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 |
|---|---|---|---|---|
| MRA chest w IV cont HCPCS C8909 | $595.98 | $1,610.75 | $767.59 – $822.42 | 5 |
| MRA chest wwo IV cont HCPCS C8911 | $843.69 | $2,280.25 | $767.59 – $822.42 | 5 |
| MRA ext low(run-off)pst cntrst CPT 73725 | not published | not published | $114.79 – $834.66 | 7 |
| MRA pelvis CPT 72198 | not published | not published | $113.45 – $829.91 | 7 |
| MRA spinal canal CPT 72159 | not published | not published | $112.44 – $841.47 | 7 |
| MRA upper extremity post contrast-bil CPT 73225 | not published | not published | $107.97 – $842.15 | 7 |
| MRA w/cont, abd HCPCS C8900 | $595.98 | $1,610.75 | $773.95 – $829.23 | 5 |
| MRA w/cont, lwr ext HCPCS C8912 | $1,191.96 | $3,221.50 | $779.02 – $834.66 | 6 |
| Mra, w/dye, upper extremity HCPCS C8934 | $887.26 | $2,398.00 | $1,997.99 – $1,997.99 | 5 |
| MRA without cont, abd HCPCS C8901 | $560.27 | $1,514.25 | $773.95 – $829.23 | 5 |
| MRA without cont, lwr ext HCPCS C8913 | $1,120.55 | $3,028.50 | $757.13 – $834.66 | 6 |
| MRA without fol w/cont, abd HCPCS C8902 | $980.13 | $2,649.00 | $773.95 – $829.23 | 5 |
| MRA without fol w/cont, lwr ext HCPCS C8914 | $1,907.17 | $5,154.50 | $779.02 – $1,288.63 | 6 |
| MRA without fol w/cont, pelvis HCPCS C8920 | $810.76 | $2,191.25 | $1,997.99 – $1,997.99 | 5 |
| Mra, w/o&w/dye, spinal canal HCPCS C8933 | $555.93 | $1,502.50 | $785.37 – $841.47 | 5 |
| Mra, w/o&w/dye, upper extr HCPCS C8936 | $1,085.03 | $2,932.50 | $1,997.99 – $1,997.99 | 5 |
| Mr elastography CPT 76391 | not published | not published | $179.61 – $919.72 | 28 |
| MRI brain w/dye CPT 70558 | not published | not published | $169.34 – $861.20 | 29 |
| MRI brain without dye CPT 70557 | not published | not published | $183.36 – $2,086.20 | 29 |
| MRI brain without & w/dye CPT 70559 | not published | not published | $169.34 – $1,023.78 | 29 |
| MRI breast c- unilateral CPT 77046 | $663.69 | $1,793.75 | $172.28 – $919.72 | 24 |
| MRI breast c-+ w/cad uni CPT 77048 | not published | not published | $283.93 – $511.61 | 5 |
| MRI breast without cont bi CPT 77047 | $869.96 | $2,351.25 | $171.59 – $919.72 | 28 |
| MRI breast w IV cont bi CPT 77049 | not published | not published | $282.54 – $509.49 | 5 |
| MRI cardiac morph & func wo IV cont CPT 75557 | $717.52 | $1,939.25 | $152.98 – $919.72 | 30 |
| MRI cardiac morph & func wwo IV cont CPT 75561 | $884.49 | $2,390.50 | $168.98 – $1,358.84 | 30 |
| MRI cardiac morph & func wwo IV cont w/stress img CPT 75563 | not published | not published | $201.28 – $3,006.08 | 30 |
| MRI chest without contrast CPT 71550 | $901.97 | $2,437.75 | $91.34 – $919.72 | 30 |
| MRI chest without & w/contrast CPT 71552 | $1,182.06 | $3,194.75 | $142.78 – $1,358.84 | 30 |
| MRI chest w IV cont CPT 71551 | $927.41 | $2,506.50 | $108.17 – $3,006.08 | 30 |
| MRI fetal ea addl gestation CPT 74713 | not published | not published | $141.21 – $413.93 | 6 |
| MRI fetal sngl/1st gestation CPT 74712 | not published | not published | $112.82 – $919.72 | 29 |
| MRI guid ndl plc s&i CPT 77021 | $388.78 | $1,050.75 | $95.29 – $783.13 | 7 |
| MRI guid parenchymal tiss ablation CPT 77022 | not published | not published | $265.24 – $449.30 | 6 |
| MRI loex nonjt w IV cont CPT 73719 | $1,953.60 | $5,280.00 | $101.53 – $1,358.84 | 30 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $2,051.28 | $5,544.00 | $84.59 – $919.72 | 30 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $2,141.75 | $5,788.50 | $135.23 – $1,358.84 | 30 |
| MRI orbit/face/neck without contrast CPT 70540 | $932.86 | $2,521.25 | $84.59 – $919.72 | 30 |
| MRI orbit/face/neck without & w/contrast CPT 70543 | $1,270.49 | $3,433.75 | $134.83 – $1,358.84 | 30 |
| MRI orbit fac&nck w IV cont CPT 70542 | $940.26 | $2,541.25 | $101.53 – $1,358.84 | 30 |
| MRI tmj CPT 70336 | $372.68 | $1,007.25 | $92.97 – $919.72 | 30 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $1,932.33 | $5,222.50 | $84.19 – $919.72 | 30 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $2,248.86 | $6,078.00 | $135.23 – $1,358.84 | 30 |
| MRI upper extremity w/dye CPT 73219 | $1,854.07 | $5,011.00 | $101.53 – $1,358.84 | 30 |
| MRI w/cont, breast, bi HCPCS C8906 | $991.69 | $2,680.25 | $2,001.32 – $2,001.32 | 5 |
| MRI w/cont, breast, uni HCPCS C8903 | $781.26 | $2,111.50 | $2,001.32 – $2,001.32 | 5 |
| MRI without fol w/cont, breast HCPCS C8908 | $991.69 | $2,680.25 | $1,013.94 – $1,086.36 | 5 |
| MRI without fol w/cont, brst, un HCPCS C8905 | $781.26 | $2,111.50 | $1,021.55 – $1,094.52 | 5 |
| Mr safety determination physician/other qhp CPT 76016 | not published | not published | $83.75 – $335.00 | 23 |
| Mr safety implant elec prepj CPT 76018 | not published | not published | $87.31 – $349.24 | 23 |
| Mr safety implt pos&/immoblj CPT 76019 | not published | not published | $56.50 – $226.00 | 23 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | not published | not published | $23.30 – $93.20 | 23 |
| Mr sfty med physics xm cstmz CPT 76017 | not published | not published | $229.93 – $919.72 | 23 |
| Mr spectroscopy CPT 76390 | $442.89 | $1,197.00 | $83.75 – $809.51 | 30 |
| Msh2 gene dup/delete variant CPT 81297 | not published | not published | $173.13 – $853.20 | 29 |
| Msh2 gene full seq CPT 81295 | not published | not published | $173.13 – $1,526.80 | 29 |
| Msh2 gene known variants CPT 81296 | not published | not published | $147.83 – $1,350.92 | 29 |
| Msh6 gene dup/delete variant CPT 81300 | not published | not published | $184.52 – $952.00 | 29 |
| Msh6 gene full seq CPT 81298 | not published | not published | $328.48 – $2,567.40 | 29 |
| Msh6 gene known variants CPT 81299 | not published | not published | $184.02 – $1,232.00 | 29 |
| Mthfr gene analy common variants CPT 81291 | $383.14 | $1,035.50 | $65.34 – $261.36 | 29 |
| M.tuberculo dna dir probe CPT 87555 | not published | not published | $21.11 – $107.52 | 30 |
| Mucin synovial fluid CPT 83872 | not published | not published | $5.86 – $23.44 | 30 |
| Mucopolysaccharides CPT 83864 | not published | not published | $21.11 – $114.00 | 30 |
| Multi family grp psychotherapy CPT 90849 | not published | not published | $34.47 – $611.32 | 30 |
| Multifocal erg w/i&r CPT 92274 | not published | not published | $94.44 – $595.32 | 27 |
| Multiple sleep latency test CPT 95805 | $1,166.89 | $3,153.75 | $113.11 – $2,018.88 | 30 |
| Mumps antibody igg CPT 86735 | $45.23 | $122.25 | $13.05 – $52.20 | 30 |
| Muscle-skin graft arm CPT 15736 | not published | not published | $1,261.52 – $2,136.66 | 7 |
| Muscle-skin graft leg CPT 15738 | not published | not published | $1,365.17 – $2,312.85 | 7 |
| Muscle-skin graft trunk CPT 15734 | not published | not published | $1,461.78 – $2,457.75 | 7 |
| Muscle test cran nerv unilat CPT 95867 | $149.11 | $403.00 | $33.06 – $1,184.84 | 30 |
| Muscle test hemidiaphragm CPT 95866 | not published | not published | $29.98 – $595.32 | 30 |
| Muscle test larynx CPT 95865 | not published | not published | $33.96 – $490.44 | 30 |
| Muscle test one fiber CPT 95872 | not published | not published | $28.97 – $595.32 | 30 |
| Muscle transfers CPT 23397 | not published | not published | $1,264.32 – $2,102.66 | 7 |
| Muscle transfer shoulder/arm CPT 23395 | not published | not published | $1,416.72 – $2,374.76 | 7 |
| Musc/tdn transfer upr a/e 1 CPT 24301 | not published | not published | $823.98 – $1,374.78 | 7 |
| Mycobacteria dna amp probe CPT 87551 | $145.04 | $392.00 | $37.00 – $192.96 | 30 |
| Mycophenolate mofetil 250 mg capsule HCPCS J7517 | $359.47 | $971.55 | $1.50 – $1.50 | 5 |
| Mycoplasma antibody igm CPT 86738 | $25.35 | $68.50 | $13.24 – $52.96 | 30 |
| Myd88 gene p.leu265pro vrnt CPT 81305 | $275.65 | $745.00 | $175.40 – $701.60 | 28 |
| Myelogphy 2/> spine regions CPT 72270 | $542.14 | $1,465.25 | $60.72 – $3,006.08 | 30 |
| Myelography l-s spine CPT 72265 | $482.85 | $1,305.00 | $51.38 – $3,006.08 | 30 |
| Myelography neck spine CPT 72240 | $436.60 | $1,180.00 | $53.54 – $3,006.08 | 30 |
| Myelography thoracic spine CPT 72255 | $464.81 | $1,256.25 | $52.46 – $3,006.08 | 30 |
| Myelography via inj w/s&i 2+ regions CPT 62305 | $911.87 | $2,464.50 | $142.23 – $3,006.08 | 29 |
| Myelography via inj w/s&i cervical CPT 62302 | $690.14 | $1,865.25 | $138.70 – $3,006.08 | 29 |
| Myelography via inj w/s&i lumbosacral CPT 62304 | $849.61 | $2,296.25 | $135.98 – $3,006.08 | 29 |
| Myelography via inj w/s&i thoracic CPT 62303 | $715.86 | $1,934.75 | $139.78 – $3,006.08 | 29 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $295.72 | $799.25 | $11.53 – $46.12 | 30 |
| Myocardial resection 33542 CPT 33542 | not published | not published | $2,976.58 – $4,984.19 | 7 |
| Myocrd img pet 1std rst/strs CPT 78491 | not published | not published | $98.80 – $1,841.43 | 6 |
| Myocrd img pet mlt rst&strs CPT 78492 | not published | not published | $124.41 – $1,849.61 | 6 |
| Myomectomy abdom complex CPT 58146 | not published | not published | $1,277.60 – $2,181.56 | 7 |
| Myomectomy abdom method CPT 58140 | not published | not published | $1,017.31 – $1,733.28 | 7 |
| Myomectomy vag method CPT 58145 | not published | not published | $604.16 – $1,024.46 | 7 |
| Myringoplasty CPT 69620 | not published | not published | $531.16 – $915.62 | 7 |
| Nalbuphine 10 mg/ml injection solution HCPCS J2300 | $14.10 | $38.10 | $19.78 – $19.78 | 5 |
| Narcosynthesis CPT 90865 | not published | not published | $143.78 – $611.32 | 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.