healthcosts.net

Ascension St. John Medical Center (St. John Medical Center, Inc.)

1923 S Utica Ave, Tulsa, OK · Ascension · · NPI 1154417368

Source: hospital's published price file ↗ · Published Jan 1, 2026 · Ingested Sep 8, 2026

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
Lat retinacular release open CPT 27425 not published not published $472.09 – $822.42 7
Lavage cannulation maxillary sinus CPT 31000 not published not published $111.70 – $883.56 30
Lavh >250 gms 58553 CPT 58553 not published not published $1,259.80 – $2,145.51 7
Lb with mastopexy 15839 CPT 15839 not published not published $788.35 – $1,357.10 7
Lead capillary CPT 83655 $41.16 $111.25 $12.11 – $48.44 30
Lefort i-1 piece without graft CPT 21141 not published not published $1,487.39 – $2,522.37 7
Lefort i-2 piece without graft CPT 21142 not published not published $1,474.94 – $2,593.80 7
Lefort i-3/> piece with graft CPT 21147 not published not published $1,873.81 – $3,241.40 7
Lefort i-3/> piece without graft CPT 21143 not published not published $1,528.63 – $2,738.69 7
Lefort ii anterior intrusion CPT 21150 not published not published $1,872.63 – $2,881.55 7
Leg vein fusion 34530 CPT 34530 not published not published $1,088.73 – $1,804.02 7
Leg Vein Ultrasound (DVT study, both legs) CPT 93970 $407.46 $1,101.25 $42.81 – $919.72 30
Leishmania antibody CPT 86717 not published not published $11.38 – $49.00 30
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 – $1,631.93 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 $9.27 – $9.27 5
Leukacyte transfusion CPT 86950 not published not published $33.88 – $675.96 29
Leukocyte phagocytosis CPT 86344 not published not published $8.34 – $41.56 30
Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 $8,124.05 $21,956.90 $185.43 – $214.57 6
Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 $4,175.52 $11,285.20 $648.99 – $648.99 5
Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 $0.11 $0.31 $0.18 – $0.18 5
Levetiracetam therapeutic drug level CPT 80177 $70.39 $190.25 $13.25 – $53.00 29
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 $34.00 $91.90 $19.78 – $19.78 5
Lidocaine therapeutic drug level CPT 80176 $59.29 $160.25 $14.69 – $58.76 30
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 – $1,541.45 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 – $2,531.90 7
Ligation of femoral vein CPT 37650 not published not published $527.21 – $887.73 7
Ligation of inf vena cava CPT 37619 $4,675.69 $12,637.00 $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 – $392.51 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 $3,662.26 $9,898.00 $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 – $595.32 30
Limited visual field xm CPT 92081 not published not published $17.97 – $226.00 30
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 $64.58 $174.54 $40.76 – $40.76 5
Lipase CPT 83690 $44.68 $120.75 $6.89 – $27.56 30
Lip exc/transverse wedge/w closure 40510 CPT 40510 not published not published $388.09 – $666.65 7
Lipoprotein blood high res frac & quant CPT 83701 not published not published $26.06 – $135.44 30
Lipoprotein blood quant CPT 83704 $40.05 $108.25 $33.35 – $136.76 30
Lipoprotein direct measurement hdl CPT 83718 $36.72 $99.25 $8.19 – $32.76 30
Lipoprotein direct measurement ldl CPT 83721 $29.79 $80.50 $10.16 – $42.00 30
Lipoprtn dir meas sd ldl chl CPT 83722 not published not published $34.19 – $136.76 28
Lip surgery procedure CPT 40799 not published not published $220.89 – $3,867.85 28
Listeria monocytogenes CPT 86723 not published not published $13.19 – $52.76 30
Lithium therapeutic drug level CPT 80178 $45.51 $123.00 $6.61 – $26.44 30
Liver abs/cyst dr opn 1-2 stge CPT 47010 not published not published $1,297.06 – $2,229.86 7
Liver ds alys 3 bmrk srm alg CPT 81517 not published not published $176.19 – $704.76 23
Liver elastography 91200 CPT 91200 not published not published $25.15 – $595.32 29
Liver Function Test CPT 80076 $44.31 $119.75 $8.17 – $32.68 30
Liver hem/re-expl wnd/remove pack 47362 CPT 47362 not published not published $1,546.03 – $2,682.23 7
Liver imaging CPT 78201 $321.62 $869.25 $27.20 – $2,048.04 30
Liver imag w/vasclr flow CPT 78202 not published not published $31.67 – $2,048.04 30
Liver/spleen imag static only CPT 78215 $406.08 $1,097.50 $30.74 – $1,528.92 30
Liver/spleen imag w/vasclr flow CPT 78216 $429.48 $1,160.75 $35.68 – $1,528.92 30
Lmtd oph exam general anes CPT 92019 not published not published $79.04 – $131.30 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 $1.51 – $1.51 5
Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 $13.56 $36.65 $19.78 – $19.78 5
Loudness balance test CPT 92562 not published not published $24.29 – $1,184.84 30
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 $3,951.68 – $3,951.68 5
Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 $715.30 $1,933.25 $80.04 – $677.36 30
Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 $902.80 $2,440.00 $77.00 – $1,358.84 30
Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 $843.69 $2,280.25 $73.00 – $404.60 30
Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 $1,396.84 $3,775.25 $147.87 – $1,358.84 30
Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 $1,054.87 $2,851.00 $112.11 – $1,358.84 30
Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 $924.82 $2,499.50 $92.97 – $919.72 30
Lower Back (Lumbar Spine) X-ray CPT 72100 $148.46 $401.25 $13.80 – $404.60 30
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 – $756.04 29
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 – $1,851.65 7
Lsh w/t/o ut 250 g or less CPT 58542 not published not published $905.34 – $1,822.40 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 $21.99 – $87.96 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.