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 |
|---|---|---|---|---|
| Reconstruction of jaw joint CPT 21243 | not published | not published | $1,838.26 – $3,103.31 | 7 |
| Reconstruction of lower jaw CPT 21244 | not published | not published | $1,133.75 – $1,985.66 | 7 |
| Reconstruction of mouth CPT 40840 | not published | not published | $698.91 – $1,176.84 | 7 |
| Reconstruction of mouth CPT 40842 | not published | not published | $685.89 – $1,202.69 | 7 |
| Reconstruction of mouth CPT 40843 | not published | not published | $896.80 – $1,629.20 | 7 |
| Reconstruction of mouth CPT 40844 | not published | not published | $1,175.08 – $2,050.28 | 7 |
| Reconstruction of mouth CPT 40845 | not published | not published | $1,370.96 – $2,304.69 | 7 |
| Reconstruction of nail bed CPT 11762 | $1,694.60 | $4,580.00 | $202.22 – $348.29 | 7 |
| Reconstruction of nose CPT 30410 | not published | not published | $1,266.92 – $2,201.30 | 7 |
| Reconstruction of nose CPT 30420 | not published | not published | $1,479.19 – $2,548.89 | 7 |
| Reconstruction of orbit CPT 21256 | not published | not published | $1,292.48 – $2,286.32 | 7 |
| Reconstruction of throat CPT 42950 | not published | not published | $853.31 – $1,490.43 | 7 |
| Reconstruction of urethra CPT 53410 | not published | not published | $1,101.00 – $1,807.43 | 7 |
| Reconstruction of urethra CPT 53415 | not published | not published | $1,274.20 – $2,086.32 | 7 |
| Reconstruction of urethra CPT 53430 | not published | not published | $1,088.32 – $1,792.46 | 7 |
| Reconstruction of urethra CPT 54308 | not published | not published | $803.57 – $1,317.65 | 7 |
| Reconstruction of urethra CPT 54312 | not published | not published | $959.30 – $1,507.44 | 7 |
| Reconstruction of urethra CPT 54316 | not published | not published | $1,171.40 – $1,840.08 | 7 |
| Reconstruction of urethra CPT 54318 | not published | not published | $798.34 – $1,292.48 | 7 |
| Reconstruction of urethra CPT 54322 | not published | not published | $870.27 – $1,439.42 | 7 |
| Reconstruction of urethra CPT 54324 | not published | not published | $1,089.54 – $1,785.66 | 7 |
| Reconstruction of urethra CPT 54326 | not published | not published | $1,064.71 – $1,744.16 | 7 |
| Reconstruction tongue fold CPT 41520 | not published | not published | $270.92 – $479.58 | 7 |
| Reconstruct lip with flap CPT 40527 | not published | not published | $692.84 – $1,165.28 | 7 |
| Reconstruct lip w/local flap 40525 CPT 40525 | not published | not published | $610.32 – $1,039.43 | 7 |
| Reconstruct lower jaw bone CPT 21255 | not published | not published | $1,526.88 – $2,476.79 | 7 |
| Reconstruct orbit/forehead CPT 21172 | not published | not published | $1,991.47 – $3,482.21 | 7 |
| Reconstruct shoulder joint CPT 23470 | not published | not published | $1,331.60 – $2,227.14 | 7 |
| Reconstruct shoulder joint CPT 23472 | not published | not published | $1,617.69 – $2,704.68 | 7 |
| Reconstruct ulna/radioulnar CPT 25337 | not published | not published | $959.93 – $1,631.24 | 7 |
| Reconstruct upper jaw bone CPT 21206 | not published | not published | $1,238.72 – $2,323.74 | 7 |
| Reconstruct urethra/bladder CPT 53431 | not published | not published | $1,301.32 – $2,129.19 | 7 |
| Reconstruct urethra stage 1 CPT 53420 | not published | not published | $947.18 – $1,550.97 | 7 |
| Reconstruct urethra stage 2 CPT 53425 | not published | not published | $1,055.62 – $1,727.16 | 7 |
| Reconstruct vena cava 34502 CPT 34502 | not published | not published | $1,752.08 – $2,918.96 | 7 |
| Rectal sensation test CPT 91120 | not published | not published | $60.29 – $1,184.84 | 30 |
| Red cell mass multiple CPT 78121 | not published | not published | $20.08 – $2,048.04 | 30 |
| Red cell mass single CPT 78120 | not published | not published | $14.66 – $1,528.92 | 30 |
| Red cell sequestration CPT 78140 | not published | not published | $38.65 – $1,528.92 | 30 |
| Red cell survival study CPT 78130 | not published | not published | $38.65 – $1,528.92 | 30 |
| Redo endovas vena cava filtr CPT 37192 | $3,481.89 | $9,410.50 | $414.40 – $697.26 | 6 |
| Reduce bowel obstruction 44050 CPT 44050 | not published | not published | $1,019.32 – $1,736.00 | 7 |
| Reduce testis torsion CPT 54600 | not published | not published | $509.44 – $832.62 | 7 |
| Reduction of facial bones CPT 21209 | not published | not published | $679.34 – $1,185.68 | 7 |
| Reduction of procidentia 45900 CPT 45900 | $657.12 | $1,776.00 | $212.96 – $3,468.96 | 30 |
| Re-exploration of chest 32120 CPT 32120 | not published | not published | $977.67 – $1,637.36 | 7 |
| Re-explore parathyroids CPT 60502 | not published | not published | $1,418.04 – $2,397.20 | 7 |
| Refill maint impl spine pump CPT 95991 | not published | not published | $44.34 – $1,123.16 | 30 |
| Refill/maint pump/resvr syst CPT 96522 | $111.93 | $302.50 | $116.76 – $801.64 | 30 |
| Regadenoson 0.4 mg/5 ml intravenous syringe HCPCS J2785 | $82.61 | $223.28 | $73.38 – $73.38 | 5 |
| Reimplant artery each 35697 CPT 35697 | not published | not published | $170.48 – $287.07 | 7 |
| Reinforce clavicle CPT 23490 | not published | not published | $924.57 – $1,586.34 | 7 |
| Reinforce eye wall CPT 67250 | not published | not published | $786.55 – $1,482.95 | 7 |
| Reinforce/graft eye wall CPT 67255 | not published | not published | $736.64 – $1,610.84 | 7 |
| Reinforce shoulder bones CPT 23491 | not published | not published | $1,117.12 – $1,867.97 | 7 |
| Reinforce thigh CPT 27495 | not published | not published | $1,246.30 – $2,084.28 | 7 |
| Reinforce tibia CPT 27745 | not published | not published | $832.60 – $1,398.60 | 7 |
| Reinnervate larynx CPT 31590 | not published | not published | $935.07 – $1,648.92 | 7 |
| Reinsertion of spinal fixation device 22849 CPT 22849 | not published | not published | $1,444.45 – $2,393.12 | 7 |
| Reinsert ocular implant CPT 65155 | not published | not published | $847.71 – $1,614.92 | 7 |
| Release encircling material CPT 67115 | not published | not published | $489.04 – $935.34 | 7 |
| Release eye tissue CPT 67343 | not published | not published | $652.24 – $1,253.03 | 7 |
| Release facial nerve CPT 69720 | not published | not published | $1,280.37 – $2,236.67 | 7 |
| Release facial nerve CPT 69725 | not published | not published | $2,070.43 – $3,535.94 | 7 |
| Release facial nerve CPT 69955 | not published | not published | $2,174.24 – $3,720.98 | 7 |
| Release finger contracture CPT 26525 | not published | not published | $680.25 – $1,174.79 | 7 |
| Release forearm/hand tendon CPT 26449 | not published | not published | $757.01 – $1,272.75 | 7 |
| Release inner ear canal CPT 69960 | not published | not published | $2,126.60 – $3,620.30 | 7 |
| Release knuckle contracture CPT 26520 | not published | not published | $677.35 – $1,172.75 | 7 |
| Release middle ear bone CPT 69650 | not published | not published | $862.79 – $1,510.83 | 7 |
| Release muscles of hand CPT 26593 | not published | not published | $620.31 – $1,078.20 | 7 |
| Release of eye fluid CPT 67015 | not published | not published | $578.92 – $1,091.12 | 7 |
| Release of foot tendon CPT 28220 | not published | not published | $336.02 – $563.25 | 7 |
| Release of foot tendon 28225 CPT 28225 | not published | not published | $288.61 – $485.70 | 7 |
| Release of foot tendons CPT 28222 | not published | not published | $389.44 – $659.85 | 7 |
| Release of foot tendons CPT 28226 | not published | not published | $350.34 – $695.90 | 7 |
| Release of lower leg tendon CPT 27680 | not published | not published | $471.94 – $802.70 | 7 |
| Release of lower leg tendons CPT 27681 | not published | not published | $569.63 – $1,004.06 | 7 |
| Release of lung 32220 CPT 32220 | not published | not published | $1,778.01 – $2,984.25 | 7 |
| Release of midfoot joint CPT 28260 | not published | not published | $572.49 – $944.19 | 7 |
| Release of midfoot joint CPT 28264 | not published | not published | $748.14 – $1,351.65 | 7 |
| Release of shoulder ligament CPT 23415 | not published | not published | $760.57 – $1,280.91 | 7 |
| Release palm contracture CPT 26040 | not published | not published | $322.71 – $566.66 | 7 |
| Release palm contracture CPT 26121 | not published | not published | $642.28 – $1,093.85 | 7 |
| Release palm contracture CPT 26123 | not published | not published | $880.00 – $1,527.17 | 7 |
| Release palm contracture CPT 26125 | not published | not published | $307.27 – $505.43 | 7 |
| Release palm contracture 26045 CPT 26045 | not published | not published | $495.69 – $857.79 | 7 |
| Release palm & finger tendon CPT 26442 | not published | not published | $993.22 – $1,744.16 | 7 |
| Release palm/finger tendon CPT 26440 | not published | not published | $647.54 – $1,112.90 | 7 |
| Release thumb contracture CPT 26508 | not published | not published | $658.94 – $1,156.43 | 7 |
| Release wrist/forearm tendon CPT 25295 | not published | not published | $572.83 – $957.11 | 7 |
| Relieve bladder contracture CPT 52640 | not published | not published | $349.99 – $576.86 | 7 |
| Relieve cranial pressure 61345 CPT 61345 | not published | not published | $2,197.06 – $3,723.02 | 7 |
| Relocation of testis(es) CPT 54680 | not published | not published | $901.83 – $1,450.98 | 7 |
| Relocation skin pocket aicd CPT 33223 | $1,107.32 | $2,992.75 | $456.00 – $764.60 | 7 |
| Relocation skin pocket pm CPT 33222 | $1,078.37 | $2,914.50 | $374.05 – $637.40 | 7 |
| Rem/biv cast full arm/leg CPT 29705 | $471.57 | $1,274.50 | $52.61 – $1,010.52 | 30 |
| Rem/biv cast shldr/hip spica CPT 29710 | not published | not published | $92.87 – $1,010.52 | 30 |
| Rem endovas vena cava filter CPT 37193 | $4,756.07 | $12,854.25 | $403.47 – $698.61 | 6 |
| Rem interrog dev eval icpms CPT 93297 | not published | not published | $29.46 – $141.88 | 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.