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
Ophth Ultrasound b & quant a CPT 76510 not published not published $73.79 – $490.44 30
Oph Ultrasound dx ant sgm Ultrasound uni/bi CPT 76513 not published not published $41.10 – $404.60 30
Oph Ultrasound dx quan a-scan only CPT 76511 not published not published $49.23 – $404.60 30
Opn impltj crnl nrv nea&pg CPT 64568 not published not published $723.27 – $1,140.78 6
Opn impltj nea neuromuscular CPT 64580 not published not published $325.45 – $564.62 7
Opn impltj nea perph nerve CPT 64575 not published not published $317.68 – $586.38 7
Opn impltj nea sacral nerve CPT 64581 not published not published $747.33 – $1,240.10 7
Opn tx complx malar fx CPT 21365 not published not published $1,216.30 – $2,076.12 7
Opn tx complx malar w/grft CPT 21366 not published not published $1,262.68 – $2,386.32 7
Opn tx depress front sinus fx 21343 CPT 21343 not published not published $1,241.21 – $2,262.51 7
Opn tx dprsd zygomatic arch CPT 21356 not published not published $402.47 – $703.38 7
Opn tx nasomax fx multple CPT 21347 not published not published $1,190.97 – $2,061.17 7
Opn tx nasomax fx w/fixj CPT 21346 not published not published $991.09 – $1,699.26 7
Opn tx orbit fx combined CPT 21387 not published not published $780.77 – $1,368.66 7
Opn tx orbit fx periorbital CPT 21386 not published not published $727.92 – $1,300.64 7
Opn tx orbit fx transantral CPT 21385 not published not published $746.13 – $1,278.87 7
Opn tx orbit fx w/bone grft CPT 21408 not published not published $961.99 – $1,658.45 7
Opn tx orbit fx w/implant CPT 21407 not published not published $697.27 – $1,219.70 7
Opn tx orbit fx without impl 21406 CPT 21406 not published not published $587.38 – $1,043.51 7
Opn tx orbit periorbtl implt CPT 21390 not published not published $842.40 – $1,500.63 7
Opn tx orbit periorbt w/grft CPT 21395 not published not published $1,067.37 – $1,836.68 7
Oprelvekin injection HCPCS J2355 $353.44 $955.25 $185.43 – $185.43 5
Opscpy extnd on/mac draw CPT 92202 not published not published $56.50 – $226.00 23
Opscpy extnd rta draw uni/bi CPT 92201 not published not published $56.50 – $226.00 23
Optx acrclv dslc aq/chrn grf CPT 23552 not published not published $716.26 – $1,210.17 7
Optx acromclv dislc aqt/chrn CPT 23550 not published not published $614.85 – $1,048.95 7
Optx acute shoulder dislc CPT 23660 not published not published $629.84 – $1,074.80 7
Optx carpl scphd fx int fixj CPT 25628 not published not published $776.30 – $1,319.69 7
Optx clavicular fx w/int fix CPT 23515 not published not published $765.82 – $1,328.54 7
Optx complicated mndblr fx CPT 21470 not published not published $1,305.43 – $2,246.19 7
Optx crpl fx oth/thn scph ea CPT 25645 not published not published $611.56 – $1,044.87 7
Optx gr hmrl tbrs fx int fix CPT 23630 not published not published $818.21 – $1,443.50 7
Optx lunate dislocation CPT 25695 not published not published $686.92 – $1,161.87 7
Optx medial ankle fx CPT 27766 not published not published $663.42 – $1,125.14 7
Optx mndblr cndylr fx CPT 21465 not published not published $998.31 – $1,744.85 7
Optx mndblr fx wo ntrdntl CPT 21461 not published not published $966.59 – $1,748.25 7
Optx mndblr fx xtrnl fixj CPT 21454 not published not published $598.21 – $1,008.14 7
Optx mndblr/max alv ridge fx CPT 21445 not published not published $649.66 – $1,151.67 7
Optx palatal/max fracture CPT 21422 not published not published $725.79 – $1,236.69 7
Optx partclr fx&/dslc elbw w CPT 24587 not published not published $1,198.45 – $1,999.26 7
Optx post ankle fx CPT 27769 not published not published $764.16 – $1,353.71 7
Optx prox humrl fx w/int fix CPT 23615 not published not published $953.45 – $1,633.28 7
Optx prx hmrl fx fix rpr rpl CPT 23616 not published not published $1,375.68 – $2,294.49 7
Optx radial shaft fracture CPT 25515 not published not published $725.64 – $1,231.26 7
Optx rad/uln dislc aqt/chrnc CPT 25676 not published not published $683.50 – $1,156.43 7
Optx rdcrpl/ntrcrpl dislc 1+ CPT 25670 not published not published $660.47 – $1,108.82 7
Optx rdl shft fx&cltx rad/ul CPT 25525 not published not published $861.65 – $1,437.38 7
Optx rdl shft fx&dstl rad/ul CPT 25526 not published not published $1,046.96 – $1,756.41 7
Optx rdl&uln shft fx rds&uln CPT 25575 not published not published $973.93 – $1,656.41 7
Optx rdl&uln shft fx rds/uln CPT 25574 not published not published $713.67 – $1,238.73 7
Optx scapular fx w/int fixj CPT 23585 not published not published $1,046.11 – $1,814.91 7
Optx sho dislc fx CPT 23670 not published not published $921.89 – $1,620.36 7
Optx sho dislc neck fx fixj CPT 23680 not published not published $998.36 – $1,713.56 7
Optx strclv dslc aq/chrn grf CPT 23532 not published not published $673.68 – $1,146.23 7
Optx strnclav dislc aqt/chrn CPT 23530 not published not published $587.67 – $1,051.67 7
Optx tmprmand dislocation CPT 21490 not published not published $1,010.93 – $1,722.39 7
Optx trns-scphprlnr fx dislc CPT 25685 not published not published $798.25 – $1,350.98 7
Optx ulnar shft fx int fixj CPT 25545 not published not published $677.17 – $1,144.19 7
Optx ulnar styloid fracture CPT 25652 not published not published $665.96 – $1,140.78 7
Oral aprepitant HCPCS J8501 $91.24 $246.60 $9.27 – $9.27 5
Oral busulfan HCPCS J8510 $232.30 $627.85 $9.27 – $9.27 5
Orchiectomy partial CPT 54522 not published not published $664.09 – $1,111.53 7
Orchiopexy (fowler-stephens) CPT 54650 not published not published $814.59 – $1,310.84 7
Orchiopexy ingun/scrot appr CPT 54640 not published not published $533.63 – $885.69 7
Organic acids total quant ea spec CPT 83918 $147.17 $397.75 $17.46 – $94.40 30
Oritavancin 400 mg intravenous solution HCPCS J2407 $1,212.12 $3,276.00 $34.51 – $36.98 5
Oropharyngeal biopsy 42800 CPT 42800 not published not published $122.35 – $212.93 7
Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 $12.47 $33.71 $19.78 – $19.78 5
Ortho ewhf rigd without jnt cstm w HCPCS L3765 $782.70 $2,115.40 $1,965.08 – $1,965.08 1
Orthopantogram CPT 70355 not published not published $9.70 – $335.00 30
Orthop traing supvj phys/qhp CPT 92066 not published not published $56.50 – $226.00 23
Orthosis lso rigd frm hyperex HCPCS L0472 $813.61 $2,198.95 $697.01 – $697.01 1
Oscillation chest wall mechanical per session CPT 94669 $110.08 $297.50 $33.43 – $773.88 29
Osmolality blood CPT 83930 $53.56 $144.75 $6.61 – $26.44 30
Osmolality urine CPT 83935 $39.22 $106.00 $6.82 – $27.28 30
Ostectomy complete 1st metatarsal head 28111 CPT 28111 not published not published $362.52 – $621.75 7
Ostectomy scapula partial CPT 23190 not published not published $604.65 – $1,047.59 7
Osteochondral knee allograft CPT 27415 not published not published $1,522.53 – $2,533.94 7
Osteochondral knee autograft CPT 27416 not published not published $1,070.15 – $1,806.06 7
Osteochondral talus autogrft CPT 28446 not published not published $1,316.98 – $2,257.76 7
Osteopath manip tx/5-6 body region 98927 CPT 98927 $47.82 $129.25 $24.07 – $96.28 30
Osteopath manip tx/7-8 body region 98928 CPT 98928 not published not published $24.07 – $112.25 30
Osteopath manip tx/9-10 body region98929 CPT 98929 not published not published $24.07 – $134.01 30
Osteoplasty humerus CPT 24420 not published not published $1,085.00 – $1,827.15 7
Osteot humerus w/wo int fixj CPT 24400 not published not published $901.08 – $1,513.56 7
Osteotomy/graft tarsal/calcaneus/talus 28305 CPT 28305 not published not published $741.78 – $1,224.45 7
Ot evaluation high complexity patient/family CPT 97167 $74.56 $201.50 $85.24 – $379.84 29
Ot evaluation low complexity patient/family CPT 97165 $74.56 $201.50 $85.24 – $379.84 29
Ot evaluation moderate complexity patient/family CPT 97166 $74.56 $201.50 $85.24 – $379.84 29
Other immunoelectrophoresis CPT 86325 not published not published $14.66 – $92.52 30
Oth resp proc, group HCPCS G0239 $61.88 $167.25 $13.30 – $21.77 6
Oth resp proc, indiv HCPCS G0238 $20.54 $55.50 $10.43 – $19.73 6
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 not published not published $46.34 – $185.36 28
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 $34.50 $93.25 $38.32 – $170.64 30
Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 $33.95 $91.75 $25.70 – $102.80 30
Otolaryngo binocular microscopy 92504 CPT 92504 not published not published $10.58 – $20.28 7
Otoplasty 69300 CPT 69300 not published not published $505.17 – $892.49 7
Ot re-evaluation patient/family CPT 97168 $38.30 $103.50 $56.10 – $261.08 29
Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 $34.50 $93.25 $32.36 – $129.44 30
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 not published not published $20.11 – $80.44 23

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.