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 |
|---|---|---|---|---|
| Prp i/hern init block >5 yr CPT 49507 | not published | not published | $652.78 – $1,084.32 | 7 |
| Pr planning advance care 1st 30 minutes CPT 99497 | not published | not published | $85.24 – $351.96 | 24 |
| Prq cardiac angio addl art CPT 92921 | not published | not published | $14,322.87 – $19,366.00 | 6 |
| Prq card revasc chronic addl CPT 92944 | $7,990.52 | $21,596.00 | $14,322.87 – $21,347.00 | 6 |
| Prq card revasc mi 1 vsl CPT 92941 | $8,878.24 | $23,995.25 | $757.51 – $21,347.00 | 7 |
| Prq card revasc mi 1 vsl drug-eluting HCPCS C9606 | $12,467.24 | $33,695.25 | $14,322.87 – $28,560.00 | 6 |
| Prq card stent w/angio addl CPT 92929 | $7,990.52 | $21,596.00 | $14,322.87 – $21,347.00 | 6 |
| Prq revasc byp graft 1 art and/or branches CPT 92937 | $8,878.24 | $23,995.25 | $673.50 – $21,347.00 | 7 |
| Prq revasc byp graft addl CPT 92938 | $7,990.52 | $21,596.00 | $14,322.87 – $21,347.00 | 6 |
| Prq skel fix clcnl fx w/mnpj CPT 28406 | not published | not published | $568.75 – $972.08 | 7 |
| Prq skel fix epcndylr hum fx CPT 24566 | not published | not published | $754.93 – $1,318.32 | 7 |
| Prq skel fix sprcndlr hum fx CPT 24538 | not published | not published | $808.20 – $1,367.99 | 7 |
| Prq skel fix talus fx w/mnpj CPT 28436 | not published | not published | $454.77 – $826.50 | 7 |
| Prq skel fix tarsl fx w/mnpj CPT 28456 | not published | not published | $289.33 – $586.38 | 7 |
| Prq tcat plmt ntrac st 1 les CPT 92928 | $8,878.24 | $23,995.25 | $673.91 – $21,347.00 | 7 |
| Prq trlml c athrc st angiop1 CPT 92933 | $8,878.24 | $23,995.25 | $755.97 – $21,347.00 | 7 |
| Prq trluml c angiop 1art&/br CPT 92920 | $5,845.45 | $15,798.50 | $605.50 – $19,366.00 | 7 |
| Prq trluml c athrc 1 art&/br CPT 92924 | $12,319.24 | $33,295.25 | $722.70 – $19,366.00 | 7 |
| Prq trluml revsc ch occ ant CPT 92943 | $8,878.24 | $23,995.25 | $756.77 – $21,347.00 | 7 |
| Pr removal drug delivery implant CPT 11982 | not published | not published | $112.97 – $1,518.28 | 30 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $150.31 | $406.25 | $52.63 – $490.44 | 30 |
| Pr removal intrauterine device CPT 58301 | $113.31 | $306.25 | $75.56 – $1,157.40 | 30 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $243.18 | $657.25 | $209.13 – $1,520.16 | 30 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $120.81 | $326.50 | $62.02 – $756.04 | 30 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $125.34 | $338.75 | $65.63 – $756.04 | 30 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $129.50 | $350.00 | $49.75 – $756.04 | 30 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $146.43 | $395.75 | $65.94 – $756.04 | 30 |
| Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child CPT 15100 | not published | not published | $776.07 – $1,331.25 | 7 |
| Pr subsequent hospital care e/m normal newborn per day CPT 99462 | not published | not published | $37.23 – $49.34 | 2 |
| Prtl exc bone olecrn process CPT 24147 | not published | not published | $676.55 – $1,141.46 | 7 |
| Prtl exc bone radial h/n CPT 24145 | not published | not published | $641.54 – $1,087.04 | 7 |
| Prtl exchange transfuse nb CPT 36456 | not published | not published | $120.82 – $1,663.40 | 29 |
| Prtl excision bone clavicle CPT 23180 | not published | not published | $727.19 – $1,231.26 | 7 |
| Prtl excision bone scapula CPT 23182 | not published | not published | $717.58 – $1,217.66 | 7 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $1,074.85 | $2,905.00 | $178.81 – $330.60 | 7 |
| PSA (Prostate) Test CPT 84153 | $76.96 | $208.00 | $18.39 – $73.56 | 30 |
| Psych/neuropsych test admin automated result 96146 CPT 96146 | not published | not published | $23.30 – $93.20 | 23 |
| Psychoanalysis CPT 90845 | not published | not published | $100.65 – $611.32 | 25 |
| Psychoeducation 45 min + HCPCS G0177 | $210.44 | $568.75 | $122.36 – $122.36 | 5 |
| Psychotherapy group therapy CPT 90853 | $210.44 | $568.75 | $28.36 – $351.96 | 30 |
| Psychotherapy patient individual therapy 30 minutes CPT 90832 | $210.44 | $568.75 | $70.84 – $611.32 | 24 |
| Psychotherapy patient individual therapy 45 minutes CPT 90834 | $210.44 | $568.75 | $94.45 – $611.32 | 24 |
| Psychotherapy patient individual therapy 60 minutes CPT 90837 | $210.44 | $568.75 | $142.05 – $611.32 | 24 |
| Psych test eval svc phys/qhp 1st hr CPT 96130 | not published | not published | $296.21 – $1,184.84 | 23 |
| Psychthrp grp 45-50min mcr HCPCS G0410 | $210.44 | $568.75 | $477.49 – $477.49 | 5 |
| Psycl/nrpsyc tech 1st CPT 96138 | not published | not published | $379.57 – $1,518.28 | 23 |
| Psy/npsy phys/qhp 2> tst 1st 30 min CPT 96136 | not published | not published | $122.61 – $490.44 | 23 |
| Psytx complex interactive CPT 90785 | not published | not published | $10.15 – $15.61 | 6 |
| Psytx pt w/e&m 16-37 min CPT 90833 | not published | not published | $73.37 – $73.37 | 1 |
| Psytx pt w/e&m 38-52 min CPT 90836 | not published | not published | $92.90 – $92.90 | 1 |
| Psytx pt w/e&m 53+ min CPT 90838 | not published | not published | $122.75 – $122.75 | 1 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $25.07 | $67.75 | $13.54 – $54.16 | 30 |
| Pt application of modality >=1 area hot/cold packs CPT 97010 | $7.59 | $20.50 | $5.50 – $10.89 | 7 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $32.38 | $87.50 | $17.61 – $70.44 | 30 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $29.05 | $78.50 | $13.11 – $52.44 | 30 |
| Pt application of modality traction mechanical CPT 97012 | $23.87 | $64.50 | $13.54 – $54.16 | 30 |
| Pten gene dup/delet variant CPT 81323 | not published | not published | $99.97 – $1,200.00 | 29 |
| Pten gene full sequence CPT 81321 | not published | not published | $600.00 – $2,400.00 | 29 |
| Pten gene known fam variant CPT 81322 | not published | not published | $46.60 – $186.40 | 29 |
| Pterygomaxillary fossa surg any appr 31040 CPT 31040 | not published | not published | $811.28 – $1,411.52 | 7 |
| Pt evaluation high complexity patient/family CPT 97163 | $74.56 | $201.50 | $87.76 – $370.64 | 29 |
| Pt evaluation low complexity patient/family CPT 97161 | $74.56 | $201.50 | $87.76 – $370.64 | 29 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $74.56 | $201.50 | $87.76 – $370.64 | 29 |
| Pt init/spiromet rec/review/interp 94016 CPT 94016 | not published | not published | $22.53 – $90.12 | 30 |
| Pt re-evaluation patient/family CPT 97164 | $40.89 | $110.50 | $59.34 – $254.28 | 29 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | not published | not published | $39.17 – $156.68 | 30 |
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | $32.38 | $87.50 | $14.88 – $25.17 | 6 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $30.43 | $82.25 | $27.21 – $108.84 | 30 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $19.61 | $53.00 | $27.07 – $110.88 | 30 |
| Pt wheelchair management each 15 minutes CPT 97542 | $29.60 | $80.00 | $29.05 – $116.20 | 30 |
| Pul art balloon repr percut CPT 92997 | not published | not published | $736.20 – $1,210.17 | 7 |
| Pul art balloon repr percut CPT 92998 | not published | not published | $364.10 – $599.30 | 7 |
| Pulm endartercomy w/bypass 33916 CPT 33916 | not published | not published | $1,977.19 – $7,952.13 | 7 |
| Pulmonary decortication partial 32225 CPT 32225 | not published | not published | $1,115.48 – $1,870.01 | 7 |
| Pulmonary vent imaging CPT 78579 | $328.56 | $888.00 | $171.03 – $1,528.92 | 29 |
| Pulse ox continuous overnight monitoring CPT 94762 | $78.07 | $211.00 | $24.80 – $595.32 | 30 |
| Pulse ox multiple CPT 94761 | $52.91 | $143.00 | $4.68 – $10.15 | 7 |
| Pulse ox single CPT 94760 | $24.88 | $67.25 | $2.98 – $6.24 | 7 |
| Punc of shunt for asp or inj CPT 61070 | $668.13 | $1,805.75 | $64.04 – $2,634.96 | 30 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $69.01 | $186.50 | $17.37 – $490.44 | 30 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $191.94 | $518.75 | $103.96 – $1,520.16 | 30 |
| Puncture/clear windpipe 31612 CPT 31612 | $2,427.76 | $6,561.50 | $54.42 – $90.48 | 7 |
| Puncture spinal lumbar diagnostic CPT 62270 | $507.55 | $1,371.75 | $87.57 – $2,634.96 | 30 |
| Pvb thoracic 2nd+ inj site CPT 64462 | not published | not published | $61.78 – $106.11 | 6 |
| Pvb thoracic cont infusion CPT 64463 | not published | not published | $101.61 – $2,634.96 | 29 |
| Pvb thoracic single inj site CPT 64461 | $514.58 | $1,390.75 | $98.36 – $2,634.96 | 29 |
| Pyloroplasty 43800 CPT 43800 | not published | not published | $1,013.93 – $1,725.12 | 7 |
| Pyridoxine hcl 100 mg HCPCS J3415 | $9.79 | $26.45 | $19.78 – $19.78 | 5 |
| Pyruvate CPT 84210 | $81.03 | $219.00 | $11.47 – $57.92 | 30 |
| Pyruvate kinase CPT 84220 | $46.16 | $124.75 | $9.44 – $37.76 | 30 |
| Quan puplmtry phy/qhp uni/bi CPT 95919 | not published | not published | $122.61 – $490.44 | 23 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $664.15 | $1,795.00 | $279.19 – $2,048.04 | 29 |
| Quant diff pulm perf w/imaging CPT 78597 | $328.56 | $888.00 | $175.70 – $1,528.92 | 29 |
| Quest t3 uptake CPT 84479 | $37.28 | $100.75 | $6.47 – $25.88 | 30 |
| Quinupristin/dalfopristin HCPCS J2770 | $358.62 | $969.25 | $185.43 – $185.43 | 5 |
| Rabies ig heat-treated human im/subq 90376 CPT 90376 | $815.67 | $2,204.50 | $106.51 – $1,389.28 | 29 |
| Rabies ig ht&sol human im/sc CPT 90377 | not published | not published | $241.15 – $964.60 | 23 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $4,350.89 | $11,759.15 | $145.53 – $1,159.64 | 29 |
| Rabies vaccine id CPT 90676 | not published | not published | $264.47 – $1,057.88 | 28 |
| Radiation handling CPT 77790 | $104.80 | $283.25 | $15.10 – $196.56 | 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.