published | $1.09 – $10.89 | 7 |
| Ghs epidermal shaving diameter >2.0 cm CPT 11303 | not published | not published | $82.91 – $1,520.16 | 30 |
| Ghs excision ingrown nail CPT 11765 | $314.32 | $849.50 | $72.31 – $1,520.16 | 30 |
| Ghs eye exam CPT 92002 | not published | not published | $53.12 – $490.32 | 30 |
| Ghs eyelid foreign body-embedded - bil CPT 67938 | $435.86 | $1,178.00 | $115.28 – $1,137.40 | 30 |
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.