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 |
|---|---|---|---|---|
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | not published | not published | $2,068.90 – $3,562.47 | 7 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $748.42 – $1,297.23 | 7 |
| G-tube reposition CPT 43761 | $536.50 | $1,450.00 | $116.88 – $925.40 | 30 |
| Gu dilat ureter/urethra s&i CPT 74485 | $1,213.69 | $3,280.25 | $34.57 – $201.24 | 7 |
| Guided cath fluid drainage 10030 CPT 10030 | $1,261.42 | $3,409.25 | $174.28 – $2,677.08 | 29 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $7,743.36 | $20,928.00 | $820.42 – $928.83 | 6 |
| Gum graft CPT 41870 | not published | not published | $336.71 – $498.00 | 6 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $413.55 – $756.44 | 7 |
| Hair removal by electrolysis 17380 CPT 17380 | not published | not published | $82.60 – $2,329.08 | 29 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $250.03 – $1,520.16 | 30 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $376.10 – $1,520.16 | 30 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $91.09 | $246.20 | $19.78 – $19.78 | 5 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $17.61 | $47.59 | $8.63 – $8.63 | 5 |
| Hand-held pefr meter a4614 HCPCS A4614 | $16.59 | $44.85 | $40.80 – $40.80 | 5 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | not published | not published | $7.09 – $7.09 | 1 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $835.61 – $1,448.94 | 7 |
| Hand tendon reconstruction CPT 26500 | not published | not published | $655.04 – $1,128.54 | 7 |
| Hand tendon reconstruction CPT 26502 | not published | not published | $742.64 – $1,287.03 | 7 |
| Hand X-ray CPT 73130 | $262.70 | $710.00 | $10.66 – $335.00 | 30 |
| Haptoglobin quantitative CPT 83010 | $57.17 | $154.50 | $12.58 – $50.32 | 30 |
| Harvest allogeneic stem cell CPT 38205 | not published | not published | $93.51 – $151.70 | 7 |
| Harvest auto stem cells CPT 38206 | not published | not published | $93.51 – $154.41 | 7 |
| Harvest cultured skin graft 15040 CPT 15040 | not published | not published | $142.11 – $238.10 | 7 |
| Harvest eye tissue alograft CPT 68371 | not published | not published | $418.93 – $759.84 | 7 |
| Harvest femoropopliteal vein 35572 CPT 35572 | not published | not published | $398.18 – $763.65 | 7 |
| Harvest stem cell concentrte CPT 38215 | not published | not published | $55.99 – $1,663.40 | 30 |
| Harvest vein for bypass 35500 CPT 35500 | not published | not published | $368.31 – $711.37 | 7 |
| Hast w/i&r phys/qhp CPT 94452 | not published | not published | $18.31 – $490.44 | 30 |
| Hast w/oxygen titrate CPT 94453 | not published | not published | $23.73 – $490.44 | 30 |
| Hba1/hba2 full gene sequence CPT 81259 | not published | not published | $600.00 – $2,400.00 | 29 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | not published | not published | $202.40 – $809.60 | 29 |
| Hba1/hba2 gene fam vrnt CPT 81258 | not published | not published | $375.25 – $1,501.00 | 29 |
| Hbb full gene sequence CPT 81364 | not published | not published | $324.58 – $1,298.32 | 29 |
| Hbb gene com variants CPT 81361 | not published | not published | $174.81 – $699.24 | 29 |
| Hbb gene dup/del variants CPT 81363 | not published | not published | $202.40 – $809.60 | 29 |
| Hbb gene known fam variant CPT 81362 | not published | not published | $375.25 – $1,501.00 | 29 |
| Hbot, full body chamber, 30m HCPCS G0277 | $207.29 | $560.25 | $49.95 – $78.23 | 6 |
| Hc ea ha check monaural CPT 92594 | not published | not published | $20.51 – $82.50 | 6 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | $425.78 | $1,150.75 | $43.60 – $744.20 | 30 |
| Hcg free betachain test CPT 84704 | not published | not published | $15.29 – $61.16 | 30 |
| Hcg qualitative CPT 84703 | $33.39 | $90.25 | $7.52 – $30.08 | 30 |
| Hcg quantitative CPT 84702 | $64.47 | $174.25 | $15.05 – $60.20 | 30 |
| Hc hearing aid chck binaurl CPT 92593 | not published | not published | $35.67 – $103.50 | 6 |
| Hc hearing aid chck monarl CPT 92592 | not published | not published | $21.78 – $70.50 | 6 |
| Hc hearing aid exam both ears CPT 92591 | not published | not published | $69.21 – $222.00 | 6 |
| Hc hearing aid exam one ear CPT 92590 | not published | not published | $54.05 – $202.50 | 6 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $178.25 | $481.75 | $61.23 – $61.23 | 5 |
| Hc metata joint dislocation anes CPT 28635 | $2,307.69 | $6,237.00 | $146.10 – $244.22 | 7 |
| Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks CPT 17311 | not published | not published | $423.53 – $2,329.08 | 30 |
| Hc mohs micrographic h/n/h/f/g each addl stage CPT 17312 | not published | not published | $225.32 – $373.46 | 7 |
| Hc mohs trunk/arm/leg 1st stage 5 blocks CPT 17313 | not published | not published | $379.78 – $2,329.08 | 30 |
| Hc mohs trunk/arm/leg ea addl block any stage CPT 17315 | not published | not published | $59.61 – $97.95 | 7 |
| Hc mohs trunk/arm/leg ea stage after 1st stage CPT 17314 | not published | not published | $209.06 – $346.94 | 7 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | not published | not published | $65.56 – $2,048.04 | 30 |
| Hc nm fusion spect CT unlisted CPT 78999 | not published | not published | $382.23 – $1,528.92 | 28 |
| Hc nm kidney imaging with flow CPT 78701 | not published | not published | $30.74 – $1,528.92 | 30 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | not published | not published | $59.96 – $2,048.04 | 30 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | not published | not published | $97.70 – $1,839.39 | 6 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | not published | not published | $224.22 – $2,639.88 | 29 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | not published | not published | $408.54 – $2,639.88 | 29 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | not published | not published | $646.42 – $2,639.88 | 29 |
| Hdr rdncl skn surf brachytx CPT 77767 | not published | not published | $173.55 – $1,000.60 | 29 |
| Hdr rdncl skn surf brachytx CPT 77768 | not published | not published | $250.15 – $1,000.60 | 29 |
| Head CT scan (with and without contrast) CPT 70470 | $1,065.14 | $2,878.75 | $80.04 – $677.36 | 30 |
| Head CT scan (with contrast) CPT 70460 | $883.28 | $2,387.25 | $71.19 – $677.36 | 30 |
| Head CT scan (without contrast) CPT 70450 | $891.79 | $2,410.25 | $53.78 – $404.60 | 30 |
| Heart first pass add-on CPT 78496 | not published | not published | $20.85 – $82.31 | 7 |
| Heart first pass multiple CPT 78483 | not published | not published | $99.49 – $2,048.04 | 30 |
| Heart image spect CPT 78494 | not published | not published | $77.59 – $1,528.92 | 30 |
| Heart infarct image CPT 78466 | not published | not published | $44.79 – $1,528.92 | 30 |
| Heart infarct image (ef) CPT 78468 | not published | not published | $53.14 – $2,048.04 | 30 |
| Heart tmr w/other procedure 33141 CPT 33141 | not published | not published | $150.23 – $249.65 | 7 |
| Heinz bodies direct CPT 85441 | not published | not published | $4.20 – $16.80 | 30 |
| Helicobacter pylori antibody igm CPT 86677 | $65.49 | $177.00 | $15.37 – $67.40 | 30 |
| Hemagglutination inhibition CPT 86280 | not published | not published | $8.19 – $32.76 | 30 |
| Hematocrit CPT 85014 | $19.24 | $52.00 | $2.37 – $9.48 | 30 |
| Hematopoietic nuclear tx CPT 79403 | $1,555.57 | $4,204.25 | $84.09 – $852.80 | 30 |
| Hemiepiphyseal arrest CPT 24470 | not published | not published | $690.12 – $1,077.51 | 7 |
| Hemodialysis one evaluation CPT 90935 | $824.45 | $2,228.25 | $80.46 – $2,662.36 | 30 |
| Hemoglobin CPT 85018 | $19.61 | $53.00 | $2.37 – $9.48 | 30 |
| Hemoglobin copper sulfate CPT 83026 | not published | not published | $2.61 – $16.04 | 30 |
| Hemoglobin fetal qualitative CPT 83033 | $26.36 | $71.25 | $6.25 – $32.00 | 30 |
| Hemoglobin f (fetal) chemical CPT 83030 | not published | not published | $8.60 – $42.96 | 30 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $43.01 | $116.25 | $7.82 – $32.80 | 30 |
| Hemoglobin-oxygen affinity CPT 82820 | not published | not published | $10.42 – $53.36 | 30 |
| Hemoglobin plasma CPT 83051 | $46.81 | $126.50 | $7.31 – $29.24 | 30 |
| Hemoglobin urine CPT 83069 | not published | not published | $3.95 – $15.80 | 30 |
| Hemolysin acid CPT 85475 | not published | not published | $8.87 – $35.48 | 30 |
| Hemolysins/agglutinins auto CPT 86940 | $27.75 | $75.00 | $8.60 – $35.08 | 30 |
| Hemolysins and agglutinins incubated CPT 86941 | $61.79 | $167.00 | $12.11 – $48.44 | 30 |
| Hemophilus influenza antibdy CPT 86684 | not published | not published | $15.84 – $63.36 | 30 |
| Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 | $596.72 | $1,612.75 | $192.39 – $3,468.96 | 30 |
| Hemorrhoidopexy stapling 46947 CPT 46947 | not published | not published | $401.41 – $712.22 | 7 |
| Hepagam b im injection HCPCS J1571 | $1,118.05 | $3,021.75 | $40.76 – $40.76 | 5 |
| Heparin assay CPT 85520 | $77.24 | $208.75 | $13.09 – $52.36 | 30 |
| Heparin bolus from bag HCPCS J1644 | $48.58 | $131.30 | $0.28 – $0.28 | 5 |
| Heparin neutralization CPT 85525 | $49.21 | $133.00 | $11.84 – $47.36 | 30 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $4.69 | $12.68 | $0.22 – $0.22 | 5 |
| Hepatectomy removal of liver 47120 CPT 47120 | not published | not published | $2,547.76 – $4,310.07 | 7 |
| Hepatitis a antibody igm CPT 86709 | $69.38 | $187.50 | $11.26 – $45.04 | 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.