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 |
|---|---|---|---|---|
| Mayo vasoactive intestinal peptide CPT 84586 | $130.15 | $351.75 | $35.33 – $141.32 | 30 |
| Mayo vitamin b-2 (riboflavin) CPT 84252 | $102.58 | $277.25 | $20.24 – $80.96 | 30 |
| Mayo vitamin b3 (niacin) CPT 84591 | $61.98 | $167.50 | $12.25 – $68.24 | 30 |
| Mayo vitamin k CPT 84597 | $148.93 | $402.50 | $13.72 – $54.88 | 30 |
| Mayo zonisamide therapeutic drug level CPT 80203 | $66.05 | $178.50 | $13.25 – $53.00 | 29 |
| Maze/extensive/w/card/pulm bypass 33259 CPT 33259 | not published | not published | $949.80 – $1,001.45 | 2 |
| Mcoln1 gene CPT 81290 | not published | not published | $39.31 – $228.36 | 29 |
| Mcp joint arthroscopy dx CPT 29900 | not published | not published | $462.19 – $834.66 | 7 |
| Mcp joint arthroscopy surg CPT 29901 | not published | not published | $543.61 – $980.93 | 7 |
| Mcp joint arthroscopysurg 29902 CPT 29902 | not published | not published | $536.66 – $1,101.33 | 7 |
| Meas lung vol thru 2 yrs CPT 94013 | not published | not published | $22.47 – $2,018.88 | 29 |
| Measure kidney pressure CPT 50396 | not published | not published | $131.97 – $2,539.64 | 30 |
| Measurement post void urine by ultrasound CPT 51798 | $95.92 | $259.25 | $18.50 – $226.00 | 30 |
| Measure ureter pressure CPT 50686 | not published | not published | $100.44 – $595.32 | 30 |
| Mechlorethamine hcl inj HCPCS J9230 | $231.27 | $625.05 | $185.43 – $185.43 | 5 |
| Mecp2 gene dup/delet variant CPT 81304 | not published | not published | $150.00 – $600.00 | 29 |
| Mecp2 gene full seq CPT 81302 | not published | not published | $527.87 – $2,111.48 | 29 |
| Mecp2 gene known variant CPT 81303 | not published | not published | $74.21 – $480.00 | 29 |
| Medial canthopexy CPT 21280 | not published | not published | $568.35 – $1,089.77 | 7 |
| Mediastinoscpy w/lmph nod bx CPT 39402 | not published | not published | $459.32 – $789.20 | 6 |
| Mediastinoscpy w/medstnl bx 39401 CPT 39401 | not published | not published | $351.15 – $604.37 | 6 |
| Medical testimony CPT 99075 | not published | not published | not published | 0 |
| Med physic dos eval rad exps CPT 76145 | not published | not published | $504.72 – $2,018.88 | 24 |
| Medroxyprogesterone 150 mg/ml im injection (wrapper) HCPCS J1050 | $9.25 | $25.00 | $0.34 – $0.34 | 5 |
| Meg evoked single CPT 95966 | not published | not published | $250.05 – $3,871.04 | 29 |
| Meg spontaneous CPT 95965 | not published | not published | $502.13 – $3,871.04 | 29 |
| Meniscal trnspl knee w/scpe CPT 29868 | not published | not published | $1,831.16 – $3,091.05 | 7 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | $23.53 | $63.60 | $19.78 – $19.78 | 5 |
| Mepolizumab 100 mg/ml subcutaneous auto-injector HCPCS J2182 | $64.75 | $175.00 | $36.78 – $39.41 | 5 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $9.79 | $26.46 | $1.42 – $1.42 | 5 |
| Mesh/prosth/ pelvic floor rpr/vag 57267 CPT 57267 | not published | not published | $286.50 – $482.99 | 7 |
| Mesna 100 mg/ml intravenous solution HCPCS J9209 | $35.39 | $95.65 | $4.05 – $4.05 | 5 |
| Metabolic Blood Panel (Basic) CPT 80048 | $31.73 | $85.75 | $8.46 – $33.84 | 30 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $40.79 | $110.25 | $10.56 – $42.24 | 30 |
| Metabolic panel ionized ca CPT 80047 | $76.78 | $207.50 | $8.86 – $54.92 | 30 |
| Methacholine chloride 0.0625 mg/ml nebulization soln HCPCS J7674 | $0.97 | $2.63 | $0.68 – $0.68 | 5 |
| Methadone injection HCPCS J1230 | $45.23 | $122.25 | $19.78 – $19.78 | 5 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $21.13 | $57.10 | $19.78 – $19.78 | 5 |
| Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 | $52.04 | $140.65 | $19.78 – $19.78 | 5 |
| Methotrexate therapeutic drug level CPT 80204 | $101.75 | $275.00 | $38.57 – $154.28 | 24 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | $344.73 | $931.70 | $0.70 – $0.70 | 5 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $35.98 | $97.25 | $19.78 – $19.78 | 5 |
| Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 | $0.39 | $1.06 | $0.34 – $0.34 | 5 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $2.39 | $6.45 | $0.73 – $0.73 | 5 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $9.25 | $25.00 | $19.78 – $19.78 | 5 |
| Mgmt promoter methylation analysis CPT 81287 | $118.96 | $321.50 | $74.21 – $498.56 | 29 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $135.03 | $364.95 | $8.63 – $8.63 | 5 |
| Microalbumin urine screen CPT 82044 | not published | not published | $4.95 – $24.92 | 30 |
| Microbe susceptible mlc CPT 87187 | not published | not published | $10.04 – $160.68 | 30 |
| Microdissection laser CPT 88380 | $463.98 | $1,254.00 | $81.21 – $326.83 | 7 |
| Microdissection manual CPT 88381 | $42.74 | $115.50 | $47.23 – $105.74 | 7 |
| Microfluid analy tears CPT 83861 | not published | not published | $22.48 – $89.92 | 29 |
| Microsatellite instability CPT 81301 | $422.36 | $1,141.50 | $348.56 – $1,394.24 | 29 |
| Microsurg tehniq require use oper micro (add-on)69990 CPT 69990 | not published | not published | $246.58 – $453.19 | 7 |
| Microvolt t-wave assess CPT 93025 | not published | not published | $50.39 – $595.32 | 30 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $22.29 | $60.25 | $0.20 – $0.20 | 5 |
| Middle cerebral artery echo CPT 76821 | $220.98 | $597.25 | $42.87 – $404.60 | 30 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | $24.64 | $66.60 | $4.59 – $4.59 | 5 |
| Minocycline hydrochloride HCPCS J2265 | $34.97 | $94.50 | $0.34 – $0.34 | 5 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | $246.05 | $665.00 | $18.09 – $46.95 | 6 |
| Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 | $78.44 | $212.00 | $46.95 – $46.95 | 5 |
| Mitral valve replacement w/bypass 33430 CPT 33430 | not published | not published | $3,170.49 – $5,283.50 | 7 |
| Mlh1 gene CPT 81288 | $118.96 | $321.50 | $182.46 – $769.28 | 24 |
| Mlh1 gene dup/delete variant CPT 81294 | not published | not published | $202.40 – $809.60 | 29 |
| Mlh1 gene full seq CPT 81292 | not published | not published | $675.40 – $2,701.60 | 29 |
| Mlh1 gene known variants CPT 81293 | not published | not published | $295.64 – $1,324.00 | 29 |
| Mlt osteot rlgnm imed rd hum CPT 24410 | not published | not published | $1,159.47 – $1,989.05 | 7 |
| Mnl appl strs jt radiography CPT 77071 | $45.70 | $123.50 | $45.70 – $335.00 | 30 |
| Mnpj anes sho jt fixj aprats CPT 23700 | $1,854.53 | $5,012.25 | $211.73 – $359.85 | 7 |
| Mnpj elbow under anes CPT 24300 | not published | not published | $410.52 – $757.80 | 7 |
| Mnpj of tmj w/anesth CPT 21073 | not published | not published | $261.63 – $474.14 | 7 |
| Mnt subs tx for change dx HCPCS G0270 | $24.14 | $65.25 | $30.20 – $51.71 | 6 |
| Mobilization of colon 44139 CPT 44139 | not published | not published | $137.90 – $225.17 | 7 |
| Modification of contact lens CPT 92325 | not published | not published | $28.99 – $490.44 | 30 |
| Modified maze/limited 33254 CPT 33254 | not published | not published | $1,540.40 – $2,584.95 | 7 |
| Modified maze/limited /w other op 33257 CPT 33257 | not published | not published | $653.96 – $678.94 | 2 |
| Mog-igg1 antb flo cytmtry ea CPT 86363 | not published | not published | $37.73 – $150.92 | 23 |
| Mopath procedure level 1 CPT 81400 | $212.47 | $574.25 | $63.96 – $255.84 | 29 |
| Mopath procedure level 3 CPT 81402 | $212.01 | $573.00 | $150.33 – $601.32 | 29 |
| Mopath procedure level 5 CPT 81404 | $966.72 | $2,612.75 | $74.21 – $1,099.32 | 29 |
| Mopath procedure level 6 CPT 81405 | $1,126.65 | $3,045.00 | $74.21 – $1,205.40 | 29 |
| Mopath procedure level 7 CPT 81406 | $906.32 | $2,449.50 | $74.21 – $1,131.52 | 29 |
| Mopath procedure level 8 CPT 81407 | $710.68 | $1,920.75 | $74.21 – $3,385.08 | 29 |
| Mopath procedure level 9 CPT 81408 | $1,144.13 | $3,092.25 | $74.21 – $2,270.00 | 6 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $48.56 | $131.25 | $8.00 – $8.00 | 5 |
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | $210.23 | $568.20 | $14.70 – $15.75 | 5 |
| Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 | $281.94 | $762.00 | $163.00 – $652.00 | 29 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted CPT 88361 | not published | not published | $71.42 – $1,368.68 | 30 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $153.18 | $414.00 | $66.49 – $652.00 | 30 |
| Motion analysis video/3d CPT 96000 | not published | not published | $106.10 – $2,018.88 | 30 |
| Motion test w/ft press meas CPT 96001 | not published | not published | $126.86 – $3,871.04 | 30 |
| Motor &/ sens nrve cndj test CPT 95905 | not published | not published | $69.70 – $1,518.28 | 29 |
| Mouth vestibule bx/w complex rpr 40814 CPT 40814 | not published | not published | $324.46 – $573.45 | 7 |
| M/phmtrc alys ishquant/semiq CPT 88373 | not published | not published | $51.37 – $103.40 | 6 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $1,293.52 | $3,496.00 | $163.00 – $652.00 | 29 |
| M/phmtrc alysishquant/semiq CPT 88369 | not published | not published | $75.09 – $126.53 | 6 |
| M/phmtrc alys skeletal musc CPT 88355 | not published | not published | $60.01 – $652.00 | 30 |
| Mpl gene analysis common variants CPT 81338 | $174.83 | $472.50 | $150.33 – $601.32 | 24 |
| MRA abdomen post contrast CPT 74185 | not published | not published | $113.45 – $829.23 | 7 |
| MRA aorta thoracic w/wo contrast CPT 71555 | not published | not published | $114.72 – $822.42 | 7 |
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.