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 |
|---|---|---|---|---|
| Radiation physics consult CPT 77336 | $147.45 | $398.50 | $67.67 – $505.16 | 30 |
| Radiation therapy dose plan CPT 77300 | $139.21 | $376.25 | $34.86 – $505.16 | 30 |
| Radiation treatment aid(s) CPT 77332 | $244.76 | $661.50 | $33.37 – $505.16 | 30 |
| Radiation treatment aid(s) CPT 77333 | $298.50 | $806.75 | $29.14 – $505.16 | 30 |
| Radiation treatment aid(s) CPT 77334 | $447.24 | $1,208.75 | $72.58 – $1,392.84 | 30 |
| Radiation treatment delivery CPT 77401 | $129.69 | $350.50 | $25.15 – $416.64 | 30 |
| Radiation treatment delivery CPT 77402 | $89.73 | $242.50 | $104.16 – $416.64 | 29 |
| Radiation treatment delivery CPT 77412 | $214.88 | $580.75 | $225.81 – $1,000.60 | 29 |
| Radical abdominal hysterectomy 58210 CPT 58210 | not published | not published | $2,012.27 – $3,343.43 | 7 |
| Radical resection of elbow CPT 24149 | not published | not published | $1,263.87 – $2,157.08 | 7 |
| Radical resection sternum 21630 CPT 21630 | not published | not published | $1,352.82 – $2,276.12 | 7 |
| Radic resect abd tumor<5cm 22904 CPT 22904 | not published | not published | $1,172.93 – $1,949.60 | 6 |
| Radic resect shoulder tumor 5cm/> 23078 CPT 23078 | not published | not published | $1,599.65 – $2,660.46 | 6 |
| Radiesse injection HCPCS Q2026 | $1,171.09 | $3,165.10 | $19.78 – $19.78 | 5 |
| Radiology port images(s) CPT 77417 | $83.44 | $225.50 | $11.15 – $28.09 | 7 |
| Radiotherapy dose plan imrt CPT 77301 | $2,138.05 | $5,778.50 | $494.78 – $3,989.80 | 7 |
| Radium ra223 dichl ther/uci HCPCS A9606 | $265.66 | $718.00 | $162.54 – $174.15 | 5 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $587.75 | $1,588.50 | $54.25 – $577.53 | 7 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $809.28 | $2,187.25 | $67.68 – $1,012.89 | 7 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | not published | not published | $642.34 – $642.34 | 1 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $727.51 | $1,966.25 | $68.92 – $609.51 | 7 |
| Radphm lcl tumor plr sgl day CPT 78800 | $398.21 | $1,076.25 | $41.29 – $1,528.92 | 30 |
| Radphm quant measure sgl area add-on CPT 78835 | not published | not published | $82.65 – $82.65 | 1 |
| Rad rescj tum dstl/shft hum CPT 24150 | not published | not published | $1,073.51 – $2,871.33 | 7 |
| Rad rescj tum shoulder<5 cm CPT 23077 | not published | not published | $1,272.58 – $2,106.74 | 7 |
| Rad rescj tum tiss a/e 5 cm+ CPT 24079 | not published | not published | $1,479.35 – $2,450.94 | 6 |
| Rad rescj tum tiss a/e <5cm CPT 24077 | not published | not published | $896.90 – $1,919.67 | 7 |
| Rad resec soft tis tum/ft/toe/<3cm 28046 CPT 28046 | not published | not published | $771.36 – $1,377.51 | 7 |
| Rad resect abd tumor 5 cm/> CPT 22905 | not published | not published | $1,489.34 – $2,465.91 | 6 |
| Rad resect hand tumor < 3 cm CPT 26117 | not published | not published | $701.05 – $1,376.82 | 7 |
| Rad resect hand tumor 3 cm/> CPT 26118 | not published | not published | $1,162.55 – $1,953.68 | 6 |
| Rad resection tum radial h/n CPT 24152 | not published | not published | $805.79 – $2,491.76 | 7 |
| Rad resect tumor/neck/ant thor/<5cm21557 CPT 21557 | not published | not published | $642.80 – $1,784.30 | 7 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | $188.33 | $509.00 | $72.83 – $78.03 | 5 |
| Rapid desensitization CPT 95180 | $412.09 | $1,113.75 | $112.83 – $1,518.28 | 30 |
| Rapid Strep Test CPT 87880 | $48.56 | $131.25 | $12.77 – $66.12 | 30 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | $294.71 | $796.50 | $648.99 – $648.99 | 5 |
| Rbc count only automated CPT 85041 | $13.41 | $36.25 | $3.02 – $12.08 | 30 |
| Rbc depletion of harvest CPT 38212 | not published | not published | $55.99 – $1,663.40 | 30 |
| Rbc serum pretx incubj drugs CPT 86975 | not published | not published | $14.59 – $1,518.28 | 29 |
| Rcnst bfrnt sp orb rm&lw fhd CPT 21175 | not published | not published | $2,351.72 – $4,414.14 | 7 |
| Rdctj forehead cntrg only CPT 21137 | not published | not published | $768.91 – $1,298.60 | 7 |
| Rdctj forehead cntrg&prostc CPT 21138 | not published | not published | $988.26 – $1,555.05 | 7 |
| Rdctj forehead cntrg&setback CPT 21139 | not published | not published | $1,110.31 – $1,849.61 | 7 |
| Realignment of knee CPT 27457 | not published | not published | $1,046.92 – $1,772.06 | 7 |
| Realignment of tendons CPT 26437 | not published | not published | $650.58 – $1,122.42 | 7 |
| Rebuild eardrum structures CPT 69632 | not published | not published | $1,167.40 – $2,025.78 | 7 |
| Rebuild eardrum structures CPT 69633 | not published | not published | $1,123.49 – $1,959.12 | 7 |
| Rebuild eardrum structures CPT 69636 | not published | not published | $1,491.54 – $2,580.20 | 7 |
| Rebuild outer ear canal CPT 69310 | not published | not published | $1,157.81 – $2,039.39 | 7 |
| Rebuild outer ear canal CPT 69320 | not published | not published | $1,648.62 – $2,855.69 | 7 |
| Rechanneling of artery CPT 35361 | not published | not published | $1,754.90 – $2,962.49 | 7 |
| Rechanneling of artery 35305 CPT 35305 | not published | not published | $1,413.99 – $2,390.40 | 7 |
| Rechanneling of artery 35341 CPT 35341 | not published | not published | $1,573.59 – $2,665.22 | 7 |
| Rechanneling w/graft tibioperoneal trunk artery 35304 CPT 35304 | not published | not published | $1,478.61 – $2,487.68 | 7 |
| Rechanneling w/wo patch graft abd aorta 35331 CPT 35331 | not published | not published | $1,666.54 – $2,822.36 | 7 |
| Rechanneling w/wo patch graft deep profunda fem art 35372 CPT 35372 | not published | not published | $1,126.03 – $1,901.99 | 7 |
| Rechanneling w/wo patch grf axillary-brachial 35321 CPT 35303 | not published | not published | $1,424.07 – $2,412.84 | 7 |
| Reconst lwr jaw w/fixation CPT 21196 | not published | not published | $1,603.74 – $2,742.09 | 7 |
| Reconst lwr jaw w/graft CPT 21194 | not published | not published | $1,573.76 – $2,557.74 | 7 |
| Reconst lwr jaw without fixation CPT 21195 | not published | not published | $1,461.13 – $2,498.57 | 7 |
| Reconst lwr jaw without graft CPT 21193 | not published | not published | $1,315.39 – $2,312.18 | 7 |
| Reconst major injured chest 32820 CPT 32820 | not published | not published | $1,560.14 – $2,633.25 | 7 |
| Reconst pectus excavatum/carinatum opn 21740 CPT 21740 | not published | not published | $1,154.51 – $2,245.50 | 7 |
| Reconstr lwr jaw segment CPT 21198 | not published | not published | $1,257.14 – $2,157.75 | 7 |
| Reconstr lwr jaw w/advance CPT 21199 | not published | not published | $1,130.20 – $1,887.69 | 7 |
| Reconstruct ankle joint CPT 27702 | not published | not published | $1,067.43 – $1,802.67 | 7 |
| Reconstruct cleft foot CPT 28360 | not published | not published | $1,025.99 – $2,010.14 | 7 |
| Reconstruct cleft palate CPT 42200 | not published | not published | $947.08 – $1,606.76 | 7 |
| Reconstruct cleft palate CPT 42205 | not published | not published | $1,014.19 – $1,678.17 | 7 |
| Reconstruct cleft palate CPT 42210 | not published | not published | $1,154.28 – $1,918.98 | 7 |
| Reconstruct cleft palate CPT 42215 | not published | not published | $768.91 – $1,357.10 | 7 |
| Reconstruct cleft palate CPT 42220 | not published | not published | $584.13 – $983.64 | 7 |
| Reconstruct cleft palate CPT 42225 | not published | not published | $954.07 – $1,653.02 | 7 |
| Reconstruct elbow joint CPT 24360 | not published | not published | $991.59 – $1,653.69 | 7 |
| Reconstruct elbow joint CPT 24361 | not published | not published | $1,107.46 – $1,851.65 | 7 |
| Reconstruct elbow joint CPT 24362 | not published | not published | $1,171.96 – $1,952.33 | 7 |
| Reconstruct elbow lat ligmnt CPT 24344 | not published | not published | $1,192.42 – $2,019.66 | 7 |
| Reconstruct elbow med ligmnt CPT 24346 | not published | not published | $1,194.73 – $2,021.70 | 7 |
| Reconstruct extra finger CPT 26587 | $1,848.61 | $4,996.25 | $1,047.06 – $1,921.71 | 7 |
| Reconstruct finger joint CPT 26545 | not published | not published | $730.84 – $1,274.12 | 7 |
| Reconstruct finger joint CPT 26548 | not published | not published | $807.62 – $1,379.55 | 7 |
| Reconstruct head of radius CPT 24365 | not published | not published | $697.11 – $1,174.11 | 7 |
| Reconstruct head of radius CPT 24366 | not published | not published | $747.80 – $1,250.30 | 7 |
| Reconstruction ankle joint CPT 27703 | not published | not published | $1,230.37 – $2,096.54 | 7 |
| Reconstruction knee CPT 27427 | not published | not published | $782.07 – $1,321.05 | 7 |
| Reconstruction knee CPT 27428 | not published | not published | $1,213.05 – $2,052.32 | 7 |
| Reconstruction knee CPT 27429 | not published | not published | $1,359.06 – $2,301.29 | 7 |
| Reconstruction of anus CPT 46753 | not published | not published | $622.04 – $1,097.93 | 7 |
| Reconstruction of bile ducts 47800 CPT 47800 | not published | not published | $1,714.79 – $2,930.52 | 7 |
| Reconstruction of eyelid CPT 67971 | not published | not published | $744.97 – $1,393.83 | 7 |
| Reconstruction of eyelid CPT 67973 | not published | not published | $966.46 – $1,795.86 | 7 |
| Reconstruction of eyelid CPT 67974 | not published | not published | $962.66 – $1,793.15 | 7 |
| Reconstruction of eyelid CPT 67975 | not published | not published | $702.78 – $1,317.65 | 7 |
| Reconstruction of jaw CPT 21245 | not published | not published | $977.36 – $1,662.53 | 7 |
| Reconstruction of jaw CPT 21246 | not published | not published | $943.78 – $1,538.73 | 7 |
| Reconstruction of jaw CPT 21248 | not published | not published | $966.30 – $1,671.38 | 7 |
| Reconstruction of jaw CPT 21249 | not published | not published | $1,376.69 – $2,296.53 | 7 |
| Reconstruction of jaw joint CPT 21240 | not published | not published | $1,221.22 – $2,048.91 | 7 |
| Reconstruction of jaw joint CPT 21242 | not published | not published | $1,117.39 – $1,872.74 | 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.